Effects of intradialytic exercise on the physical function, depression and quality of life for haemodialysis patients: a systematic review and meta-analysis of randomised controlled trials

BackgroundModerate-to-severe cancer-related fatigue occurs in 45% of patients with cancer and interferes with many aspects of quality of life. Although physical exercise has level 1 evidence for improvement of cancer-related fatigue, it has a relatively high behavioural demand compared with other non-pharmacological interventions. The aim of this updated meta-analysis was to address the efficacy of light therapy in improving cancer-related fatigue in patients with cancer.MethodsWe included randomised controlled trials investigating the efficacy of bright white light (BWL) therapy in ameliorating cancer-related fatigue in patients with cancer. This meta-analysis was conducted using a random-effects model. The target outcomes were changes in cancer-related fatigue associated with BWL or dim red light (DRL).ResultsThere were 9 articles with 231 participants included. The main results revealed that daily morning BWL for 30 min was associated with significantly better improvement in fatigue severity compared with DRL (k=5, Hedges’ g=−0.414, 95% CI −0.740 to −0.087, p=0.013). The subgroup without psychiatric comorbidities (k=4, Hedges’ g=−0.479, 95% CI −0.801 to −0.156, p=0.004) was associated with significantly better improvement in fatigue severity with BWL than with DRL. In contrary, BWL was not associated with significantly different changes in depression severity or quality of life compared with DRL. Finally, BWL was associated with similar acceptability (ie, dropout rate) and safety profile (ie, any discomfort) as those of DRL.ConclusionsThis meta-analysis provides an updated evidence on the rationale for application of BWL in ameliorating cancer-related fatigue in patients with different types of cancer.Trial registration numberINPLASY202140090.

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Systematic Review with Meta-Analysis: Effectiveness and Safety of Acupuncture as Adjuvant Therapy for Side Effects Management in Drug Therapy-Receiving Breast Cancer Patients

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9949777 ◽

2021 ◽

Vol 2021 ◽

pp. 1-15

Author(s):

Yau-Tuen Chan ◽

Ning Wang ◽

Chi-Wing Tam ◽

Hor-Yue Tan ◽

Yuanjun Lu ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Side Effects ◽

Randomised Controlled Trials ◽

Primary Outcome ◽

Meta Analysis ◽

Controlled Trials ◽

Real Acupuncture ◽

Randomised Controlled

Objective. To investigate the potential benefits and safety of acupuncture on managing side effects induced by drug therapies in patients with breast cancer using a PRISMA standard systematic review and meta-analysis. Methods. Published randomised controlled trials from nine databases in English and Chinese language were searched. Trials with a real acupuncture treatment group and a control group with sham acupuncture, no treatment, or waitlist control were included. The primary outcome of this study was the therapeutic effects on five symptoms induced by drug therapies, including gastrointestinal disorder, neuropathy, arthralgia, joint symptoms, and cognitive impairment. The quality of life was assessed as a secondary outcome. The risk of bias of each study was analysed according to the Cochrane Handbook. Results. Sixteen randomised controlled trials with 1189 participants were included in the meta-analysis. The primary outcome and all subgroup analyses showed statistically significant improvements in the management of side effects by real acupuncture. The quality of life of patients has enhanced during the treatment. Conclusion. Although the number of publications is limited, a clear preliminary conclusion could be drawn by the meta-analysis, suggesting the beneficial adjuvant role of acupuncture in patients with breast cancer who receive drug therapies. No serious adverse events were observed from all the RCTs, and the safety of acupuncture is ascertained. More standardised and sophisticated large-scale randomised controlled trials are needed to evaluate the findings further.

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A systematic review of the role of heat therapy for patients with intermittent claudication due to peripheral artery disease

Vascular Medicine ◽

10.1177/1358863x20983475 ◽

2021 ◽

pp. 1358863X2098347

Author(s):

Amy E Harwood ◽

Christopher JA Pugh ◽

Charles J Steward ◽

Campbell Menzies ◽

C Doug Thake ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Blood Pressure ◽

Randomised Controlled Trials ◽

Whole Body ◽

Controlled Trials ◽

Heat Therapy ◽

Therapy Interventions ◽

Randomised Controlled

Intermittent claudication (IC) is associated with impairments in quality of life and walking ability. Heat therapy is an emerging cardiovascular therapy, which may improve walking in patients with IC. We undertook a systematic review to establish current evidence for heat therapy for patients with IC. We searched five databases (Ovid Medline / PubMed, Embase, Scopus / Web of Science, Cochrane Library and Health Technology Assessment Databases). A total of 6751 records were screened with 76 full-text articles assessed for eligibility. We included three randomised control trials and three acute interventions. For chronic interventions, three different heat therapy interventions were used. The 6-minute walk distance significantly improved following whole-body immersion ( p = 0.03; ES 0.94, 95% CI: 0.06–1.82), but not after Waon therapy or a water-perfused garment. Ankle–brachial pressure indices were significantly improved following whole-body immersion ( p = 0.01; ES 1.10, 95% CI: 0.20–1.99) but not after other therapies. No form of heat therapy demonstrated statistical improvements in quality of life or brachial blood pressure. Acute interventions were characterised by large increases in limb blood flow and core temperature, and transient reductions in blood pressure post-heating. At present there are only three randomised controlled trials assessing heat therapy for patients with IC. Moreover, each of those randomised controlled trials utilised different heat therapies. There is also very limited study of the acute physiological responses to different heat therapy interventions in these populations. Future research should establish appropriate heat therapy protocols and implement more randomised trials to understand its effectiveness. PROSPERO: CRD42020187941

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Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-097891 ◽

2017 ◽

Vol 52 (8) ◽

pp. 505-513 ◽

Cited By ~ 69

Author(s):

Maike G Sweegers ◽

Teatske M Altenburg ◽

Mai J Chinapaw ◽

Joeri Kalter ◽

Irma M Verdonck-de Leeuw ◽

...

Keyword(s):

Quality Of Life ◽

Energy Expenditure ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Delivery Mode ◽

Exercise Interventions ◽

Patients With Cancer ◽

Randomised Controlled

ObjectiveCertain exercise prescriptions for patients with cancer may improve self-reported quality of life (QoL) and self-reported physical function (PF). We investigated the effects of exercise on QoL and PF in patients with cancer and studied differences in effects between different intervention-related and exercise-related characteristics.DesignWe searched four electronic databases to identify randomised controlled trials investigating exercise effects on QoL and PF in patients with cancer. Pooled effects (Hedges’ g) were calculated using Comprehensive Meta-Analysis software. Subgroup analyses were conducted based on intervention dimensions, including timing, duration and delivery mode, and exercise dimensions, including frequency, intensity, type and time (FITT factors).ResultsWe included 74 exercise arms. Patients who were randomised to exercise interventions had significantly improved QoL (g=0.15, 95% CI (0.10 to 0.20), n=67 exercise arms) and PF (g=0.21, 95% CI (0.15 to 0.27), n=59 exercise arms) compared with patients in control groups. We found a significant between-group difference for exercise delivery mode, with significant beneficial effects for supervised exercise interventions (g=0.20, 95% CI (0.14 to 0.26) for QoL and g=0.27, 95% CI (0.20 to 0.33) for PF), but not for unsupervised interventions (g=0.04, 95% CI (−0.06 to 0.13) for QoL and g=0.09, 95% CI (−0.01 to 0.19) for PF). No statistically significant differences in intervention effects were found for variations in intervention timing, duration or exercise FITT factors. Unsupervised exercise with higher weekly energy expenditure was more effective than unsupervised exercise with lower energy expenditure (z=2.34, p=0.02).ConclusionsExercise interventions, especially when supervised, have statistically significant and small clinical benefit on self-reported QoL and PF in patients with cancer. Unsupervised exercise intervention effects on PF were larger when prescribed at a higher weekly energy expenditure.

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