{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:46:30Z","timestamp":1788799590016,"version":"build-2803163510"},"reference-count":70,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Aromatase inhibitors are prescribed in breast cancer due to their associated lower rate of cancer recurrence compared to tamoxifen. However, aromatase inhibitor\u2010induced arthralgia (AIIA) is one of the leading causes of treatment nonadherence, increasing the risk of cancer recurrence. The pathophysiology of AIIA is poorly understood, and although current recommendations for AIIA include lifestyle changes and analgesics depending on the severity of symptoms, there is no established effective treatment. The aim of this study is to explore the presentation and mechanism of AIIA and investigate the feasibility and efficacy of different exercise interventions (aerobic, resistance, aerobic and resistance combined, and yoga or tai chi) in patients with AIIA to guide the development of formal exercise prescription guidelines. Findings indicate that a mixed\u2010modality regimen of aerobic and resistance exercises is feasible and safe and may serve the most benefit in improving joint pain, functionality, and quality of life. More specifically, the weekly regimen should consist of 150\u2009min of aerobic exercise with two sessions of at least six resistance exercises, 8 to 12 repetitions, three sets each. Supplementary yoga and tai chi may be recommended twice a week depending on a patient's target symptoms. Yoga was associated with improved physical functionality, whereas tai chi was related to improvements in mental health. However, the feasibility and impact of combined aerobic and resistance exercise protocols with yoga or tai chi in our target population were not investigated in this review. The use of large, randomized controlled trials is recommended for future studies.<\/jats:p>","DOI":"10.1002\/pmrj.13193","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T13:33:06Z","timestamp":1716471186000},"page":"1406-1416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The role of exercise in aromatase inhibitor\u2010induced arthralgia"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8133-0456","authenticated-orcid":false,"given":"Kerstin","family":"Yu","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Portes","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Stephen","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Wingate University  Wingate North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation University of Miami Miller School of Medicine  Miami Florida USA"},{"name":"Mount Vernon Rehabilitation Medicine Associates  Alexandria Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Felix","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary J.","family":"Farkas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Molinares","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Tiozzo","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1604700"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61074-1"},{"issue":"4","key":"e_1_2_13_4_1","first-page":"291","article-title":"Long\u2010term efficacy and safety of anastrozole for adjuvant treatment of early breast cancer in postmenopausal women","volume":"5","author":"Gangadhara S","year":"2009","journal-title":"Ther Clin Risk Manag"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21165625"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2021.713700","article-title":"Aromatase inhibitor\u2010associated musculoskeletal syndrome: understanding mechanisms and management","volume":"12","author":"Hyder T","year":"2021","journal-title":"Front Endocrinol"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-009-0692-7"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.0261"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3747\/co.v17i1.474"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67059-6"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/20503121221078722"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/bcr2818"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt037"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2010.04.009"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-021-06368-4"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)55701-X"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-8993(97)00092-9"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22009"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.180.1.630"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0610812104"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.5435"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-006-9394-6"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-007-9774-6"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13058-015-0599-7"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2022.25.e40"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605768"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2007.10.004"},{"key":"e_1_2_13_28_1","unstructured":"ACSM.ACSM Guidelines for Exercise and Cancer.2019Available from:https:\/\/www.acsm.org\/blog-detail\/acsm-certified-blog\/2019\/11\/25\/acsm-guidelines-exercise-cancer-download"},{"key":"e_1_2_13_29_1","unstructured":"How much physical activity do adults need?2022Available from:https:\/\/www.cdc.gov\/physicalactivity\/basics\/adults\/index.htm."},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002116"},{"key":"e_1_2_13_31_1","unstructured":"CDC.Exercise or Physical Activity.2022Available from:https:\/\/www.cdc.gov\/nchs\/fastats\/exercise.htm"},{"key":"e_1_2_13_32_1","unstructured":"Experts Update Exercise Guidelines for People Treated for Cancer.2019Available from:https:\/\/www.breastcancer.org\/research-news\/updated-exercise-guidelines-for-cancer."},{"issue":"9","key":"e_1_2_13_33_1","first-page":"1484","article-title":"Physical activity levels among breast cancer survivors","volume":"36","author":"Irwin ML","year":"2004","journal-title":"Med Sci Sports Exerc"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.862078"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.2165\/11317750-000000000-00000"},{"issue":"4","key":"e_1_2_13_36_1","first-page":"540","article-title":"Endothelial function and physical exercise","volume":"111","author":"Pagan LU","year":"2018","journal-title":"Arq Bras Cardiol"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.1991.11700983"},{"issue":"5","key":"e_1_2_13_38_1","first-page":"S114","article-title":"A meta\u2010analytic review of aerobic fitness and reactivity to psychosocial stressors","volume":"19","author":"Crews DJ","year":"1987","journal-title":"Med Sci Sports Exerc"},{"key":"e_1_2_13_39_1","volume-title":"Textbook of Work Physiology: Physiological Bases of Exercise","author":"\u00c5strand P\u2010O","year":"2003"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.2006.00373.x"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2007.04.005"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2826.1999.00342.x"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1053\/beem.1999.0046"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2013.12.002"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20490"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.2147\/ciia.2006.1.3.295"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.03.010"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-199504000-00021"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-200101000-00021"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.3233\/IES-2011-0430"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2017-0174"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2018.33.4.435"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.0572"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12155"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.1547"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32051"},{"key":"e_1_2_13_57_1","first-page":"2","article-title":"Medical yoga therapy","volume":"4","author":"Stephens I","year":"2017","journal-title":"Children (Basel)"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/165410"},{"issue":"6","key":"e_1_2_13_59_1","first-page":"18","article-title":"Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial","volume":"15","author":"Saper RB","year":"2009","journal-title":"Altern Ther Health Med"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2005.11.689"},{"key":"e_1_2_13_61_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/6016532"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.18.1601"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7110404"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31979"},{"key":"e_1_2_13_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-015-3351-1"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1159\/000134301"},{"key":"e_1_2_13_67_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3756"},{"key":"e_1_2_13_68_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534735411413270"},{"issue":"6","key":"e_1_2_13_69_1","first-page":"38","article-title":"Tai chi for well\u2010being of breast cancer survivors with aromatase inhibitor\u2010associated arthralgias: a feasibility study","volume":"19","author":"Galantino ML","year":"2013","journal-title":"Altern Ther Health Med"},{"key":"e_1_2_13_70_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17186511"},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-007-9638-0"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.13193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T11:06:06Z","timestamp":1733742366000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.13193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,23]]},"references-count":70,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/pmrj.13193"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.13193","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,23]]},"assertion":[{"value":"2024-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}