Rehabilitation Sciences Post-graduate Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
Neuroendocrinology Research Centre/Endocrinology Section, Medical School and Clementino Fraga Filho University Hospital, Federal University of the Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
Endocrine. 2019 Nov;66(2):301-309. doi: 10.1007/s12020-019-02011-x. Epub 2019 Jul 17.
Although the focus of acromegaly treatment is the hormonal control of the disease, a new perspective must be given to the functional rehabilitation of these patients, especially when considering the recent increase in survival. The aim of this study was to evaluate the effects of therapist-oriented home rehabilitation (TOHR) on patients with acromegaly.
Seventeen adults with acromegaly followed an exercise programme from a booklet with instructions for each exercise prescribed, for 2 months, and were reassessed after 1 month of washout. At each of the 3 timepoints (before and after the intervention and at the 1-month follow-up), the participants were subjected to the following assessments: body composition through bioimpedance, health-related quality of life (HRQoL) using the Acromegaly Quality of Life (AcroQoL) questionnaire, general fatigue through the Functional Assessment of Chronic Illness Therapy-Fatigue scale, handgrip strength, lower extremity functionality using isometric dynamometry and the Lower Extremity Functional Scale (LEFS), body balance through stabilometry, and functional capacity through 6-minute walking distance (6MWD).
After performing TOHR, improvements in general fatigue, quadriceps muscle strength, LEFS, 6MWD, balance control and all AcroQoL dimensions were observed (all P < 0.05). After 1 month of washout, however, these gains were lost for all parameters, except the LEFS and balance control.
In acromegaly, TOHR results in improvements in muscle function, functional capacity, general fatigue, body balance, and HRQoL. Large randomized controlled trials are needed to replicate these benefits and to recommend rehabilitation, especially for those with long-term illness.
尽管肢端肥大症治疗的重点是疾病的激素控制，但必须为这些患者提供新的功能康复视角，尤其是在考虑到最近生存时间延长的情况下。本研究旨在评估面向治疗师的家庭康复（TOHR）对肢端肥大症患者的影响。
17 名成年肢端肥大症患者按照指导手册中的说明进行锻炼，持续 2 个月，并在洗脱期 1 个月后进行重新评估。在 3 个时间点（干预前、干预后和 1 个月随访时），对参与者进行以下评估：生物电阻抗法评估身体成分，使用肢端肥大症生活质量问卷（AcroQoL）评估健康相关生活质量（HRQoL），使用慢性病治疗疲劳量表-功能评估（FACIT-F）评估一般疲劳，使用握力计评估握力，使用等长测力计和下肢功能量表（LEFS）评估下肢功能，使用稳定计评估身体平衡，使用 6 分钟步行距离（6MWD）评估功能能力。
进行 TOHR 后，一般疲劳、股四头肌力量、LEFS、6MWD、平衡控制和所有 AcroQoL 维度均得到改善（均 P<0.05）。然而，在洗脱期 1 个月后，除了 LEFS 和平衡控制外，所有参数的这些改善均消失。
在肢端肥大症中，TOHR 可改善肌肉功能、功能能力、一般疲劳、身体平衡和 HRQoL。需要进行大型随机对照试验来复制这些益处，并推荐康复治疗，特别是对于长期患病的患者。
