Breast cancer survivors : impact of moderate-to-vigorous exercise on cognitive impairment

Abstract

Background: Breast cancer is a global health concern that results in a substantial symptom burden from both cancer and its treatment. Cognitive impairment is a common-experienced symptom of this illness and this dissertation attempts to identify whether moderate-to vigorous exercise (MPVA) has a beneficial impact on cancer-related cognitive impairment in breast cancer survivors. Research question & PICO: Does moderate-to-vigorous exercise improve cancer-related cognitive impairment in women following breast cancer treatment? The PICO framework was developed as follows: (P) – women after primary treatment for breast cancer; (I) – moderate to vigorous exercise; (C) – no comparison; (O) – A reduction in cancer-related cognitive impairment. Method: A systematic literature review was conducted using three electronic databases and a search through relevant reference lists. Keywords, synonyms, Boolean operators, limiters, and inclusion and exclusion criteria were utilised to refine the search according to the research question. The main inclusion criteria included; individuals who completed primary treatment for breast cancer, moderate to vigorous exercise, and cognitive function as an outcome. The exclusion criteria included; individuals undergoing primary treatment, other types of exercise, and outcomes other than cognitive function. A total of four RCTs and one quasi-experimental study were retrieved and the CASP tool and the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies were used for their critical appraisal. The critical appraisal process was illustrated by a PRISMA flow diagram. Results: Although not all of the outcomes that were measured in the five key studies had statistically significant results, all of them had at least one outcome with statistically significant results. In fact, three of the RCTs and the quasi-experimental study, MVPA had a statistically significant effect on processing speed. In another RCT by Philips et al. (2016), MVPA had statistically significant effects on subjective memory impairment. Conclusions: The results show that MVPA does have an effect on cognitive dysfunction in breast cancer survivors post-primary treatment, although further research is recommended to enable concrete conclusions. Implications & Recommendations: The development of standardised evidence-based guidelines related to MVPA should be considered and patient advice based on evidence based research should be advocated that promotes MPVA in breast cancer survivors.