Martha Bianca Andrade, Vacchi Cindy de Oliveira, Fattori Rafael Ailton, Macagnan Fabrício Edler
Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.
Multiprofessional Residency Program in Oncohematology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.
J Child Health Care. 2021 Mar;25(1):18-30. doi: 10.1177/1367493520903626. Epub 2020 Feb 4.
Previous studies have shown beneficial effects of physical exercise (PE) in adults submitted to hematopoietic stem cell transplantation (HSCT). Conduct a systematic review about the effects of PE on the functional capacity of children and adolescents submitted to HSCT. The studies were searched in the databases MEDLINE (via PubMed), Central Register of Controlled Trials (Cochrane CENTRAL), EMBASE, LILACS, and Evidence Database in Physical Therapy (PEDro) (CRD42018080093). Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. Randomized and nonrandomized clinical trials comparing PE with usual treatment in children and adolescents aged 3-18 years were included. The risk of bias was assessed using the Cochrane Collaboration tool and ROBINS-I tool, and the overall quality of the evidence was determined by the GRADE system. We included three studies with 91 patients. PE improved the functional capacity assessed by the timed up and down stairs test (MD -1.23 [95% CI, 2.27 to -.20, I2 = 0%]), but there was no significant effect in the six-minute walk test (MD 44.63 [95% CI, -20.86 to 110.13, I2 = 83%]). The benefits regarding quality of life and peripheral muscle strength of these individuals were not clearly demonstrated, but positive responses were observed in relation to the analyzed data. None of the studies evaluated the fatigue. The limitations found were the high heterogeneity between studies, as well as the sample size and the low methodological rigor. PE might be favorable to improve the functional capacity of children and adolescents treated with HSCT. However, further studies are needed to clarify the best PE program.
先前的研究表明，体育锻炼（PE）对接受造血干细胞移植（HSCT）的成年人有有益影响。对体育锻炼对接受HSCT的儿童和青少年功能能力的影响进行系统评价。在MEDLINE（通过PubMed）、对照试验中央注册库（Cochrane CENTRAL）、EMBASE、LILACS和物理治疗证据数据库（PEDro）（CRD42018080093）中检索研究。两名独立的评审员进行文章筛选、数据提取和方法学质量评估。纳入了比较3至18岁儿童和青少年体育锻炼与常规治疗的随机和非随机临床试验。使用Cochrane协作工具和ROBINS-I工具评估偏倚风险，并通过GRADE系统确定证据的整体质量。我们纳入了三项研究，共91名患者。体育锻炼通过定时上下楼梯测试评估改善了功能能力（MD -1.23 [95%CI，2.27至-.20，I2 = 0%]），但在六分钟步行测试中没有显著效果（MD 44.63 [95%CI，-20.86至110.13，I2 = 83%]）。这些个体在生活质量和外周肌肉力量方面的益处没有得到明确证明，但在分析的数据中观察到了积极反应。没有一项研究评估疲劳情况。发现的局限性包括研究之间的高度异质性，以及样本量和方法学严谨性较低。体育锻炼可能有利于改善接受HSCT治疗的儿童和青少年的功能能力。然而，需要进一步的研究来阐明最佳的体育锻炼方案。
