Response to yoga protocol for treatment of breast cancer-related lymphedema
Identifieur interne : 002564 ( Pmc/Corpus ); précédent : 002563; suivant : 002565Response to yoga protocol for treatment of breast cancer-related lymphedema
Auteurs : Annette Loudon ; Tony Barnett ; Neil Piller ; Maarten A. Immink ; Andrew D. WilliamsSource :
- International Journal of Yoga [ 0973-6131 ] ; 2017.
Url:
DOI: 10.4103/0973-6131.194567
PubMed: 28149070
PubMed Central: 5225747
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Response to yoga protocol for treatment of breast cancer-related lymphedema</title><author><name sortKey="Loudon, Annette" sort="Loudon, Annette" uniqKey="Loudon A" first="Annette" last="Loudon">Annette Loudon</name><affiliation><nlm:aff id="aff1">Centre for Rural Health, University of Tasmania, Launceston, Tasmania 7250, Australia</nlm:aff></affiliation></author><author><name sortKey="Barnett, Tony" sort="Barnett, Tony" uniqKey="Barnett T" first="Tony" last="Barnett">Tony Barnett</name><affiliation><nlm:aff id="aff1">Centre for Rural Health, University of Tasmania, Launceston, Tasmania 7250, Australia</nlm:aff></affiliation></author><author><name sortKey="Piller, Neil" sort="Piller, Neil" uniqKey="Piller N" first="Neil" last="Piller">Neil Piller</name><affiliation><nlm:aff id="aff2">Department of Surgery, School of Medicine, Flinders University, Adelaide 5042, South Australia, Australia</nlm:aff></affiliation></author><author><name sortKey="Immink, Maarten A" sort="Immink, Maarten A" uniqKey="Immink M" first="Maarten A" last="Immink">Maarten A. Immink</name><affiliation><nlm:aff id="aff3">School of Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia</nlm:aff></affiliation></author><author><name sortKey="Williams, Andrew D" sort="Williams, Andrew D" uniqKey="Williams A" first="Andrew D" last="Williams">Andrew D. Williams</name><affiliation><nlm:aff id="aff4">School of Health Sciences, University of Tasmania, Launceston, Tasmania 7250, Australia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28149070</idno><idno type="pmc">5225747</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225747</idno><idno type="RBID">PMC:5225747</idno><idno type="doi">10.4103/0973-6131.194567</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">002564</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002564</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Response to yoga protocol for treatment of breast cancer-related lymphedema</title><author><name sortKey="Loudon, Annette" sort="Loudon, Annette" uniqKey="Loudon A" first="Annette" last="Loudon">Annette Loudon</name><affiliation><nlm:aff id="aff1">Centre for Rural Health, University of Tasmania, Launceston, Tasmania 7250, Australia</nlm:aff></affiliation></author><author><name sortKey="Barnett, Tony" sort="Barnett, Tony" uniqKey="Barnett T" first="Tony" last="Barnett">Tony Barnett</name><affiliation><nlm:aff id="aff1">Centre for Rural Health, University of Tasmania, Launceston, Tasmania 7250, Australia</nlm:aff></affiliation></author><author><name sortKey="Piller, Neil" sort="Piller, Neil" uniqKey="Piller N" first="Neil" last="Piller">Neil Piller</name><affiliation><nlm:aff id="aff2">Department of Surgery, School of Medicine, Flinders University, Adelaide 5042, South Australia, Australia</nlm:aff></affiliation></author><author><name sortKey="Immink, Maarten A" sort="Immink, Maarten A" uniqKey="Immink M" first="Maarten A" last="Immink">Maarten A. Immink</name><affiliation><nlm:aff id="aff3">School of Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia</nlm:aff></affiliation></author><author><name sortKey="Williams, Andrew D" sort="Williams, Andrew D" uniqKey="Williams A" first="Andrew D" last="Williams">Andrew D. Williams</name><affiliation><nlm:aff id="aff4">School of Health Sciences, University of Tasmania, Launceston, Tasmania 7250, Australia</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Yoga</title><idno type="ISSN">0973-6131</idno><idno type="eISSN">2231-2714</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Narahari, Sr" uniqKey="Narahari S">SR Narahari</name></author><author><name sortKey="Aggithaya, Mg" uniqKey="Aggithaya M">MG Aggithaya</name></author><author><name sortKey="Thernoe, L" uniqKey="Thernoe L">L Thernoe</name></author><author><name sortKey="Bose, Ks" uniqKey="Bose K">KS Bose</name></author><author><name sortKey="Ryan, Tj" uniqKey="Ryan T">TJ Ryan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Loudon, A" uniqKey="Loudon A">A Loudon</name></author><author><name sortKey="Barnett, T" uniqKey="Barnett T">T Barnett</name></author><author><name sortKey="Piller, N" uniqKey="Piller N">N Piller</name></author><author><name sortKey="Immink, Ma" uniqKey="Immink M">MA Immink</name></author><author><name sortKey="Williams, Ad" uniqKey="Williams A">AD Williams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Loudon, A" uniqKey="Loudon A">A Loudon</name></author><author><name sortKey="Barnett, T" uniqKey="Barnett T">T Barnett</name></author><author><name sortKey="Piller, N" uniqKey="Piller N">N Piller</name></author><author><name sortKey="Williams, A" uniqKey="Williams A">A Williams</name></author><author><name sortKey="Immink, Ma" uniqKey="Immink M">MA Immink</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moseley, Al" uniqKey="Moseley A">AL Moseley</name></author><author><name sortKey="Piller, Nb" uniqKey="Piller N">NB Piller</name></author><author><name sortKey="Carati, Cj" uniqKey="Carati C">CJ Carati</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Yoga</journal-id><journal-id journal-id-type="iso-abbrev">Int J Yoga</journal-id><journal-id journal-id-type="publisher-id">IJY</journal-id><journal-title-group><journal-title>International Journal of Yoga</journal-title></journal-title-group><issn pub-type="ppub">0973-6131</issn><issn pub-type="epub">2231-2714</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28149070</article-id><article-id pub-id-type="pmc">5225747</article-id><article-id pub-id-type="publisher-id">IJY-10-50</article-id><article-id pub-id-type="doi">10.4103/0973-6131.194567</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letter to Editor</subject></subj-group></article-categories><title-group><article-title>Response to yoga protocol for treatment of breast cancer-related lymphedema</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Loudon</surname><given-names>Annette</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Barnett</surname><given-names>Tony</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Piller</surname><given-names>Neil</given-names></name><xref ref-type="aff" rid="aff2">1</xref></contrib><contrib contrib-type="author"><name><surname>Immink</surname><given-names>Maarten A</given-names></name><xref ref-type="aff" rid="aff3">2</xref></contrib><contrib contrib-type="author"><name><surname>Williams</surname><given-names>Andrew D</given-names></name><xref ref-type="aff" rid="aff4">3</xref><xref ref-type="corresp" rid="cor1"></xref></contrib></contrib-group><aff id="aff1">Centre for Rural Health, University of Tasmania, Launceston, Tasmania 7250, Australia</aff><aff id="aff2"><label>1</label>Department of Surgery, School of Medicine, Flinders University, Adelaide 5042, South Australia, Australia</aff><aff id="aff3"><label>2</label>School of Health Sciences, University of South Australia, Adelaide 5000, South Australia, Australia</aff><aff id="aff4"><label>3</label>School of Health Sciences, University of Tasmania, Launceston, Tasmania 7250, Australia</aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Dr. Andrew D Williams, School of Health Science, University of Tasmania, Locked Bag 1322, Launceston, TAS 7250, Australia. E-mail: <email xlink:href="andrew.williams@utas.edu.au">andrew.williams@utas.edu.au</email></corresp></author-notes><pub-date pub-type="ppub"><season>Jan-Apr</season><year>2017</year></pub-date><volume>10</volume><issue>1</issue><fpage>50</fpage><lpage>51</lpage><permissions><copyright-statement>Copyright: © International Journal of Yoga</copyright-statement><copyright-year>2017</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.</license-p></license></permissions></article-meta></front><body><p>Dear Sir,</p><p>In their recent article, Narahari <italic>et al</italic>.[<xref rid="ref1" ref-type="bibr">1</xref>] cite and examine our article, “Yoga management of breast cancer-related lymphoedema: A randomised controlled pilot-trial”[<xref rid="ref2" ref-type="bibr">2</xref>] and make several important factual errors, the most significant of which is that they incorrectly call our publication a “Protocol for Yoga and BCRL.” In fact, the aim of our publication is quite different:</p><p>This paper presents the results for the primary outcomes of arm volume of lymphedema and extracellular fluid and the secondary outcomes of tissue induration, sensations, and their limiting effects and quality of life.[<xref rid="ref2" ref-type="bibr">2</xref>]</p><p>We believe the incorrect assumptions that Narahari <italic>et al</italic>. have made are based on their interpretation of <xref ref-type="table" rid="T1">Table 1</xref> in our publication which provided a list of the practices and postures used in our trial. This table did not provide a detailed explanation of the way the postures were carried out or of their purpose and was intended to be understood as a basic outline only. We also provided reference to the rationale for our choice of practices in an earlier publication by our team.[<xref rid="ref3" ref-type="bibr">3</xref>] Our intention is to publish the yoga protocol used in our trial which will offer the full description of how yoga was used to maximize lymphatic clearing, improve kinematic movement patterns, stability of the shoulder and lower body, improve posture, and reduce stress. Nevertheless, we shall address some of the incorrect assumptions made by Narahari <italic>et al</italic>.</p><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Brief overview of positions of Satyananda postures modified and ordered to promote lymphatic clearing. Women were also offered the choice to sit in a chair for each posture</p></caption><graphic xlink:href="IJY-10-50-g001"></graphic></table-wrap><p>Firstly, the positions of our postures and ease of movement during positional change have been misrepresented. The position in which the postures were actually carried out is given in <xref ref-type="table" rid="T1">Table 1</xref> below, reflecting ease of positional change. In addition, contrary to what Narahari <italic>et al</italic>. postulate, our practices were based on clearing the lymphatic system proximal to distal and using the breath with each movement.[<xref rid="ref3" ref-type="bibr">3</xref>] The peripheral joints of wrists, fingers, ankles, and feet were fully used, based on the method described by Moseley <italic>et al</italic>.[<xref rid="ref4" ref-type="bibr">4</xref>] Our reasoning for using the three-part yoga breath for this cohort of women will appear in our protocol publication.</p><p>As Narahari <italic>et al</italic>. point out, we did not use bhastrika. To clear the lymphatic system back into the venous system, we used the full yoga breath, chanting, and abdominal contraction with exhalation, including several postures with abdominal contraction and strong exhalation.[<xref rid="ref3" ref-type="bibr">3</xref>] The focus in our trial was on safety and as is the practice in Australia, we were conservative in our choice of pranayama techniques for this cohort of women, only two of whom had previously done yoga. We consider different cultural applications of yoga for breast cancer-related lymphedema a benefit.</p><p>Unlike our randomized controlled study, Narahari <italic>et al</italic>. provide no evidence of a control group. We stated that in comparison to the control group, there was no reduction in arm volume of lymphedema measured by circumference; however, within the yoga intervention group, there was a significant reduction. This result, we believe, would be a fairer comparison for Narahari <italic>et al</italic>. to make. One month after the completion of the yoga intervention, the significant reduction in arm volume for the yoga intervention group had changed back to the original volume and we proposed that a longer trial was needed to maintain the volume difference. As the trial of Narahari <italic>et al</italic>. was over 3 months, the reduction their women experienced adds evidence to our supposition. However, perhaps a valid comparison of these two trials is difficult as the method used by Narahari <italic>et al</italic>. to calculate arm volume was not reported. In addition, we note that yoga is only one component of the integrated intervention they offered their eight women.</p><p>While we believe that our yoga protocol has been incorrectly interpreted from the brief description in the paper discussing the primary outcomes of our pilot trial, we invite discussion with Narahari <italic>et al</italic>. on this important area of yoga. We believe the philosophy of yoga supports collaboration and unity to improve the condition of those with lymphedema who live in a variety of cultures and environments. As researchers in this field, we share with Narahari <italic>et al</italic>. our dedication to support valid research methodology to improve the lives of this cohort of people worldwide.</p><sec disp-level="2" id="sec2-1"><title>Financial support and sponsorship</title><p>This study was supported by grants from the Swan Research Institute and the Faculty of Health Sciences Seed Funding, UTAS.</p></sec><sec disp-level="2" id="sec2-2" sec-type="COI-statement"><title>Conflicts of interest</title><p>There are no conflicts of interest.</p></sec></body><back><ref-list><title>REFERENCES</title><ref id="ref1"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Narahari</surname><given-names>SR</given-names></name><name><surname>Aggithaya</surname><given-names>MG</given-names></name><name><surname>Thernoe</surname><given-names>L</given-names></name><name><surname>Bose</surname><given-names>KS</given-names></name><name><surname>Ryan</surname><given-names>TJ</given-names></name></person-group><article-title>Yoga protocol for treatment of breast cancer-related lymphedema</article-title><source>Int J Yoga</source><year>2016</year><volume>9</volume><fpage>145</fpage><lpage>55</lpage><pub-id pub-id-type="pmid">27512322</pub-id></element-citation></ref><ref id="ref2"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Loudon</surname><given-names>A</given-names></name><name><surname>Barnett</surname><given-names>T</given-names></name><name><surname>Piller</surname><given-names>N</given-names></name><name><surname>Immink</surname><given-names>MA</given-names></name><name><surname>Williams</surname><given-names>AD</given-names></name></person-group><article-title>Yoga management of breast cancer-related lymphoedema: A randomised controlled pilot-trial</article-title><source>BMC Complement Altern Med</source><year>2014</year><volume>14</volume><fpage>214</fpage><pub-id pub-id-type="pmid">24980836</pub-id></element-citation></ref><ref id="ref3"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Loudon</surname><given-names>A</given-names></name><name><surname>Barnett</surname><given-names>T</given-names></name><name><surname>Piller</surname><given-names>N</given-names></name><name><surname>Williams</surname><given-names>A</given-names></name><name><surname>Immink</surname><given-names>MA</given-names></name></person-group><article-title>Using yoga in breast cancer-related lymphoedema</article-title><source>J Lymphoedema</source><year>2012</year><volume>7</volume><fpage>27</fpage><lpage>36</lpage></element-citation></ref><ref id="ref4"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Moseley</surname><given-names>AL</given-names></name><name><surname>Piller</surname><given-names>NB</given-names></name><name><surname>Carati</surname><given-names>CJ</given-names></name></person-group><article-title>The effect of gentle arm exercise and deep breathing on secondary arm lymphedema</article-title><source>Lymphology</source><year>2005</year><volume>38</volume><fpage>136</fpage><lpage>45</lpage><pub-id pub-id-type="pmid">16353491</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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