Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Oncologist. 2012;17(8):1120-8. doi: 10.1634/theoncologist.2012-0035. Epub 2012 Jul 2.
It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program.
Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively.
The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting.
Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs.
据报道，只有 14%的临床试验被转化为实践。本文的目的是通过阐明参与者的安全性概况（例如，肌肉骨骼损伤的发生率和向医疗专业人员的转介率），促进将一种有效的乳腺癌幸存者康复运动方案进行转化，以便为临床医生提供建议，以便对健康和健身人员进行适当的培训，使他们能够安全、有效地、可持续地提供该方案。
患有和有患淋巴水肿风险的乳腺癌幸存者被随机分为每周两次举重或标准护理，为期 1 年。在 1 年后和每 3 个月分别进行了一次损伤调查和医疗评估。
举重组的累积发病率和损伤率高于对照组。在有和没有患淋巴水肿风险的乳腺癌幸存者中，举重组的损伤率分别为每 1000 次举重 2.3 次和 0.3 次。在有或没有患淋巴水肿风险的乳腺癌幸存者中，20.9%的举重组患者因需要停止或调整举重剂量而与医疗保健提供者接触。
尽管举重已被证明有效，但肌肉骨骼损伤和其他健康问题确实发生了。因此，为了成功地将这种康复干预措施转化为临床实践，与乳腺癌幸存者合作的健康和健身专业人员需要具备知识、技能和能力，以明确他们的实践范围，以满足这些医疗保健需求。
