Yoga versus massage in the treatment of aromatase inhibitor-associated knee joint pain in breast cancer survivors: a randomized controlled trial

AbstractAromatase inhibitors (AIs) are standard adjuvant therapy for postmenopausal women with oestrogen receptor-positive, early-stage, and metastatic breast cancer. Although effective, the risk of falls due to AI-associated knee joint pain significantly increased. The aim of this study was to evaluate the therapeutic effects of yoga and massage on AI-associated knee joint pain. Breast cancer survivors were randomly assigned to a 6-week yoga intervention-2-week rest-6-week massage exposure (Yoga first, n = 30) or a 6-week massage intervention-2-week rest-6-week yoga exposure (Massage first, n = 30). Evaluations of the treatment efficacy were made at baseline, post-intervention, and post-exposure using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale, plasma cytokine levels, and changes in meridian energy. The results showed that yoga, superior to massage intervention, significantly reduced AI-associated knee joint pain, as demonstrated by the WOMAC pain score. The yoga intervention improvements were also associated with changes in plasma cytokine levels and meridian energy changes. In conclusion, this study provides scientific evidence that yoga was more effective than massage for reducing AI-associated knee joint pain. Meridian energy changes may provide another scientific, objective, non-invasive way to monitor the therapeutic effects of yoga and investigate another alternative, complementary medicine.

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Randomized Exercise Trial of Aromatase Inhibitor–Induced Arthralgia in Breast Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2014.57.1547 ◽

2015 ◽

Vol 33 (10) ◽

pp. 1104-1111 ◽

Cited By ~ 145

Author(s):

Melinda L. Irwin ◽

Brenda Cartmel ◽

Cary P. Gross ◽

Elizabeth Ercolano ◽

Fangyong Li ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Strength Training ◽

Aerobic Exercise ◽

Usual Care ◽

Repeated Measures ◽

Joint Pain ◽

Breast Cancer Survivors ◽

Pain Scores ◽

The Impact

Purpose Arthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity. Patients and Methods Eligibility criteria included receiving an AI for at least 6 months, reporting ≥ 3 of 10 for worst joint pain on the Brief Pain Inventory (BPI), and reporting < 90 minutes per week of aerobic exercise and no strength training. Participants were randomly assigned to exercise (150 minutes per week of aerobic exercise and supervised strength training twice per week) or usual care. The BPI, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were completed at baseline and at 3, 6, 9, and 12 months. Intervention effects were evaluated using mixed-model repeated measures analysis, with change at 12 months as the primary end point. Results Over 12 months, women randomly assigned to exercise (n = 61) attended 70% (± standard deviation [SD], 28%) of resistance training sessions and increased their exercise by 159 (± SD, 136) minutes per week. Worst joint pain scores decreased by 1.6 points (29%) at 12 months among women randomly assigned to exercise versus a 0.2-point increase (3%) among those receiving usual care (n = 60; P < .001). Pain severity and interference, as well as DASH and WOMAC pain scores, also decreased significantly at 12 months in women randomly assigned to exercise, compared with increases for those receiving usual care (all P < .001). Conclusion Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors.

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Study design and methods for the using exercise to relieve joint pain and improve AI adherence in older breast cancer survivors (REJOIN) trial

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2021.05.011 ◽

2021 ◽

Author(s):

Shirley M. Bluethmann ◽

Cristina Truica ◽

Heidi D. Klepin ◽

Nancy Olsen ◽

Christopher Sciamanna ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Study Design ◽

Joint Pain ◽

Breast Cancer Survivors ◽

Design And Methods

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Active and Passive Coping Strategies: Comparing Psychological Distress, Cortisol, and Proinflammatory Cytokine Levels in Breast Cancer Survivors

Clinical Journal of Oncology Nursing ◽

10.1188/19.cjon.583-590 ◽

2019 ◽

Vol 23 (6) ◽

pp. 583-590 ◽

Cited By ~ 1

Author(s):

Joana Perez-Tejada ◽

Larraitz Garmendia ◽

Ainitze Labaka ◽

Oscar Vegas ◽

Eneritz Gómez-Lazaro ◽

...

Keyword(s):

Breast Cancer ◽

Psychological Distress ◽

Cancer Survivors ◽

Coping Strategies ◽

Proinflammatory Cytokine ◽

Breast Cancer Survivors ◽

Passive Coping ◽

Cytokine Levels

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Factors associated with intention to participate in a randomized yoga intervention among African American breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.e21538 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. e21538-e21538

Author(s):

Sri Lakshmi Yeruva ◽

Danyella Green ◽

Chloe Martin ◽

Teletia R Taylor

Keyword(s):

Breast Cancer ◽

African American ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Yoga Intervention ◽

Factors Associated ◽

Intention To Participate

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Survivourship Issues As Determinants of Quality of Life After Breast Cancer Treatment: Report From a Limited Resource Setting

Journal of Global Oncology ◽

10.1200/jgo.18.15700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 100s-100s

Author(s):

N. Kaur ◽

A. Gupta ◽

A.K. Sharma

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Supportive Care ◽

Cancer Survivors ◽

Emotional Distress ◽

Joint Pain ◽

Breast Cancer Survivors ◽

Breast Cancer Treatment

Background: Cancer survivorship is an unremitting struggle for breast cancer patients, as the consequence of complex treatment processes and its multitude of residual and late emerging side effects, have a significant impact on their quality of life (QOL). Unique issues of survivorship include those related to physical, psychological, social, and spiritual well-being of women. Amid a growing population of breast cancer survivors (BCs) worldwide, supportive care research is assuming greater importance in breast cancer care. Focus of survivorship research is to identify issues impacting QOL of the cancer survivors so that supportive care services can be tailored to their specific needs. Role of individual survivor's issues have been widely reported but a comprehensive picture is lacking. Aim: This study was conducted with the aim to identify important survivorship issues adversely affecting QOL of women after breast cancer treatment. Main objectives were to (1) estimate prevalence of various survivorship issues (2) assess QOL of survivors by using FACT-B and SF-36 questionnaires (3) study impact of time elapsed since treatment on survivorship issues and QOL scores (4) identify most important issues from the perspective of impact on QOL. Methods: This descriptive, hospital based, cross sectional study was conducted in 230 breast cancer survivors and a group of 112 healthy age-matched-controls, in an academic healthcare setting in northern India. A checklist of 14 commonly reported survivorship issues, and questionnaires for QOL assessment were administered to participants. Main outcome measures were (1) frequencies of survivorship issues and QOL scores among three groups divided on the basis of time elapsed since treatment (< 2 year follow-up, 2-5 year follow-up and > 5 year follow-up) (2) association of survivorship issues with QOL scores (3) stepwise regression analysis to identify issues with most significant impact on QOL of survivors. Results: Breast cancer survivors showed an improvement in their QOL over time which was sustained in long term survivors. However their quality of life remains poorer, compared with healthy women, irrespective of the duration of follow-up. The most prevalent survivorship issues were fatigue (60%), restriction of shoulder movement (59.6%), body and joint pain (63.5%), chemotherapy induced cessation of menstruation (73.3%) and loss of sexual desire (60%). However the issues which had maximum adverse effect on QOL scores were emotional distress, fatigue, postmastectomy chronic pain, cessation of menstruation, body and joint pain, vaginal dryness and sleep disturbances. Conclusion: Thus in this study, emotional distress and cancer related fatigue were found to be the chief determinants of poor QOL. Further premature menopause, with its attendant systemic symptoms, vulvo-vaginal atrophy and sexual dysfunction emerged as a key contributor to poor QOL in BCs.

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Influence of Hatha Yoga on Physical Activity Constraints, Physical Fitness, and Body Image of Breast Cancer Survivors: A Pilot Study

International Journal of Yoga Therapy ◽

10.17761/ijyt.21.1.n852143rv21x188u ◽

2011 ◽

Vol 21 (1) ◽

pp. 49-60 ◽

Cited By ~ 11

Author(s):

Marieke Van Puymbroeck ◽

Arlene Schmid ◽

Kimberly Shinew ◽

Pei-Chun Hsieh

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Body Image ◽

Pilot Study ◽

Physical Fitness ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Hatha Yoga ◽

Yoga Intervention ◽

Body Strength

Breast cancer survivors often experience changes in their perception of their bodies following surgical treatment. These changes in body image may increase self-consciousness and perceptions of physical activity constraints and reduce participation in physical activity. While the number of studies examining different types of yoga targeting women with breast cancer has increased, studies thus far have not studied the influence that Hatha yoga has on body image and physical activity constraints. The objective of this study was to explore the changes that occur in breast cancer survivors in terms of body image, perceived constraints, and physical fitness following an 8-week Hatha yoga intervention. This study used a nonrandomized two-group pilot study, comparing an 8-week Hatha yoga intervention with a light exercise group, both designed for women who were at least nine months post-treatment for breast cancer. Both quantitative and qualitative data were collected in the areas of body image, physical activity constraints,and physical fitness. Findings indicated that quantitatively, yoga participants experienced reductions in physical activity constraints and improvements in lower- and upper-body strength and flexibility, while control participants experienced improvements in abdominal strength and lower-body strength. Qualitative findings support changes in body image, physical activity constraints, and physical fitness for the participants in the yoga group. In conclusion,Hatha yoga may reduce constraints to physical activity and improve fitness in breast cancer survivors. More research is needed to explore the relationship between Hatha yoga and improvements in body image.

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