化疗引起心力衰竭的运动干预的可行性和结果。
Feasibility and Outcomes of an Exercise Intervention for Chemotherapy-Induced Heart Failure.
机构信息
Department of Health Promotion & Behavioral Sciences, The University of Texas School of Public Health, Houston (Mr Tsai); Department of Behavioral Science (Mr Tsai, Ms Harrison, and Dr Basen-Engquist), Department of Cardiology, Division of Internal Medicine (Drs Mouhayar and Durand), Department of Biostatistics (Dr Song), Department of Nursing (Dr Fadol), and Clinical Research Support Center (Ms Massey), The University of Texas MD Anderson Cancer Center, Houston; and Cardiovascular Division, Washington University School of Medicine in St Louis, St Louis, Missouri (Dr Lenihan).
出版信息
J Cardiopulm Rehabil Prev. 2019 May;39(3):199-203. doi: 10.1097/HCR.0000000000000388.
PURPOSE
Cancer treatment-related heart failure (HF) is an emerging health concern, as the number of survivors is increasing rapidly, and cardiac health issues are a leading cause of mortality in this population. While there is general evidence for the efficacy of exercise rehabilitation interventions, more research is needed on exercise rehabilitation interventions for patients specifically with treatment-induced HF and whether such interventions are safe and well-accepted. This study provides feasibility and health outcomes of a pilot exercise intervention for cancer survivors with chemotherapy-induced HF.
METHODS
Twenty-five participants were randomized to a clinic-based exercise intervention or a wait-list control group or, alternatively, allowed to enroll in a home-based exercise intervention if they declined the randomized study. For purposes of analysis, both types of exercise programs were combined into a single intervention group. Repeated-measures analysis of variance was conducted to assess for significant time and treatment group main effects separately and time × treatment group interaction effects.
RESULTS
Significant improvements in maximum oxygen uptake ((Equation is included in full-text article.)O2max) were observed in the intervention group. Intervention satisfaction and adherence were high for both clinic- and home-based interventions, with no reported serious adverse events. Enrollment was initially low for the clinic-based intervention, necessitating the addition of the home-based program as an intervention alternative.
CONCLUSIONS
Results suggest that exercise rehabilitation interventions are feasible in terms of safety, retention, and satisfaction and have the potential to improve (Equation is included in full-text article.)O2max. To maximize adherence and benefits while minimizing participant burden, an ideal intervention may incorporate elements of both clinic-based supervised exercise sessions and a home-based program.
目的
癌症治疗相关的心力衰竭（HF）是一个新出现的健康问题，因为幸存者的数量正在迅速增加，而心脏健康问题是该人群死亡的主要原因。虽然一般有证据表明运动康复干预措施有效，但仍需要更多关于专门针对治疗引起的 HF 患者的运动康复干预措施的研究，以及此类干预措施是否安全且被广泛接受。本研究提供了针对化疗诱导 HF 的癌症幸存者进行试点运动干预的可行性和健康结果。
方法
25 名参与者被随机分配到诊所基础运动干预组或候补名单对照组，或者如果他们拒绝随机研究，则允许他们参加家庭基础运动干预。为了分析的目的，将这两种运动方案合并为一个单一的干预组。采用重复测量方差分析分别评估时间和治疗组的主要效应以及时间×治疗组的交互效应。
结果
干预组的最大摄氧量（(Equation is included in full-text article.)O2max）显著提高。诊所和家庭两种干预措施的干预满意度和依从性均较高，无报告严重不良事件。诊所基础干预的入组最初较低，因此需要增加家庭基础方案作为干预的替代方案。
结论
结果表明，运动康复干预在安全性、保留率和满意度方面是可行的，并且有可能提高(Equation is included in full-text article.)O2max。为了最大限度地提高依从性和获益，同时最大限度地减少参与者负担，理想的干预措施可能结合诊所监督运动课程和家庭计划的元素。
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