Lahart Ian M, Metsios George S, Nevill Alan M, Kitas George D, Carmichael Amtul R
Faculty of Education, Health and Wellbeing, University of Wolverhampton, Walsall Campus, Gorway Road, Walsall, WS1 3BD, UK.
Department of Research and Development, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, DY1 2HQ, West Midlands, UK.
BMC Cancer. 2016 Mar 17;16:234. doi: 10.1186/s12885-016-2258-5.
To improve adherence to physical activity (PA), behavioural support in the form of behavioural change counselling may be necessary. However, limited evidence of the effectiveness of home-based PA combined with counselling in breast cancer patients exists. The aim of this current randomised controlled trial with a parallel group design was to evaluate the effectiveness of a home-based PA intervention on PA levels, anthropometric measures, health-related quality of life (HRQoL), and blood biomarkers in breast cancer survivors.
Eighty post-adjuvant therapy invasive breast cancer patients (age = 53.6 ± 9.4 years; height = 161.2 ± 6.8 cm; mass = 68.7 ± 10.5 kg) were randomly allocated to a 6-month home-based PA intervention or usual care. The intervention group received face-to-face and telephone PA counselling aimed at encouraging the achievement of current recommended PA guidelines. All patients were evaluated for our primary outcome, PA (International PA Questionnaire) and secondary outcomes, mass, BMI, body fat %, HRQoL (Functional assessment of Cancer Therapy-Breast), insulin resistance, triglycerides (TG) and total (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol were assessed at baseline and at 6-months.
On the basis of linear mixed-model analyses adjusted for baseline values performed on 40 patients in each group, total, leisure and vigorous PA significantly increased from baseline to post-intervention in the intervention compared to usual care (between-group differences, 578.5 MET-min∙wk(-1), p = .024, 382.2 MET-min∙wk(-1), p = .010, and 264.1 MET-min∙wk(-1), p = .007, respectively). Both body mass and BMI decreased significantly in the intervention compared to usual care (between-group differences, -1.6 kg, p = .040, and -.6 kg/m(2), p = .020, respectively). Of the HRQoL variables, FACT-Breast, Trial Outcome Index, functional wellbeing, and breast cancer subscale improved significantly in the PA group compared to the usual care group (between-group differences, 5.1, p = .024; 5.6, p = .001; 1.9 p = .025; and 2.8, p = .007, respectively). Finally, TC and LDL-C was significantly reduced in the PA group compared to the usual care group (between-group differences, -.38 mmol∙L(-1), p = .001; and -.3 mmol∙L(-1), p = .023, respectively).
We found that home-based PA resulted in significant albeit small to moderate improvements in self-reported PA, mass, BMI, breast cancer specific HRQoL, and TC and LDL-C compared with usual care. CLINICALTRIALS.
NCT02408107 (March 25, 2015).
为提高身体活动(PA)的依从性,可能需要以行为改变咨询形式提供的行为支持。然而,关于居家PA联合咨询对乳腺癌患者有效性的证据有限。本项采用平行组设计的随机对照试验旨在评估居家PA干预对乳腺癌幸存者PA水平、人体测量指标、健康相关生活质量(HRQoL)和血液生物标志物的有效性。
80例辅助治疗后浸润性乳腺癌患者(年龄=53.6±9.4岁;身高=161.2±6.8厘米;体重=68.7±10.5千克)被随机分配至为期6个月的居家PA干预组或常规护理组。干预组接受旨在鼓励达到当前推荐PA指南的面对面和电话PA咨询。所有患者均接受主要结局指标PA(国际PA问卷)以及次要结局指标体重、体重指数(BMI)、体脂百分比、HRQoL(癌症治疗功能评估-乳腺癌)、胰岛素抵抗、甘油三酯(TG)和总胆固醇(TC)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)胆固醇的评估,评估时间为基线期和6个月时。
基于对每组40例患者进行的经基线值调整的线性混合模型分析,与常规护理相比,干预组的总PA、休闲PA和剧烈PA从基线到干预后均显著增加(组间差异分别为578.5代谢当量-分钟∙周⁻¹,p = 0.024;382.2代谢当量-分钟∙周⁻¹,p = 0.010;264.1代谢当量-分钟∙周⁻¹,p = 0.007)。与常规护理相比,干预组的体重和BMI均显著下降(组间差异分别为-1.6千克,p = 0.040;-0.6千克/米²,p = 0.020)。在HRQoL变量中,与常规护理组相比,PA组的FACT-乳腺癌、试验结局指数、功能幸福感和乳腺癌子量表均显著改善(组间差异分别为5.1,p = 0.024;5.6,p = 0.001;1.9,p = 0.025;2.8,p = 0.007)。最后,与常规护理组相比,PA组的TC和LDL-C显著降低(组间差异分别为-0.38毫摩尔∙升⁻¹,p = 0.001;-0.3毫摩尔∙升⁻¹,p = 0.023)。
我们发现,与常规护理相比,居家PA导致自我报告的PA、体重、BMI、乳腺癌特异性HRQoL以及TC和LDL-C虽有显著改善,但改善程度较小至中等。临床试验。
NCT02408107(2015年3月25日)