Current Domestic Research Trends for Exercise Intervention for Patients with Breast Cancer Undergoing Chemotherapy or Radiotherapy

Hyun Joo Lee; You Lee Yang; Sang Hui Chu

doi:10.5388/aon.2015.15.4.185

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Lee, Yang, and Chu: Current Domestic Research Trends for Exercise Intervention for Patients with Breast Cancer Undergoing Chemotherapy or Radiotherapy

Review Article

Asian Oncology Nursing 2015; 15(4): 185-192.

Published online: 31 December 2015

DOI: https://doi.org/10.5388/aon.2015.15.4.185

Current Domestic Research Trends for Exercise Intervention for Patients with Breast Cancer Undergoing Chemotherapy or Radiotherapy

Hyun Joo Lee¹, You Lee Yang¹, Sang Hui Chu²

¹College of Nursing, Graduate School, Yonsei University, Seoul, Korea.

²Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea.

Address reprint requests to: Chu, Sang Hui. Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3257, Fax: +82-2-392-5440, shchu@yuhs.ac

Received 31 August 2015 Revised 19 October 2015 Accepted 23 December 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Cardiotoxicity following cancer chemotherapy or radiotherapy is an emerging issue for breast cancer patients. The purpose of this study was to analyze the current domestic research trends for exercise intervention for Korean breast cancer patients under chemotherapy or radiotherapy, focused on cardiovascular indices as study outcome measures and to make suggestions for future nursing studies.

Methods

A literature search was done using PubMed, CINAHL and two Korean databases to identify experimental studies reported in Korean or English between 2,000 and 2015. We identified five studies independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed by RoBANS criteria.

Results

Tai-chi exercise was used in three studies and aerobic exercise programs or yoga and walking exercise in the remaining studies. Two studies evaluated cardiovascular outcomes and showed positive findings for breast cancer patients. For cardiovascular indices, heart rate and blood pressure were used.

Conclusion

This study showed the need for conducting well-designed experimental studies including clinical cardiovascular outcomes to generate evidence on exercise intervention for cancer therapy-induced cardiotoxicity prevention. Additional studies are warranted to accelerate the potential use of exercise as a nursing intervention for cancer patients under chemotherapy or radiotherapy.

Keywords: Breast Neoplasms, Exercise, Cardiovascular System, Review

Figures and Tables

Fig. 1

Literature searching flow.

Fig. 2

Quality of selected studies.

Table 1

Summary of Selected Studies

Study	Publication journal	Study purpose	Study design	Study subjects (n)	Name of intervention
Kim et al.17)	Journal of Life Science	To evaluate the effects of tai chi exercise on shoulder joint movement and cardiovascular function in elderly breast cancer patients	Nonequivalent control group pre-post test design	n=40	Tai chi exercise
Kim et al.20)	Cancer Nursing	To explore the effects of exercise on cardiopulmonary responses and adherence in newly diagnosed breast cancer women.	Randomized control group pre-post test design	n=41	Moderate-intensity aerobic exercise
Kim & Yang21)	The Korean Journal of Physical Education	To analyze effects of yoga and walking on pulmonary function, hemoglobin, and platelet patients receiving chemotherapy and radiation therapy after breast cancer surgery.	Randomized control group pre-post test design	n=24	Yoga and walking program
Eom19)	Korean Journal of Women Health Nursing	To explore the effects of early Tai Chi program to mastectomy patients on their upper limb functions and for the emotional statement.	Nonequivalent control group pre-post test design	n=48	Tai chi exercise
Hwang & Kwak18)	Journal of Life Science	To evaluate the effects of regular Tai Chi exercise to breast cancer patients on MDA, SOD and physical fitness	Nonequivalent control group pre-post test design	n=40	Tai chi exercise

MDA=Malondialdehyde; SOD=Soperoxide sismutase.

Table 2

Specific Interventions and Outcomes of Selected Studies

Study	Study subject	Intervention description	Study outcome measures	Study results
Kim et al.17)	Patients who had undergone mastectomy within 2 months (Exp.: n=20, Cont.: n=20)	12-week Tai chi program 4 times a week, 60 min a day	Shoulder joint movement: flexion, extension, adduction, abduction Heart rate	Shoulder joint movement, including flexion, extension, adduction and abduction, significantly increased (p<.05) and heart rates decreased after intervention (p<.05).
Kim et al.20)	Breast cancer patients (Exp.: n=22, Cont.: n=19)	8-week moderate-intensity aerobic exercise Once every 2 weeks	Cardiopulmonary responses: resting and maximum heart rates, systolic blood pressure, VO₂ peak	Intervention group showed significant decreases in resting heart rate and systolic blood pressure (p<.05) and an increase in VO₂ peak (p<.001).
Kim & Yang21)	Patients receiving chemotherapy and radiation therapy after mastectomy (Exp.: n=12, Cont.: n=12)	10-week Yoga and walking program Yoga: twice a week Walking: once a week, 50~60 min a day	Forced vital capacity, forced expiratory volume-1, peak expirtory flow, maximal voluntary ventilation, hemoglobin, platelet	Intervention group showed significant increases in forced vital capacity, forced expiratory volume-1, maximal voluntary ventilation (p<.05).
Eom19)	Patients who had undergone mastectomy within 3 months (Exp.: n=25, Cont.: n=23)	12-week Tai chi program Education and group exercise: once a week	Shoulder joint movement: flexion, extension, abduction, internal/external rotation, upper limb function Emotional status	Shoulder joint movement including flexion, extension, abduction, internal/external rotation and upper limb function significantly increased after intervention (p=.001).
Hwang & Kwak18)	Patients who had undergone mastectomy (Exp.: n=20, Cont.: n=20)	12-week Tai chi program 4 times a week, 60 min a day	Physical fitness: muscle strength, flexibility, flexion, extension, adduction, abduction MDA, SOD	Shoulder flexibility, flexion, extension, adduction, abduction, MDA and SOD significantly increased after intervention (p<.05).

Exp=Experimental group; Con=Control group; MDA=Malondialdehyde; SOD=Soperoxide sismutase.

Notes

This study was supported by a research grant from the College of Nursing, Yonsei University (6-2014-0121).

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