Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Cancer Treat Rev. 2013 Oct;39(6):682-90. doi: 10.1016/j.ctrv.2013.01.001. Epub 2013 Feb 26.
We performed a systematic review and meta-analysis evaluating the effectiveness of exercise interventions compared with usual care on physical fitness, fatigue and health-related quality of life in patients with hematologic malignancies treated with stem cell transplantation. Electronic databases were searched up to June 2012. We included randomized controlled trials comparing exercise with usual care, in which at least 75% of the patients had a hematologic malignancy. Standard mean differences were calculated and pooled to generate summary effect sizes (ES) and 95% confidence intervals (CI). The Cochrane Collaboration Risk of Bias Tool was used to assess the methodological quality of the studies. Eight studies met our inclusion criteria. Exercise had a statistically significant moderately favourable effect on cardiorespiratory fitness (ES=0.53, 95% CI=0.13-0.94), lower extremity muscle strength (ES=0.56, 95% CI=0.18-0.94) and fatigue (ES=0.53, 95% CI=0.27-0.79). Significant small positive effects were found for upper extremity muscle strength, global quality of life, and physical, emotional and cognitive functioning. In conclusion, exercise seems to have beneficial effects in patients treated with stem cell transplantation. However, all studies had at least some risk of bias, and for cardiorespiratory fitness and lower extremity muscle strength substantial heterogeneity in effect sizes were observed. Further high quality research is needed to determine the optimal exercise intervention and clinical implications.
我们进行了一项系统评价和荟萃分析，评估了与常规护理相比，运动干预对接受干细胞移植治疗的血液恶性肿瘤患者的身体适应性、疲劳和健康相关生活质量的有效性。检索了截至 2012 年 6 月的电子数据库。我们纳入了比较运动与常规护理的随机对照试验，其中至少 75%的患者患有血液恶性肿瘤。计算了标准均数差值，并进行了汇总以生成汇总效应大小（ES）和 95%置信区间（CI）。使用 Cochrane 协作风险偏倚工具评估了研究的方法学质量。八项研究符合我们的纳入标准。运动对心肺适应性（ES=0.53，95%CI=0.13-0.94）、下肢肌肉力量（ES=0.56，95%CI=0.18-0.94）和疲劳（ES=0.53，95%CI=0.27-0.79）有统计学上的显著适度有利影响。上肢肌肉力量、总体生活质量以及身体、情感和认知功能也有显著的小的积极影响。总之，运动似乎对接受干细胞移植治疗的患者有有益的影响。然而，所有研究都至少存在一些偏倚风险，并且心肺适应性和下肢肌肉力量的效应大小存在显著的异质性。需要进一步进行高质量的研究，以确定最佳的运动干预措施及其临床意义。
