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抗阻运动与乳腺癌相关淋巴水肿:系统评价更新。

Resistance exercise and breast cancer related lymphedema - a systematic review update.

机构信息

Department of Physical Medicine Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria.

出版信息

Disabil Rehabil. 2020 Jan;42(1):26-35. doi: 10.1080/09638288.2018.1514663. Epub 2019 Jan 13.

Abstract

Purpose of this systematic review update was analyzing resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status. Articles published until 31 September 2017 were included. A systematic literature search was conducted utilizing PubMed, MEDLINE, and EMBASE databases. Included articles were analyzed regarding their level of evidence and their methodological quality using the Cochrane risk of bias tool. Altogether, 23 articles could be included of which 16 were independent RE intervention studies and seven additional articles. Lymphedema assessment was so heterogeneous that conduction of a thorough meta-analysis regarding lymphedema status was still impossible. In all but one study, which reported a small but methodologically weak increase in arm volume, no negative effects of RE on BCRL was recorded. RE seems to be a safe exercise intervention for BCS and not to be harmful concerning the risk of lymphedema. Lymphedema assessment methods that allow for a qualitative analysis of arm tissue composition should be favored.Implications for rehabilitationBreast cancer-related lymphedema affects a considerable proportion of breast cancer patients and is debilitating on the physical, functional, social, and psychological domain.At the current time breast cancer related lymphedema is incurable but well manageable by a number of physical therapy modalities, especially complete decongestive therapy (CDT).One of the encouraging treatment methods is resistance exercise.

摘要

本次系统评价更新的目的是分析乳腺癌幸存者(BCS)的抗阻运动(RE)干预试验,以评估其对乳腺癌相关淋巴水肿(BCRL)状况的影响。纳入截至 2017 年 9 月 31 日发表的文章。利用 PubMed、MEDLINE 和 EMBASE 数据库进行系统文献检索。使用 Cochrane 偏倚风险工具分析纳入文章的证据水平和方法学质量。共纳入 23 篇文章,其中 16 篇为独立的 RE 干预研究,另有 7 篇为附加文章。淋巴水肿评估存在很大的异质性,因此仍不可能对淋巴水肿状况进行全面的荟萃分析。除了一项报告手臂体积略有增加但方法学较弱的研究外,RE 对 BCRL 没有负面影响。RE 似乎是 BCS 的一种安全运动干预措施,不会增加淋巴水肿的风险。应优先选择允许对手臂组织成分进行定性分析的淋巴水肿评估方法。

康复意义

乳腺癌相关淋巴水肿影响相当一部分乳腺癌患者,在身体、功能、社会和心理方面造成损害。

目前,乳腺癌相关淋巴水肿是无法治愈的,但可以通过多种物理治疗方法,特别是完整消肿治疗(CDT)进行很好的管理。

一种令人鼓舞的治疗方法是抗阻运动。

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