Exploring the impact of exercise and mind–body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery

Knoerl, Robert; Giobbie‐Hurder, Anita; Sannes, Timothy S.; Chagpar, Anees B.; Dominici, Laura; Frank, Elizabeth S.; Golshan, Mehra; McTiernan, Anne; Rhei, Esther; Tolaney, Sara M.; Winer, Eric P.; Yung, Rachel; Irwin, Melinda L.; Ligibel, Jennifer A.

doi:10.1007/s00520-021-06617-8

Cited by 17 publications

(40 citation statements)

References 37 publications

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“…A wide variety of prehabilitation interventions were completed for the included studies, as described in Table 3. For the selected studies, the majority completed exercise programs [37,38,40,43,49] or had a component of exercise [39,42,48], with two studies focusing on upper limb exercise speci cally [37,38]. An additional two focused on smoking cessation [46,47], with a single study reporting on multi-modal prehabilitation [49], and a range of complementary and alternative therapies [ Group 1 (in person teaching): Received an information sheet with exercises, video links and instruction with physical demonstration performed by the research team.…”

Section: Quality Appraisal Resultsmentioning

confidence: 99%

“…For the quantitative studies, all groups were found to be comparable at baseline, and the reported outcome data was complete. An unclear bias risk was observed for some RCTs for outcome assessors being blinded to the intervention provided [40,41,44], and for participants adhering to the assigned interventions [45,47], where this information was not described within the articles. Further, unclear bias was reported for all non-randomised quantitative studies [37,42,43,48,49] due to no discussion of accounting of confounders in the study design.…”

Section: Quality Appraisal Resultsmentioning

confidence: 99%

“…One full-text was not able to be retrieved. A total of 22 articles were excluded with reasons and 14 articles met the inclusion criteria [37][38][39][40][41][42][43][44][45][46][47][48][49][50]. Of note, two publications (Thomsen et al [46] and Thomsen et al [47]) reported different data from the same study.…”

Section: Study Selectionmentioning

confidence: 99%

“…Of note, two publications (Thomsen et al [46] and Thomsen et al [47]) reported different data from the same study. The articles comprised of quantitative randomised controlled trials (n = 7) [39][40][41]44,45,47,50,48], quantitative non-randomised studies (n = 5) [37,42,43,48,49], a qualitative study (n = 1) [46] and a mixed method study (n = 1) [38].…”

Section: Study Selectionmentioning

confidence: 99%

“…The sample size for the qualitative study was 11 and the age range was 40-72 years, with the mixed methods study included 28 participants, with a mean age of 54 ± 10.98. The included studies were carried out in United States of America [37,40,41,43], Canada [38], Sweden [39], Japan [42,44,45], Denmark [46,47], China [48], United Kingdom [49], and Romania [50]. Baseline: at time of hospitalisation.…”

Section: Study Characteristicsmentioning

confidence: 99%

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A systematic review of multi-modal prehabilitation in breast cancer

Toohey

Hunter

McKinnon

et al. 2022

Preprint

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PurposeBreast cancer is the most prevalent malignancy in women. Prehabilitation may offer improvements in physical and psychological wellbeing among participants prior to treatment. This systematic review aimed to determine efficacy of prehabilitation in participants diagnosed with breast cancer. MethodsA systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. Studies exploring the impact of prehabilitation in participants with breast cancer were included. Studies were assessed independently according to pre-eligibility criteria, with data extraction and methodological quality assessed in parallel. Results3184 records were identified according to search criteria, 14 articles were included. Articles comprised of quantitative randomised controlled trials (n=7), quantitative non-randomised studies (n=5), a qualitative study (n=1), and mixed method study (n=1). The majority of selected studies completed exercise programs (n=4) or had exercise components (n=2), with two focusing on upper-limb exercise. Two articles reported smoking cessation, with single studies reporting multi-modal prehabilitation (n=1), and complementary and alternative therapies (n=5). Mostly, prehabilitation improved outcomes including: physical function, quality of life, and psychosocial variables (P<0.05). The qualitative data identified preferences for multi-modal prehabilitation, compared to unimodal with interest in receiving support for longer. ConclusionsPrehabilitation for patients with breast cancer is an emerging research area that appears to improve outcomes, however ensuring adequate intervention timeframes, follow-up and population groups should be considered for future investigations. Implications for Cancer SurvivorsThe implementation of prehabilitation interventions for individuals diagnosed with breast cancer should be utilised by multidisciplinary teams to provide holistic care to patients as it has the potential to improve outcomes across the cancer care trajectory.

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Section: Quality Appraisal Resultsmentioning

confidence: 99%

Section: Quality Appraisal Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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A systematic review of multi-modal prehabilitation in breast cancer

Toohey

Hunter

McKinnon

et al. 2022

Preprint

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Efficacy of mind‐body therapies for sleep disturbance in patients with early‐stage cancer: A systematic review and network meta‐analysis

Han

Shi

et al. 2023

Psycho-Oncology

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ObjectiveTo evaluate and compare the efficacy of different mind‐body therapies (MBTs) for sleep disturbance in patients with early‐stage cancer.MethodsRandomised controlled trials that included patients (aged ≥18 years) with early stage cancer who underwent MBTs (mindfulness, hypnosis, relaxation, yoga, and qigong) were searched in the CINAHL via the EBSCO Host, Cochrane Library, Embase, MEDLINE, PsycINFO, PubMed, and Scopus databases, from the date of database inception to October 2022. The outcomes were subjective sleep disturbance and objective sleep efficiency. Network meta‐analysis (NMA) and comparative effects ranking were performed using STATA (v14.0; STATACorp, College Station, TX, USA).ResultsForty‐seven studies investigating five MBTs were included in the NMA. For cancer patients receiving active treatment, mindfulness demonstrated the largest effect size in reducing subjective sleep disturbance (standardised mean difference [SMD]: 0.85; 95% confidence intervals [CI]: 0.20–1.50; Grading of Recommendations Assessment, Development, and Evaluation assessment: moderate), and had the highest cumulative probability compared to usual care or waitlist. For cancer patients who had completed active treatment, qigong demonstrated the largest effect size in reducing subjective sleep disturbance (SMD: 0.99; 95% CI: 0.35–1.63; GRADE: low), followed by hypnosis (SMD: 0.87; 95% CI: 0.32–1.42; GRADE: moderate), and mindfulness (SMD: 0.42; 95% CI: 0.24–0.59; GRADE: moderate). Qigong also demonstrated the largest effect size in improving objective sleep efficiency (weighted mean differences: 10.76; 95% CI: 2.01–19.50; GRADE: low); however, the effect of qigong was tested in only one study in this NMA. Among the eight different treatment conditions, cognitive behavioral therapy (CBT) showed the highest cumulative probability (surface under the cumulative ranking curve: 96.3%) in reducing subjective sleep disturbance and the second highest cumulative probability (SUCRA: 83.3%) in improving objective sleep efficiency.ConclusionThere is no evidence supporting the use of MBTs to replace or be comparable to CBT. Mindfulness can be recommended as an optional treatment for reducing sleep disturbance in patients with early‐stage cancer. Some support was observed for qigong and hypnosis in reducing sleep disturbances in patients with early‐stage cancer who had completed active treatment. More rigorous trials are warranted to confirm whether different forms of MBTs have different effects on sleep in patients with cancer.

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The effectiveness of mind-body therapy and physical training in alleviating depressive symptoms in adult cancer patients: a meta-analysis

Zeng,

Huang,

Zhao

et al. 2024

J Cancer Res Clin Oncol

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Purpose The aim of this study was to assess the effectiveness of mind-body therapy (MBT) and/or physical training in alleviating depressive symptoms among adult cancer patients through a meta-analysis. Methods PubMed, Embase, EBSCO, Web of Science, and Cochrane Library databases were searched from up to October 21, 2023. Effect sizes, 95% confidence intervals, and other pertinent values were computed utilizing a random-effects model with Review Manager 5.3 and StataMP 14. The reporting of findings adhered to the guidelines for systematic reviews and meta-analyses. The PROSPERO registration code for this review is 4,203,477,316. Results 10 randomized controlled trials (11 datasets) involving a total of 620 participants were selected for analysis. The results demonstrated that complementary therapies, encompassing MBT and physical training, were effective in alleviating depressive symptoms in adult cancer patients (SMD= -0.47; 95%CI: -0.87, -0.08; P = 0.02). Subgroup analysis indicate that physical training may effectively alleviate depressive symptoms (SMD= -0.72; 95%CI: -1.31, -0.13; P = 0.02), demonstrating moderate effect sizes. Conversely, MBT does not seem to significantly influence depressive symptoms (P = 0.69). Conclusions Complementary therapy lasting four weeks or more, incorporating physical training and MBT, has been shown to alleviate depressive symptoms in adult cancer patients. And physical training has a significant effect on depressive symptoms, while MBT has no effect. Nevertheless, given the constraints of the included studies, further research is required in the future to provide more robust evidence.

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Exploring the impact of exercise and mind–body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery

Cited by 17 publications

References 37 publications

A systematic review of multi-modal prehabilitation in breast cancer

A systematic review of multi-modal prehabilitation in breast cancer

Efficacy of mind‐body therapies for sleep disturbance in patients with early‐stage cancer: A systematic review and network meta‐analysis

The effectiveness of mind-body therapy and physical training in alleviating depressive symptoms in adult cancer patients: a meta-analysis

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