San Diego State University (SDSU) & University of California, San Diego (UCSD), Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
Explore (NY). 2013 Jul-Aug;9(4):232-43. doi: 10.1016/j.explore.2013.04.005.
Fatigue is one of the most frequently reported, distressing side effects reported by cancer survivors and often has significant long-term consequences. Research indicates that yoga can produce invigorating effects on physical and mental energy, and thereby may improve levels of fatigue. The objective of this systematic review was to examine the literature that reports the effects of randomized, controlled yoga interventions on self-reported fatigue in cancer patients and survivors. The online electronic databases, PubMed and PsycINFO, were used to search for peer-reviewed research articles studying the effects of yoga interventions on fatigue in cancer survivors. Combinations of yoga, cancer, and fatigue-related search terms were entered simultaneously to obtain articles that included all three elements. Studies were included if they met the following inclusion criteria: participants were male or female cancer patients or survivors participating in randomized, controlled yoga interventions. The main outcome of interest was change in fatigue from pre- to post-intervention. Interventions of any length were included in the analysis. Risk of bias using the format of the Cochrane Collaboration's tool for assessing risk of bias was also examined across studies.
Ten articles met inclusion criteria and involved a total of 583 participants who were predominantly female, breast cancer survivors. Four studies indicated that the yoga intervention resulted in significant reductions in self-reported fatigue from pre- to post-intervention. Three of the studies reported that there were significant reductions of fatigue among participants who attended a greater number of yoga classes. Risk of bias was high for areas of adequate selection, performance, detection, and patient-reported bias and mixed for attrition and reporting bias. Risk of bias was uniformly low for other forms of bias, including financial conflicts of interest.
Results of the studies included in this review suggest that yoga interventions may be beneficial for reducing cancer-related fatigue in women with breast cancer; however, conclusions should be interpreted with caution as a result of levels of bias and inconsistent methods used across studies. More well-constructed randomized controlled trials are needed to determine the impact of yoga interventions on fatigue in cancer patients and survivors.
疲劳是癌症幸存者最常报告的、令人痛苦的副作用之一，且通常具有重大的长期后果。研究表明，瑜伽对身心能量具有振奋作用，因此可能会改善疲劳程度。本系统评价的目的是研究报告随机对照瑜伽干预对癌症患者和幸存者自我报告疲劳影响的文献。使用在线电子数据库 PubMed 和 PsycINFO 搜索了研究瑜伽干预对癌症幸存者疲劳影响的同行评议研究文章。同时输入了瑜伽、癌症和与疲劳相关的搜索词组合，以获得包含这三个要素的文章。如果符合以下纳入标准，则将研究纳入：参与者为男性或女性癌症患者或正在参加随机对照瑜伽干预的幸存者。主要观察结果是干预前后疲劳程度的变化。纳入了任何长度的干预措施。还对研究进行了风险偏倚评估，采用了 Cochrane 协作工具评估风险偏倚的格式。
10 篇文章符合纳入标准，共涉及 583 名参与者，主要为女性，乳腺癌幸存者。四项研究表明，瑜伽干预导致自我报告的疲劳从干预前到干预后显著减少。其中三项研究报告称，参加更多瑜伽课程的参与者的疲劳感显著降低。在适当选择、执行、检测和患者报告偏倚方面的风险偏倚较高，而在失访和报告偏倚方面的风险偏倚混合。在其他形式的偏倚方面，包括财务利益冲突，风险偏倚普遍较低。
本综述中纳入的研究结果表明，瑜伽干预可能有益于减轻乳腺癌女性的癌症相关疲劳；然而，由于研究之间存在偏倚水平和方法不一致，因此应谨慎解释结论。需要更多精心设计的随机对照试验来确定瑜伽干预对癌症患者和幸存者疲劳的影响。
