Mat Pilates and belly dance: Effects on patient-reported outcomes among breast cancer survivors receiving hormone therapy and adherence to exercise.

BACKGROUND: Breast cancer treatment leads to several side effects. Exercise can help to reduce these side effects. However, it is unknown whether a mat Pilates or a belly dance intervention can improve the patient-reported outcomes of these women. OBJECTIVE: Examine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on patient reported outcomes (PROs) among breast cancer survivors, at 16 weeks, six months, and 12 months; and investigate sociodemographic and clinical predictors of intervention adherence. METHODS: Seventy-four breast cancer survivors who were receiving hormone therapy were randomly allocated into mat Pilates (n = 25), belly dance (n = 25) or control group (educational sessions) (n = 24). Mat Pilates and belly dance groups received a 16-week intervention, delivered three days a week and 60 min a session. The control group received three education sessions and continue usual care. The patient reported outcomes assessed were depressive symptoms (Beck Depression Inventory), stress (Perceived Stress Scale), optimism (Life Orientation Test), fatigue (FACT-F), sleep quality (Pittsburgh Sleep Quality Index) and pain (VAS), clinical and sociodemographic characteristics, and habitual physical activity (IPAQ short). RESULTS: All three groups showed a significant improvement in fatigue, and this effect was maintained during follow-up. No significant effects were found for depressive symptoms, optimism, stress, or pain. A history of exercise prior to breast cancer and be inactive after diagnosis were significant predictors of adherence to interventions. CONCLUSION: Mat Pilates, belly dance and a few educational sessions can be effective in improving fatigue after 16 weeks of intervention. REGISTRATION: ClinicalTrials.gov (NCT03194997).

Factors Associated with Cardiorespiratory Fitness in Breast Cancer Survivors from the State of Santa Catarina, Brazil: Cross-Sectional Study

Introduction: Oxygen consumption (VO2 ) is indicative of cardiorespiratory fitness (CRF) and lower levels are related to a higher risk of total mortality among individuals with cancer whose therapy can have adverse consequences on the cardiovascular system. Objective: To examine the associations of patient-reported sociodemographic, clinical, anthropometric outcomes and functional variables with CRF in 69 women (55±10 years) and to identify whether walking is a predictor of peak VO2 variation in this population with breast cancer (BC). Method: Female BC survivors receiving hormone therapy after two types of surgery (breast-conserving and mastectomy) underwent a CRF test on a cycle ergometer to measure peak VO2 . A questionnaire containing sociodemographic, clinical data, patient reported outcomes (PROs) (depressive symptoms, sleep quality, fatigue, body image) and self-reported walking and tests to measure body fat percentage, waist circumference, flexibility and shoulder range of motion (RoM) were performed. Results: Unemployment and retirement were associated with low CRF, as was the use of aromatase inhibitors instead of tamoxifen. Depressive symptoms, worse body image, greater waist circumference, less flexibility and shoulder RoM were also associated with low CRF. Walking duration, controlled for age and body mass index (BMI), is a 13% predictor of peak VO2 variance in this sample. Conclusion: These factors must be considered in understanding the CRF profile of BC survivors. As walking was a predictor of peak VO2 variance, it should be recommended as a type of physical activity for patients with BC using hormone therapy.

Introdução: O consumo de oxigênio (VO2 ) é indicativo de aptidão cardiorrespiratória (ACR), e níveis mais baixos estão relacionados a um maior risco de mortalidade total entre indivíduos com câncer cuja terapia pode ter consequências adversas no sistema cardiovascular. Objetivo: Examinar as associações de desfechos sociodemográficos, clínicos, antropométricos relatados pelo paciente e variáveis funcionais com a ACR de 69 mulheres (55±10 anos), e identificar se a caminhada é um preditor de variação do pico de VO2 nessa população com câncer de mama (CM). Método: Mulheres sobreviventes de CM recebendo terapia hormonal após dois tipos de cirurgias (conservadora e mastectomia) realizaram um teste de ACR em cicloergômetro para medir o VO2 pico. Um questionário contendo dados sociodemográficos e clínicos; resultados relatados pelos pacientes (RRP) (sintomas depressivos, qualidade do sono, fadiga, imagem corporal); caminhada autorreferida; e testes para medir o percentual de gordura, circunferência da cintura, flexibilidade e amplitude do movimento ADM do ombro foram realizados. Resultados: Desemprego e aposentadoria foram associados à baixa ACR, assim como o uso de inibidores de aromatase ao invés de tamoxifeno. Sintomas depressivos, pior imagem corporal, maior circunferência da cintura, menor flexibilidade e ADM do ombro também foram associados à baixa ACR. A duração da caminhada, controlada por idade e índice de massa corporal (IMC), é um preditor de 13% da variância do VO2 pico nesta amostra. Conclusão: Tais fatores devem ser considerados na compreensão do perfil de ACR de sobreviventes de CM. Como a caminhada foi um preditor da variância do VO2 pico, deve ser recomendada atividade física para pacientes com CM em uso de hormonioterapia.

Introducción: El consumo de oxígeno (VO2 ) es indicativo de aptitud cardiorrespiratoria (ACR) y los niveles más bajos se relacionan con un mayor riesgo de mortalidad total entre las personas con cáncer cuya terapia puede tener consecuencias adversas sobre el sistema cardiovascular. Objetivo: Examinar las asociaciones de los resultados sociodemográficos, clínicos, antropométricos y variables funcionales informados por las pacientes con la ACR en 69 mujeres (55±10 años) e identificar si caminar es un predictor de la variación del VO2 máximo en esta población con cáncer de mama (CM). Método: Mujeres sobrevivientes de CM que recibieron terapia hormonal después de dos tipos de cirugía (conservadora y mastectomía) se sometieron a una prueba de ACR en un cicloergómetro para medir el VO2 máximo. Se aplicó un cuestionario que contenía datos sociodemográficos, clínicos, resultados informados por los pacientes (RIP) (síntomas depresivos, calidad del sueño, fatiga, imagen corporal) y caminata autoinformada y pruebas para medir el porcentaje de grasa corporal, la circunferencia de la cintura, la flexibilidad y el rango de movimiento (RoM) del hombro. Resultados: El desempleo y la jubilación se asociaron con una baja ACR, al igual que el uso de inhibidores de la aromatasa en lugar de tamoxifeno. Síntomas depresivos, peor imagen corporal, mayor perímetro de cintura, menor flexibilidad y RoM de los hombros también se asociaron con una baja ACR. La duración de la caminata, controlada por edad e índice de masa corporal (IMC), es un predictor del 13% de la variación del VO2 pico en esta muestra. Conclusión: Estos factores deben ser considerados para comprender el perfil de ACR de los sobrevivientes de CM. Como la caminata fue un predictor de la variación del VO2 pico, debe recomendarse actividad física para pacientes con CM en terapia hormonal.

Como as Práticas Corporais Afetam os Aspectos Psicológicos de Mulheres Sobreviventes e em Tratamento para o Câncer de Mama? Revisão Sistemática da Literatura / How do Body Practices Affect the Psychological Aspects of Survivors Women Undergoing Treatment for Breast Cancer? Systematic Literature Review / ¿Cómo Inciden las Prácticas Corporales en los Aspectos Psicológicos de las Mujeres Sobrevivientes y en Tratamiento por Cáncer de Mama? Revisión Sistemática de la Literatura

Introduction: Body practices can bring physical, psychological benefits and social rehabilitation and may be an alternative treatment for breast cancer. Objective: To analyze the evidence of the results of body practices over the psychological aspects of survivors women undergoing treatment for breast cancer. Method: Systematic blind and independent review from September to December 2021 following the PRISMA guidelines, carried out in the databases: Embase Elsevier; PubMed Central; ScienceDirect; Scopus Elsevier and Web of Science ­ Core Collection. Results: Of 1,372 studies identified, 22 were included in this systematic review. Among the practices that stood out are meditation and Yoga, with anxiety being the most investigated variable by the studies. It is clear that body practices are options for non-pharmacological clinical treatments utilized in clinical practice by different health professionals in women who have survived breast cancer. Conclusion: Body practices proved to be beneficial in the treatment and psychological health of women who survived breast cancer. This evidence may help to implement body practices as a therapeutic resource to be used in the clinical practice of health professionals. However, more randomized clinical trials that follow study protocols more rigorously are suggested, so that the effectiveness of this approach can be evaluated in different clinical outcomes.

Introdução: As práticas corporais podem trazer benefícios na área de reabilitação física, psicológica e social e ser uma alternativa de tratamento para o câncer de mama. Objetivo: Analisar as evidências dos resultados das práticas corporais nos aspectos psicológicos de mulheres que sobreviveram e estavam em tratamento para câncer de mama. Método: Revisão sistemática desenvolvida de forma cega e independente, de setembro a dezembro de 2021, seguindo as diretrizes PRISMA, realizada nas bases de dados: Embase Elsevier; PubMed Central; ScienceDirect; Scopus Elsevier e Web of Science ­ Core Collection. Resultados: Dos 1.372 estudos identificados, 22 foram incluídos nesta revisão sistemática. Entre as práticas que mais se destacaram, estão a meditação e a Yoga, sendo a ansiedade a variável mais investigada pelos estudos. Fica claro que as práticas corporais são opções de tratamentos clínicos não farmacológicos utilizados na prática clínica por diferentes profissionais de saúde em mulheres que sobreviveram ao câncer de mama. Conclusão: As práticas corporais mostraram-se benéficas no tratamento e na saúde psicológica de mulheres que sobreviveram ao câncer de mama. Essas evidências podem auxiliar na implementação das práticas corporais como recurso terapêutico a ser utilizado na prática clínica dos profissionais de saúde. No entanto, são sugeridos mais ensaios clínicos randomizados que sigam os protocolos de estudo com mais rigor, para que a eficácia dessa abordagem possa ser avaliada em diferentes desfechos clínicos.

Introducción: Las prácticas corporales pueden traer beneficios en el área de rehabilitación física, psicológica y social y ser una alternativa de tratamiento para el cáncer de mama. Objetivo: Analizar las evidencias de los resultados de prácticas corporales en los aspectos psicológicos de mujeres sobrevivientes y en tratamiento por cáncer de mama. Método: Revisión sistemática desarrollada de forma ciega e independiente, de septiembre a diciembre de 2021 siguiendo los lineamientos PRISMA, realizada en las bases de datos: Embase Elsevier; PubMed Central; ScienceDirect; Scopus Elsevier e Web of Science ­ Core Collection. Resultados: De 1.372 estudios identificados, 22 se incluyeron en esta revisión sistemática. Entre las prácticas que más se destacaron están la meditación y el Yoga, siendo la ansiedad la variable más investigada entre los estudios. Es claro que las prácticas corporales son opciones de tratamientos clínicos no farmacológicos, utilizados en la práctica clínica por diferentes profesionales de la salud en mujeres que han sobrevivido al cáncer de mama. Conclusión: Las prácticas corporales demostraron ser beneficiosas en el tratamiento y la salud psicológica de las mujeres que sobrevivieron al cáncer de mama. Esta evidencia puede ayudar en la implementación de las prácticas corporales como recurso terapéutico para ser utilizado en la práctica clínica de los profesionales de la salud. Sin embargo, se sugieren más ensayos clínicos aleatorizados que sigan los protocolos de estudio de manera más rigurosa, de modo que la efectividad de este enfoque pueda evaluarse en diferentes resultados clínicos

The Effect of Body Practices and Physical Exercise on Sexual Function of Menopausal Women. A Systematic Review with Meta-Analysis.

Objective: To review randomized clinical trials on Body Practices (BP) and Physical Exercise (PE) in menopausal women and describe their effect on sexual function. Methods: Searches carried out electronically in five databases, with a temporal criterion of 10 years of publication, from August to September 2022. Methodological quality and risk of bias were assessed using the Cochrane collaboration scale and PEDro (Physiotherapy Evidence Database Physiotherapy Evidence Database) scale score. Results: The majority of the studies presented a "'low" or "'uncertain" risk of bias. The instruments for assessing sexual function were heterogeneous. Interventions included mindfulness, relaxation hypnosis, Kegel exercises, yoga, and aerobic exercise, and generally lasted 12 weeks. Seven studies were included, of which six made up the meta-analysis, showing high heterogeneity (I2 = 94.2%; p < 0.0001). The analysis of subgroups with BP showed high heterogeneity (I2 = 94.2%; p < 0.01); interventions with PE presented more favorable results (I2 = 0%; 0; p = 0.90); the sexual function instruments showed high heterogeneity (I2 = 90%; p < 0.01); and instruments of quality of life and menopausal symptoms with domains of sexual function presented favorable results for BP and PE (I2 = 0%; p = 0.63). The funnel chart presents the studies in a dispersed manner, which implies publication bias. Conclusions: Interventions with PE proved to be more efficient compared to BP, however, there are a low number of studies with PE, and those found are limited to aerobic training, without sufficient data on intensity, volume, and frequency. Further studies with PE are needed for the treatment of sexual function symptoms in order to more comprehensively describe their effect.

Association between menopausal symptoms, sexual function, and sexual activity - a cross-sectional study.

Introduction: To analyse the possible association between menopausal symptoms (somatic-vegetative, psychological, and urogenital) and sexual function with the maintenance of the sexual activity of women in menopause. Material and methods: This cross-sectional study comprised 96 menopausal women aged 40-59 (52.88 ±4.05) years, who presented a positive score to the menopause rating scale (MRS) and had serum levels of follicle stimulating hormone ≥ 25 IU/ml. Participants who used hormone replacement therapy were excluded. Results: It was observed that participants who had an active sexual life had lower medians in the somatic-vegetative (p < 0.001) and psychological symptoms (p = 0.006), as well as in the general score (p = 0.001) at the MRS; in addition, they had better sexual function in 4 domains (p < 0.005): excitement, lubrication, orgasm, and pain, as well as in the total score of the female sexual function index questionnaire (p < 0.005). It was also found that, regardless of the type of menopause (surgical or natural), women who did not engage in sexual activity had a score of 5.651 points more in the MRS (p = 0.004), demonstrating that the practice of sexual activity predicts in 10.4% the variation in the symptom score. Conclusions: Menopausal women who maintain sexual activity had a lower score on the menopause symptom score and better sexual function compared to those who did not perform sexual activity.

Relationship of fatigue with depressive symptoms and level of physical activity in women with breast cancer diagnosis / Relação da fadiga com sintomas depressivos e nível de atividade física em mulheres com diagnóstico do câncer de mama

Abstract Breast cancer is the most frequent in women, resulting in fatigue and depressive symptoms as consequence of treatment, but physical activity can help in this process. The aim of this study was to investigate the relationship between fatigue, depressive symptoms and practice of physical activity of women with breast cancer during treatment or after cancer treatment. This is a cross-sectional study with 179 women (56.89 ± 9.4 years) from the Oncology Research Center - CEPON, using questionnaire on general and clinical information, fatigue (Piper Fatigue Scale) depressive symptoms (Beck Depression Inventory) and physical activity (IPAQ - short version). Women with moderate to severe fatigue underwent physiotherapy (p = 0.001) and women with no fatigue had minimum depressive symptoms (p ?0.001). Level of physical activity was not associated with fatigue, with most women being insufficiently active and women with mild fatigue had longer walking time than those without fatigue (p = 0.049). Women with depressive symptoms were almost three times more likely of having mild to severe fatigue and those who underwent physiotherapy were twice as likely of having mild to severe fatigue. Women with fatigue had greater presence of depressive symptoms. Professionals working in the field of oncology should recommend the practice of physical activity in order to minimize the side effects of treatment and observe depressive symptoms and fatigue in these women.

Resumo O câncer de mama é o mais frequente nas mulheres, tendo como consequências do tratamento a fadiga e sintomas depressivos, no entanto a atividade física pode auxiliar neste processo. Objetivou-se investigar a relação entre fadiga, sintomas depressivos e prática de atividade física de mulheres com câncer de mama em fase de tratamento ou pós tratamento oncológico. Estudo transversal com 179 mulheres (56,89 ± 9,4 anos) do Centro de Pesquisas Oncológicas - CEPON, utilizando-se um questionário sobre informações gerais e clínicas, fadiga (Escala de Fadiga de Piper), sintomas depressivos (Inventário de Depressão de Beck) e atividade física (IPAQ - versão curta). As mulheres com fadiga moderada a intensa realizavam fisioterapia (p=0,001) e as mulheres com ausência de fadiga apresentaram sintomas depressivos mínimos (p ?0,001). O nível de atividade física não se associou com a fadiga, sendo que a maioria das mulheres era insuficientemente ativa e as mulheres com fadiga leve apresentaram um tempo de caminhada maior do que aquelas com ausência de fadiga (p=0,049). Mulheres com presença de sintomas depressivos apresentaram quase três vezes mais chance de apresentar fadiga leve a intensa e aquelas que realizavam fisioterapia apresentaram duas vezes mais chance de apresentar fadiga leve a intensa. Mulheres com fadiga apresentaram maior presença de sintomas depressivos. Os profissionais que atuam na área da saúde oncológica devem recomendar a prática de atividade física a fim de minimizar os efeitos colaterais do tratamento, e prestar atenção aos sinais de sintomas depressivos e fadiga nestas mulheres.