Efeitos da prática de Yoga sobre a fadiga relacionada ao câncer de pacientes em tratamento primário para câncer de mama: um ensaio clínico randomizado

Abstract

The aim of this dissertation was to analyze the effects of a Yoga program, compared to a control group, on physical and psychological outcomes of patients diagnosed with breast cancer undergoing treatment by the Unified Health System (SUS) in the city of Pelotas-RS. For this purpose, nine women were randomized in Yoga group (n = 5) or control group (n = 4). The participants of the Yoga group (GY) were subjected to a Yoga program, associated with health education, twice a week for eight weeks, each session lasting 60 minutes. The control group (CG) only participated in health education meetings, once a week, also for eight weeks and with 60-minute meetings. Assessments of cancer-related fatigue were performed, quality of life, pain, functional capacity and level of leisure-time physical activity pre (week 0) and post-intervention (week 9). To analyze the data, the test was used Generalized Estimating Equations (GEE) and post-hoc of Bonferroni (α=0,05). Per protocol (PP) and intention-to-treat (ITT) statistical analyses were performed. In total fatigue, a significant effect was observed in the group*time interaction in the analysis PP (p=0.039) and borderline significance in the ITT analysis (p=0.080). After eight weeks, a reduction of 38.1 ± 27.1% in fatigue was observed in the GY from pre to post, with no change in the GC. Quality of life in the physical well-being domain showed a significant effect in the group*time interaction in the PP analysis (p=0.001). There was a 6.1 ± 5.4% reduction in quality of life in GY and an 11.4 ± 10.6% increase in quality of life in CG after eight weeks. Pain perception did not change after eight weeks in either group. For functional capacity, in the 6-minute walk test, the PP and ITT analyses indicated a significant effect in the group*time interaction (PP: p = 0.035 e ITT: p = 0.046). Only GY improved 22.3 ± 19.1% from pre-to post-intervention, with no differences compared to CG. In the sit and stand tests (PP e ITT: p <0.001) and elbow flexion (PP: p = 0.018; ITT: p = 0.036), there was a significant increase 165.5 ± 586.4% and 13.4 ± 24.1% respectively in the number of repetitions from the pre- to the post-intervention moment, regardless of the group. For the level of leisure-time physical activity, an increase of 115.4 ± 203.0% in leisure-time physical activity time was observed from pre- to post-intervention, independent of the group (PP: p = 0.007; ITT: p <0.001). The results of this dissertation indicate that the practice of Yoga associated with health education significantly reduced fatigue levels and improved the aerobic capacity of patients undergoing treatment for breast cancer.