Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
J Geriatr Oncol. 2014 Apr;5(2):148-55. doi: 10.1016/j.jgo.2013.12.002. Epub 2013 Dec 28.
National guidelines suggest that women with hormone receptor positive breast cancer be considered for adjuvant endocrine treatment with an aromatase inhibitor (AI). Joint symptoms (arthralgia) are a common AI side-effect. There is a need for effective approaches to arthralgia management that enable survivors to remain on AI therapy while optimizing as pain-free a life as possible. This feasibility study investigates a 6-week self-directed walking program in a sample of elderly female breast cancer survivors on AIs reporting joint pain.
Walk With Ease (WWE) goal--minimum 30 min of walking 5 days a week (150 min per week). Eligibility: age >65; Stage I-III breast cancer; ≥3 months of AI therapy; self-reported joint pain/stiffness.
(1) walking--number of days/week and number of minutes/walk, (2) visual analog scales (VAS) for joint pain, fatigue and stiffness, and (3) arthritis self-efficacy (ASE) to manage joint pain and fatigue.
t-tests, correlation coefficients and effect sizes.
Sample target of 20 was achieved--mean age 71 (65-87), 85% Caucasian, mean BMI 29. Proportion walking 150 min/week increased from 21% at baseline to 50% at 6 weeks (p < 0.001). Mean joint pain at baseline (39.7 + 26.9) decreased 10% (p = 0.63), fatigue (37.4+33.3) decreased 19% (p = 0.31), joint stiffness (46.1 + 27.2) decreased 32% (p = 0.07).
A self-directed walking program among elderly breast cancer survivors on AI therapy significantly increased total time of walking per week over a 6 week period. Joint pain, stiffness, and fatigue also decreased, although not significantly. Testing within a larger sample is warranted.
国家指南建议，激素受体阳性乳腺癌患者应考虑接受芳香化酶抑制剂（AI）辅助内分泌治疗。关节症状（关节痛）是 AI 的常见副作用。需要有效的方法来管理关节痛，使幸存者能够继续接受 AI 治疗，同时尽可能无痛地生活。这项可行性研究调查了在接受 AI 治疗的老年女性乳腺癌幸存者中，为期 6 周的自我指导步行计划对报告关节疼痛的患者的效果。
步行轻松（WWE）目标——每周至少 30 分钟，5 天/周（每周 150 分钟）。入选标准：年龄 >65 岁；I-III 期乳腺癌；AI 治疗时间≥3 个月；自我报告的关节疼痛/僵硬。
（1）步行——每周天数/周和每次步行分钟数，（2）关节疼痛、疲劳和僵硬的视觉模拟量表（VAS），（3）关节炎自我效能（ASE）以管理关节疼痛和疲劳。
t 检验、相关系数和效应大小。
达到了 20 名的样本目标——平均年龄 71 岁（65-87 岁），85%为白种人，平均 BMI 为 29。每周步行 150 分钟的比例从基线时的 21%增加到 6 周时的 50%（p < 0.001）。基线时的平均关节疼痛（39.7 + 26.9）下降了 10%（p = 0.63），疲劳（37.4 + 33.3）下降了 19%（p = 0.31），关节僵硬（46.1 + 27.2）下降了 32%（p = 0.07）。
在接受 AI 治疗的老年乳腺癌幸存者中，自我指导的步行计划在 6 周内显著增加了每周总的步行时间。关节疼痛、僵硬和疲劳也有所减轻，尽管没有显著意义。在更大的样本中进行测试是有必要的。
