Chung, C., Lee, S., Hwang, S., & Park, E. (2013). Systematic review of exercise effects on health outcomes in women with breast cancer. Asian Nursing Research, 7, 149–159. 

DOI Link

Purpose

STUDY PURPOSE: To explore the effects of exercise on health outcomes for women with breast cancer
 
TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: MEDLINE and EMBASE
 
KEYWORDS: Breast neoplasm, breast cancer, breast tumor, breast carcinoma, breast adenocarcinoma, breast sarcoma, mastectomy, lymph node excision, lymph node dissection, sentinel lymph node biopsy, rehabilitation, physical therapy techniques, musculoskeletal manipulation, sports, physical activity, walking, jogging, cycling, bicycling, dance, aerobic, weight, training, muscle, endurance, resistance, strength, stretching, movement, and motion
 
INCLUSION CRITERIA: Included women who were diagnosed with breast cancer, studies that revealed that the women had undergone any type of surgical procedure, studies that reported any type of exercise intervention, and studies that were published in a journal or book in English or Korean
 
EXCLUSION CRITERIA: Animal studies, unoriginal articles (e.g., using secondary data), studies written in neither Korean nor English, unpublished grey articles, case studies, studies not dealing with postoperative patients with breast cancer, studies not evaluating the effectiveness of exercise intervention with a control, and studies not reporting relevant health outcomes

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 902
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: The guidelines of the National Evidence-Based Healthcare Collaborating Agency were followed. Quality of evidence and internal validity were assessed using the Korean version of the Scottish Intercollegiate Guidelines Network (SIGN) methodology containing 10 items, which was translated from the original checklist developed in 2008 by SIGN.

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED = 11
 
TOTAL PATIENTS INCLUDED IN REVIEW = 902
 
SAMPLE RANGE ACROSS STUDIES: 30–154 patients
 
KEY SAMPLE CHARACTERISTICS: Women diagnosed with breast cancer who underwent a surgical intervention

Results

The physical, psychological, physiologic, and behavioral aspects of the patients included in most of the studies were changed significantly by the exercise interventions. Physiotherapy improved range of motion, shoulder function, and pain, regardless of the intervention dosages. The effect of the interventions on lymphedema wasn’t apparent at six months but was visible at 12 months’ follow-up. Eight weeks of aerobic exercise was effective for psychological and behavioral outcomes through 24 weeks postintervention, but no significant long-term physical health effects were apparent. Aqualymphatic therapy affected emotional and social quality of life (QOL) but not physical QOL or limb volume. Dance and movement was not effective for lymphedema or health-related QOL. It only was effective for breast cancer-related QOL. Home-based rehabilitation improved some range of motion but did not affect pain, lymphedema, or strength.

Conclusions

Physical therapy is beneficial for shoulder range of motion when implemented soon after surgery. Any type of structured exercise could improve shoulder mobility, range of motion, and shoulder function in a relatively short period of time. The long-term effects of physiotherapy need to be studied more extensively. Multimodal exercise and comprehensive rehabilitation, including physical therapy, had physical and psychological effects. Aerobic exercise and dance and movement had a positive psychological effect. Exercise is essential to lymphedema treatment and management.

Limitations

Few of the studies included long-term follow-up to measure the effects of the interventions on lymphedema development and severity.

Nursing Implications

Informing patients with breast cancer about the importance of exercise after receiving surgery and teaching patients ways to decrease the limitations that may occur after surgery is necessary.

Legacy ID

4896