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癌症康复:一项强化与体能训练计划的结果评估

Cancer rehabilitation: outcome evaluation of a strengthening and conditioning program.

作者信息

Swenson Karen K, Nissen Mary Jo, Knippenberg Kathryn, Sistermans Annemiek, Spilde Paul, Bell Elaine M, Nissen Julia, Chen Cathleen, Tsai Michaela L

机构信息

Author Affiliations: Oncology Research Department, Park Nicollet Institute (Drs Swenson and M. J. Nissen and Mss Knippenberg, Bell, and J. Nissen); Park Nicollet Rehabilitation Services, Park Nicollet Health Services (Ms Sistermans and Mr Spilde); Park Nicollet Frauenshuh Cancer Center (Dr Chen); and US Oncology (Dr Tsai), Minneapolis, Minnesota.

出版信息

Cancer Nurs. 2014 May-Jun;37(3):162-9. doi: 10.1097/NCC.0b013e318288d429.

Abstract

BACKGROUND

Cancer treatments can lead to detriments in patients' health and declines in quality of life (QOL). Cancer rehabilitation programs may improve functional status, symptom control, and QOL.

OBJECTIVE

The objective of this study was to determine if an outpatient, physical therapy-supervised Cancer Rehabilitation Strengthening and Conditioning (CRSC) program improved patients' conditioning level, functional status, QOL, and symptoms.

METHODS

This was a prospective study of oncology patients participating in CRSC program. Measurements included conditioning level (6-minute walk test [SMWT], metabolic equivalent level, grip strength), functional status (Physical Component Summary of Short Form 36), QOL (Mental Component Summary of Short Form 36), and symptoms (M. D. Anderson Symptom Inventory). Paired t tests were conducted to determine significant changes between pre- and post-CRSC program measures, and regression methods identified predictors of change from baseline.

RESULTS

One hundred fifteen patients with cancer were enrolled in the study; 75 patients completed pre- and post-CRSC program measures. Significant improvements were noted in SMWT by 186.4 ft, SMWT speed by 0.35 mph, treadmill time (3.5 minutes longer), metabolic equivalent level (by 0.87 units), QOL, symptom severity, symptom interference with daily life, fatigue, shortness of breath, and sadness.

CONCLUSIONS

In a pretest-posttest design, significant improvements were noted in conditioning level, functional status, QOL, and symptoms. Greater improvements were noted in participants who were most deconditioned at baseline.

IMPLICATIONS FOR PRACTICE

Further research should be conducted to provide additional support for CRSC programs. Cancer rehabilitation strengthening and condition programs may benefit patients across the continuum of care, including deconditioned patients.

摘要

背景

癌症治疗可能会损害患者健康并导致生活质量(QOL)下降。癌症康复计划可能会改善功能状态、症状控制和生活质量。

目的

本研究的目的是确定门诊物理治疗监督下的癌症康复强化与体能训练(CRSC)计划是否能改善患者的体能水平、功能状态、生活质量和症状。

方法

这是一项对参与CRSC计划的肿瘤患者进行的前瞻性研究。测量指标包括体能水平(6分钟步行试验[SMWT]、代谢当量水平、握力)、功能状态(简短健康调查问卷36项的身体成分总结)、生活质量(简短健康调查问卷36项的心理成分总结)和症状(MD安德森症状量表)。采用配对t检验来确定CRSC计划前后测量指标之间的显著变化,并使用回归方法确定基线变化的预测因素。

结果

115名癌症患者参与了该研究;75名患者完成了CRSC计划前后的测量。SMWT增加了186.4英尺,SMWT速度提高了0.35英里/小时,跑步机时间延长了3.5分钟,代谢当量水平提高了0.87单位,生活质量、症状严重程度、症状对日常生活的干扰、疲劳、呼吸急促和悲伤等方面均有显著改善。

结论

在前后测试设计中,体能水平、功能状态、生活质量和症状均有显著改善。基线时体能最差的参与者改善更为明显。

对实践的启示

应进行进一步研究以提供对CRSC计划的更多支持。癌症康复强化与体能训练计划可能会使连续护理过程中的患者受益,包括体能较差的患者。

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