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太极拳对患有芳香化酶抑制剂相关关节痛的乳腺癌幸存者健康状况的影响:一项可行性研究。

Tai chi for well-being of breast cancer survivors with aromatase inhibitor-associated arthralgias: a feasibility study.

作者信息

Galantino Mary Lou, Callens Mary L, Cardena Gregg J, Piela Nicole L, Mao Jun James

出版信息

Altern Ther Health Med. 2013 Nov-Dec;19(6):38-44.

Abstract

CONTEXT

Arthralgia is common and debilitating for a significant proportion of breast cancer survivors (BCSs) and leads to poor adherence to aromatase inhibitors (AIs). Despite increased recognition of the negative impact of arthralgia on function and the poor adherence that results, very few interventions have been developed to target this side effect.

OBJECTIVE

This study aimed to determine the feasibility of tai chi to improve well-being for women experiencing AI-associated arthralgias (AIAAs).

DESIGN

The study was a pilot to (1) demonstrate the feasibility of recruitment and retention for a tai chi trial, (2) determine the safety of tai chi, and (3) identify the outcomes (function, pain, and quality of life[QOL]) that tai chi may impact.

SETTING

The study took place at the Gilda's Club South Jersey in Linwood, NJ, USA.

PARTICIPANTS

Postmenopausal women with a history of stage I-III breast cancer reporting AIAA were enrolled.

INTERVENTION

Group tai chi was practiced for 1 h 2 ×/wk for 8 wks.

OUTCOME MEASURES

Functional outcomes included (1) sit-and-reach (SR), (2) functional reach (FR), (3) the Berg Balance Scale (BBS), and (4) timed up-and-go (TUG). The following patient-reported outcomes (PROs) were evaluated pre- and postintervention: (1) the Hospital Anxiety and Depression Scale (HADS), (2) the Functional Assessment of Cancer Therapy-Breast (FACT-B), (3) the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-Fatigue), (4) the Brief Pain Inventory (BPI), (5) the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT-GOG-Ntx), and (6) the Functional Assessment of Chronic Illness Therapy- Spiritual Well-being Scale (FACIT-Sp). Participants also recorded their tai chi experiences in a journal.

RESULTS

For the 12 participants, adherence to the classes was 75%, with no adverse events reported. Participants experienced significant improvement from baseline to follow-up for the HADS anxiety (P = .003) and depression (P = .020) scales, the emotional well-being scale of the FACT-B (P = .027), the FACIT-Fatigue (P = .030), and the sit-and-teach test (P = .016). The BBS (P = .090), TUG (P = .241), BPI severity subscale (P = .058), and physical well-being subscale of the FACT-B (P = .052) showed no significant improvement. Participants reported increased relaxation, reduced stress, and enhanced sleep quality and duration. They valued the group's and the instructor's support.

CONCLUSION

The research team demonstrated the feasibility of a tai chi intervention for improving wellbeing for breast cancer patients with AIAA and identified measures that may be sensitive to the impact of a tai chi intervention in this population.

摘要

背景

关节痛在很大一部分乳腺癌幸存者(BCS)中很常见且使人衰弱,并导致对芳香化酶抑制剂(AI)的依从性差。尽管人们越来越认识到关节痛对功能的负面影响以及由此导致的依从性差,但针对这种副作用的干预措施却很少。

目的

本研究旨在确定太极拳改善患有AI相关关节痛(AIAA)女性幸福感的可行性。

设计

该研究是一项试点研究,旨在(1)证明太极拳试验招募和保留参与者的可行性,(2)确定太极拳的安全性,以及(3)确定太极拳可能影响的结果(功能、疼痛和生活质量[QOL])。

地点

该研究在美国新泽西州林伍德的吉尔达俱乐部南泽西进行。

参与者

招募有I-III期乳腺癌病史且报告有AIAA的绝经后女性。

干预措施

每周进行2次集体太极拳练习,每次1小时,共8周。

结果测量

功能结果包括(1)坐位体前屈(SR)、(2)功能性伸手距离(FR)、(3)伯格平衡量表(BBS)和(4)计时起立行走测试(TUG)。在干预前后评估以下患者报告的结果(PRO):(1)医院焦虑抑郁量表(HADS)、(2)癌症治疗功能评估-乳腺癌(FACT-B)、(3)慢性病治疗功能评估-疲劳(FACIT-疲劳)、(4)简明疼痛量表(BPI)、(5)癌症治疗功能评估/妇科肿瘤学组-神经毒性(FACT-GOG-Ntx)和(6)慢性病治疗功能评估-精神幸福感量表(FACIT-Sp)。参与者还在日记中记录了他们的太极拳体验。

结果

对于12名参与者,课程依从率为75%,未报告不良事件。参与者从基线到随访,HADS焦虑量表(P = .003)和抑郁量表(P = .020)、FACT-B的情绪幸福感量表(P = .027)、FACIT-疲劳量表(P = .030)以及坐位体前屈测试(P = .016)均有显著改善。BBS(P = .090)、TUG(P = .241)、BPI严重程度子量表(P = .058)和FACT-B的身体幸福感子量表(P = .052)无显著改善。参与者报告放松感增加、压力减轻、睡眠质量和时长提高。他们重视团体和教练的支持。

结论

研究团队证明了太极拳干预对改善患有AIAA的乳腺癌患者幸福感的可行性,并确定了可能对该人群太极拳干预影响敏感的测量指标。

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