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癌症中心运动肿瘤学计划的制定、实施和效果。

Development, implementation, and effects of a cancer center's exercise-oncology program.

机构信息

Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.

Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

出版信息

Cancer. 2019 Oct 1;125(19):3437-3447. doi: 10.1002/cncr.32297. Epub 2019 Jun 17.

Abstract

BACKGROUND

National and international bodies acknowledge the benefit of exercise for people with cancer, yet limited accessibility to related programing remains. Given their involvement in managing the disease, cancer centers can play a central role in delivering exercise-oncology services. The authors developed and implemented a clinically integrated exercise-oncology program at a major cancer center and evaluated its effectiveness and participant experience.

METHODS

A hospital-based program with prescribed at-home exercise was developed and accepted referrals over a 42-month period (3.5 years). Implementation was conducted in 2 phases: a pilot phase for women with breast cancer and men with genitourinary cancer and a roll-out phase for all patients with cancer. Enrolled patients were assessed and received an exercise prescription as well as a program manual, resistance bands, and a stability ball from a kinesiologist. Program participation and effectiveness were evaluated up to 48 weeks after the baseline assessment using intention-to-treat analyses. Participants in the roll-out phase were asked to complete a program experience questionnaire at the completion of the 48-week follow-up.

RESULTS

In total, 112 participants enrolled in the pilot, and 150 enrolled in the roll-out phase. Program attrition to 48 weeks was 48% and 65% in the pilot and roll-out phases, respectively. In participants who consented to research evaluation of their performance, objective and patient-reported measures of functional capacity improved significantly from baseline in both phases. Participants were highly satisfied with the program.

CONCLUSIONS

Despite significant drop-out to program endpoints, our cancer-exercise program demonstrated clinically relevant improvement in functional outcomes and was highly appreciated by participants.

摘要

背景

国家和国际机构都承认运动对癌症患者的益处,但相关项目的可及性仍然有限。鉴于癌症中心在管理疾病方面的参与,它们可以在提供运动肿瘤学服务方面发挥核心作用。作者在一家主要癌症中心开发并实施了一项临床综合运动肿瘤学计划,并评估了其效果和参与者体验。

方法

该医院设立了一个基于医院的项目,提供规定的家庭运动,并在 42 个月(3.5 年)的时间内接受转介。实施分为两个阶段:第一阶段为女性乳腺癌和男性泌尿生殖系统癌症患者,第二阶段为所有癌症患者。入组患者接受评估,并接受运动处方以及运动生理学家提供的计划手册、阻力带和稳定球。通过意向治疗分析,在基线评估后 48 周评估计划参与和效果。在 48 周随访结束时,开展阶段的参与者被要求完成一个计划体验问卷。

结果

共有 112 名患者参加了试点,150 名患者参加了开展阶段。到 48 周时,试点和开展阶段的计划退出率分别为 48%和 65%。在同意对其表现进行研究评估的参与者中,在两个阶段,客观和患者报告的功能能力指标都从基线显著改善。参与者对该计划非常满意。

结论

尽管有大量患者在项目结束时退出,但我们的癌症运动项目在功能结果方面显示出了临床相关的改善,并且得到了参与者的高度赞赏。

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