Physical Therapy Program, Department of Exercise Science, University of South Carolina, Blatt PE Center, 101G, Columbia, SC 29208 (USA).
Office of Strategic Research, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland; Cancer Prevention and Control, Department of Hematology/Oncology, West Virginia University Cancer Institute, Morgantown, West Virginia.
Phys Ther. 2020 Mar 10;100(3):363-415. doi: 10.1093/ptj/pzz184.
Cancer rehabilitation research has accelerated over the last decade. However, closer examination of the published literature reveals that the majority of this work has focused on psychological interventions and cognitive and behavioral therapies. Recent initiatives have aggregated expert consensus around research priorities, highlighting a dearth in research regarding measurement of and interventions for physical function. Increasingly loud calls for the need to address the myriad of physical functional impairments that develop in people living with and beyond cancer have been published in the literature. A detailed survey of the landscape of published research has not been reported to our knowledge.
This scoping review systematically identified literature published between 2008 and 2018 related to the screening, assessment, and interventions associated with physical function in people living with and beyond cancer.
PubMed and CINAHL were searched up to September 2018.
Study selection included articles of all levels of evidence on any disease stage and population. A total of 11,483 articles were screened for eligibility, 2507 full-text articles were reviewed, and 1055 articles were selected for final inclusion and extraction.
Seven reviewers recorded type of cancer, disease stage, age of participants, phase of treatment, time since diagnosis, application to physical function, study design, impairments related to physical function, and measurement instruments used.
Approximately one-third of the articles included patients with various cancer diagnoses (30.3%), whereas the rest focused on a single cancer, most commonly breast (24.8%). Most articles (77%) measured physical function following the completion of active cancer treatment with 64% representing the assessment domain. The most commonly used measures of physical function were the Medical Outcomes Study 36-Item Health Survey Questionnaire (29%) and the European Organization for Research and Treatment of cancer Quality of Life Questionnaire-Cancer 30 (21.5%).
Studies not written in English, study protocols, conference abstracts, and unpublished data were excluded.
This review elucidated significant inconsistencies in the literature regarding language used to define physical function, measurement tools used to characterize function, and the use of those tools across the cancer treatment and survivorship trajectory. The findings suggested that physical function in cancer research is predominantly measured using general health-related quality-of-life tools rather than more precise functional assessment tools. Interdisciplinary and clinician-researcher collaborative efforts should be directed toward a unified definition and assessment of physical function.
过去十年，癌症康复研究进展迅速。然而，仔细审查已发表的文献发现，大部分工作都集中在心理干预以及认知和行为疗法上。最近的各项举措围绕研究重点，汇总了专家共识，突出了在身体功能测量和干预方面研究的不足。文献中越来越多地呼吁解决癌症患者及其康复者中出现的各种身体功能障碍。但是，我们尚未检索到针对已发表研究领域的详细调查。
本范围界定综述系统地确定了 2008 年至 2018 年间发表的与癌症患者及其康复者身体功能相关的筛查、评估和干预措施相关的文献。
截至 2018 年 9 月，在 PubMed 和 CINAHL 中进行了检索。
研究选择包括针对任何疾病阶段和人群的所有证据水平的文章。共筛选出 11483 篇符合条件的文章，对 2507 篇全文文章进行了审查，最终纳入并提取了 1055 篇文章。
7 位审阅者记录了癌症类型、疾病阶段、参与者年龄、治疗阶段、诊断后时间、对身体功能的应用、研究设计、与身体功能相关的障碍以及使用的测量仪器。
约三分之一的文章纳入了各种癌症诊断的患者（30.3%），其余的则侧重于单一癌症，最常见的是乳腺癌（24.8%）。大多数文章（77%）在完成癌症治疗后测量身体功能，其中 64%代表评估领域。最常用的身体功能测量方法是医疗结局研究 36 项健康调查问卷（29%）和欧洲癌症研究与治疗组织生活质量问卷-癌症 30 项（21.5%）。
排除了非英语撰写的研究、研究方案、会议摘要和未发表的数据。
本综述阐明了文献中在用于定义身体功能的语言、用于描述功能的测量工具以及在癌症治疗和生存轨迹中使用这些工具方面存在的显著不一致。研究结果表明，癌症研究中身体功能主要使用一般健康相关生活质量工具进行测量，而不是更精确的功能评估工具。应该开展跨学科和临床研究人员协作努力，以实现身体功能的统一定义和评估。
