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Abstract
Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients.Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326.Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15–0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19–0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15–0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28–1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08–0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43–2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20–0.68, p = 0.0004), and anxiety (MD = −4.90, 95% CI −7.83 to −1.98, p = 0.001) in breast cancer patients compared with the control group.Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.
Highlights
Breast cancer is the most commonly diagnosed cancer and being the leading cause of cancer-related mortality in female [1,2,3], the long-term survival rates after a diagnosis of breast cancer are steadily rising in recent years [4,5,6]
Tai Chi Chuan (TCC) had a positive effect on quality of life (QOL) in breast cancer patients compared with the non-exercised therapy (SMD = 0.37, 95% confidence interval (CI) 0.15–0.59, p = 0.001, I2 = 0%) (Figure 3)
Subgroup meta-analyses of 12 and 25 weeks durations showed that TCC improved QOL in breast cancer patients (12 weeks: standardized mean difference (SMD) = 0.40, 95% CI 0.19–0.62, p = 0.0003, I2 = 0%; 25 weeks: SMD = 0.38, 95% CI 0.15–0.62, p = 0.002, I2 = 0%), but meta-analyses of 3 and 6 weeks both were no statistical significance (3 weeks: SMD = 0.23, 95% CI −0.01 to 0.47, p = 0.06, I2 = 0%; 6 weeks: SMD = 0.04, 95% CI −0.52 to 0.60, p = 0.89, I2 = 0%)
Summary
Breast cancer is the most commonly diagnosed cancer and being the leading cause of cancer-related mortality in female [1,2,3], the long-term survival rates after a diagnosis of breast cancer are steadily rising in recent years [4,5,6]. Complementary therapies, especially mind-body practices, are effective approaches to manage breast cancer symptoms, and side-effects of treatment [12]. Tai Chi Chuan (TCC) and Qigong are complementary therapies involving physical and psychological aspects [19]. They are ancient Chinese mind-body exercises that both combine meditation, breathing, relaxation, and physical activity [20,21,22]. Because other forms of Qigong are different from the way of practicing TCC, this review only focused on the effects of TCC on breast cancer patients. Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients
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