Resistance Exercise and Art Therapy on Body Image in Breast Cancer: A Scoping Review

Abstract

Background: Treatments for breast cancer are invasive, causing visible changes such as loss of the breast, body weight change, and hair loss. These changes in conjunction with the pressure for women to conform to societal beauty standards may lead to body image disturbance in breast cancer survivors (BCS). The aims of this scoping review were to explore the nature, characteristics, and extent of the literature examining resistance exercise or art therapy on body image in BCS; and examine how body image is defined and measured across the studies. Methods: We searched the literature up to January 2020, which included conducting electronic searches of three major databases and checking references of screened articles. Results: Ninety-three articles were identified, 28 underwent full-text screening, with 8 studies eligible for inclusion in the review. Five randomized control trials, one hybrid effectiveness-implementation trial, and two single group studies were found. All studies showed significant within-group difference in body image scores, with two studies showing a between-group difference in favor of resistance exercise. No studies were found combining resistance exercise and art therapy. None of the studies defined the aspect of body image they wished to measure, and only one used theory to inform their research. Discussion: Preliminary evidence supports the benefit of resistance exercise and art therapy as single interventions to improve body image perception among BCS. Findings suggest the need for closer attention to the delivery format of interventions. Future research is needed that is theory-informed, with a clear definition of the aspect of body image of interest, and with body image as the primary outcome.

Feasibility and acceptability of study methods and psychosocial interventions for body image targeting women diagnosed with breast cancer: a protocol for a systematic review

“…Current intervention approaches include: psychoeducation, cognitive behavioural therapy, physical activity, art therapy, mindfulness, and expressive writing. [12][13][14] Existing reviews of such interventions focus on their effects on women's body image, which is useful to provide insight into whether psychosocial interventions for body image targeting women diagnosed with breast cancer are efficacious (or effective). Nevertheless, reviews assessing the feasibility and acceptability of interventions remain equally important because, ultimately, if an intervention is not feasible or acceptable to women, they are unlikely to access it and adhere to it, thereby directly affecting its effects on body image.…”

“…The provision of psychosocial interventions for body image targeting women diagnosed with breast cancer is a rapidly expanding area of research and practice to improve cancer care. Current intervention approaches include: psychoeducation, cognitive behavioural therapy, physical activity, art therapy, mindfulness, and expressive writing 12–14. Existing reviews of such interventions focus on their effects on women’s body image, which is useful to provide insight into whether psychosocial interventions for body image targeting women diagnosed with breast cancer are efficacious (or effective).…”

“…12 13 Reviews focusing on the effects of such interventions identified several approaches used (eg, psychoeducation, cognitive behavioural therapy, physical activity, art therapy, mindfulness, expressive writing) to improve body image. [12][13][14] Promising evidence related to the improvement of body image was found for some interventions comprising psychotherapy, psychoeducation or physical activity in women diagnosed with breast cancer. [12][13][14] However, these reviews also serve to highlight the absence of significant improvements in body image in several studies.…”

“…[12][13][14] Promising evidence related to the improvement of body image was found for some interventions comprising psychotherapy, psychoeducation or physical activity in women diagnosed with breast cancer. [12][13][14] However, these reviews also serve to highlight the absence of significant improvements in body image in several studies. Thus, despite the existence of a wide range of psychosocial interventions for body image, the authors of existing reviews emphasise the need for more research in this field.…”

“…In response, there has been a rapid increase in the number of studies delivering psychosocial interventions to women diagnosed with breast cancer with the purpose of improving body image 12 13. Reviews focusing on the effects of such interventions identified several approaches used (eg, psychoeducation, cognitive behavioural therapy, physical activity, art therapy, mindfulness, expressive writing) to improve body image 12–14. Promising evidence related to the improvement of body image was found for some interventions comprising psychotherapy, psychoeducation or physical activity in women diagnosed with breast cancer 12–14.…”