步行干预对实体瘤治疗患者心肺适能、自我报告的身体功能及疼痛的影响
Impact of a walking intervention on cardiorespiratory fitness, self-reported physical function, and pain in patients undergoing treatment for solid tumors.
作者信息
Griffith Kathleen, Wenzel Jennifer, Shang JingJing, Thompson Carol, Stewart Kerry, Mock Victoria
机构信息
Center for Nursing Research, Johns Hopkins University School of Nursing, Baltimore, Maryland 21201, USA.
出版信息
Cancer. 2009 Oct 15;115(20):4874-84. doi: 10.1002/cncr.24551.
BACKGROUND
Cancer treatment is associated with decline in measured and self-reported physical function and increased pain. In the current study, the authors evaluated the impact of a walking intervention on these outcomes during chemotherapy/radiation.
METHODS
Patients with breast, prostate, and other cancers (N=126) were randomized to a home-based walking intervention (exercise) or usual care (control). Exercise dose during the intervention was assessed using a 5-item Physical Activity Questionnaire. Outcome measures were cardiorespiratory fitness, expressed as peak oxygen uptake (VO2) measured during treadmill testing (n=85) or estimated by 12-minute walk (n=27), and self-reported physical function, role limitations, and pain derived from Medical Outcomes Study Short Form 36. Linear regression was used to evaluate pre-to-post intervention change outcomes between groups.
RESULTS
The mean (standard deviation) age of the patients was 60.2 (10.6) years. Diagnoses included prostate (55.6%) and breast (32.5%) cancer. Treatment included external beam radiotherapy (52.3%) and chemotherapy (34.9%). Exercise patients reported worsening Medical Outcomes Study physical function role limitations by the end of cancer treatment (P=.037). Younger age was associated with improved Medical Outcomes Study physical function (P=.048). In all patients, increased exercise dose was associated with decreased Medical Outcomes Study pain (P=.046), regardless of diagnosis. The percent change of VO2 between prostate and nonprostate cancer patients when adjusted for baseline VO2 and Physical Activity Questionnaire values was 17.45% (P=.008), with better VO2 maintenance in the prostate group.
CONCLUSIONS
Exercise during cancer treatment improves cardiorespiratory fitness and self-reported physical function in prostate cancer patients and in younger patients, regardless of diagnosis, and may attenuate loss of those capacities in patients undergoing chemotherapy. Exercise also reduces the pain experience.
背景
癌症治疗与实测及自我报告的身体功能下降和疼痛加剧相关。在本研究中，作者评估了步行干预对化疗/放疗期间这些结果的影响。
方法
患有乳腺癌、前列腺癌及其他癌症的患者（N = 126）被随机分为居家步行干预组（运动组）或常规护理组（对照组）。使用一份5项的体力活动问卷评估干预期间的运动剂量。结果指标包括心肺适能，通过在跑步机测试中测得的峰值摄氧量（VO₂）表示（n = 85），或通过12分钟步行估算（n = 27），以及自我报告的身体功能、角色限制和源自医学结局研究简表36的疼痛。采用线性回归评估组间干预前后的变化结果。
结果
患者的平均（标准差）年龄为60.2（10.6）岁。诊断包括前列腺癌（55.6%）和乳腺癌（32.5%）。治疗包括外照射放疗（52.3%）和化疗（34.9%）。运动组患者报告在癌症治疗结束时医学结局研究身体功能角色限制恶化（P = 0.037）。年龄较小与医学结局研究身体功能改善相关（P = 0.048）。在所有患者中，无论诊断如何，运动剂量增加与医学结局研究疼痛减轻相关（P = 0.046）。在根据基线VO₂和体力活动问卷值进行调整后，前列腺癌患者与非前列腺癌患者之间VO₂的百分比变化为17.45%（P = 0.008），前列腺癌组的VO₂维持情况更好。
结论
癌症治疗期间的运动可改善前列腺癌患者及年轻患者（无论诊断如何）的心肺适能和自我报告的身体功能，并可能减轻接受化疗患者这些能力的丧失。运动还能减轻疼痛体验。
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