The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis

Abstract

Purpose This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice (PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP alone or (4) BGA alone in cancer patients and survivors (CPaS). Methods PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to 6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach. Results Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity of PIP + BGA comparing to WLC were found for anxiety (SMD − 1.29 [−1.71; − 0.86]), depression (SMD − 0.79 [− 1.10; − 0.48]), functional impairment (SMD − 0.72 [− 0.95; − 0.50]), PA (self-reported: (SMD − 0.58 [− 0.84; − 0.32]) and objectively measured: (SMD − 0.51 [− 0.90; − 0.13])) and social impairment (SMD − 0.33 [− 0.58; − 0.08]). When comparing PIP + BGA to OI, fatigue (SMD − 0.35 [− 0.51; − 0.20]) and PA (SMD − 0.26 [− 0.41; − 0.11]) at PI, and fatigue (SMD − 0.34 [− 0.58; − 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone. Conclusions PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions such as WLC, usual care and education. However, further research is needed on ‘how’ and ‘when’ PIP + BGA should be provided in cancer rehabilitation. Implications for Cancer Survivors PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA and reduce DS.

Graded exercise with motion style acupuncture therapy for a patient with failed back surgery syndrome and major depressive disorder: a case report and literature review

“…GET strengthens physical capacity and provides psychological encouragement by demonstrating objective improvements in patient performance ( 15 ). GET has been shown to be effective in ameliorating the conditions of patients with cancer with comorbid mental disabilities such as depression, anxious mood, and catastrophizing ( 16 ). The respective therapeutic effects of MSAT and exercise for LBP or depressive mood are widely recognized; however, the clinical application and synergies of combining these treatments are novel for pain or mental disorders.…”