Vanderbyl B L, Mayer M J, Nash C, Tran A T, Windholz T, Swanson T, Kasymjanova G, Jagoe R T
McGill Cancer Nutrition Rehabilitation Program, Segal Cancer Centre, Jewish General Hospital, Room E-809, 3755 Ch de la Cote-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada.
School of Kinesiology and Physical Education, McGill University, Montreal, Canada.
Support Care Cancer. 2017 Jun;25(6):1749-1758. doi: 10.1007/s00520-017-3579-x. Epub 2017 Jan 19.
Patients with advanced cancer frequently experience anxiety, depression and poor quality of life (QOL), as well as physical symptoms such as fatigue and weakness. Physical exercise has potential to help control these symptoms but the optimal training prescription is still not clear. We performed a study comparing medical Qigong (QG) and standard endurance and strength training (SET) in patients with advanced stage non-small cell lung (NSCLC) and gastrointestinal (GI) cancers.
A randomized, cross-over study was performed in patients with advanced NSCLC and GI cancers receiving or eligible for chemotherapy. Patients received supervised QG or SET twice-weekly for 6 weeks. Psychological functioning, QOL, symptoms and physical functioning were assessed before and after each intervention period.
Nineteen patients completed both interventions. Comparing interventions revealed no difference between QG and SET on change in anxiety or depression scores or QOL. However, SET treatment was better at improving perceived strength (P = 0.05) and walking distance (P = 0.02). The order in which interventions were performed had a significant impact on the improvement in certain symptoms (sleep quality, breathlessness, P < 0.05), QOL (P = 0.01) and walking distance (P = 0.008). In all cases, the beneficial effects of the exercise interventions were markedly reduced during the second interval.
QG and SET are equivalent in their impact on many aspects of psychological function in cancer patients. However, SET leads to greater improvements in exercise capacity and helps reduce some symptoms. The reduction in beneficial effect of SET on exercise function when offered as the second intervention is a new finding that warrants further study.
晚期癌症患者经常会出现焦虑、抑郁和生活质量低下的情况,同时伴有疲劳和虚弱等身体症状。体育锻炼有可能帮助控制这些症状,但最佳训练方案仍不明确。我们开展了一项研究,比较医学气功(QG)与标准耐力和力量训练(SET)对晚期非小细胞肺癌(NSCLC)和胃肠道(GI)癌症患者的效果。
对正在接受化疗或符合化疗条件的晚期NSCLC和GI癌症患者进行了一项随机交叉研究。患者每周接受两次有监督的QG或SET训练,为期6周。在每个干预期前后评估心理功能、生活质量、症状和身体功能。
19名患者完成了两种干预。比较两种干预发现,QG和SET在焦虑或抑郁评分变化或生活质量方面没有差异。然而,SET治疗在改善感知力量(P = 0.05)和步行距离(P = 0.02)方面效果更好。干预实施的顺序对某些症状(睡眠质量、呼吸急促,P < 0.05)、生活质量(P = 0.01)和步行距离(P = 0.008)的改善有显著影响。在所有情况下,运动干预的有益效果在第二个时间段明显降低。
QG和SET对癌症患者心理功能的许多方面影响相当。然而,SET能更大程度地改善运动能力并有助于减轻一些症状。当作为第二种干预提供时,SET对运动功能有益效果的降低是一个新发现,值得进一步研究。