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比较接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者和健康女性进行有氧加抗阻训练的运动反应。

Comparing exercise responses to aerobic plus resistance training between postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy women.

机构信息

a School of Technology and Sciences , State University (UNESP) , Presidente Prudente , Sao Paulo , Brazil.

b Institute of Biosciences , State University (UNESP) , Sao Paulo , Brazil.

出版信息

Disabil Rehabil. 2019 Sep;41(18):2175-2182. doi: 10.1080/09638288.2018.1460877. Epub 2018 Apr 12.

Abstract

The aim of this study was to explore whether postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy differ from healthy postmenopausal women in their response to the same aerobic + resistance training. The participants were separated into two groups: postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy for an average of 20 months (18 women) and healthy postmenopausal women (24 women). We assessed aerobic capacity (predicted maximum oxygen uptake (VOmax) and maximum running velocity test (Vmax)) through a walking test, upper and lower body muscle strength using an estimated one-repetition maximum test, and body composition by dual-energy X-ray absorptiometry at baseline and at three, six, and nine months, respectively. The exercise program was performed three times/week over nine months and consisted of 40 min of machine-based strength training (seated cable row, bench press, leg extension, leg press, and leg curl, as well as bridge, abdominal, and standard plank exercises) followed by 30 min of treadmill walking. Analysis of variance (ANOVA) with repeated measures was used to compare the groups over time. Postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy postmenopausal women presented similar improvements in estimated lower body strength, predicted VO and V, and body fat mass. For maximal upper body strength, there was a significant group x time interaction after six months of training ( = 0.01). The healthy postmenopausal women presented a significant increase in upper body strength after six months, while postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy demonstrated an improvement only at nine months of training. The breast cancer survivors undergoing aromatase inhibitor therapy presented increased lean mass while healthy postmenopausal women maintained values over time (Breast cancer: 33.7 ± 3.9(Pre) vs. 34.1 ± 3.4 kg (Post) and healthy women: 36.4 ± 5.1 (Pre) vs. 36.4 ± 5.0 kg (Post),  = 0.004). Our findings suggest that postmenopausal women undergoing aromatase inhibitor therapy for breast cancer demonstrated adaptations and similar trainability to the same regimen of resistance + aerobic training as healthy postmenopausal women. Implications for Rehabilitation Combined exercise program (aerobic plus resistance) is an important non-pharmacological strategies to improve strength, aerobic capacity, and body composition in breast cancer survivors undergoing aromatase inhibitor therapy. Furthermore, it is important to highlight that the time of intervention seems to influence the upper body strength response in this population. This study showed that trainers and other specialists do not need to modify the prescription of exercise related to healthy women, since the combined exercise program induced similar benefits in strength, aerobic capacity, and body composition in postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy postmenopausal women.

摘要

本研究旨在探讨正在接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者与健康绝经后女性对相同的有氧+抗阻训练的反应是否存在差异。参与者被分为两组:正在接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者(平均 20 个月,18 名女性)和健康绝经后女性(24 名女性)。我们通过步行测试评估有氧能力(预测最大摄氧量(VOmax)和最大跑步速度测试(Vmax)),使用估计的一次重复最大测试评估上下肢肌肉力量,通过双能 X 射线吸收法在基线和三个月、六个月和九个月分别评估身体成分。运动方案在九个月内每周进行三次,每次 40 分钟,包括基于机器的力量训练(坐姿划船、卧推、腿伸展、腿推举和腿弯举,以及桥接、腹部和标准平板支撑练习),然后进行 30 分钟的跑步机步行。使用重复测量方差分析(ANOVA)比较两组随时间的变化。正在接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者和健康绝经后女性的下肢力量、预测 VO 和 V 以及体脂肪量均有相似的改善。对于最大上肢力量,训练六个月后出现显著的组间时间交互作用( = 0.01)。健康绝经后女性在六个月后上肢力量显著增加,而正在接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者仅在九个月的训练后有所改善。接受芳香化酶抑制剂治疗的乳腺癌幸存者的瘦体重增加,而健康绝经后女性的瘦体重随时间保持不变(乳腺癌:33.7 ± 3.9(Pre) 与 34.1 ± 3.4 kg (Post) 和健康女性:36.4 ± 5.1 (Pre) 与 36.4 ± 5.0 kg (Post),  = 0.004)。我们的研究结果表明,正在接受芳香化酶抑制剂治疗的乳腺癌女性对阻力+有氧训练方案的适应和可训练性与健康绝经后女性相似。这对康复的意义联合运动方案(有氧加阻力)是改善正在接受芳香化酶抑制剂治疗的乳腺癌患者力量、有氧能力和身体成分的重要非药物策略。此外,需要强调的是,干预时间似乎会影响该人群的上肢力量反应。本研究表明,培训师和其他专家不需要修改与健康女性相关的运动处方,因为联合运动方案在接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者和健康绝经后女性中诱导了相似的力量、有氧能力和身体成分益处。

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