School of Medicine, Western Sydney University, NSW, Australia.
WNICM Health Research Institute, Western Sydney University, NSW, Australia.
Integr Cancer Ther. 2022 Jan-Dec;21:15347354221137321. doi: 10.1177/15347354221137321.
Weight gain after breast cancer is common, and obesity after breast cancer increases breast cancer recurrence and mortality. Mindfulness-based interventions (MBIs) and yoga have been shown to be effective in managing obesity/overweight in people without breast cancer. There is a need to systematically map the extent and range of evidence on yoga and MBIs for managing obesity/overweight after breast cancer in order to aid planning and commissioning of future research.
We conducted a scoping review informed by methods described by Levac et al. Five electronic databases were searched for any peer-reviewed original research (including systematic reviews) that examined the role of yoga and/or MBIs for managing overweight/obesity after breast cancer. Data were extracted on study, population, intervention, comparator and outcome characteristics, and described narratively.
We found 18 publications representing 15 unique studies (11 clinical trials, 2 systematic reviews, and 2 observational studies). There were 10 studies on yoga, and 5 on MBIs. Of the clinical trials, only 4/11 examined a weight-related outcome as the primary outcome. The remaining trials examined lifestyle or metabolic outcomes (5/11) or unrelated outcomes such as psychological health (2/11). Gaps in the literature included small sample sizes, lack of cultural diversity amongst participants, inadequate reporting of the intervention, few lifestyle co-interventions offered, lack of active comparator groups, and inadequate safety reporting.
There is a need for adequately-powered RCTs that adhere to reporting guidelines. The use of gold-standard methods for measuring outcomes, and active comparator groups, is also recommended.
乳腺癌后体重增加很常见,而乳腺癌后肥胖会增加乳腺癌复发和死亡的风险。基于正念的干预(MBIs)和瑜伽已被证明在管理非乳腺癌人群中的肥胖/超重方面是有效的。有必要系统地绘制关于瑜伽和 MBIs 管理乳腺癌后肥胖/超重的证据范围和程度,以帮助规划和委托未来的研究。
我们进行了一项范围审查,方法是借鉴 Levac 等人描述的方法。五个电子数据库被搜索了任何同行评审的原始研究(包括系统评价),这些研究考察了瑜伽和/或 MBIs 在管理乳腺癌后超重/肥胖中的作用。提取了关于研究、人群、干预、比较和结局特征的数据,并进行了叙述性描述。
我们发现了 18 篇文献,代表了 15 项独特的研究(11 项临床试验、2 项系统评价和 2 项观察性研究)。有 10 项关于瑜伽的研究,5 项关于 MBIs 的研究。在临床试验中,只有 4/11 将体重相关的结局作为主要结局进行了检验。其余的试验检验了生活方式或代谢结局(11/11)或无关结局,如心理健康(11/11)。文献中的空白包括样本量小、参与者缺乏文化多样性、干预措施报告不充分、提供的生活方式共同干预措施少、缺乏活性对照组以及缺乏充分的安全性报告。
需要进行足够大样本量的 RCT,并且要遵守报告指南。建议使用测量结局的黄金标准方法和活性对照组。