Systemic Actions of Breast Cancer Facilitate Functional Limitations

Wang, Ruizhong; Nakshatri, Harikrishna

doi:10.3390/cancers12010194

Cited by 10 publications

(10 citation statements)

References 178 publications

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“…Several types of interventions have been proposed to treat or reduce BCF, including counseling, psycho-education, physical and mind-body activity, massage therapy, acupuncture, music therapy, supplements (e.g., ginseng, vitamin D, psychostimulants), and physical exercise (13). Among these, the supervised physical exercise is supported by the strongest evidence of safety and effectiveness in reducing BCF (15)(16)(17)(18)(19). Nevertheless, the optimal exercise interventions scheme (i.e., type, combination, frequency, intensity, and duration) to reduce BCF remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Impact of Rehabilitation on Breast Cancer Related Fatigue: A Pilot Study

et al. 2020

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Breast cancer fatigue (BCF) is a complex and multidimensional condition characterized by a persistent sense of physical and/or mental stiffness, resulting in a substantial impairment of health-related quality of life in breast cancer survivors. Aim of this prospective cohort study was to evaluate the feasibility and the effectiveness of a 4-week rehabilitation protocol on BCF, muscle mass, strength, physical performance, and quality of life in breast cancer (BC) survivors. We recruited adult BC women with a diagnosis of BCF, according to the International Classification of Diseases 10 criteria, referred to the Outpatient Service for Oncological Rehabilitation of a University Hospital. All participants performed a specific physical exercise rehabilitative protocol consisting of 60-min sessions repeated 2 times/week for 4 weeks. All outcomes were evaluated at the baseline (T0), at the end of the 4-week rehabilitation treatment (T1), and at 2 months follow up (T2). The primary outcome measure was the Brief Fatigue Inventory (BFI); secondary outcomes included: Fat-Free Mass and Fat Mass, assessed by Bioelectrical Impedance Analysis (BIA); Hand Grip Strength Test (HGS); Short Physical Performance Battery (SPPB); 10-meter walking test (10 MWT); 6-min walking test (6 MWT); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Thirty-six women (mean age: 55.17 ± 7.76 years) were enrolled in the study. Significant reduction of BCF was observed both after the 4-week rehabilitation treatment (T1) (BFI: 5.4 ± 1.6 vs. 4.2 ± 1.7; p = 0.004) and at the follow-up visit (T2) (BFI: 5.4 ± 1.6 vs. 4.4 ± 1.6; p = 0.004). Moreover, significant differences (p < 0.001) HGS, SPPB, 10 MWT, 6 MWT, and EORTC QLQ-C30 were found at T1, while at T2 all the outcome measures were significantly different (p < 0.05) from the baseline. The rehabilitation protocol seemed to be feasible, safe, and effective in reducing BCF, improving muscle mass and function, and improving HRQoL in a cohort of BC survivors. The results of this study could improve awareness of this underestimated disease, suggesting the definition of a specific therapeutic exercise protocol to reduce BCF.

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Section: Introductionmentioning

confidence: 99%

Impact of Rehabilitation on Breast Cancer Related Fatigue: A Pilot Study

et al. 2020

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“…Cytokines and chemokines secreted by tumours have been associated with functional limitations/cachexia as they interfere with host immunity and myogenesis 11,12 . 13 Most of these cytokines/chemokines are upstream of and, in some cases, downstream of nuclear factor-kappaB (NF-κB) signaling. 14 Thus, muscle loss in cancer patients may be similar to age-associated muscle loss, which is accompanied with systemic inflammation and increased levels of cytokines including interleukin 1 (IL-1), IL-6, IL-10, IL-13, tumour necrosis factor alpha (TNFα), and granulocyte-macrophage colonystimulating factor.…”

Section: Introductionmentioning

confidence: 99%

“…Cytokines and chemokines secreted by tumours have been associated with functional limitations/cachexia as they interfere with host immunity and myogenesis 11,12 13 . Most of these cytokines/chemokines are upstream of and, in some cases, downstream of nuclear factor‐kappaB (NF‐κB) signaling 14 .…”

Section: Introductionmentioning

confidence: 99%

Aging‐associated skeletal muscle defects in HER2/Neu transgenic mammary tumour model

Wang

Kumar

Bhat‐Nakshatri

et al. 2020

JCSM Rapid Communications

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Background Loss of skeletal muscle volume and functional limitations are poor prognostic markers in breast cancer patients. Several molecular defects in skeletal muscle including reduced myoblast determination protein 1 (MyoD) levels and increased protein turn over due to enhanced proteosomal activity have been suggested as causes of skeletal muscle loss in cancer patients. However, it is unknown whether molecular defects in skeletal muscle are dependent on tumour aetiology. Methods We characterized functional and molecular defects of skeletal muscle in mouse mammary tumour virus (MMTV)-Neu (Neu+) mice (n = 6-12), an animal model that represents HER2 + human breast cancer, and compared the results with well-characterized luminal B breast cancer model MMTV-PyMT (PyMT+). Functional studies such as grip strength, rotarod performance, and ex vivo muscle contraction were performed to measure the effects of cancer on skeletal muscle. Expression of muscle-enriched genes and microRNAs as well as circulating cytokines/chemokines were measured. Because nuclear factor-kappaB (NF-κB) pathway plays a significant role in skeletal muscle defects, the ability of NF-κB inhibitor dimethylaminoparthenolide (DMAPT) to reverse skeletal muscle defects was examined. Results Neu+ mice showed skeletal muscle defects similar to accelerated aging. Compared with age and sex-matched wild type mice, Neu+ tumour-bearing mice had lower grip strength (202 ± 6.9 vs. 179 ± 6.8 g grip force, P = 0.0069) and impaired rotarod performance (108 ± 12.1 vs. 30 ± 3.9 s, P < 0.0001), which was consistent with reduced muscle contractibility (P < 0.0001). Skeletal muscle of Neu+ mice (n = 6) contained lower levels of CD82 + (16.2 ± 2.9 vs. 9.0 ± 1.6) and CD54 + (3.8 ± 0.5 vs. 2.4 ± 0.4) muscle stem and progenitor cells (P < 0.05), suggesting impaired capacity of muscle regeneration, which was accompanied by decreased MyoD, p53, and miR-486 expression in muscles (P < 0.05). Unlike PyMT+ mice, which showed skeletal muscle mitochondrial defects including reduced mitochondria levels and peroxisome proliferator-activated receptor gamma co-activator 1 (beta), Neu + mice displayed accelerated aging-associated changes including muscle fibre shrinkage and increased extracellular matrix deposition. Circulating 'aging factor' and cachexia and fibromyalgia-associated chemokine CC motif chemokine ligand 11 (Ccl11) was elevated in Neu+ mice (1439.56 ± 514 vs. 1950 ± 345 pg/mL, P < 0.05). Treatment of Neu+ mice with DMAPT significantly restored grip strength (205 ± 6 g force), rotarod performance (74 ± 8.5 s), reversed molecular alterations associated with skeletal muscle aging, reduced circulating Ccl11 (1083.26 ± 478 pg/mL), and improved animal survival. Conclusions These results suggest that breast cancer subtype has a specific impact on the type of molecular and structural changes in skeletal muscle, which needs to be taken into consideration while designing therapies to reduce breast cancer-induced skeletal muscle loss and functional limitations.

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“…It is safe and effective for patients at risk of breast cancer–related lymphedema and those with BCRL at all points in the life trajectory [ 14 , 20 , 21 ]. In addition, rehabilitation exercise can stimulate the release of β -endorphin, exciting the patient’s central nervous system, relieve their pain while improving sleep and mood, also can make nervous system release inhibition muscle tension and mental depression of the micro electrical stimulation, in order to eliminate or reduce fatigue [ 22 , 23 ], improve exercise compliance [ 24 ], its role in reducing breast cancer-related fatigue has been demonstrated [ 25 , 26 ]. In addition, after upper limb exercise and muscle relaxation training, the affected shoulder function and health-related quality of life were significantly improved, and early rehabilitation treatment (including range of motion of shoulder and intensive exercise) could improve the range of motion of shoulder after breast cancer surgery [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, rehabilitation exercise can stimulate the release of β -endorphin, exciting the patient’s central nervous system, relieve their pain while improving sleep and mood, also can make nervous system release inhibition muscle tension and mental depression of the micro electrical stimulation, in order to eliminate or reduce fatigue [ 22 , 23 ], improve exercise compliance [ 24 ], its role in reducing breast cancer-related fatigue has been demonstrated [ 25 , 26 ]. In addition, after upper limb exercise and muscle relaxation training, the affected shoulder function and health-related quality of life were significantly improved, and early rehabilitation treatment (including range of motion of shoulder and intensive exercise) could improve the range of motion of shoulder after breast cancer surgery [ 26 , 27 ]. Therefore, it is very important to develop a scientific functional exercise plan for breast cancer patients after surgery and urge them to carry out gradual functional exercise for the recovery of upper limb and shoulder joint function and reduce the incidence of complications.…”

Section: Introductionmentioning

confidence: 99%

Upper limb rehabilitation system based on virtual reality for breast cancer patients: Development and usability study

Zhou

Wang

et al. 2021

PLoS ONE

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Background Functional exercise is crucial for breast cancer patients after surgery, and the use of virtual reality technology to assist patients with postoperative upper limb functional rehabilitation has gradually attracted the attention of researchers. However, the usability of the developed rehabilitation system is still unknown to a large extent. The purpose of this study was to develop a virtual reality upper limb rehabilitation system for patients after breast cancer surgery and to explore its usability. Methods We built a multidisciplinary team based on virtual reality and human-computer interaction technology and designed and developed an upper limb function rehabilitation system for breast cancer patients after surgery. Breast cancer patients were recruited from a grade III-a general hospital in Changchun city for the experiment. We used the System Usability Scale to evaluate the system availability, the Presence Questionnaire scale to measure the immersive virtual reality scene, and the Simulator Sickness Questionnaire subjective measurement scale for simulator sickness symptoms. Results This upper limb rehabilitation system hardware consisted of Head-mounted Display, a control handle and notebook computers. The software consisted of rehabilitation exercises and game modules. A total of 15 patients were tested on this system, all of whom were female. The mean age was 54.73±7.78 years, and no patients were excluded from the experiment because of adverse reactions such as dizziness and vomiting. The System Usability Scale score was 90.50±5.69, the Presence Questionnaire score was 113.40±9.58, the Simulator Sickness Questionnaire-nausea score was 0.93±1.16, the Simulator Sickness Questionnaire-oculomotor score was 0.80±1.27, the Simulator Sickness Questionnaire-disorientation score was 0.80±1.27, and the Simulator Sickness Questionnaire total score was 2.53±3.40. Conclusions This study fills in the blanks regarding the upper limb rehabilitation of breast cancer patients based on virtual reality technology system usability research. As the starting point of research in the future, we will improve the system’s function and design strictly randomized controlled trials, using larger samples in the promotion, to evaluate its application in breast cancer patients with upper limbs and other physiological functions and the feasibility and effects of rehabilitation.

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Systemic Actions of Breast Cancer Facilitate Functional Limitations

Cited by 10 publications

References 178 publications

Impact of Rehabilitation on Breast Cancer Related Fatigue: A Pilot Study

Impact of Rehabilitation on Breast Cancer Related Fatigue: A Pilot Study

Aging‐associated skeletal muscle defects in HER2/Neu transgenic mammary tumour model

Upper limb rehabilitation system based on virtual reality for breast cancer patients: Development and usability study

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