Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, The Netherlands.
Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Br J Sports Med. 2018 Apr;52(8):505-513. doi: 10.1136/bjsports-2017-097891. Epub 2017 Sep 27.
Certain exercise prescriptions for patients with cancer may improve self-reported quality of life (QoL) and self-reported physical function (PF). We investigated the effects of exercise on QoL and PF in patients with cancer and studied differences in effects between different intervention-related and exercise-related characteristics.
We searched four electronic databases to identify randomised controlled trials investigating exercise effects on QoL and PF in patients with cancer. Pooled effects (Hedges' g) were calculated using Comprehensive Meta-Analysis software. Subgroup analyses were conducted based on intervention dimensions, including timing, duration and delivery mode, and exercise dimensions, including frequency, intensity, type and time (FITT factors).
We included 74 exercise arms. Patients who were randomised to exercise interventions had significantly improved QoL (g=0.15, 95% CI (0.10 to 0.20), n=67 exercise arms) and PF (g=0.21, 95% CI (0.15 to 0.27), n=59 exercise arms) compared with patients in control groups. We found a significant between-group difference for exercise delivery mode, with significant beneficial effects for supervised exercise interventions (g=0.20, 95% CI (0.14 to 0.26) for QoL and g=0.27, 95% CI (0.20 to 0.33) for PF), but not for unsupervised interventions (g=0.04, 95% CI (-0.06 to 0.13) for QoL and g=0.09, 95% CI (-0.01 to 0.19) for PF). No statistically significant differences in intervention effects were found for variations in intervention timing, duration or exercise FITT factors. Unsupervised exercise with higher weekly energy expenditure was more effective than unsupervised exercise with lower energy expenditure (z=2.34, p=0.02).
Exercise interventions, especially when supervised, have statistically significant and small clinical benefit on self-reported QoL and PF in patients with cancer. Unsupervised exercise intervention effects on PF were larger when prescribed at a higher weekly energy expenditure.
某些针对癌症患者的运动处方可能会提高自我报告的生活质量（QoL）和自我报告的身体功能（PF）。我们调查了运动对癌症患者 QoL 和 PF 的影响，并研究了不同干预相关和运动相关特征之间的影响差异。
我们搜索了四个电子数据库，以确定调查运动对癌症患者 QoL 和 PF 影响的随机对照试验。使用 Comprehensive Meta-Analysis 软件计算合并效应（Hedges'g）。根据干预维度（包括时间、持续时间和交付模式）和运动维度（包括频率、强度、类型和时间（FITT 因素））进行亚组分析。
我们纳入了 74 个运动组。与对照组相比，随机分配到运动干预组的患者 QoL（g=0.15，95%CI（0.10 至 0.20），n=67 个运动组）和 PF（g=0.21，95%CI（0.15 至 0.27），n=59 个运动组）显著改善。我们发现运动交付模式存在显著的组间差异，监督运动干预具有显著的有益效果（QoL 的 g=0.20，95%CI（0.14 至 0.26）和 PF 的 g=0.27，95%CI（0.20 至 0.33）），但非监督干预则不然（QoL 的 g=0.04，95%CI（-0.06 至 0.13）和 PF 的 g=0.09，95%CI（-0.01 至 0.19））。干预时机、持续时间或运动 FITT 因素的变化对干预效果没有统计学上的显著差异。每周能量消耗较高的非监督运动比能量消耗较低的非监督运动更有效（z=2.34，p=0.02）。
运动干预，尤其是监督干预，对癌症患者的自我报告 QoL 和 PF 具有统计学意义和较小的临床益处。当每周能量消耗较高时，非监督运动干预对 PF 的影响更大。
