The Effects Of Exercise On The Quality Of Life Of Patients With Breast Cancer: A Systematic Review And Meta-analysis Based On The QLQ-C30 Quality Of Life Scale Part 2
Sep 14, 2023
The effect of exercise on the improvement of fatigue symptoms in patients with BC
Cistanche can act as an anti-fatigue and stamina enhancer, and experimental studies have shown that the decoction of Cistanche tubulosa could effectively protect the liver hepatocytes and endothelial cells damaged in weight-bearing swimming mice, upregulate the expression of NOS3, and promote hepatic glycogen synthesis, thus exerting anti-fatigue efficacy. Phenylethanoid glycoside-rich Cistanche tubulosa extract could significantly reduce the serum creatine kinase, lactate dehydrogenase, and lactate levels, and increase the hemoglobin (HB) and glucose levels in ICR mice, and this could play an anti-fatigue role by decreasing the muscle damage and delaying the lactic acid enrichment for energy storage in mice. Compound Cistanche Tubulosa Tablets significantly prolonged the weight-bearing swimming time, increased the hepatic glycogen reserve, and decreased the serum urea level after exercise in mice, showing its anti-fatigue effect. The decoction of Cistanchis can improve endurance and accelerate the elimination of fatigue in exercising mice, and can also reduce the elevation of serum creatine kinase after load exercise and keep the ultrastructure of skeletal muscle of mice normal after exercise, which indicates that it has the effects of enhancing physical strength and anti-fatigue. Cistanchis also significantly prolonged the survival time of nitrite-poisoned mice and enhanced the tolerance against hypoxia and fatigue.
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The results of the heterogeneity test of the included studies were I2 =67.18%, P=0.01. Therefore, a random effects model was used for meta-analysis. The results showed that after some time and intensity of exercise, the fatigue symptoms of BC patients were significantly lighter than those of the control group who did not exercise (Hedges’s g =−0.51, 95% CI: −0.84, −0.19, Figure 10). The sensitivity analysis demonstrated that the sequential removal of individual studies did not produce significant changes in the overall effect size, indicating the stability and consistency of the results.
The effect of exercise on the improvement of nausea and vomiting symptoms in patients with BC
The results of the heterogeneity test of the included studies were I2 =45.79%, P=0.01. The results showed that after a period of exercise and intensity, the symptoms of nausea and vomiting in patients with BC were significantly lighter than those in the control group who did not exercise (Hedges’s g =−0.35, 95% CI: −0.60, −0.10, Figure 11). The sensitivity analysis revealed that the stepwise removal of individual studies did not lead to significant alterations in the overall effect size. This indicates that the results remained relatively stable and consistent throughout the analysis.
The effect of exercise on the improvement of pain symptoms in patients with BC
The results of the heterogeneity test of the included studies were I2 =88.41%, P<0.001. Therefore, a random effects model was used for meta-analysis. The results showed that after some time and intensity of exercise, there was no significant difference in pain symptoms between BC patients and control patients who did not exercise (Hedges’s g =−0.37, 95% CI: −0.92, 0.18, Figure 12). The sensitivity analysis indicated that the exclusion of studies one by one did not have a substantial impact on the overall effect size, suggesting that the results remained relatively stable and consistent.
The effect of exercise on the improvement of dyspnea symptoms in patients with BC
The results of the heterogeneity test of the included studies were I2 =61.41%, P=0.03, so the random effect model was used for meta-analysis. The results showed that after a certain period of exercise and intensity, the symptoms of dyspnea in patients with BC were significantly lighter than those in the control group who did not exercise (Hedges’s g =−0.37, 95% CI: −0.67, −0.07, Figure 13). The sensitivity analysis indicated that the systematic removal of studies individually did not result in significant changes to the overall effect size, highlighting the stability and consistency of the findings.
The effect of exercise on the improvement of insomnia symptoms in patients with BC
The results of the heterogeneity test of the included studies were I2 =65.71%, P<0.001. Therefore, a random effects model was used for meta-analysis. The results showed that after a certain period of exercise and intensity, the symptoms of insomnia in patients with BC were significantly lighter than those in the control group who did not exercise (Hedges’s g =−0.59, 95% CI: −0.91, −0.26, Figure 14). The sensitivity analysis conducted by systematically excluding studies one by one demonstrated that the overall effect size remained largely unaffected, suggesting the robustness and stability of the results.
The effect of exercise on improving the symptoms of loss of appetite in patients with BC
The results of the heterogeneity test of the included studies were I2 =96.69%, P<0.001. Therefore, a random effects model was used for meta-analysis. The results showed that after some time and intensity of exercise, there was no significant difference in the symptoms of loss of appetite between BC patients and control patients who did not exercise (Hedges’s g =−0.71, 95% CI: −1.76, 0.34, Figure 15). The sensitivity analysis revealed that the incremental removal of individual studies did not have a substantial impact on the magnitude of the overall effect value. These findings indicate that the results remained relatively stable and consistent across the analysis.
The effect of exercise on the improvement of constipation symptoms in patients with BC
The results of the heterogeneity test of the included studies were I2 =0.00%, P=0.77. The results showed that after some time and intensity of exercise, there was no significant difference in constipation symptoms between BC patients and control patients who did not exercise (Hedges’s g =−0.13, 95% CI: −1.28, 0.02, Figure 16). The sensitivity analysis indicated that the exclusion of individual studies, performed in a stepwise manner, had minimal influence on the overall effect size. This suggests that the results remained stable and consistent throughout the analysis.
The effect of exercise on the improvement of diarrhea in patients with BC
The heterogeneity test conducted on the included studies demonstrated a negligible level of heterogeneity (I2=0.00%, P=0.59). The results showed that after exercise, there was no significant difference in diarrhea symptoms between BC patients and control patients who did not exercise (Hedges’s g =−0.10, 95% CI: −0.26, 0.06, Figure 17). The sensitivity analysis demonstrated that the removal of individual studies had negligible impact on the overall effect size, suggesting the stability and consistency of the results.
Exercise improves the economic status of BC patients
The heterogeneity test conducted on the included studies revealed moderate heterogeneity (I2 =60.54%, P=0.02). Therefore, a random effects model was used for meta-analysis. The results showed that after some time and intensity of exercise, the economic difficulties of BC patients were significantly lighter than those of the control group who did not exercise, and the difference was statistically significant (Hedges’s g =−0.48, 95% CI: −0.78, −0.18, Figure 18). The sensitivity analysis revealed that the exclusion of individual studies did not substantially alter the magnitude of the overall effect, indicating the stability and robustness of the results.
Publication bias
The funnel plot showed slight asymmetry (Figure 19). We speculated that there may be some publication bias, but it was difficult to quantify.
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