Progressive Relaxation Training in Breast Cancer Patients Receiving Aromatatase Inhibitor Therapy

NCT ID: NCT04163692

Last Updated: 2021-04-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-25

Study Completion Date

2020-09-24

Brief Summary

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This study evaluates the effects of progressive relaxation exercises on artralgia, quality of life and anxiety-deppression in breast cancer patients receiving aromatase inhibitor. Half of the participants will receive supervised progressive relaxing exercises, while other half will not receive any exercise but only advice about relaxing.

Hypothesis: Progressive relaxation exercises improve the pain, quality of life and emotional status in breast cancer patients receiving aromatase inhibitor therapy.

Detailed Description

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Aromatase inhibitors (AI) can cause musculoskeletal problems and increased risk of fracture as side effects in breast cancer (BC) survivors. In particular, arthralgia can be observed in almost 50% of patients receiving AI. Moreover; cognitive dysfunctions , decreases in quality of life , anxiety and depression , sleep problems and fatigue can be seen in some of patients receiving AI. According to these possible side effects, evaluation and treatment of such health profiles, pain and symptoms is important in terms of improving the quality of life of the patients.

Progressive muscle relaxation exercises (PRE) were first described by Jacobson in 1938. PRE are in use today with different arrangements and updates. It was well defined physiological, perceptual and behavioral positive findings of muscle relaxation.

PRE was thought to be effective on artralgia, quality of life and anxiety-depression in BC survivors receiving AI.

The patients have been searched from the medical records of brest health center in a local hospital. Necessary permissions to use this data was provided from medical coordinator of the hospital and from the coordinator of Breast Health Center.

The study was conducted as two armed, assessor blinded and randomised controlled trial. BC survivors who are receiving AI were randomised to study (performed PRE) or control (no intervention) group. Eligible patients were provided information about the the study and invited to participate in study via phone call. All assessments and exercise training was carried out in Physiotherapy Department of the same hospital. Outcomes were assessed baseline and at 6th-week intervention Primary endpoint was pain assessment assessed by Brief Pain inventory. Secondary endpoints were quality of life assessed by Functional Assessment of Chronic Illness Therapy and emotional status by Hospital Anxiety and Depression scales.

Statistical analysis Sample size was calculated by using a previous study mentioned the impact of yoga on functional outcomes in breast cancer survivors with aromatase inhibitor-associated arthralgias. The mean and standart deviation data of the FACT-B parameter was used with the power (1-type II error) of 0.80 and a type I error of 0.05. Therefore, it was aimed to recruit at least 20 participants per group. In total, with dropout rate of 30%, it was estimated to recruit 26 patients in each group.

Mean \[95% confidence intervals (CI)\], standard deviations and frequency rates was analyzed for baseline charecteristics. Group distributions were examined with the Kolmogorov Simirnov test. Groups analysis were performed using the non parametric test methods due to the low number of participants. Mann-Whitney U test for the analysis of quantitative independent data, and Wilcoxon test was used for the analysis of dependent data. Mc-Nemar Test was used for dependent variables and Chi-Square test was used for independent variables in the analysis of qualitative data. Cohen's Formula used for calculating efect size of differences between and within the groups. Figures are performed by the SPSS graphics. P value \<0.05 was considered as significant.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A computer generated list of random sequence numbers was created with 1:1 allocation ratio to randomise participants into study or control groups. Randomisation sequence was concealed until assignment of interventions. The group allocation was made by study researcher who implemented the PRE.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Exercise Group

Progressive relaxation exercises (PRE) as 1 day supervised and 3 days home based program in a week, for 6 weeks

Group Type EXPERIMENTAL

Progressive relaxation exercises

Intervention Type OTHER

Following intructions have been performed by patients:

* Punch your hands and contract your forearm
* Punch your hands, push your elbow towards the seat
* Bend your elbows
* Push your shoulders back
* Press your knee down and pull your toes towards you
* Pull your knees towards you and push your feet down
* Tighten your hips
* Push your head back
* Lift your eyebrows
* Make wrinkles on your nose
* Tighten your teeth
* Push your chin down
* Close your eyes and think of good things.

Control Group

Information was provided about pain and its treatment and the importance of relaxing exercises without any intervention, up to 6 weeks.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Progressive relaxation exercises

Following intructions have been performed by patients:

* Punch your hands and contract your forearm
* Punch your hands, push your elbow towards the seat
* Bend your elbows
* Push your shoulders back
* Press your knee down and pull your toes towards you
* Pull your knees towards you and push your feet down
* Tighten your hips
* Push your head back
* Lift your eyebrows
* Make wrinkles on your nose
* Tighten your teeth
* Push your chin down
* Close your eyes and think of good things.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Using Aromatase Inhibitors for more than 6 months
* Diagnosis of breast cancer stage 1-3
* Postmenopausal woman aged under 70 years and with hormone-receptor positive
* Approval of physician for participating in PRE program

Exclusion Criteria

* Participation on a regular physical training in the previous 6 months period
* Communication problems
* Neurological or ortopedical problems
* Presence of lyphedema diagnosis
Minimum Eligible Age

30 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Hacettepe University

OTHER

Sponsor Role lead

Responsible Party

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Umut Bahçacı

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Umut Bahcacı, MSc

Role: PRINCIPAL_INVESTIGATOR

Florence Nightingale Hospital, Istanbul

Zeynep Erdoğan İyigün, Asst. Prof.

Role: PRINCIPAL_INVESTIGATOR

Florence Nightingale Hospital, Istanbul

Songul Atasavun Uysal, Prof.

Role: PRINCIPAL_INVESTIGATOR

Hacettepe University

Çetin Ordu, Asst. Prof.

Role: PRINCIPAL_INVESTIGATOR

Florence Nightingale Hospital, Istanbul

Vahit Özmen, Prof.

Role: STUDY_CHAIR

Florence Nightingale Hospital, Istanbul

Gürsel Remzi Soybir, Prof.

Role: STUDY_CHAIR

Memorial Etiler Health Center

Locations

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Florence Nightingale Hospital

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Cuzick J, Sestak I, Forbes JF, Dowsett M, Knox J, Cawthorn S, Saunders C, Roche N, Mansel RE, von Minckwitz G, Bonanni B, Palva T, Howell A; IBIS-II investigators. Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet. 2014 Mar 22;383(9922):1041-8. doi: 10.1016/S0140-6736(13)62292-8. Epub 2013 Dec 12.

Reference Type BACKGROUND
PMID: 24333009 (View on PubMed)

Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet. 2015 Oct 3;386(10001):1341-1352. doi: 10.1016/S0140-6736(15)61074-1. Epub 2015 Jul 23.

Reference Type BACKGROUND
PMID: 26211827 (View on PubMed)

Mincey BA, Duh MS, Thomas SK, Moyneur E, Marynchencko M, Boyce SP, Mallett D, Perez EA. Risk of cancer treatment-associated bone loss and fractures among women with breast cancer receiving aromatase inhibitors. Clin Breast Cancer. 2006 Jun;7(2):127-32. doi: 10.3816/CBC.2006.n.021.

Reference Type BACKGROUND
PMID: 16800971 (View on PubMed)

Bender CM, Sereika SM, Brufsky AM, Ryan CM, Vogel VG, Rastogi P, Cohen SM, Casillo FE, Berga SL. Memory impairments with adjuvant anastrozole versus tamoxifen in women with early-stage breast cancer. Menopause. 2007 Nov-Dec;14(6):995-8. doi: 10.1097/gme.0b013e318148b28b.

Reference Type BACKGROUND
PMID: 17898668 (View on PubMed)

Cella D, Fallowfield L, Barker P, Cuzick J, Locker G, Howell A; ATAC Trialistsa9 Group. Quality of life of postmenopausal women in the ATAC ("Arimidex", tamoxifen, alone or in combination) trial after completion of 5 years' adjuvant treatment for early breast cancer. Breast Cancer Res Treat. 2006 Dec;100(3):273-84. doi: 10.1007/s10549-006-9260-6. Epub 2006 Jun 21.

Reference Type BACKGROUND
PMID: 16944295 (View on PubMed)

Breckenridge LM, Bruns GL, Todd BL, Feuerstein M. Cognitive limitations associated with tamoxifen and aromatase inhibitors in employed breast cancer survivors. Psychooncology. 2012 Jan;21(1):43-53. doi: 10.1002/pon.1860. Epub 2010 Oct 21.

Reference Type BACKGROUND
PMID: 20967847 (View on PubMed)

So WK, Marsh G, Ling WM, Leung FY, Lo JC, Yeung M, Li GK. The symptom cluster of fatigue, pain, anxiety, and depression and the effect on the quality of life of women receiving treatment for breast cancer: a multicenter study. Oncol Nurs Forum. 2009 Jul;36(4):E205-14. doi: 10.1188/09.ONF.E205-E214.

Reference Type BACKGROUND
PMID: 19581224 (View on PubMed)

Related Links

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Other Identifiers

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PREBCA

Identifier Type: -

Identifier Source: org_study_id

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