Müller Carsten, Krauth Konstantin A, Gerß Joachim, Rosenbaum Dieter
Institute of Sports Science, Work Unit Human Performance and Training in Sports, University of Münster, Horstmarer Landweg 62b, 48149, Münster, Germany.
Institute of Experimental Musculoskeletal Medicine, Movement Analysis Laboratory, University Hospital Münster, Domagkstr. 3, 48149, Münster, Germany.
Support Care Cancer. 2016 Sep;24(9):3793-802. doi: 10.1007/s00520-016-3198-y. Epub 2016 Apr 7.
Chronic health conditions and impaired quality of life are commonly experienced in childhood cancer survivors. While rehabilitation clinics support patients in coping with the disease, studies evaluating an inpatient rehabilitation program on promoting physical activity (PA) and health-related quality of life (HRQoL) are missing.
A 4-week inpatient rehabilitation program was prospectively evaluated. One hundred fifty patients with leukemia or lymphoma (N = 86), brain tumors (N = 38), and sarcomas (N = 26) were enrolled on average 17 months after cessation of acute medical treatment. PA amount and cadence (indicating the intensity of walking activity) using the StepWatch™ 3 Activity Monitor and HRQoL global and physical well-being scores using the KINDL(®) questionnaire were assessed before, immediately after, and 6 and 12 months following the program and analyzed using multiple linear mixed models.
Significant effects on PA were only found at 12-month follow-up for amount and cadence variables (all p < 0.05). While leukemia and lymphoma patients revealed the highest PA level throughout the study, rehabilitation effects were more pronounced for cadence variables in brain tumor and sarcoma patients. The rehabilitation program had immediate (t = 4.56, p < 0.001) and sustainable effects on HRQoL global scores (6-month follow-up, t = 4.08, p < 0.001; 12-month follow-up, t = 3.13, p < 0.006).
Immediate and sustainable increases in HRQoL indicate that a 4-week rehabilitation program is beneficial for improving psychosocial well-being, while the significant increase in PA levels could be related to general recovery as well. The lack of a control group hampers the evaluation of the rehabilitation program on promoting PA levels in pediatric cancer patients.
儿童癌症幸存者常患有慢性健康问题且生活质量受损。虽然康复诊所帮助患者应对疾病,但评估住院康复项目对促进身体活动(PA)和健康相关生活质量(HRQoL)影响的研究尚缺。
对一个为期4周的住院康复项目进行前瞻性评估。150例白血病或淋巴瘤患者(N = 86)、脑肿瘤患者(N = 38)和肉瘤患者(N = 26)在急性药物治疗停止后平均17个月入组。使用StepWatch™ 3活动监测仪评估PA量和步频(表明步行活动强度),并使用KINDL(®)问卷在项目开始前、结束后即刻、以及项目结束后6个月和12个月评估HRQoL总体及身体幸福感评分,采用多重线性混合模型进行分析。
仅在12个月随访时发现PA量和步频变量有显著影响(所有p < 0.05)。虽然白血病和淋巴瘤患者在整个研究中PA水平最高,但脑肿瘤和肉瘤患者步频变量的康复效果更明显。康复项目对HRQoL总体评分有即刻(t = 4.56,p < 0.001)和持续影响(6个月随访,t = 4.08,p < 0.001;12个月随访,t = 3.13,p < 0.006)。
HRQoL的即刻和持续提高表明,为期4周的康复项目有利于改善心理社会幸福感,而PA水平的显著提高也可能与总体恢复有关。缺乏对照组妨碍了对康复项目促进儿科癌症患者PA水平效果的评估。