Etude de faisabilité SKYPE « Suivi en Kinésithérapie et Yoga - Projet Educatif » auprès de patientes présentant des douleurs dues à l’hormonothérapie après un cancer du sein
Physiotherapy, Yoga and Educational Project for Patients Suffering from Pain Due to Hormone Therapy after Breast Cancer: The SKYPE Feasibility Study
Abstract
Approximately 50% of breast cancer patients under hormone therapy experience osteoarticular pain, which increases the risk of treatment discontinuation and relapse. The aim of the study was to assess the feasibility of yoga practice associated with patient education (PE) for at-home practice in breast cancer patients under hormone therapy. We also evaluated osteoarticular pain, flexibility and patients’ satisfaction. In this study, intervention was split into two 6-week periods (P): P1 consisting of a supervised yoga-PE session of 90 minutes/week and 15-minutes of daily at-home yoga, and P2, involving daily autonomous athome yoga sessions. Feasibility was evaluated by patient adherence defined as completion of at least 4 out of the 6 supervised yoga-PE sessions and 70% or more of the at-home yoga sessions. Evaluations (at inclusion and at the end of each period) consisted in assessment of osteoarticular pain, forward flexibility and patient satisfaction. Twenty-four women with a median age of 53 years [36–72] were included. Feasibility was validated with a successful adherence rate reaching 83%, combined with a mean satisfaction score of 10/10 [8–10]. In addition, 58% of patients reported reduced osteoarticular pain, with a 2-point reduction on the numerical rating scale. The forward flexibility also improved, with a median gain of 8 cm. Combined physiotherapy-yoga-PE intervention is a feasible strategy, increasing at-home yoga practice with potential benefit on pain, flexibility, and patient satisfaction. Evaluation of this innovative program is ongoing in a larger randomized multicenter trial.
Résumé
Environ la moitié des patientes traitées par hormonothérapie (HT) après un cancer du sein souffrent de douleurs ostéo-articulaires, ce qui augmente les interruptions de traitement et les risques de récidives. Notre objectif était de montrer la faisabilité et l’adhésion des patientes à un programme de kinésithérapie-yoga basé sur l’apprentissage d’une pratique quotidienne de yoga et d’évaluer l’évolution de la douleur, la souplesse et la satisfaction. La faisabilité était évaluée par l’assiduité à au moins 4/6 séances encadrées et 70% de la pratique autonome. L’intervention se déroulait sur deux périodes (P) de 6 semaines : P1 comprenant une séance hebdomadaire de yoga encadrée par une kinésithérapeute et 15 minutes de yoga en autonomie et P2, 15 minutes de yoga/jour en autonomie. Les évaluations ont eu lieu à l’inclusion et à la fin de chaque période. Nous avons inclus 24 patientes d’âge médian de 53 ans [range 36–72]. La faisabilité a été validée avec une adhésion à 83%. La douleur a diminué de 2 points sur l’échelle numérique (EN) pour 58% des patients. La souplesse s’est améliorée, le gain médian était de 8 cm. La satisfaction médiane était de 10/10 [range 8–10]. L’intervention combinée de kinésithérapie-yoga-éducation thérapeutique du patient est une stratégie faisable pour augmenter la pratique de yoga autonome. Il y a potentiellement des bénéfices sur la douleur, la souplesse et la satisfaction, ce qui est en cours d’évaluation dans une étude randomisée, multicentrique.
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