康复期间个性化运动建议对乳腺癌患者客观测量的身体活动水平、疲劳及疲劳相关生物标志物可持续性的影响。
Influence of Personalized Exercise Recommendations During Rehabilitation on the Sustainability of Objectively Measured Physical Activity Levels, Fatigue, and Fatigue-Related Biomarkers in Patients With Breast Cancer.
作者信息
Zimmer Philipp, Baumann Freerk T, Oberste Max, Schmitt Joachim, Joisten Niklas, Hartig Philipp, Schenk Alexander, Kuhn Rafaela, Bloch Wilhelm, Reuss-Borst Monika
机构信息
2 National Center for Tumor Diseases (NCT) and German Cancer Research Center, Heidelberg, Germany.
3 Department I of Internal Medicine, Center for integrated oncology Cologne Bonn, University Hospital of Cologne, Cologne, Germany.
出版信息
Integr Cancer Ther. 2018 Jun;17(2):306-311. doi: 10.1177/1534735417713301. Epub 2017 Jun 15.
PURPOSE
Only one-third of patients with breast cancer reach the recommended activity level of 15 to 25 MET h/wk. The aim of this study was to determine the influence of personalized exercise recommendations during rehabilitation on patients' physical activity level, fatigue, and self-perceived cognitive function as well as on side effect-associated biomarkers.
METHODS
Total metabolic rate, physical activity level, mean MET and steps, fatigue, self-perceived cognitive functioning , and biomarkers (C-reactive protein [CRP], interleukin 6, macrophage migration inhibiting factor [MIF], tumor necrosis factor [TNF]-α, brain-derived neurotrophic factor [BDNF], insulin-like growth factor 1 [IGF1]) were assessed in 60 patients with breast cancer in the aftercare phase before ( t) and 8 months after ( t) the intervention. The rehabilitation program consisted of an initial 3-week period and a 1-week stay after 4 months.
RESULTS
Paired t-test indicated a statistically significant increase in all activity outcomes from t to t. Patients' mean activity level significantly increased from 14.89 to 17.88 MET h/wk. Fatigue and self-perceived cognitive functioning significantly improved from t to t. CRP levels significantly decreased, and BDNF as well as IGF1 levels significantly increased over time. Correlation analysis revealed statistically significant negative associations between fatigue, physical activity, and markers of inflammation (TNF-α and MIF). Furthermore, significant positive correlations between subjective cognitive functioning and all dimensions of fatigue were observed.
CONCLUSIONS
The results support the importance of personalized exercise recommendations to increase physical activity levels in patients with breast cancer. Furthermore, the results highlighti an association between physical activity, fatigue, and inflammation.
目的
仅有三分之一的乳腺癌患者达到了推荐的每周15至25代谢当量小时的活动水平。本研究的目的是确定康复期间个性化运动建议对患者身体活动水平、疲劳、自我感知的认知功能以及副作用相关生物标志物的影响。
方法
在60例乳腺癌患者的随访阶段，于干预前（t）和干预后8个月（t）评估总代谢率、身体活动水平、平均代谢当量和步数、疲劳、自我感知的认知功能以及生物标志物（C反应蛋白[CRP]、白细胞介素6、巨噬细胞移动抑制因子[MIF]、肿瘤坏死因子[TNF]-α、脑源性神经营养因子[BDNF]、胰岛素样生长因子1[IGF1]）。康复计划包括最初为期3周的阶段以及4个月后的1周住院。
结果
配对t检验表明，从t到t所有活动结果均有统计学意义的增加。患者的平均活动水平从14.89代谢当量小时/周显著增加至17.88代谢当量小时/周。从t到t疲劳和自我感知的认知功能显著改善。随着时间推移，CRP水平显著降低，BDNF以及IGF1水平显著升高。相关性分析显示，疲劳、身体活动与炎症标志物（TNF-α和MIF）之间存在统计学意义的负相关。此外，观察到主观认知功能与疲劳的所有维度之间存在显著正相关。
结论
结果支持个性化运动建议对提高乳腺癌患者身体活动水平的重要性。此外，结果突出了身体活动、疲劳和炎症之间的关联。
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