在乳腺癌幸存者中，行走的轻松程度与更多的自由生活体力活动和较少的抑郁症状相关：初步随机试验。
Ease of walking associates with greater free-living physical activity and reduced depressive symptomology in breast cancer survivors: pilot randomized trial.
机构信息
Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd, Webb Building #248, Birmingham, AL, 35233-2432, USA.
Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
出版信息
Support Care Cancer. 2018 May;26(5):1675-1683. doi: 10.1007/s00520-017-4015-y. Epub 2017 Dec 14.
PURPOSE
We hypothesized exercise training-induced improvements in ease of walking would associate with favorable changes in objectively measured physical activity (PA) and self-reported depressive symptoms following a PA behavior-change intervention in non-metastatic breast cancer survivors (BCS).
METHODS
Twenty-seven BCS received random assignment to an intervention (INT) or control group (CON). INT included counseling/group discussions coupled with supervised exercise tapered to unsupervised exercise. PA, depressive symptoms, and ease of walking were evaluated pre-/post-intervention using 10-day accelerometry, HADS depression subscale, and indirect calorimetry during a standardized treadmill test, respectively. PA composite score was calculated by converting weekly minutes of moderate-to-vigorous PA and average steps/day to z-scores then dividing the sum by 2. Cardiac efficiency was determined by dividing steady-state oxygen uptake by heart rate to evaluate the volume of oxygen consumed per heartbeat.
RESULTS
ANCOVA revealed a significant time by group interaction showing the INT group exhibited greater positive changes in the PA composite compared to the CON (INT, + 0.14 ± 0.66 au vs. CON, - 0.48 ± 0.49 au; p = 0.019; η = 0.21). Changes occurring from baseline to follow-up, among all participants, revealed improved ease of walking (less oxygen uptake) associated with increased PA composite (r = - 0.52; p = 0.010) and lower depressive symptomology (r = 0.50; p = 0.012) adjusted for age, race, and months since cancer diagnosis. Increased cardiac efficiency during the standardized treadmill test also associated with less daily sedentary time (r = - 0.52; p = 0.021).
CONCLUSIONS
These data support the assertion that reducing the physiological difficulty of walking may contribute to greater engagement in free-living PA, less sedentary time, and decreased psychosocial distress among BCS.
目的
我们假设，在非转移性乳腺癌幸存者（BCS）中，经过锻炼行为改变干预后，与步行轻松度相关的改善与客观测量的身体活动（PA）和自我报告的抑郁症状的有利变化有关。
方法
27 名 BCS 随机分配到干预组（INT）或对照组（CON）。INT 包括咨询/小组讨论，以及与监督性锻炼相结合的逐渐过渡到非监督性锻炼。在标准化跑步机测试中，分别使用 10 天加速度计、HADS 抑郁分量表和间接热量法评估干预前/后的 PA、抑郁症状和步行轻松度。PA 综合评分是通过将每周中等至剧烈 PA 的分钟数和平均步数/天转换为 z 分数，然后将总和除以 2 来计算的。通过将静息状态摄氧量除以心率来计算心脏效率，以评估每搏耗氧量。
结果
ANCOVA 显示，时间与组之间存在显著的相互作用，表明与 CON 相比，INT 组在 PA 综合评分方面表现出更大的积极变化（INT，+0.14±0.66 au 与 CON，-0.48±0.49 au；p=0.019；η²=0.21）。所有参与者从基线到随访的变化显示，步行轻松度的改善（摄氧量减少）与 PA 综合评分的增加（r=-0.52；p=0.010）和抑郁症状的降低（r=-0.50；p=0.012）相关，这些变化是在调整了年龄、种族和癌症诊断后得到的。标准化跑步机测试中，心脏效率的提高也与每日久坐时间的减少相关（r=-0.52；p=0.021）。
结论
这些数据支持了这样一种观点，即减少步行的生理难度可能有助于 BCS 更多地参与自由生活 PA、减少久坐时间和降低心理社会困扰。
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