University of Northern Colorado and the Rocky Mountain Cancer Rehabilitation Institute, Greeley, CO, USA.
University of Northern Colorado and the Rocky Mountain Cancer Rehabilitation Institute, Greeley, CO, USA
Integr Cancer Ther. 2014 Nov;13(6):473-81. doi: 10.1177/1534735414547108. Epub 2014 Aug 22.
PURPOSE: Despite mounting evidence indicating that exercise training has a positive effect on cancer recovery, the influence of cancer type on the response to exercise training remains uncharacterized. Therefore, the adaptations to exercise training were compared between groups composed of 7 different forms of cancer. METHODS: A total of 319 cancer survivors completed fatigue inventories and participated in assessments of cardiorespiratory function, which encompassed aerobic capacity (VO2 peak), pulmonary function (forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1]), and resting blood pressure and heart rate. Participants were divided into 7 groups based on cancer type, including breast cancer (BC, n = 170), prostate cancer and other male urogenital neoplasia (PC, n = 38), hematological malignancies (HM, n = 34), colorectal cancer (CC, n = 25), gynecological cancers (GC, n = 20), glandular and epithelial neoplasms (GEN, n = 20), and lung cancer (LC, n = 12). All participants completed an individualized, multimodal exercise intervention consisting of cardiorespiratory, flexibility, balance, and muscular strength training 3 days per week for 3 months. Following the intervention, all subjects were reassessed. Generalized Estimating Equations with exchangeable working correlation structure was used to model each response; the group by time interaction effect represented the effect of cancer type on exercise-associated improvements. RESULTS: No significant (P > .05) group by time interaction effects were observed between different types of cancer for any parameter. Pre- to postexercise contrasts revealed significant improvements in VO2 peak in BC, PC, HM, and GEN at the Bonferroni adjusted significance level (.00714). Heart rate was significantly lowered in the BC and CC groups. Mean fatigue indices decreased by at least 17% in all groups, but these changes were only significant in the BC, HM, CC, and GC groups. Systolic blood pressure decreased significantly in BC and GC, and diastolic blood pressure decreased significantly only in the BC group while pulmonary function remained unchanged in all cancer types. CONCLUSION: Although trends toward improved cardiorespiratory and fatigue parameters only reached significance in some groups, there were no significant differences between cancer types. This suggests that cardiorespiratory and fatigue improvements following rehabilitative exercise are not dependent on cancer type. Further research investigating alternative physiological parameters are needed to confirm the relationship between cancer type and exercise-mediated rehabilitation.
目的:尽管越来越多的证据表明运动训练对癌症康复有积极影响,但癌症类型对运动训练反应的影响仍未得到明确。因此,本研究比较了由 7 种不同癌症组成的组之间对运动训练的适应性。
方法:共有 319 名癌症幸存者完成了疲劳量表,并参与了心肺功能评估,包括有氧能力(VO2 峰值)、肺功能(用力肺活量 [FVC] 和 1 秒用力呼气量 [FEV1])以及静息血压和心率。参与者根据癌症类型分为 7 组,包括乳腺癌(BC,n=170)、前列腺癌和其他男性泌尿生殖系统肿瘤(PC,n=38)、血液恶性肿瘤(HM,n=34)、结直肠癌(CC,n=25)、妇科癌症(GC,n=20)、腺体和上皮肿瘤(GEN,n=20)和肺癌(LC,n=12)。所有参与者都完成了一项个体化的多模式运动干预,包括心肺、柔韧性、平衡和肌肉力量训练,每周 3 天,持续 3 个月。干预结束后,所有受试者都重新进行评估。采用可交换工作相关结构的广义估计方程来对每个反应进行建模;癌症类型对运动相关改善的影响由组间时间交互效应表示。
结果:在任何参数上,不同类型的癌症之间均未观察到显著的(P>.05)组间时间交互效应。与运动前相比,BC、PC、HM 和 GEN 组的 VO2 峰值显著增加,在 Bonferroni 调整的显著性水平(.00714)上具有显著性差异。BC 和 CC 组的心率显著降低。所有组的平均疲劳指数均降低至少 17%,但仅在 BC、HM、CC 和 GC 组中具有显著性差异。BC 和 GC 组的收缩压显著降低,而 BC 组的舒张压显著降低,所有癌症类型的肺功能均无变化。
结论:尽管一些组的心肺和疲劳参数的改善趋势仅达到显著水平,但不同癌症类型之间没有差异。这表明,康复运动后心肺和疲劳的改善与癌症类型无关。需要进一步研究替代生理参数,以确认癌症类型与运动介导的康复之间的关系。
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