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计算机定制的体育活动干预对前列腺癌和结直肠癌患者和幸存者的短期疗效:一项随机对照试验。

Short-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: a randomized controlled trial.

机构信息

Department of Psychology and Educational Sciences, Open University of the Netherlands, PO Box 2960, 6401 DL, Heerlen, The Netherlands.

Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.

出版信息

Int J Behav Nutr Phys Act. 2018 Oct 30;15(1):106. doi: 10.1186/s12966-018-0734-9.

Abstract

BACKGROUND

Physical activity (PA) is beneficial in improving negative physical and psychological effects of cancer and cancer treatment, but adherence to PA guidelines is low. Computer-tailored PA interventions can reach large populations with little resources. They match with patients' preference for home-based, unsupervised PA programs and are thus promising for the growing population of cancer survivors. The current study assessed the efficacy of a computer-tailored PA intervention in (four subgroups of) prostate and colorectal cancer survivors.

METHODS

Prostate and colorectal cancer patients and survivors were randomized to the OncoActive intervention group (N = 249), or a usual-care waiting-list control group (N = 229). OncoActive participants received a pedometer and computer-tailored PA advice, both Web-based via an interactive website and with printed materials. Minutes moderate-to-vigorous PA (MVPA) and days ≥30 min PA were assessed with an accelerometer (ActiGraph) at baseline and 6 months. Further, questionnaires were used to assess self-reported PA, fatigue, distress, and quality of life at baseline, 3 and 6 months. Differences between both groups were assessed using linear regression analyses (complete cases and intention-to-treat). In addition, efficacy in relation to age, gender, education, type of cancer, and time since treatment was examined.

RESULTS

Three months after baseline OncoActive participants significantly increased their self-reported PA (PA days: d = 0.46; MVPA: d = 0.23). Physical functioning (d = 0.23) and fatigue (d = - 0.21) also improved significantly after three months. Six months after baseline, self-reported PA (PA days: d = 0.51; MVPA: d = 0.37) and ActiGraph MVPA (d = 0.27) increased significantly, and ActiGraph days (d = 0.16) increased borderline significantly (p = .05; d = 0.16). Furthermore, OncoActive participants reported significantly improvements in physical functioning (d = 0.14), fatigue (d = - 0.23) and depression (d = - 0.32). Similar results were found for intention-to-treat analyses. Higher increases in PA were found for colorectal cancer participants at 3 months, and for medium and highly educated participants' PA at 6 months. Health outcomes at 6 months were more prominent in colorectal cancer participants and in women.

CONCLUSIONS

The OncoActive intervention was effective at increasing PA in prostate and colorectal cancer patients and survivors. Health-related effects were especially apparent in colorectal cancer participants. The intervention provides opportunities to accelerate cancer recovery. Long-term follow-up should examine further sustainability of these effects.

TRIAL REGISTRATION

The study was registered in the Dutch Trial Register ( NTR4296 ) on October 17 2018.

摘要

背景

身体活动(PA)有益于改善癌症和癌症治疗的负面生理和心理影响,但对 PA 指南的遵循率较低。计算机量身定制的 PA 干预措施可以用很少的资源覆盖大量人群。它们符合患者对基于家庭、无需监督的 PA 计划的偏好,因此对不断增长的癌症幸存者群体具有很大的潜力。本研究评估了计算机量身定制的 PA 干预措施在前列腺癌和结直肠癌幸存者(四个亚组)中的疗效。

方法

前列腺癌和结直肠癌患者和幸存者被随机分配到 OncoActive 干预组(N=249)或常规护理等待名单对照组(N=229)。OncoActive 参与者通过互动网站和印刷材料获得计步器和计算机量身定制的 PA 建议,这两种方式均基于网络。在基线和 6 个月时使用加速度计(ActiGraph)评估中等至剧烈 PA(MVPA)和≥30 分钟 PA 的天数。此外,在基线、3 个月和 6 个月时使用问卷评估自我报告的 PA、疲劳、困扰和生活质量。使用线性回归分析(完整案例和意向治疗)评估两组之间的差异。此外,还检查了与年龄、性别、教育程度、癌症类型和治疗后时间相关的疗效。

结果

基线后 3 个月,OncoActive 参与者的自我报告 PA 显著增加(PA 天数:d=0.46;MVPA:d=0.23)。三个月后,身体机能(d=0.23)和疲劳(d=-0.21)也显著改善。基线后 6 个月,自我报告的 PA(PA 天数:d=0.51;MVPA:d=0.37)和 ActiGraph MVPA(d=0.27)显著增加,ActiGraph 天数(d=0.16)也略有显著增加(p=0.05;d=0.16)。此外,OncoActive 参与者报告身体机能(d=0.14)、疲劳(d=-0.23)和抑郁(d=-0.32)显著改善。意向治疗分析也得出了类似的结果。3 个月时,结直肠癌参与者的 PA 增加幅度较高,6 个月时,中等和高学历参与者的 PA 增加幅度较高。6 个月时的健康结果在结直肠癌参与者和女性中更为明显。

结论

OncoActive 干预措施在增加前列腺癌和结直肠癌患者和幸存者的 PA 方面是有效的。健康相关的效果在结直肠癌参与者中尤为明显。该干预措施为加速癌症康复提供了机会。长期随访应进一步检查这些效果的可持续性。

试验注册

该研究于 2018 年 10 月 17 日在荷兰试验注册中心(NTR4296)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c324/6208119/cddf42842c2a/12966_2018_734_Fig1_HTML.jpg

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