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Efficacy of supervised exercise on sleep of women who survived breast cancer: a systematic review with meta-analysis

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Abstract

Purpose

To analyze the efficacy of supervised exercise (SE) compared with control protocols on sleep parameters of women who survived breast cancer.

Methods

This systematic review with meta-analysis searched studies using the following electronic databases: PubMed, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Library, and EMBASE. The PEDro scale assessed the bias risk, and the study protocol was registered in the PROSPERO (no. CRD42023420894).

Results

Of 3,566 identified studies, 13 randomized clinical trials involving 847 women diagnosed with breast cancer were included. Interventions consisted of SE in an outpatient setting (62%) or combined protocols with supervised and home exercises. Most interventions (85%) used multicomponent protocols with aerobic and resistance exercises. Usual care and health education were the most reported controls. SE decreased the sleep disturbance score (− 31.61 [95% confidence interval =  − 39.40 to − 23.83]) of the European Organisation for Research and Treatment of Cancer quality of life questionnaire and daytime dysfunction score (− 0.41 [95% confidence interval =  − 0.73 to − 0.09]) of the Pittsburgh Sleep Quality Index (PSQI). Also, SE presented a tendency to improve the self-reported sleep quality score of the PSQI (p = 0.06).

Conclusion

SE increased the subjective sleep quality and immobility time and decreased sleep disturbance and daytime dysfunction symptoms in women who survived breast cancer. Most SE protocols were multicomponent, with aerobic and resistance exercises ranging from moderate to high intensity.

Implications for cancer survivors.

Supervised exercise may improve sleep quality and reduce symptoms of sleep disorders, contributing to survival outcomes.

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Data availability

This manuscript use data previously published by other authors and all data are presented into results section.

References

  1. Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Global Burden of Disease 2019 Cancer Collaboration, et al. Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. JAMA Oncol. 2022;8:420.

    Article  PubMed  Google Scholar 

  2. Xu S, Thompson W, Ancoli-Israel S, Liu L, Palmer B, Natarajan L. Cognition, quality-of-life, and symptom clusters in breast cancer: using Bayesian networks to elucidate complex relationships. Psychooncology. 2018;27:802–9.

    Article  PubMed  Google Scholar 

  3. Imanian M, Imanian M, Karimyar M. Sleep quality and fatigue among breast cancer patients undergoing chemotherapy. IJHOSCR [Internet]. 2019 [cited 2023 Apr 27]; Available from: https://publish.kne-publishing.com/index.php/IJHOSCR/article/view/1894

  4. Lourenço A, Dantas AAG, Souza JC, Araujo CM, Araujo DN, Lima INDF, et al. Sleep quality is associated with disability and quality of life in breast cancer survivors: a cross‐sectional pilot study. Eur J Cancer Care [Internet]. 2021 [cited 2023 Mar 15];30. Available from: https://onlinelibrary.wiley.com/doi/https://doi.org/10.1111/ecc.13339

  5. Momayyezi M, Fallahzadeh H, Farzaneh F, Momayyezi M. Sleep quality and cancer-related fatigue in patients with cancer. J Caring Sci. 2021;10:145–52.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Otte JL, Davis L, Carpenter JS, Krier C, Skaar TC, Rand KL, et al. Sleep disorders in breast cancer survivors. Support Care Cancer. 2016;24:4197–205.

    Article  PubMed  Google Scholar 

  7. De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: a systematic review and meta-analysis. Psychoneuroendocrinology. 2022;143:105843.

    Article  PubMed  Google Scholar 

  8. Hayes SC, Steele ML, Spence RR, Gordon L, Battistutta D, Bashford J, et al. Exercise following breast cancer: exploratory survival analyses of two randomized, controlled trials. Breast Cancer Res Treat. 2018;167:505–14.

    Article  CAS  PubMed  Google Scholar 

  9. Courneya KS, Segal RJ, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, et al. Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial. Breast Cancer Res Treat. 2014;144:361–9.

    Article  CAS  PubMed  Google Scholar 

  10. Kim C-J, Kang D-H, Park J-W. A meta-analysis of aerobic exercise interventions for women with breast cancer. West J Nurs Res. 2009;31:437–61.

    Article  PubMed  Google Scholar 

  11. Waltman NL, Twiss JJ, Ott CD, Gross GJ, Lindsey AM, Moore TE, et al. The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial. Osteoporos Int. 2010;21:1361–9.

    Article  CAS  PubMed  Google Scholar 

  12. Yang H, Yang Z, Pan H, Zhou Q. Effects of physical activity on sleep problems in breast cancer survivors: a meta-analysis. Support Care Cancer. 2021;29:4023–32.

    Article  PubMed  Google Scholar 

  13. Matthews EE, Janssen DW, Djalilova DM, Berger AM. Effects of exercise on sleep in women with breast cancer. Sleep Med Clin. 2018;13:395–417.

    Article  PubMed  Google Scholar 

  14. Westphal T, Rinnerthaler G, Gampenrieder SP, Niebauer J, Thaler J, Pfob M, et al. Supervised versus autonomous exercise training in breast cancer patients: a multicenter randomized clinical trial. Cancer Med. 2018;7:5962–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLoS Med. 2021;18:e1003583.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lasserson TJ, Thomas J, Higgins JP. Starting a review. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editors. Cochrane handbook for systematic reviews of interventions [Internet]. 1st ed. Wiley; 2019 [cited 2023 Apr 24]. p. 1–12. Available from: https://onlinelibrary.wiley.com/doi/https://doi.org/10.1002/9781119536604.ch1

  17. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5:210.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Shiwa SR, Costa LOP, Moser LAD de L, Aguiar de IC, Oliveira LVF de. PEDro: a base de dados de evidências em fisioterapia. Fisioter Mov. 2011; 24, 523–33.

  19. Armijo-Olivo S, da Costa BR, Cummings GG, Ha C, Fuentes J, Saltaji H, et al. PEDro or Cochrane to assess the quality of clinical trials? A meta-epidemiological study. Bayer A, editor. PLoS ONE. 2015;10:e0132634.

  20. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, Sami N, Norris MK, Fox FS, et al. Aerobic and resistance exercise improve patient-reported sleep quality and is associated with cardiometabolic biomarkers in Hispanic and non-Hispanic breast cancer survivors who are overweight or obese: results from a secondary analysis. Sleep. 2021;44:zsab111.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rogers LQ, Fogleman A, Trammell R, Hopkins-Price P, Vicari S, Rao K, et al. Effects of a physical activity behavior change intervention on inflammation and related health outcomes in breast cancer survivors: pilot randomized trial. Integr Cancer Ther. 2013;12:323–35.

    Article  CAS  PubMed  Google Scholar 

  23. Rogers LQ, Vicari S, Trammell R, Hopkins-Price P, Fogleman A, Spenner A, et al. Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors. Med Sci Sports Exerc. 2014;46:1077–88.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rogers LQ, Fogleman A, Trammell R, Hopkins-Price P, Spenner A, Vicari S, et al. Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial: Mediators of exercise effects on sleep in breast cancer survivors. Psychooncology. 2015;24:302-310.

    Article  PubMed  Google Scholar 

  25. Rogers LQ, Courneya KS, Oster RA, Anton PM, Phillips S, Ehlers DK, et al. Physical activity intervention benefits persist months post-intervention: randomized trial in breast cancer survivors. J Cancer Surviv [Internet]. 2023 [cited 2023 Mar 14]; Available from: https://link.springer.com/https://doi.org/10.1007/s11764-022-01329-2

  26. Ghavami H, Akyolcu N. The impact of lifestyle interventions in breast cancer women after completion of primary therapy: a randomized study. J Breasth Health. 2017;13:94–9.

    Article  Google Scholar 

  27. Monazzami A, Momenpour R, Alipoor E, Yari K, Payandeh M. The effects of concurrent training on the body composition, quality of life, and sleep quality of postmenopausal women with breast cancer. J Kermanshah Univ Med Sci. 2020;24(3):e101186.

    Article  Google Scholar 

  28. de Barbosa KP, da Silva LGT, Garcia PA, de Freitas CA, da Silva ECF, Pereira TV, et al. Effectiveness of Pilates and circuit-based exercise in reducing arthralgia in women during hormone therapy for breast cancer: a randomized, controlled trial. Support Care Cancer. 2021;29:6051–9.

    Article  PubMed  Google Scholar 

  29. Paulo TRS, Rossi FE, Viezel J, Tosello GT, Seidinger SC, Simões RR, et al. The impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy: a randomized controlled trial. Health Qual Life Outcomes. 2019;17:17.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Aydin M, Kose E, Odabas I, Meric Bingul B, Demirci D, Aydin Z. The effect of exercise on life quality and depression levels of breast cancer patients. Asian Pac J Cancer Prev. 2021;22:725–32.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Roveda E, Vitale JA, Bruno E, Montaruli A, Pasanisi P, Villarini A, et al. Protective effect of aerobic physical activity on sleep behavior in breast cancer survivors. Integr Cancer Ther. 2017;16:21–31.

    Article  PubMed  Google Scholar 

  32. Kim S, Ko YH, Song Y, Kang MJ, Lee H, Kim SH, et al. Pre-post analysis of a social capital-based exercise adherence intervention for breast cancer survivors with moderate fatigue: a randomized controlled trial. Support Care Cancer. 2020;28:5281–9.

    Article  PubMed  Google Scholar 

  33. Jang MK, Han J, Kim SH, Ko YH, Kim SY, Kim S. Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial. BMC Cancer. 2021;21:855.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Reverte-Pagola G, Sánchez-Trigo H, Saxton J, Sañudo B. Supervised and non-supervised exercise programs for the management of cancer-related fatigue in women with breast cancer: a systematic review and meta-analysis. Cancers. 2022;14:3428.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Depenbusch J, Sweegers MG, Aaronson NK, Wengström Y, Backman M, Arraras JI, et al. PERSPECTIVEs on supervised exercise programs in people with metastatic breast cancer- a qualitative study in four European countries. Support Care Cancer. 2023;31:281.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Stout NL, Baima J, Swisher AK, Winters-Stone KM, Welsh J. A systematic review of exercise systematic reviews in the cancer literature (2005–2017). PM R. 2017;9(9S2):S347–84.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, et al. Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA A Cancer J Clin. 2019;69:468–84.

    Article  Google Scholar 

  38. Avancini A, Pala V, Trestini I, Tregnago D, Mariani L, Sieri S, et al. Exercise levels and preferences in cancer patients: a cross-sectional study. IJERPH. 2020;17:5351.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51:2375–90.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Tseng T-H, Chen H-C, Wang L-Y, Chien M-Y. Effects of exercise training on sleep quality and heart rate variability in middle-aged and older adults with poor sleep quality: a randomized controlled trial. J Clin Sleep Med. 2020;16:1483–92.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Shorofi SA, Nozari-Mirarkolaei F, Arbon P, Bagheri-Nesamie M. Depression and sleep quality among iranian women with breast cancer. Asian Pac J Cancer Prev. 2021;22:3433–40.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Peterson LL, Ligibel JA. Physical activity and breast cancer: an opportunity to improve outcomes. Curr Oncol Rep. 2018;20:50.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank Universidade Federal de Pernambuco and CAPES for the financial support provided for translating the manuscript.

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) – Finance Code 001.

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Authors and Affiliations

  1. Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife-PE, 50740-560, Brazil

    Mariana Pifano de Moura Ferraz Barbosa, Naiany Tenorio de Jesus, Vanessa Maria da Silva Alves Gomes & Diego Dantas

  2. Clinical Epidemiology Program, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil

    Anke Bergmann

  3. Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago de Chile, Chile

    Cinara Sacomori

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  1. Mariana Pifano de Moura Ferraz Barbosa
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Correspondence to Diego Dantas.

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de Moura Ferraz Barbosa, M.P., de Jesus, N.T., Bergmann, A. et al. Efficacy of supervised exercise on sleep of women who survived breast cancer: a systematic review with meta-analysis. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01532-3

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