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渐进式上肢运动和肌肉放松训练对乳腺癌女性术后上肢功能和健康相关生活质量的影响:一项临床随机对照试验。

Effects of Progressive Upper Limb Exercises and Muscle Relaxation Training on Upper Limb Function and Health-Related Quality of Life Following Surgery in Women with Breast Cancer: A Clinical Randomized Controlled Trial.

机构信息

School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China.

出版信息

Ann Surg Oncol. 2019 Jul;26(7):2156-2165. doi: 10.1245/s10434-019-07305-y. Epub 2019 Apr 10.

DOI:10.1245/s10434-019-07305-y
PMID:30972655
Abstract

OBJECTIVE

The aim of this study was to examine the effects of progressive upper limb exercises and muscle relaxation training (PULE-MRT) on upper limb function and health-related quality of life (HRQoL) following surgery in Chinese mainland women with breast cancer (BC).

METHODS

Overall, 102 patients following surgery (i.e. mastectomy or breast-conserving surgery, with sentinel lymph node biopsy or axillary lymph node dissection) were randomly allocated to the intervention (n = 51) or control (n = 51) groups. The former received PULE-MRT plus routine nursing care, whereas the latter received only routine nursing care for 6 months. Upper limb function and HRQoL were measured at baseline and 1, 3, and 6 months using Constant-Murley scores (CMS) and Functional Assessment of Cancer Therapy-Breast version 4.0 (FACT-Bv4.0), respectively.

RESULTS

All patients in the intervention group completed the exercises and training, with 100% compliance and no adverse events. The intervention group had significantly higher total CMS and FACT-Bv4.0 scores at 1-, 3-, and 6-month follow-up than the control group. The significant effects in total CMS comparisons were group (F = 25.30, p < 0.001), time (F = 18.02, p < 0.001), and group-by-time interaction (F = 9.95, p < 0.001), and, in FACT-Bv4.0, total score comparisons were group (F = 15.87, p < 0.001), time (F = 17.92, p < 0.001), and group-by-time interaction (F = 7.88, p < 0.001). Similar results were observed for the scale scores of CMS and FACT-Bv4.0.

CONCLUSIONS

PULE-MRT had positive effects on improving upper limb function and HRQoL following surgery in women with BC and could be used as an optional rehabilitation management strategy in post-surgery BC patient populations. Trial Registration ChiCTR-IOR-16008253 (Chictr.org.cn; 9 April 2016).

摘要

目的

本研究旨在探讨渐进式上肢锻炼和肌肉放松训练(PULE-MRT)对中国大陆乳腺癌(BC)术后女性上肢功能和健康相关生活质量(HRQoL)的影响。

方法

共纳入 102 例术后(即乳腺癌根治术或保乳术,伴前哨淋巴结活检或腋窝淋巴结清扫术)患者,随机分为干预组(n=51)和对照组(n=51)。前者接受 PULE-MRT 联合常规护理,后者仅接受常规护理 6 个月。采用 Constant-Murley 评分(CMS)和癌症治疗功能评估-乳房 4.0 版(FACT-Bv4.0)分别于基线和 1、3、6 个月评估上肢功能和 HRQoL。

结果

干预组所有患者均完成了锻炼和训练,依从性为 100%,无不良事件发生。干预组在 1、3、6 个月随访时的 CMS 总分和 FACT-Bv4.0 总分均显著高于对照组。在 CMS 总分比较中,组间差异有统计学意义(F=25.30,p<0.001),时间差异有统计学意义(F=18.02,p<0.001),组间与时间交互作用差异有统计学意义(F=9.95,p<0.001);在 FACT-Bv4.0 总分比较中,组间差异有统计学意义(F=15.87,p<0.001),时间差异有统计学意义(F=17.92,p<0.001),组间与时间交互作用差异有统计学意义(F=7.88,p<0.001)。CMS 和 FACT-Bv4.0 量表评分也观察到类似的结果。

结论

PULE-MRT 对改善 BC 术后女性上肢功能和 HRQoL 具有积极作用,可作为 BC 术后患者的一种可选康复管理策略。

试验注册

ChiCTR-IOR-16008253(Chictr.org.cn;2016 年 4 月 9 日)。

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