What is the evidence of dance and Pilates interventions on the psychological aspects and sexual function of female breast cancer survivors? A systematic review with meta-analysis of randomized trials

Authors

  • Juliana Larissa da Silveira Altenhofen Groth Universidade do Estado de Santa Catarina https://orcid.org/0000-0003-2821-8717
  • Danielly Yani Fausto Universidade do Estado de Santa Catarina
  • Leonessa Boing Universidade do Estado de Santa Catarina
  • Julia Cristina Barcelos de Souza Universidade do Estado de Santa Catarina
  • Júlia Beatriz Bocchi Martins Universidade do Estado de Santa Catarina https://orcid.org/0000-0001-8226-0292
  • Patrícia Severo dos Santos Saraiva Universidade do Estado de Santa Catarina
  • Adriana Coutinho de Azevedo Guimarães Universidade do Estado de Santa Catarina https://orcid.org/0000-0001-5167-2921

DOI:

https://doi.org/10.47197/retos.v69.114956

Keywords:

Breast neoplasms, dance therapy, exercise, exercise and movement techniques, psychological stress

Abstract

Introduction: Breast cancer has the highest mortality rate among women worldwide. It is estimated that physical exercise can be beneficial in preventing as well as treating the disease.

Objective: To analyze dance and/or Pilates interventions and describe their effects on psychological aspects and sexual function in women who are breast cancer survivors.

Methods: The studies were identified in five databases, published between 2012 and 2023, following the PRISMA guidelines, registered in PROSPERO. The PEDro and Cochrane Rob2 scales were used to assess the quality of the studies. Effects were reported with mean differences, standard deviations and 95% confidence intervals and the I2 test was used to assess heterogeneity.

Results: Seven studies were included in the systematic review, of which six were included in the meta-analysis. In general, the studies showed no heterogeneity (I2 = 0%; p=1.00), dance showed high heterogeneity (I2 = 77%; p<0.01), Pilates showed high heterogeneity (I2 = 89%; p< 0.01). Self-esteem showed low heterogeneity (I2 = 0%; p=0.58), stress, average (I2 = 38%; p=0.18), while the variables that showed high were sexual function (I2 = 77%; p=0.01), body image (I2 = 69%; p=0.04), depressive symptoms (I2 = 68%; p=0.01) and optimism (I2 = 63%; p=0.01).

Conclusion: Both interventions proved to be efficient in psychological aspects and sexual function, however, more studies with dance and Pilates are needed for breast cancer survivors in the variables self-esteem and optimism.

References

Boing, Leonessa, de Bem Fretta, Tatiana, Stein, Francine, Lyra, Vanessa Bellani, Moratelli, Jéssica Ama-ro, da Silveira, Juliana, dos Santos Saraiva, Patrícia Severo, Bergmann, Anke, Lynch, Brigid M., & de Azevedo Guimarães, Adriana Coutinho. (2023). Can mat Pilates and belly dance be effecti-ve in improving body image, self-esteem, and sexual function in patients undergoing hormonal treatment for breast cancer? A randomized clinical trial. Archives of Women’s Mental Health. https://doi.org/10.1007/s00737-023-01294-4

Boing, Leonessa, Fretta, Tatiana de Bem, Lynch, Brigid M., Dias, Mirella, Rosa, Luciana Martins da, Bap-tista, Fátima, Bergmann, Anke, Fausto, Danielly Yani, Bocchi Martins, Julia Beatriz, & Guimarães, Adriana Coutinho de Azevedo. (2023). Mat Pilates and belly dance: Effects on pa-tient-reported outcomes among breast cancer survivors receiving hormone therapy and ad-herence to exercise. Complementary Therapies in Clinical Practice, 50, 101683. https://doi.org/10.1016/j.ctcp.2022.101683

Boing, Leonessa, Rafael, Aline Dandara, Braga, Helena de Oliveira, De Moraes, Alan de Jesus Pires, Sperandio, Fabiana Flores, & Guimarães, Adriana Coutinho de Azevedo. (2017). Dance as treatment therapy in breast cancer patients – a systematic review. Revista Brasileira de Ativid-ade Física & Saúde, 22(4), 319–331. https://doi.org/10.12820/rbafs.v.22n4p319-331

Booth, Alison, Clarke, Mike, Dooley, Gordon, Ghersi, Davina, Moher, David, Petticrew, Mark, & Stewart, Lesley. (2012). The nuts and bolts of PROSPERO: an international prospective register of sys-tematic reviews. Systematic Reviews, 1(1), 2. https://doi.org/10.1186/2046-4053-1-2

Caldwell, Karen, Adams, Marianne, Quin, Rebecca, Harrison, Mandy, & Greeson, Jeffrey. (2013). Pilates, mindfulness and somatic education. Journal of Dance & Somatic Practices, 5(2), 141–153. https://doi.org/10.1386/jdsp.5.2.141_1

Costa, Natália Silva da, Silva, Amanda Suzane Alves da, & Melo-Neto, João Simão de. (2022). Effects of dance therapy in women with breast cancer: A systematic review protocol. PLOS ONE, 17(6), e0257948. https://doi.org/10.1371/journal.pone.0257948

de Camargos, Mayara Goulart, Paiva, Bianca Sakamoto Ribeiro, de Oliveira, Marco Antônio, de Souza Ferreira, Paula, de Almeida, Vinicius Tolentino Nardoto, de Andrade Cadamuro, Sandra, de Al-meida, Carla Simone Leite, & Paiva, Carlos Eduardo. (2020). An explorative analysis of the dif-ferences in levels of happiness between cancer patients, informal caregivers and the general population. BMC Palliative Care, 19(1), 106. https://doi.org/10.1186/s12904-020-00594-1

del-Rosal-Jurado, Alicia, Romero-Galisteo, Rita, Trinidad-Fernández, Manuel, González-Sánchez, Ma-nuel, Cuesta-Vargas, Antonio, & Ruiz-Muñoz, Maria. (2020). Therapeutic Physical Exercise Post-Treatment in Breast Cancer: A Systematic Review of Clinical Practice Guidelines. Journal of Clinical Medicine, 9(4), 1239. https://doi.org/10.3390/jcm9041239

Denig, Luiza Andreatta, Boing, Leonessa, Fretta, Tatiana de Bem, Sperandio, Fabiana Flores, & Guimarães, Adriana Coutinho de Azevedo. (2022). Efeito da dança do ventre na função sexual e imagem corporal de pacientes em hormonioterapia para o câncer de mama - ensaio clínico randomizado. Fisioterapia Em Movimento, 35(spe). https://doi.org/10.1590/fm.2022.35602.0

Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629

Espíndula, Roberta Costa, Nadas, Gabriella Barbosa, Rosa, Maria Inês da, Foster, Charlie, Araújo, Flor-entino Cardoso de, & Grande, Antonio Jose. (2017). Pilates for breast cancer: A systematic re-view and meta-analysis. Revista Da Associação Médica Brasileira, 63(11), 1006–1012. https://doi.org/10.1590/1806-9282.63.11.1006

Fatkulina, Natalja, Hendrixson, Vaiva, Rauckiene-michealsson, Alona, Kievisiene, Justina, Razbadaus-kas, Arturas, & Sobrinho, Cesar Agostinis. (2021). Dance / Movement Therapy as an Interven-tion in Breast Cancer Patients : A Systematic Review. 2021.

Fretta, Tatiana de Bem, Boing, Leonessa, Baffa, Augusto do Prado, Borgatto, Adriano Ferreti, & Coutinho de Azevedo Guimarães, Adriana. (2021). Mat pilates method improve postural align-ment women undergoing hormone therapy adjunct to breast cancer treatment. Clinical trial. Complementary Therapies in Clinical Practice, 44(June), 1–7. https://doi.org/10.1016/j.ctcp.2021.101424

Giaquinto, Angela N., Sung, Hyuna, Miller, Kimberly D., Kramer, Joan L., Newman, Lisa A., Minihan, Adair, Jemal, Ahmedin, & Siegel, Rebecca L. (2022). Breast Cancer Statistics, 2022. CA: A Cancer Journal for Clinicians, 72(6), 524–541. https://doi.org/10.3322/caac.21754

He, Xiaole, Ng, Marques Shek Nam, Choi, Kai Chow, & So, Winnie Kwok Wei. (2022). Effects of a 16-week dance intervention on the symptom cluster of fatigue-sleep disturbance-depression and quality of life among patients with breast cancer undergoing adjuvant chemotherapy: A ran-domized controlled trial. International Journal of Nursing Studies, 133, 104317. https://doi.org/10.1016/j.ijnurstu.2022.104317

Higgins, Julian PT, Savović, Jelena, Page, Matthew J., Elbers, Roy G., & Sterne, Jonathan AC. (2022). As-sessing risk of bias in a randomized trial. Cochrane Handbook for Systematic Reviews of Inter-ventions Version 6.3 (Updated February 2022).; Cochrane. https://training.cochrane.org/handbook/current/chapter-08

Ho, Rainbow T. H., Fong, Ted C. T., Cheung, Irene K. M., Yip, Paul S. F., & Luk, Mai Yee. (2016). Effects of a Short-Term Dance Movement Therapy Program on Symptoms and Stress in Patients with Breast Cancer Undergoing Radiotherapy: A Randomized, Controlled, Single-Blind Trial. Journal of Pain and Symptom Management, 51(5), 824–831. https://doi.org/10.1016/j.jpainsymman.2015.12.332

Ho, Rainbow T. H., Fong, Ted C. T., & Yip, Paul S. F. (2018). Perceived stress moderates the effects of a randomized trial of dance movement therapy on diurnal cortisol slopes in breast cancer pa-tients. Psychoneuroendocrinology, 87(4), 119–126. https://doi.org/10.1016/j.psyneuen.2017.10.012

Hutton, Brian, Salanti, Georgia, Caldwell, Deborah M., Chaimani, Anna, Schmid, Christopher H., Camer-on, Chris, Ioannidis, John P. A., Straus, Sharon, Thorlund, Kristian, Jansen, Jeroen P., Mulrow, Cynthia, Catalá-López, Ferrán, Gøtzsche, Peter C., Dickersin, Kay, Boutron, Isabelle, Altman, Douglas G., & Moher, David. (2015). The PRISMA Extension Statement for Reporting of Sys-tematic Reviews Incorporating Network Meta-analyses of Health Care Interventions: Checklist and Explanations. Annals of Internal Medicine, 162(11), 777–784. https://doi.org/10.7326/M14-2385

Instituto Nacional de Câncer (INCA). (2022). Conceito e Magnitude. Ministério Da Educação. https://www.gov.br/inca/pt-br/assuntos/gestor-e-profissional-de-saude/controle-do-cancer-de-mama/conceito-e-magnitude

Islami, Farhad, Goding Sauer, Ann, Miller, Kimberly D., Siegel, Rebecca L., Fedewa, Stacey A., Jacobs, Eric J., McCullough, Marjorie L., Patel, Alpa V., Ma, Jiemin, Soerjomataram, Isabelle, Flanders, W. Dana, Brawley, Otis W., Gapstur, Susan M., & Jemal, Ahmedin. (2018). Proportion and num-ber of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: A Cancer Journal for Clinicians, 68(1), 31–54. https://doi.org/10.3322/caac.21440

Joaquim, Ana, Leão, Inês, Antunes, Pedro, Capela, Andreia, Viamonte, Sofia, Alves, Alberto J., Helguero, Luísa A., & Macedo, Ana. (2022). Impact of physical exercise programs in breast cancer survi-vors on health-related quality of life, physical fitness, and body composition: Evidence from systematic reviews and meta-analyses. Frontiers in Oncology, 12. https://doi.org/10.3389/fonc.2022.955505

Leite, Bruna, de Bem Fretta, Tatiana, Boing, Leonessa, & Coutinho de Azevedo Guimarães, Adriana. (2021). Can belly dance and mat Pilates be effective for range of motion, self-esteem, and de-pressive symptoms of breast cancer women? Complementary Therapies in Clinical Practice, 45, 101483. https://doi.org/10.1016/j.ctcp.2021.101483

Maher, Christopher G., Sherrington, Catherine, Herbert, Robert D., Moseley, Anne M., & Elkins, Mark. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physi-cal Therapy, 83(8), 713–721. http://www.ncbi.nlm.nih.gov/pubmed/12882612

McCrary, J. Matt, Redding, Emma, & Altenmüller, Eckart. (2021). Performing arts as a health resource? An umbrella review of the health impacts of music and dance participation. PLOS ONE, 16(6), e0252956. https://doi.org/10.1371/journal.pone.0252956

Mok, Jonathon, Brown, Marie-Juliet, Akam, Elizabeth C., & Morris, Mhairi A. (2022). The lasting effects of resistance and endurance exercise interventions on breast cancer patient mental wellbeing and physical fitness. Scientific Reports, 12(1), 3504. https://doi.org/10.1038/s41598-022-07446-3

Newman, Lisa A. (2022). Breast cancer screening in low and middle-income countries. Best Practice & Research Clinical Obstetrics & Gynaecology, 83, 15–23. https://doi.org/10.1016/j.bpobgyn.2022.03.018

Ortega, Miguel A., Fraile-Martínez, Oscar, García-Montero, Cielo, Pekarek, Leonel, Guijarro, Luis G., Castellanos, Alejandro J., Sanchez-Trujillo, Lara, García-Honduvilla, Natalio, Álvarez-Mon, Mel-chor, Buján, Julia, Zapico, Álvaro, Lahera, Guillermo, & Álvarez-Mon, Miguel A. (2020). Physical Activity as an Imperative Support in Breast Cancer Management. Cancers, 13(1), 55. https://doi.org/10.3390/cancers13010055

Ouzzani, Mourad, Hammady, Hossam, Fedorowicz, Zbys, & Elmagarmid, Ahmed. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 5(1), 210. https://doi.org/10.1186/s13643-016-0384-4

Pinto-Carral, Arrate, Molina, Antonio J., de Pedro, Álvaro, & Ayán, Carlos. (2018). Pilates for women with breast cancer: A systematic review and meta-analysis. Complementary Therapies in Medi-cine, 41, 130–140. https://doi.org/10.1016/j.ctim.2018.09.011

Soares Falcetta, Frederico, de Araújo Vianna Träsel, Henrique, de Almeida, Fernando Kude, Rangel Ribeiro Falcetta, Mariana, Falavigna, Maicon, & Dornelles Rosa, Daniela. (2018). Effects of physical exercise after treatment of early breast cancer: systematic review and meta-analysis. Breast Cancer Research and Treatment, 170(3), 455–476. https://doi.org/10.1007/s10549-018-4786-y

Souza, Elisa Teixeira de. (2020). Embodiment (Corporalização), Soma e Dança: alguns nexos possíveis. Revista Brasileira de Estudos Da Presença, 10(4). https://doi.org/10.1590/2237-266092446

Souza, Lizandra Ellem Silva de, Apolinário, Joelma Maria dos Santos da Silva, Farias, Anderson Fer-nandes de Carvalho, Silva, Nataly Soares da, Koproski, Ana Claudia, Moura, Layanne Cavalcante de, Moura, Lucyanna Cavalcante de, Santos, Dulcicleide Rodrigues, Henrique, Giuliano Araújo, & Barboza, Bruno Ricardo Leite. (2022). Dificuldades encontradas por pacientes portadoras do câncer de mama. Research, Society and Development, 11(5), e24311528175. https://doi.org/10.33448/rsd-v11i5.28175

Sung, Hyuna, Ferlay, Jacques, Siegel, Rebecca L., Laversanne, Mathieu, Soerjomataram, Isabelle, Jemal, Ahmedin, & Bray, Freddie. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Inci-dence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clini-cians, 71(3), 209–249. https://doi.org/10.3322/caac.21660

Viechtbauer, Wolfgang. (2010). Conducting Meta-Analyses in R with the metafor Package. Journal of Statistical Software, 36(3). https://doi.org/10.18637/jss.v036.i03

World Health Organization (WHO). (2023). Global Breast Cancer Initiative Implementation Framework Global Breast Cancer Initiative Implementation Framework.

Downloads

Published

31-07-2025

Issue

Section

Theoretical systematic reviews and/or meta-analysis

How to Cite

da Silveira Altenhofen Groth, J. L., Yani Fausto, D., Boing, L., Barcelos de Souza, J. C., Bocchi Martins, J. B., Severo dos Santos Saraiva, P., & Coutinho de Azevedo Guimarães, A. (2025). What is the evidence of dance and Pilates interventions on the psychological aspects and sexual function of female breast cancer survivors? A systematic review with meta-analysis of randomized trials. Retos, 69, 1448-1462. https://doi.org/10.47197/retos.v69.114956