Brown Justin C, Ko Emily M, Schmitz Kathryn H
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA(∗)(†)(‡).
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA(∗)(†)(‡).
PM R. 2015 Feb;7(2):113-22. doi: 10.1016/j.pmrj.2014.09.003. Epub 2014 Sep 10.
The health benefits of exercise increase in dose-response fashion among cancer survivors. However, it is unclear how to identify cancer survivors who may require a pre-exercise evaluation before they progress from the common recommendation of walking to unsupervised moderate- to vigorous-intensity exercise.
To clarify how to identify cancer survivors who should undergo a pre-exercise evaluation before they progress from the common recommendation of walking to unsupervised moderate- to vigorous-intensity exercise.
Electronic survey.
Forty-seven (n = 47) experts in the field of exercise physiology, rehabilitation medicine, and cancer survivorship.
Not applicable.
We synthesized peer-reviewed guidelines for exercise and cancer survivorship and identified 82 health factors that may warrant a pre-exercise evaluation before a survivor engages in unsupervised moderate- to vigorous-intensity exercise. The 82 health factors were classified into 3 domains: (1) clinical health factors; (2) comorbidity and device health factors; and (3) medications. We surveyed a sample of experts asking them to identify which of the 82 health factors among cancer survivors would indicate the need for a pre-exercise evaluation before they engaged in moderate- to vigorous-intensity exercise.
The response rate to our survey was 75% (n = 47). Across the 3 domains of health factors, acute symptoms, comorbidities, and medications related to cardiovascular disease were agreed on to indicate a pre-exercise evaluation for survivors before they engaged in unsupervised moderate- to vigorous-intensity exercise. Other health factors in the survey included hematologic, musculoskeletal, systemic, gastrointestinal, pulmonary, and neurological symptoms and comorbidities. Eighteen experts (38%) said it was difficult to provide absolute answers because no 2 patients are alike, and their decisions are made on a case-by-case basis.
The results from this expert survey will help to identify which cancer survivors should undergo a pre-exercise evaluation before they engage in unsupervised moderate- to vigorous-intensity exercise.
运动对癌症幸存者健康的益处呈剂量反应关系增加。然而，尚不清楚如何识别那些在从常见的步行建议过渡到无监督的中等至高强度运动之前可能需要进行运动前评估的癌症幸存者。
阐明如何识别那些在从常见的步行建议过渡到无监督的中等至高强度运动之前应接受运动前评估的癌症幸存者。
电子调查。
47名运动生理学、康复医学和癌症幸存者领域的专家。
不适用。
我们综合了同行评审的运动与癌症幸存者指南，确定了82个健康因素，这些因素可能使幸存者在进行无监督的中等至高强度运动之前需要进行运动前评估。这82个健康因素分为3个领域：（1）临床健康因素；（2）合并症和器械健康因素；（3）药物。我们对一组专家进行了调查，询问他们在癌症幸存者中，这82个健康因素中的哪些因素表明在进行中等至高强度运动之前需要进行运动前评估。
我们的调查回复率为75%（n = 47）。在健康因素的3个领域中，与心血管疾病相关的急性症状、合并症和药物被一致认为表明幸存者在进行无监督的中等至高强度运动之前需要进行运动前评估。调查中的其他健康因素包括血液学、肌肉骨骼、全身、胃肠道、肺部和神经系统症状及合并症。18名专家（38%）表示很难给出绝对答案，因为没有两个患者是相同的，他们的决定是根据具体情况做出的。
这项专家调查的结果将有助于识别哪些癌症幸存者在进行无监督的中等至高强度运动之前应接受运动前评估。
