School of Health Sciences, University of Tasmania, Launceston, Australia.
BMC Complement Altern Med. 2014 Jul 1;14:214. doi: 10.1186/1472-6882-14-214.
Secondary arm lymphoedema continues to affect at least 20% of women after treatment for breast cancer requiring lifelong professional treatment and self-management. The holistic practice of yoga may offer benefits as an adjunct self-management option. The aim of this small pilot trial was to gain preliminary data to determine the effect of yoga on women with stage one breast cancer-related lymphoedema (BCRL). This paper reports the results for the primary and secondary outcomes.
Participants were randomised, after baseline testing, to receive either an 8-week yoga intervention (n = 15), consisting of a weekly 90-minute teacher-led class and a 40-minute daily session delivered by DVD, or to a usual care wait-listed control group (n = 13). Primary outcome measures were: arm volume of lymphoedema measured by circumference and extra-cellular fluid measured by bioimpedance spectroscopy. Secondary outcome measures were: tissue induration measured by tonometry; levels of sensations, pain, fatigue, and their limiting effects all measured by a visual analogue scale (VAS) and quality of life based on the Lymphoedema Quality of Life Tool (LYMQOL). Measurements were conducted at baseline, week 8 (post-intervention) and week 12 (four weeks after cessation of the intervention).
At week 8, the intervention group had a greater decrease in tissue induration of the affected upper arm compared to the control group (p = 0.050), as well as a greater reduction in the symptom sub-scale for QOL (p = 0.038). There was no difference in arm volume of lymphoedema or extra-cellular fluid between groups at week 8; however, at week 12, arm volume increased more for the intervention group than the control group (p = 0.032).
An 8-week yoga intervention reduced tissue induration of the affected upper arm and decreased the QOL sub-scale of symptoms. Arm volume of lymphoedema and extra-cellular fluid did not increase. These benefits did not last on cessation of the intervention when arm volume of lymphoedema increased. Further research trials with a longer duration, higher levels of lymphoedema and larger numbers are warranted before definitive conclusions can be made.
乳腺癌治疗后，至少有 20%的女性会出现继发性手臂淋巴水肿，需要终身接受专业治疗和自我管理。整体瑜伽练习可能作为一种辅助自我管理选择带来益处。本小型试验旨在获得初步数据，以确定瑜伽对患有一期乳腺癌相关淋巴水肿（BCRL）的女性的影响。本文报告了主要和次要结局的结果。
参与者在基线测试后随机分为接受 8 周瑜伽干预（n=15）或常规护理等待对照组（n=13）。瑜伽干预包括每周一次 90 分钟的教师主导课程和通过 DVD 进行的每日 40 分钟课程。主要结局测量是：淋巴水肿手臂体积（通过周长测量）和细胞外液（通过生物阻抗光谱测量）。次要结局测量是：组织硬度（通过张力计测量）；感觉、疼痛、疲劳水平及其限制作用（均通过视觉模拟量表（VAS）测量）和基于淋巴水肿生活质量工具（LYMQOL）的生活质量。测量在基线、第 8 周（干预后）和第 12 周（干预停止四周后）进行。
第 8 周时，与对照组相比，干预组患侧上臂的组织硬度下降更大（p=0.050），生活质量症状子量表的改善更大（p=0.038）。两组在第 8 周时手臂淋巴水肿体积或细胞外液无差异；然而，第 12 周时，干预组手臂淋巴水肿体积的增加大于对照组（p=0.032）。
8 周瑜伽干预减少了患侧上臂的组织硬度，降低了生活质量症状子量表。手臂淋巴水肿体积和细胞外液没有增加。干预停止后，这些益处没有持续，手臂淋巴水肿体积增加。需要进行持续时间更长、淋巴水肿程度更高、样本量更大的进一步研究试验，才能得出明确结论。
