Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia; Centre for Allied Health Research and Education, Cabrini Institute, Malvern, Victoria, Australia.
Department of Physiotherapy, The University of Melbourne, Carlton, Victoria, Australia; Cancer Allied Health Service, Peter MacCallum Cancer Centre, Melbourne, Australia.
Braz J Phys Ther. 2019 Mar-Apr;23(2):79-92. doi: 10.1016/j.bjpt.2018.11.007. Epub 2018 Nov 17.
The natural history of physical activity levels during and following gynaecological cancer treatment is not well understood. This is required in order to establish the time at which physical activity levels are lowest in order to target cancer rehabilitation or exercise interventions in gynaecological cancer population accordingly.
To conduct a systematic review to evaluate the impact of gynaecological cancer treatments on physical activity levels and to summarise the pattern of changes in physical activity levels over time among patients with gynaecological cancer.
A comprehensive literature search was performed via MEDLINE (1946-2018), CINAHL (1982-2018), EMBASE (1947-2018), Ovid Emcare (1947-2018), PsycINFO (1806-2018) and the Cochrane Library (1991-2018). Studies were eligible for inclusion if they had assessed changes in physical activity levels during and after gynaecological cancer treatment. The methodological quality of the eligible studies was assessed by two independent reviewers using the Joanna Briggs Institute Critical Appraisal Tools.
In total, six studies (three cohort studies and three cross-sectional studies) with 1607 participants were included. All studies used patient-reported physical activity measures. Two of the three cohort studies measured patient-recalled physical activity levels before diagnosis (baseline), and length of follow-up varied across all studies. The majority of participants were treated surgically±adjuvant therapy. Physical activity levels decreased at 6 months following surgery when compared with pre-treatment levels. Approximately 91% of participants did not meet physical activity guidelines 2 years following diagnosis, and 58% reported being less physically active 3 years after diagnosis, compared with the pre-diagnosis levels.
Despite the paucity of evidence and limitations in the current body of literature, this review demonstrated that compared to pre-diagnosis, levels of physical activity remain low in gynaecological cancer survivors up to 3 years after diagnosis. More research is warranted to better characterise the pattern of change of physical activity levels across the disease trajectory and identify changes in physical activity patterns by cancer treatments and gynaecological tumour streams in order to target interventions accordingly.
妇科癌症治疗期间和之后体力活动水平的自然史尚不清楚。这是必要的，以便确定体力活动水平最低的时间，以便相应地针对妇科癌症人群进行癌症康复或运动干预。
进行系统评价，评估妇科癌症治疗对体力活动水平的影响，并总结妇科癌症患者随时间推移体力活动水平的变化模式。
通过 MEDLINE（1946-2018 年）、CINAHL（1982-2018 年）、EMBASE（1947-2018 年）、Ovid Emcare（1947-2018 年）、PsycINFO（1806-2018 年）和 Cochrane Library（1991-2018 年）进行全面文献检索。如果研究评估了妇科癌症治疗期间和之后体力活动水平的变化，则符合纳入标准。两名独立评审员使用 Joanna Briggs 研究所批判性评价工具评估合格研究的方法学质量。
共纳入 6 项研究（3 项队列研究和 3 项横断面研究），共 1607 名参与者。所有研究均使用患者报告的体力活动测量方法。3 项队列研究中有 2 项在诊断前（基线）测量了患者回忆的体力活动水平，所有研究的随访时间长短不一。大多数参与者接受了手术+辅助治疗。与治疗前水平相比，手术后 6 个月体力活动水平下降。大约 91%的参与者在诊断后 2 年内未达到体力活动指南，58%的参与者报告在诊断后 3 年内体力活动减少，与诊断前水平相比。
尽管证据不足且目前文献存在局限性，但本综述表明，与诊断前相比，妇科癌症幸存者在诊断后 3 年内体力活动水平仍然较低。需要进一步研究以更好地描述疾病轨迹中体力活动水平的变化模式，并确定癌症治疗和妇科肿瘤类型对体力活动模式的变化，以便相应地进行干预。
