Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J, Woodard S, Wells G, Reid R
Department of Medical Oncology, Ottawa Regional Cancer Centre, Ottawa, Ontario, Canada.
J Clin Oncol. 2001 Feb 1;19(3):657-65. doi: 10.1200/JCO.2001.19.3.657.
Self-directed and supervised exercise were compared with usual care in a clinical trial designed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer.
One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life, aerobic capacity, and body weight. Participants were randomly allocated to one of three intervention groups: usual care (control group), self-directed exercise, or supervised exercise. Quality of life, aerobic capacity, and body weight measures were repeated at 26 weeks. The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks.
Physical functioning in the control group decreased by 4.1 points, whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups, respectively (P =.04). Post hoc analysis showed a moderately large (and clinically important) difference between the self-directed and control groups (9.8 points; P =.01) and a more modest difference between the supervised and control groups (6.3 points; P =.09). No significant differences between groups were observed for changes in quality of life scores. In a secondary analysis of participants stratified by type of adjuvant therapy, supervised exercise improved aerobic capacity (+3.5 mL/kg/min; P =.01) and reduced body weight (-4.8 kg; P <.05) compared with usual care only in participants not receiving chemotherapy.
Physical exercise can blunt some of the negative side effects of breast cancer treatment, including reduced physical functioning. Self-directed exercise is an effective way to improve physical functioning compared with usual care. In participants not receiving chemotherapy, supervised exercise may increase aerobic capacity and reduce body weight compared with usual care.
在一项旨在评估结构化运动对I期和II期乳腺癌女性身体功能及健康相关生活质量其他方面影响的临床试验中，对自我指导运动和监督运动与常规护理进行比较。
123名I期和II期乳腺癌女性完成了一般健康相关生活质量、疾病及部位特异性健康相关生活质量、有氧能力和体重的基线评估。参与者被随机分配到三个干预组之一：常规护理（对照组）、自我指导运动或监督运动。在26周时重复进行生活质量、有氧能力和体重测量。主要结局是基线至26周期间简短健康调查问卷-36身体功能量表的变化。
对照组的身体功能下降了4.1分，而自我指导运动组和监督运动组分别增加了5.7分和2.2分（P = 0.04）。事后分析显示，自我指导运动组与对照组之间存在中度较大（且具有临床意义）的差异（9.8分；P = 0.01），监督运动组与对照组之间的差异较小（6.3分；P = 0.09）。各小组间生活质量得分的变化未观察到显著差异。在按辅助治疗类型分层的参与者的二次分析中，与仅接受常规护理相比，监督运动仅在未接受化疗的参与者中提高了有氧能力（+3.5毫升/千克/分钟；P = 0.01）并减轻了体重（-4.8千克；P < 0.05）。
体育锻炼可以减轻乳腺癌治疗的一些负面副作用，包括身体功能下降。与常规护理相比，自我指导运动是改善身体功能的有效方法。在未接受化疗的参与者中，与常规护理相比，监督运动可能会提高有氧能力并减轻体重。
