Effect of Chinese Traditional Wushu on Cancer-Related Fatigue, Sleep Quality and Upper Limb Dysfunction of Breast Cancer Survivors: A Systematic Review and Meta-Analysis

Abstract

Objective. This study is aimed at evaluating the effect of Chinese traditional Wushu (CTW) on cancer-related fatigue (CRF), sleep quality, and upper limb dysfunction. Data Sources. We searched studies containing randomized controlled trials up to July 2021 in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database, and China Biological Medicine on this topic. Methods. A randomized controlled trial of CTW on major outcome indicators such as CRF, sleep quality, and upper limb dysfunction of breast cancer survivors. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Stata 16.0 software. The quality of the evidence was assessed by the Cochrane Collaboration Risk of Bias (ROB2.0). Results. Eighteen studies met the requirements for meta-analysis ( $n=1331$ ). We found that CTW has no obvious effect on improving breast cancer survivors’ CRF ( $\text{SMD}=-0.733$ ; $P=0.059$ ; $I^2=89.3$ %), but it can effectively improve their sleep quality ( $\text{WMD}=-2.266$ ; $P=0.022$ ; $I^2=99.2$ %) and upper limb dysfunction ( $\text{SMD}=1.262$ ; $P\le 0.001$ ; $I^2=88.5$ %). Conclusion. Although more studies on this topic are needed to prove the effectiveness of this method, the results of our review show that CTW is significantly helpful for better sleep and upper limb dysfunction. But the effects on CRF will need to be confirmed further. Implications for Cancer Survivors. In the future intervention process, to verify the effectiveness of CTW on improving CRF for breast cancer survivors, it would be suggested to pay close attention to breast cancer survivors’ response to exercise, achieve regular follow-up, strictly conduct the intervention scheme on the premise of ensuring absolute security, and reduce the loss of intervention objects.