Physical rehabilitation for the management of cancer-related fatigue during cytotoxic treatment: a systematic review with meta-analysis.

OBJECTIVE: To assess the effect of physical therapy on cancer-related fatigue (CRF) during cytotoxic anticancer treatment. METHODS: Systematic review with meta-analysis of randomized clinical trials published from 2010 to 2021 (EMBASE, MEDLINE, PEDro; SciELO, and LILACS). Studies assessing the effect of supervised physical therapy (IG) for the management of CRF on adults undergoing anticancer treatment compared with a control group (CG) covering usual care or any uncontrolled practice, such as recommendations about exercise and health education, were included in this review. RESULTS: A total of 22 studies were included in the SR and 21 in the meta-analysis, resulting in 1.992 individuals (CG = 973 and IG = 1.019). There was a reduction in general fatigue [SMD = - 0.69; 95%CI (- 1.15, - 0.22) p < 0.01; I2 = 87%; NNT = 3], with greater weight attributed to combined exercise (44%). Physical fatigue also reduced [SMD = - 0.76; 95%CI (- 1.13, - 0.39) p < 0.01; I2 = 90%; NNT = 2], with greater weight for resistance exercise (50%) and greater effect with combined exercise [SMD = - 1.90; 95%CI (- 3.04, - 0.76) p < 0.01; I 2 = 96%]. There was reduction in general fatigue with moderate intensity (74%) [SMD = - 0.89; 95%CI (- 1.61, - 0.17) p < 0.02; I2 = 90%] and physical fatigue [SMD = - 1.00; 95%CI (- 1.54, - 0.46) p < 0.01; I2 = 92%], while high intensity reduced only general fatigue [SMD = - 0.35; 95%CI (- 0.51, - 0.20) p < 0.01; I2 = 0%]. The number of overall and weekly sessions has been shown to contribute to the reduction of CRF. CONCLUSION: Physical rehabilitation with moderate intensity promoted greater relief of general and physical fatigue. Even after controlling for high heterogeneity, the quality of evidence, summarized in GRADE, was considered moderate for general fatigue and low for physical fatigue.

Evaluation of the functional capacity and quality of life of children and adolescents during and after cancer treatment.

OBJECTIVE: To evaluate the functional capacity and quality of life of children and adolescents during cancer treatment and post-treatment. METHODS: Cross-sectional study of patients during cancer treatment and post-treatment, assessed by the 6-minute walk test (6MWT) and the Pediatric Quality of Life ™ questionnaire (cancer module). RESULTS: Sixty-five patients, aged 11.2±3.5 years, mostly males (50.8%) and white (90.8%), with high incidence of hematological cancers (81.5%) participated in the study. The performance in the 6MWT was 23.1% inferior comparing the mean predicted and achieved (584.3±5 and 447.7±78.6 m, respectively). The percentage difference between the predicted and achieved 6MWT, and the different phases of cancer treatment were significantly different between patients in treatment (73.7±12.8) and post-treatment (84.5±9.1). When grouped by the different diagnoses, it was possible to observe that the distance covered by the patients with leukemia showed results closer to that predicted (80.7±11.7). Regarding the health-related quality of life questionnaire (HRQL), the child's perception (78.0±14.56) was better than that reported by their parents (72.4±17.74). However, when we compared HRQL with the 6MWT, there was no association between them (p=0.597). CONCLUSIONS: Children and adolescents undergoing cancer treatment or post-treatment showed a 23% deficit in functional capacity. In relation to HRQL results, children's perception was higher than that of their parents.

Functional capacity, pulmonary function, and quality of life in hematopoietic stem cell transplantation survivors.

OBJECTIVE: Hematopoietic stem cell transplantation (HSCT) is used as a treatment for several diseases. The objective was to evaluate the functional capacity, pulmonary function, and quality of life (QoL) in HSCT survivors. METHODS: The patients were submitted to spirometry and six-minute walk test (6MWT) and evaluation of QoL (Functional Assessment of Cancer Therapy Bone Marrow Transplantation-FACT-BMT) and the level of physical activity (Human Activity Profile-HAP) in the post-HSCT outpatient ambulatory. RESULTS: The sample was composed of 103 individuals with a mean age of 42.1 ± 12 and a median HSCT time of 5 (2-11) years. The average distance walked in the 6MWT was 524.7 ± 73.5 m; the FACT-BMT score, 82 ± 8.7 points; FEV1, 76.8 ± 22.6%; and HAP, 71.9 ± 11.2 points. There was a significant difference between debilitated and physically active individuals for the variables: forced expiratory volume in the first second (FEV1) in liters (p = 0.008) and % of predicted (p = 0.017), FEV1/FVC (p = 0.032), distance on the 6MWT (p < 0.001), fatigue after the 6MWT (p < 0.001), and physical well-being (p = 0.005). CONCLUSIONS: HSCT survivors have long-term changes in functional capacity, pulmonary function, and QoL. Subjects more active had better results in pulmonary function and functional capacity.

Repercussões do tratamento cirúrgico do câncer de mama sobre a propriocepção, sensibilidade e funcionalidade / Repercussions of surgical treatment of breast cancer over proprioception, sensibility and functionality

Introdução: O câncer de mama é o que mais acomete as mulheres e pode trazer consequências funcionais. Objetivo: Avaliar os efeitos da mastectomia radical modificada sobre a propriocepção, sensibilidade e funcionalidade do membro homolateral a cirurgia e relacionar a sensibilidade com a propriocepção. Métodos: As avaliações foram no período pré-operatório e pós-operatório de 60 dias, utilizando-se o cinesiômetro, estesiômetro e o questionário Disabilities of the Arm, Shoulder and Hand (DASH). Resultados: Foram avaliadas 8 mulheres. Não houve diferença de funcionalidade no pré e pós-operatório (p = 0,156), na sensibilidade para os nervos torácico longo (p = 0,783) e intercostobraquial (p = 0,423), e propriocepção (p = 0,672). Houve correlação da sensibilidade nos dermátomos dos dois nervos com a propriocepção (r = 0,920 e r = 0,723). Conclusão: O tratamento do câncer não teve influência expressiva sobre a propriocepção, sensibilidade e funcionalidade, mas encontrou-se relação entre sensibilidade e propriocepção do membro superior. (AU)

Introduction: Breast cancer is what most attack women and can bring functional consequences. Objective: To evaluate the effects of modified radical mastectomy on proprioception, sensibility and functionality of the upper limb ipsilateral to surgery and relate the sensibility with the proprioception. Methods: The evaluations were in the preoperative and 60 days after surgery, using a cinesiometer, esthesiometer and the questionnaire Disabilities of Arm, Shoulder and Hand (DASH). Results: Eight women were evaluated. There was no difference of functionality (p = 0.156), in sensibility for the long thoracic (p = 0.783) and intercostobrachial (p = 0.423) nerves and proprioception (p = 0.672). There was correlation between sensibility on dermatomes of the two nerves with proprioception (r = 0.920 and r = 0.723). Conclusion: Surgical treatment of breast cancer had no expressive influence on proprioception, sensitivity and functionality, but we found relationship between sensitivity and proprioception of the upper member. (AU)

Efeitos do Kinesio Taping sobre o edema linfático / Effects of Kinesiology Taping on the lymphatic edema

Introdução: O linfedema é caracterizado pelo acúmulo excessivo e persistente de fluidos e proteínas nos espaços intersticiais pela incompetência do sistema linfático. Acredita-se que a propriedade elástica da bandagem promove tensões e trações superficiais na pele capazes de drenar os fluidos corporais. Objetivo: Esta revisão sistemática se propôs a investigar os efeitos da Kinesio Taping (KT) sobre o edema linfático. Métodos: Pesquisa do tipo exploratóriodocumental com abordagem quantitativa, cujas bases de dados consultadas foram: Lilacs, Medline, Scielo e Periódicos Capes. Utilizaram-se os descritores: "bandagem elástica funcional" "fita atlética", "linfotaping" "linfedema", "linfoedema" e seus respectivos termos em inglês. Resultados: Foram selecionados cinco ensaios clínicos randomizados e comparados os elementos considerados relevantes para a análise dos efeitos da KT, como o público alvo, o grau de edema linfático do membro superior, o método utilizado para avaliação do linfedema, a disposição dos grupos nas pesquisas e o método de aplicação da KT. Conclusão: Os resultados evidenciam redução significativa do linfedema nos grupos que utilizaram a KT, tanto de forma isolada como associada a outras técnicas, porém a KT quando comparada a Terapia Complexa Descongestiva apresenta resultados inferiores na redução do linfedema.(AU)

Introduction: Lymphedema is characterized by excessive and persistent accumulation of fluids and proteins in the interstitial space, caused by the incompetence of the lymphatic system. It is believed that the elastic property of the bandage promotes tensions and superficial skin tractions which are able to drain body fluids. Objective: This systematic review intends to investigate the effects of Kinesiology Taping (KT) on the lymphatic edema. Methods: This research is exploratory-documentary type with a quantitative approach, whose databases consulted were: Lilacs, Medline, Scielo and Capes. It was used the keywords: "bandagem elástica funcional" "fita atlética","linfotaping" "linfedema", "linfoedema" and their respective terms in English. Results: Five randomized clinical trials were selected and we compared the relevant elements to the analysis of the effects of KT, as the patient target, the degree of lymphedema of the upper limb, the method that was used for the evaluation of lymphedema, the arrangement of the groups in the studies and the KT method application. Conclusion: The results showed there was a significant reduction of lymphedema in the groups that used KT, used either alone or associated with other techniques, however the KT compared to the Complex Decongestive Therapy presents lower results in reducing lymphedema.(AU)