Therapeutic Exercises for Female Breast Cancer Survivors: Assessment of Cardiopulmonary, Anthropometric and Quality of life outcomes.
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Breast cancer (BC) is a prevalent disease whose incidence continues to rise especially in economically developing countries. Reduction in cardiopulmonary capacity of BC Survivors, which is positively associated with reduction in quality of life (QoL) and premature death, is a major problem associated with the disease. Therapeutic approaches that will improve cardiopulmonary capacity, QoL and survival rate of BC survivors are pressing concern. This study therefore investigated the effects of therapeutic exercises on selected cardiopulmonary, anthropometric and QoL parameters in premenopausal and postmenopausal BC survivors. Ninety-six (96) female BC survivors with stage I, II and III BC, recruited through referrals by physicians from the Radiotherapy and Oncology Department of Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos State completed the study. They were randomly assigned to 4 groups (A, B, C and D) and each group was further subdivided into 2 subgroups (1 and 2) based on their menopausal status. Group A underwent moderate intensity aerobic exercise using treadmill with educational and counseling sessions, Group B, stretching exercises with educational and counseling sessions and Group C, combined moderate intensity aerobic exercise using treadmill and stretching exercise with educational and counseling sessions. Group D was the control group which had no therapeutic exercise intervention but had only group educational and counseling sessions. Topics discussed during the group educational and counseling sessions included problems BC survivors are faced with as a result of the disease and its treatments as well as the means to deal with them. The duration of therapeutic exercises started at 15 minutes for weeks 1 – 3 and systematically increased by 5 minutes after every 3 weeks. Therapeutic exercise frequency was 3 times a week for 12 weeks. The moderate intensity for aerobic exercise was calculated as the equivalence of the subjects’ target heart rates. Statistical Package for Social Sciences (SPSS) version 20.0 was used to analyse the data. Data was analysed using descriptive statistics of mean and standard deviation. Analysis of variance (ANOVA) was used to compare the physical characteristic variables of subjects across groups. Repetitive ANOVA was used to compare the cardiovascular, pulmonary and anthropometric variables across the baseline, end of 3rd, 6th, 9th and 12th weeks within the groups. Paired t test was used to compare the pre and post treatment mean values of the same outcome variables within groups. Paired t test was used to compare the changes in the selected variables of premenopausal BC survivors with those of postmenopausal BC survivors at the end of 12th week. Paired t test was also used to compare the changes in the various exercise groups with those of the control group. Friedman test was used to analyse QoL values within groups and Kruskal-Wallis H test across groups. Level of significance was set at p<0.05. Subjects in the three therapeutic exercise groups had significant improvements in the cardiopulmonary and QoL variables although in various degrees. Those in Group C recorded the highest improvements followed by those in Group A and then those in Group B. Improvements in the cardiovascular variables of Groups B and C were more in the postmenopausal BC survivors than those of the premenopausal BC survivors while the reverse was the case for Group A. No significant improvement was observed in the anthropometric variables of any of the groups. Combined aerobic exercise using treadmill and stretching exercise brought about the most significant therapeutic effects on selected cardiovascular and pulmonary parameters in BC survivors. This was followed by aerobic exercise using treadmill alone and then stretching exercise alone. All the therapeutic exercises brought about significant improvements in the QoL of the BC survivors. The combined exercise therapy and stretching exercise alone brought about more prominent therapeutic improvements in the cardiovascular parameters of postmenopausal BC survivors than those of premenopausal BC survivors. None of the therapeutic exercises brought about significant improvements in the anthropometric variables of the BC survivors. Therefore, an ideal dosage of therapeutic exercise intervention that improves cardiopulmonary functions and QoL of BC survivors is combined moderate intensity aerobic exercise using treadmill and stretching exercise performed for 30 minutes, 3 times a week for at least 12 weeks.
A Thesis Submitted to the School of Postgraduate Studies, University of Lagos.
Breast cancer , Cardiopulmonary , Therapeutic approaches , Research Subject Categories::INTERDISCIPLINARY RESEARCH AREAS::Caring sciences::Physiotherapy
Aweto, H.A (2014), Therapeutic Exercises for Female Breast Cancer Survivors: Assessment of Cardiopulmonary, Anthropometric and Quality of life outcomes. A Thesis Submitted to University of Lagos School of Postgraduate Studies Phd Thesis and Dissertation, 170pp.