BMC Complementary and Alternative Medicine | |
The effect of yoga on women with secondary arm lymphoedema from breast cancer treatment | |
Andrew D Williams3  Denis Visentin3  Maarten A Immink4  Neil Piller1  Tony Barnett2  Annette Loudon2  | |
[1] School of Medicine, Flinders University, Adelaide, South Australia, 5042, Australia;University Department of Rural Health, University of Tasmania, Launceston, TAS, 7250, Australia;School of Human Life Sciences, University of Tasmania, Launceston, TAS, 7250, Australia;School of Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia | |
关键词: Randomised control trial; Quality of life; Symptoms; Arm lymphoedema; Yoga; | |
Others : 1232149 DOI : 10.1186/1472-6882-12-66 |
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received in 2012-04-03, accepted in 2012-05-28, 发布年份 2012 | |
【 摘 要 】
Background
Women who develop secondary arm lymphoedema subsequent to treatment associated with breast cancer require life-long management for a range of symptoms including arm swelling, heaviness, tightness in the arm and sometimes the chest, upper body impairment and changes to a range of parameters relating to quality of life. While exercise under controlled conditions has had positive outcomes, the impact of yoga has not been investigated. The aim of this study is to determine the effectiveness of yoga in the physical and psycho-social domains, in the hope that women can be offered another safe, holistic modality to help control many, if not all, of the effects of secondary arm lymphoedema.
Methods and design
A randomised controlled pilot trial will be conducted in Hobart and Launceston with a total of 40 women receiving either yoga intervention or current best practice care. Intervention will consist of eight weeks of a weekly teacher-led yoga class with a home-based daily yoga practice delivered by DVD. Primary outcome measures will be the effects of yoga on lymphoedema and its associated symptoms and quality of life. Secondary outcome measures will be range of motion of the arm and thoracic spine, shoulder strength, and weekly and daily physical activity. Primary and secondary outcomes will be measured at baseline, weeks four, eight and a four week follow up at week twelve. Range of motion of the spine, in a self-nominated group, will be measured at baseline, weeks eight and twelve. A further outcome will be the women’s perceptions of the yoga collected by interview at week eight.
Discussion
The results of this trial will provide information on the safety and effectiveness of yoga for women with secondary arm lymphoedema from breast cancer treatment. It will also inform methodology for future, larger trials.
Trial registration
ACTRN12611000202965
【 授权许可】
2012 Loudon et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20151113000614916.pdf | 241KB | download | |
Figure 1. | 38KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Warren AG, Brorson H, Borund LJ, Slavin SA: Lymphedema: A comprehensive review. Ann Plast Surg 2007, 59:464-472.
- [2]Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G: Prognostic factors for lymphedema after primary treatment of breast carcinoma. Cancer 2001, 92:1783-1787.
- [3]National Breast and Ovarian Cancer Centre: Review of research evidence on secondary lymphoedema: Incidence, prevention, risk factors and treatment. NBOCC, Surry Hills, NSW, Australia; 2008.
- [4]Australian Institute of Health and Welfare & National Breast and Ovarian Cancer Centre: Breast Cancer in Australia: an overview, 2009. Cancer series no. 50. Cat. No. CAN 46. AIHW, Canberra; 2009.
- [5]Hayes S, Janda M, Cornish B, Battistutta D, Newman B: Lymphedema following breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol 2008, 26:3536-3542.
- [6]Ridner SH, Montgomery LD, Hepworth JT, Stewart BR, Armer JM: Comparison of upper limb volume measurement techniques and arm symptoms between healthy volunteers and individuals with known lymphedema. Lymphology 2007, 40:35-46.
- [7]Dawes DJ, Meterissian S, Goldberg M, Mayo NE: Impact of lymphoedema on arm function and health-related quality of life in women following breast cancer surgery. J Rehabil Med 2008, 40:651-658.
- [8]Armer JM, Porock D: Self-Management of fatigue among women with lymphedema. Lymphology 2002, 35:208-213.
- [9]Lee TS, Kilbreath SL, Sullivan G, Refshauge KM, Beith JM: Patient perceptions of arm care and exercise advice after breast cancer surgery. Oncol Nurs Forum 2010, 37:85-91.
- [10]Thomas-MacLean R, Miedema B, Tatemichi SR: Breast cancer-related lymphedema: Women's experiences with an underestimated condition. Can Fam Physician 2005, 51:247-255.
- [11]Crosbie J, Kilbreath SL, Dylke E, Refshauge KM, Nicholson LL, Beith JM, Spillane AJ, White K: Effects of mastectomy on shoulder and spinal kinematics during bilateral upper-limb movement. Phys Ther 2010, 90:679-692.
- [12]Shamley DR, Srinanaganathan R, Oskrochi R, Lascurain-Aguirrebena I, Sugden E: Three-dimensional scapulothoracic motion following treatment for breast cancer. Breast Cancer Res Treat 2009, 118:315-322.
- [13]Ridner SH, Bonner CM, Deng J, Sinclair VG: Voices from the shadows: living with lymphedema. Cancer Nurs 2012, 35:E18-E26.
- [14]Towers A, Carnevale FA, Baker ME: The psychosocial effects of cancer-related lymphedema. J Palliat Care 2008, 24:134-143.
- [15]Keeley V, Crooks S, Locke J, Veigas D, Riches K, Hilliam R: A quality of life measure for limb lymphoedema (LYMQOL). Journal of Lymphoedema 2010, 5:26-37.
- [16]Lymphoedema Framework: Best Practice for the Management of Lymphoedema. International Consensus. United Kingdom: MEP Ltd, London; 2006.
- [17]National Breast and Ovarian Centre: Lymphoedema – What you need to know. NBOCC, Surry Hills, NSW; 2008.
- [18]Ridner SH: The psycho-social impact of lymphedema. Lymphat Res Biol 2009, 7:109-112.
- [19]Cheifetz O, Haley L, Breast Canc A: Management of secondary lymphedema related to breast cancer. Can Fam Physician 2010, 56:1277-1284.
- [20]Poage E, Singer M, Armer JM, Poundall M, Shellabarger MJ: Demystifying lymphedema: development of the lymphedema putting evidence into practice card. Clin J Oncol Nurs 2008, 12:951-964.
- [21]National Lymphedema Network: Position Statement of the National Lymphedema Network. San Francisco, California, USA, San Francisco, California, USA; 2011. http://www.lymphnet.org?pdfDocs/nlnexercise.pdf webcite date cited 8.8.11
- [22]Schmitz KH, Ahmed RL, Troxel AB, Cheville A, Smith R, Lewis-Grant L, Bryan CJ, Williams-Smith CT, Green QP: Weight-lifting in women with breast-cancer-related lymphedema. N Engl J Med 2009, 361:664-673.
- [23]Ahmed RL, Thomas W, Yee D, Schmitz KH: Randomised controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol 2006, 24:2765-2772.
- [24]Moseley AL, Piller NB: Exercise for limb lymphoedema; evidence that it is beneficial. Journal of Lymphoedema 2008, 3:51-56.
- [25]Hayes SC, Reul-Hirche HM, Turner J: Exercise and secondary lymphedema : safety, potential benefits, and research-related issues. Med Sci Sports Exerc 2009, 41:483-489.
- [26]Moseley AL, Piller NB, Carati CJ: The effect of gentle arm exercise and deep breathing on secondary arm lymphedema. Lymphology 2005, 38:136-145.
- [27]McClure MK, McClure RJ, Day R, Brufsky AM: Randomised controlled trial of the breast cancer recovery program for women with breast cancer-related lymphedema. Am J Occup Ther 2010, 64:59-72.
- [28]Tidhar D, Katz-Leurer M: Aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study. Support Care Cancer 2010, 18:383-392.
- [29]Finnane A, Liu Y, Battistutta D, Janda M, Hayes SC: Lymphedema after breast or gynecological cancer: use and effectiveness of mainstream and complementary therapies. J Altern Complement Med 2011, 17:867-869.
- [30]Narahari S, Ryan TJ, Bose KS, Prasanna KS, Aggithaya GM: Integrating modern dermatology and Ayurveda in the treatment of vitiligo and lymphedema in India. Int J Dermatol 2011, 50:310-334.
- [31]Chandwani KD, Thornton B, Perkins GH, Banu Arun, Raghuram NV, Nagendra HR, Wei Q, Cohen L: Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer. J Soc Integr Oncol 2010, 8:43-55.
- [32]Rao RM, Telles S, Nagendra HR, Nagarathna R, Gopinath KS, Srinath S, Srikantaiah C: Effects of yoga on natural killer cell counts in early breast cancer. Med Sci Monit 2007, 14:3-4.
- [33]Carlson LE, Speca M, Faris P, Patel KD: One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behav Immunity 2007, 21:1038-1049.
- [34]Speed-Andrews AE, Stevinson C, Belanger L, Mirus JJ, Courneya KS: A pilot evaluation of an Iyengar Yoga program for breast cancer survivors. Cancer Nurs 2010, 33:369-381.
- [35]Bower JE, Garet D, Sternlieb B: Yoga for persistent fatigue in breast cancer survivors: results of a pilot study. Evidence-Based Complementary and Altern Med 2011 2011.
- [36]Galantino ML, Desai K, Greene L, Demichele A, Stricker CT, Mao JJ: Impact of Yoga on Functional Outcomes in Breast Cancer Survivors With Aromatase Inhibitor-Associated Arthralgias. Integr Cancer Ther 2011.
- [37]Thomas-MacLean R, Robertson S, Quinlan E, Kowalski K, Hamoline R, Spriggs P: Yoga for women with arm morbidity after breast cancer. Psycho-Oncology 2010, 19:S265.
- [38]Van Puymbroeck M, Schmid A, Shinew K, Hsieh P: Influence of hatha yoga on physical activity constraints, physical fitness, and body image of breast cancer survivors: a pilot study. International Journal of Yoga Ther 2011, 21:49-60.
- [39]Lymphoedema Management. [http://lymphology.asn.au/new/lymp_mang.php webcite]
- [40]Johansson K, Tibe K, Weibull A, Newton RU: Low intensity resistance exercise for breast cancer patients with arm lymphedema with or without compression sleeves. Lymphology 2005, 38:167-189.
- [41]Czerniec SA, Ward LC, Refshauge KM, Beith JM, Lee MJ, York S, Kilbreath SL: Assessment of breast cancer-related arm lymphedema-comparison of physical measurement methods and self-report. Cancer Invest 2010, 28:54-62.
- [42]Saraswati S (Ed): Asana, Pranayama, Mudra, Bandha. Bihar School of Yoga, Munger; 1996.
- [43]Cornish B, Bunce IH, Ward LC, Jones LC, Thomas BJ: Bioelectrical impedance for monitoring the efficacy of lymphoedema treatment programmes. Breast Cancer Res Treat 1996, 38:169176.
- [44]Rockson SG: Bioimpedance analysis in the assessment of lymphoedema diagnosis and management. Journal of Lymphoedema 2007, 2:44-48.
- [45]Koelmeyer L, Shanley K, Reul-Hirch HM, Piller NB: Setting a National Standard for Measurement of Lymphoedema Limbs. Australasian Associaton of Lymphology. Mt Colah, NSW, Australia; 2004. Topic Standards and Guidelines. From http://www.lymphology.asn.au/new/document/updatedProtcol 161204.pdf webcite date cited 10.5.2011
- [46]Stanton AWB, Badger C, Sitzia J: Non-invasive assessment of the lymphedematous limb. Lymphology 2000, 33:122-135.
- [47]Clodius L, Deak L, Piller NB: A new instrument for the evaluation of tissue tonicity in lymphoedema. Lymphology 1976, 9:1-5.
- [48]Bates DO, Levick JR, Mortimer PS: Quantification of rate and depth of pitting in human edema using an electronic tonometer. Lymphology 1994, 27:159-172.
- [49]Moseley AL, Piller NB: Relationships between limb size and composition using objective measures. Their role in providing better treatment outcomes. Lymphology 2007, 40:170-175.
- [50]Piller NB: To measure or not to measure? What and when is the question. Journal of Lymphoedema 2007, 2:39-45.
- [51]Harms-Ringdahl K, Carlsson AM, Ekholm J, Raustorp A, Svensson T, Toresson HG: Pain assessment with different intensity scales in response to loading of joint structures. Pain 1986, 27:401-411.
- [52]Jahr S, Schoppe B, Reisshauer A: Effect of treatment with low-intensity and extremely low-frequency elecrostatic fields of breast tissue and pain in patients with secondary breast lymphoedema. J Rehabil Med 2008, 40:645-650.
- [53]Riddle DL, Rothstein JM, Lamb RL: Goniometric reliability in a clinical setting: Shoulder measurements. Phys Ther 1987, 67:668-673.
- [54]Box R, Reul-Hirche HM, Bullock-Saxton JE, Furnival CF: Physiotherapy after breast cancer surgery: results of a randomised controlled study to mimimise lymphoedema. Breast Cancer Res Treat 2002, 75:51-64.
- [55]Todd J, Scally A, Dodwell D, Horgan K, Topping A: A randomised controlled trial of two programmes of shoulder exercise following axillary node dissection for invasive breast cancer. Physiotherapy 2008, 94:265-273.
- [56]Box R, Reul-Hirch HM, Bullock-Saxton JE, Furnival CF: Shoulder movement after breast cancer surgery: results of a randomised controlled study of postoperative physiotherapy. Breast Cancer Research and Treatment 2002, 75:35-50.
- [57]Leggin BG, Neuman RM, Ianotti JP, Williams GR, Thompson EC: Intrarater and interrater reliability of three isometric dynamometers in assessing shoulder strength. J Should Elb Surg 1996, 5:18-24.
- [58]Johansson K, Ingvar C, Albertsson M, Ekdahl C: Arm lymphoedema, shoulder mobility and muscle strength after breast cancer treatment - a prospective 2-year study. Adv Physiother 2001, 3:55-66.
- [59]Kendall FP, Kendall-McCreary E, Provance PG, Rodgers MM, Romani WA: Muscles: Testing and Function with posture and pain. 5th edition. Lippincott Williams and Wilkins, Baltimore, Maryland, USA; 2005.
- [60]Bohannon RW: Dynamometer measurements of hand-grip strength predict multiple outcomes. Percept Mot Ski 2001, 93:323-328.
- [61]Menegoni F, Vismara L, Capodaglio P, Crivellini M, Galli M: Kinematics of trunk movements: protocol design and application in obese females. J Appl Biomater Biomech 2008, 6:178-185.
- [62]Schmitz KH, Troxel AB, Cheville A, Lewis-Grant L, Bryan CJ, Gross CR, Lytle LA, Ahmed RL: Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials 2009, 30:233-245.