ABSTRACT
OBJECTIVE: To investigate the effect of Pilates compared with circuit-based exercise in reducing arthralgia in women during hormone therapy for breast cancer. DESIGN: Single-blind randomized controlled trial, parallel. SETTING: University hospital of Brasilia and Brazilian Association for Assistance to People with Cancer. PARTICIPANTS: Sixty women with arthralgia were recruited. Eligibility criteria included women complaining of arthralgia during hormone therapy for breast cancer. The exclusion criteria were women with active cancer, lymphedema, limitations to physical exercise, or limitation to answer some questionnaires. MAIN OUTCOME MEASURES: Primary: Pain. Secondary: Function, flexibility, and sleep quality. Outcomes were assessed at baseline and the end of the intervention (8 weeks) by the same blinded evaluator. INTERVENTION: Sixty participants were randomly assigned 20 to each of the three groups: Pilates, circuit-based exercise, and control groups. Exercise was performed twice per week for 75 min, over a period of 8 weeks. Participants in the control group were instructed to continue their usual activities. The Kolmogorov-Smirnov test was used to verify the normality of the outcomes. Intergroup differences were calculated using Kruskal-Wallis test with post hoc Mann Whitney U testing and the parametric data between the three groups with ANOVA of repeated measures with Bonferroni post hoc. RESULTS: The Pilates group demonstrated a significant difference in pain reduction compared to the circuit group (mean difference: -1.95 points, p = 0.020). CONCLUSION: Pilates was more effective than circuit-based exercise in reducing arthralgia in women during hormone therapy for breast cancer. TRIAL REGISTRATION: http://www.ensaiosclinicos.gov.br/rg/RBR-3wsdhs/ Registered on Octob 16th 2017.
Subject(s)
Breast Neoplasms , Circuit-Based Exercise , Exercise Movement Techniques , Arthralgia/chemically induced , Arthralgia/therapy , Breast Neoplasms/drug therapy , Exercise Therapy , Female , Hormones , Humans , Single-Blind MethodABSTRACT
Introdução: O câncer é uma doença que envolve extenso sofrimento emocional, físico e social, o que favorece o aparecimento de diversas morbidades, incluindo ansiedade. Terapias complementares, como a musicoterapia, têm sido estudadas como alternativas para a abordagem da ansiedade. Objetivo: Revisar sistematicamente os estudos e determinar a efetividade da musicoterapia na redução da ansiedade de pacientes oncológicos. Método: A pesquisa foi realizada em seis bases de dados incluindo MEDLINE/PubMed, SciELO, Scopus, CINAHL, Cochrane e Web of Science, sem restrição de data, sexo, etnia ou tipos de câncer. Foram incluídos somente ensaios clínicos randomizados que avaliaram a ansiedade como um dos desfechos, bem como os que utilizaram a musicoterapia como intervenção e que envolveram amostra com indivíduos adultos diagnosticados com câncer. Foram excluídos os estudos em que a musicoterapia não foi realizada por um profissional especializado, não foi proposto grupo controle, não foi disponibilizado o estudo na integra, associaram pacientes com outras doenças além do câncer e incluíram no grupo experimental outra intervenção além da música. Resultado: Foram encontrados 1.909 estudos, sendo oito elegíveis. A maioria dos estudos demonstrou benefícios da musicoterapia na ansiedade. Conclusão:A musicoterapia é efetiva na redução da ansiedade de pessoas com câncer. No entanto, mais estudos com novas tecnologias e mais detalhes sobre a intervenção são necessários para a confirmação dos resultados.
Introduction: Cancer is a disease that involves extensive emotional, physical and social suffering, which favors the appearance of various morbidities, including anxiety. Complementary therapies, such as music therapy, have been studied as alternatives to an approach to anxiety. Objective: To conduct a systematic review of the literature and determine the effectiveness of music therapy to reduce anxiety of oncologic patients. Method: The research was conducted in six databases including MEDLINE/PubMed, SciELO, Scopus, CINAHL, Cochrane and Web of Science without restriction of date, gender, ethnicity or cancer types. It were included only randomized controlled trials that evaluated anxiety as one of the outcomes, as well as those using music therapy as an intervention, involving a sample with adult individuals diagnosed with cancer. The exclusion criteria were studies where music therapy was not performed by a skilled professional, without control group, studies not fully available, that associated patients with diseases other than cancer and which included in the experimental group another intervention instead of music. Result: A total of 1909 studies were found, of which eight were eligible. The majority of the studies have demonstrated benefits of music therapy for anxiety. Conclusion: Music therapy is effective in reducing the anxiety of people with cancer. However, more studies with new methodologies and further details about the intervention are necessary to confirm the results.
Introducción: El cáncer es una enfermedad que implica extensión emocional, física y social, lo que favorece la aparición de diversas morbilidades, incluida la ansiedad. Las terapias complementarias, como la musicoterapia, se han estudiado como alternativas al enfoque de la ansiedad. Objetivo: Revisar la literatura sobre la efectividad de la musicoterapia para el tratamiento de pacientes con trastornos de ansiedad y cáncer. Método:La investigación se realizó en seis bases de datos, incluyendo MEDLINE/PubMed, SciELO, Scopus, CINAHL, Cochrane y Web of Science, sin restricciones de fecha, género, etnia o tipos de cáncer. Se incluyeron solo ensayos controlados aleatorios de estudios que evaluaron la ansiedad como uno de los resultados, así como el uso de la musicoterapia como una intervención y la participación de una muestra con individuos adultos diagnosticados con cáncer. Los estudios en los que la musicoterapia no fue realizada por un profesional especializado, no se propuso un grupo de control, no se disponía de un estudio completo, se asociaron pacientes con enfermedades distintas al cáncer y se incluyó otra intervención además de la música en el grupo experimental. Resultados: Se encontraron 1.909 estudios, de los cuales ocho fueron elegibles. La mayoría de los estudios han demostrado los beneficios de la musicoterapia en la ansiedad. Conclusión: Esta revisión sistemática concluyó que la musicoterapia es efectiva para reducir la ansiedad de las personas con cáncer. Sin embargo, se necesitan más estudios con nuevas tecnologías y más detalles sobre la intervención para confirmar los resultados.
Subject(s)
Humans , Male , Female , Anxiety/therapy , Music Therapy , Neoplasms/psychologyABSTRACT
Considering that the muscles of the anus perform a critical role in maintaining continence, losses in their structure can negatively affect the physiological control of the intestinal contents. Anorectal electro-stimulation (ARES) has been reported to have a positive effect on the functionality of treated patients, but how ARES affects the structural tissues of the anorectal segment remains unknown. Because the study of how ARES structurally affects human tissues is not possible, this study aimed to clarify these effects in a murine model, which has a similar anorectal segment (structure and physiology) to humans. For the descriptive and comparative study, randomly selected nulliparous adult Wistar rats (n = 5) were submitted to 30 anorectal sessions of ARES with a biphasic current (700 µs, 50 Hz from 2 to 4 mA). After treatment, the animals were euthanized, and the anorectal segments were dissected and processed for histopathological analysis. Our results showed that ARES increased the widths of the mucosal, submucosal and muscle layers of the rectum, as well as the number of leukocytes in the mucosa. ARES also caused hyperplasia of the smooth muscle of the internal anal sphincter and hypertrophy of the external anal sphincter muscle. In conclusion, our results showed that ARES had not only a positive effect on the structure (morphology) of all tissues associated with the rectum and anus but, more importantly, on the structural gain of the muscles (hyperplasia and hypertrophy), which could point to a functional gain of the anal sphincter, reinforcing the applicability of ARES as a non-invasive treatment for anal incontinence.
