Department of Urology, The First Hospital of China Medical University, Liaoning, China.
Department of Breast, The First Hospital of China Medical University, Liaoning, China.
Support Care Cancer. 2020 Apr;28(4):1587-1596. doi: 10.1007/s00520-019-05186-1. Epub 2019 Dec 18.
Evidence is mixed regarding the effect of exercise programs on improving musculoskeletal symptoms and quality of life. Previous meta-analyses have not focused specifically on the musculoskeletal symptoms. Therefore, this meta-analysis aimed to evaluate the effect of exercise on these outcomes in breast cancer survivors taking aromatase inhibitors.
PubMed, CINAHL, EMBASE, Web of Science, Wan Fang, CNKI, VIP, and CBM were searched for randomized control trials or quasi-experimental studies from the establishment of the database to May 2019. Studies comparing exercise programs with usual care among breast cancer survivors taking aromatase inhibitors were included. The primary outcome was the degree of musculoskeletal symptoms, as assessed by scores of pain, stiffness, and grip strength. The secondary outcome was the total quality of life score.
A total of 9 studies involving 743 participants were included. Exercise programs were more effective than usual care in improving musculoskeletal symptoms among breast cancer patients taking AIs. The subgroup scores of pain (SMD = -0.46, 95% CI -0.79 to -0.13, P = 0.006), stiffness (SMD = -0.40, 95% CI -0.71 to -0.08, P = 0.01), and grip strength (SMD = 0.43, 95% CI 0.16 to 0.71, P = 0.002) benefited from exercise interventions. Similar effects were found for the quality of life scores (SMD = 2.24, 95% CI 0.28 to 4.21, P = 0.03).
Results indicate that exercise relieves musculoskeletal symptoms and improves quality of life, which can be used to motivate patients to exercise actively under professional guidance. Due to a small sample size, further research is required to ensure the effectiveness of exercise on musculoskeletal symptoms and quality of life.
关于运动方案对改善肌肉骨骼症状和生活质量的影响，证据不一。先前的荟萃分析并未专门针对肌肉骨骼症状。因此，本荟萃分析旨在评估运动对接受芳香化酶抑制剂治疗的乳腺癌幸存者这些结局的影响。
从数据库建立到 2019 年 5 月，我们在 PubMed、CINAHL、EMBASE、Web of Science、万方、CNKI、VIP 和 CBM 中搜索了比较接受芳香化酶抑制剂治疗的乳腺癌幸存者的运动方案与常规护理的随机对照试验或准实验研究。纳入的研究比较了接受芳香化酶抑制剂治疗的乳腺癌幸存者的运动方案与常规护理。主要结局是肌肉骨骼症状的严重程度，通过疼痛、僵硬和握力评分来评估。次要结局是总生活质量评分。
共有 9 项研究涉及 743 名参与者被纳入。运动方案在改善接受 AI 治疗的乳腺癌患者的肌肉骨骼症状方面比常规护理更有效。疼痛（SMD=-0.46，95%CI-0.79 至-0.13，P=0.006）、僵硬（SMD=-0.40，95%CI-0.71 至-0.08，P=0.01）和握力（SMD=0.43，95%CI0.16 至 0.71，P=0.002）的亚组评分均从运动干预中获益。生活质量评分也有相似的效果（SMD=2.24，95%CI0.28 至 4.21，P=0.03）。
结果表明，运动可以缓解肌肉骨骼症状并提高生活质量，这可以用来激励患者在专业指导下积极运动。由于样本量较小，需要进一步的研究来确保运动对肌肉骨骼症状和生活质量的有效性。
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