Can Exercise Reduce the Autonomic Dysfunction of Patients With Cancer and Its Survivors? A Systematic Review and Meta-Analysis

Lavín-Pérez, Ana Myriam; Collado‐Mateo, Daniel; Mayo, Xián; Liguori, Gary; Humphreys, Liam; Jiménez, Alfonso

doi:10.3389/fpsyg.2021.712823

Cited by 11 publications

(14 citation statements)

References 64 publications

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“…for cancer patients and survivors. Controlled physical activity, mindfulness-based interventions and breathing exercises appear to be effective and have a positive effect on parasympathetic activity (Laborde et al, 2022;Lavín-Pérez et al, 2021;Niederer et al, 2013;Wang et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Impact of Cancer and 12 Weeks of Chemotherapy on the Balance of the Autonomic Nervous System in Cancer Patients

Bazalova¹,

Kapounková²,

Kišš

2023

StS

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Cancer and its treatment itself (especially chemotherapy) is associated with number of negative effects on the human body. These include mainly cardiac toxicity, peripheral neuropathy, bone loss, depression, anxiety, nausea, pain, cognitive changes, fatigue, fitness reduction and more. Fatigue is one of the most common negative effects, often persists long after treatment and is described as insurmountable and is associated with lower parasympathetic activity. The autonomic nervous system (ANS) is the main homeostatic regulatory system of the body, it regulates involuntary physiological processes. We believe that this part of the peripheral nervous system can be negatively affected by cancer and chemotherapy, which can have a negative impact on all the processes that control this system. Most drugs used in oncology lead to chemotherapy-induced peripheral neuropathy and are expected to have an influence on the autonomic nervous system. Activity and balance of the autonomic nervous system depend on a range of dynamically changing and quantitatively different conditions such as age, stress, physical activity, sleep, illness, fatigue and more. Methods: To evaluate ANS activity, spectral analysis of heart rate variability (HRV) was assessed. During treatment, 19 oncological patients with prescribed adjuvant chemotherapy measured HRV 3 times a week using a chest strap with a HRV monitor mySASY and mySASY software. Parasympathetic activity (PA), sympathetic activity (S), total score (TS) and total power (TP) were selected as indicators of ANS activity. The patients were women aged 50.38 ± 10,29 with BMI 25,72 ± 4,16. The mean values for the first 14 days of treatment and then for 14 days after 12 weeks of treatment were compared. Data normality was verified by Kolmogorov-Smirnov test (K-S) and static significance was calculated by t-test. All statistical tests were performed at a significance level of 5%. Results: There was a significant decrease in values for three parameters. The PA decreased from 3,80 ± 1,56 to 3,14 ± 1,67 (p = .03), TP decreased from 3,65 ± 1,87 to 2,82 ± 2,08 (p = .04), TS decreased from 3,40 ± 1,67 to 2,67 ± 1,73 (p = .01). Sympathetic activity was somewhat but not significantly higher, increased from 6,74 ± 1,22 to 6,80 ± 1,44 (p = .83). Conclusion: During the 12 weeks of treatment with adjuvant chemotherapy, there was a significant reduction in parasympathetic activity, total score, and total power. A decrease in PA is usually associated with lower regenerative abilities of the organism, a decrease in TP is associated with a decrease in the activity of the entire ANS. TS evaluates the total power and balance of both ANS branches. The higher the values, the more the body is regenerated and ready for further stress and response to stress.

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Section: Discussionmentioning

confidence: 99%

Impact of Cancer and 12 Weeks of Chemotherapy on the Balance of the Autonomic Nervous System in Cancer Patients

Bazalova¹,

Kapounková²,

Kišš

2023

StS

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“…Some studies have suggested that interventions such as exercise training may help improve HRV and autonomic function with improved cardiorespiratory fitness in cancer patients. 19,20 According to the National Institutes of Health, Yoga is one of the most commonly used complementary therapies, with emerging evidence supporting its use among adults diagnosed with cancer. 43 Yoga practice has been shown to increase the heart rate variability (HRV) by increasing activity of the parasympathetic nervous system (PNS) and reducing stress and anxiety.…”

Section: Discussionmentioning

confidence: 99%

Effects of an 18-Week Integrated Yoga Program on Cardiac Autonomic Function in Breast Cancer Patients Undergoing Adjuvant Chemotherapy: A Randomized Controlled Trial

Inbaraj,

Udupa,

Raghavendra

et al. 2023

Integr Cancer Ther

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Background: Cardiotoxicity is a commonly observed adverse effect seen in breast cancer (BC) patients undergoing chemotherapy with attributes toward cardiac autonomic dysfunction (CAD). Yoga, a mind-body system of medicine that has been shown to improve cardiac autonomic nervous system (ANS) activity in various health conditions, could be an effective adjuvant approach in addressing CAD. Objective: This study aims to investigate the protective effects of Integrated Yoga Therapy (IYT) on ANS functioning, assessed using Heart rate variability (HRV) in breast cancer patients undergoing chemotherapy. Methods: A total of 68 (stage I-III) BC patients were randomly assigned into 2 groups: Treatment as Usual group (TAU) and TAU with Yoga Therapy group (TAUYT). All patients underwent anthracycline-based adjuvant chemotherapy for a total of 6 cycles with 21 days/cycle. During chemotherapy, the TAUYT group received IYT 5 days a week for 18 weeks, compared with usual care alone in the TAU group. Resting heart rate (RHR) and HRV, measured in both the time and frequency domains, were used to assess the cardiac ANS function of each patient before and after 6 cycles of chemotherapy. Results: A total of 30 subjects in the TAU group and 29 subjects in the TAUYT group were included in the analysis. At baseline (before chemotherapy), there were no significant differences between the TAU and TAUYT groups in terms of RHR and HRV indices. However, after chemotherapy, patients in the TAU group had a significantly higher average RHR ( P < .02) and lower HRV indices with reduced parasympathetic indices: RMSSD ( P < .01), pNN50% ( P < .04), high-frequency power ( P < .001) and increased sympathetic indices: low-frequency power ( P < .001) with sympathovagal imbalance: LF/HF ( P < .001) compared with patients in the TAUYT group. Conclusion: The study showed the protective effects of yoga therapy on CAD in patients receiving anthracycline-based chemotherapy for BC, proposing yoga as a potential adjuvant intervention in improving cardiac health and preventing cardiovascular-related morbidities. Trial Registration: This trial is registered with the Clinical Trials Registry-India (CTRI) database (CTRI/2020/10/028446; October 16, 2020).

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“…Significant changes were also found in the LF and the LF/HF ratio between exercise and control groups. Also, beneficial changes may occur with resistance and endurance workouts [92].…”

Section: Exercise Practicementioning

confidence: 99%

Cardiovascular Dysautonomia in Patients with Breast Cancer

Geraldes¹,

Caldeira²,

Afonso³

et al. 2022

TOCMJ

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Breast cancer is the most frequent malignant disease among women, being responsible for a considerable percentage of fatalities and comorbidities every year. Despite advances in early detection and therapy, evidence shows that breast cancer survivors are at increased risk of developing other chronic conditions, such as cardiovascular diseases. Autonomic dysfunction is an emerging, but poorly understood topic that has been suggested as a risk factor for cardiovascular disease in breast cancer patients. It clinically manifests through persistently elevated heart rates and abnormal heart rate variability, even before any signs of cardiovascular dysfunction appear. Since changes in the left ventricular ejection fraction only manifest when myocardial injury has already occurred, it has been hypothesized that autonomic dysfunction can constitute an early biomarker of cardiovascular impairment in breast cancer patients. This review focuses on the direct and indirect effects of cancer and its treatment on the autonomic nervous system in breast cancer patients. We highlight the mechanisms potentially involved in cancer and antineoplastic therapy-related autonomic imbalance and review the potential strategies to prevent and/or attenuate autonomic dysfunction. There are gaps in the current knowledge; more research in this area is needed to identify the relevance of autonomic dysfunction and define beneficial interventions to prevent cardiovascular disease in breast cancer patients.

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Can Exercise Reduce the Autonomic Dysfunction of Patients With Cancer and Its Survivors? A Systematic Review and Meta-Analysis

Cited by 11 publications

References 64 publications

Impact of Cancer and 12 Weeks of Chemotherapy on the Balance of the Autonomic Nervous System in Cancer Patients

Impact of Cancer and 12 Weeks of Chemotherapy on the Balance of the Autonomic Nervous System in Cancer Patients

Effects of an 18-Week Integrated Yoga Program on Cardiac Autonomic Function in Breast Cancer Patients Undergoing Adjuvant Chemotherapy: A Randomized Controlled Trial

Cardiovascular Dysautonomia in Patients with Breast Cancer

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