O'Connor Dominic, Lennon Olive, Wright Sarah, Caulfield Brian
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
The Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland.
Support Care Cancer. 2020 Nov;28(11):5529-5536. doi: 10.1007/s00520-020-05394-0. Epub 2020 Mar 16.
Concurrent neuromuscular electrical stimulation (NMES) involving sub-tetanic low frequency and tetanic high frequency which targets aerobic and muscular fitness is a potential alternative to conventional exercise in cancer rehabilitation. However, its safety and feasibility in patients with advanced cancer are unknown. The aim of this feasibility study was to determine safety and feasibility and evaluate changes in functional and health-related quality of life (HR-QoL) outcomes in individuals with advanced cancer and poor performance status after concurrent NMES. These results should help inform the design of future studies.
Participants with advanced cancer and poor performance status (Eastern Cooperative Oncology Group scale ≥ 2) (n = 18) were recruited. The intervention included a novel NMES intervention implemented over a 4-week period. Functional exercise capacity, lower limb muscle endurance and HR-QoL were measured by 6-min walk test (6MWT), 30-s sit-to-stand (30STS) and European Organization for Research and Treatment quality of life questionnaire core-30 (EORTC QLQ C30) pre and post-intervention. Participants unable to complete the 6-min walk test completed the timed up and go test. Participant experience and the impact of the intervention on daily life were investigated through semi-structured interviews.
Ten of 18 participants completed the intervention. No adverse events were reported. Seven of 8 participants improved 6MWT performance (2 of 2 improved timed up and go), 8 of 10 participants improved 30STS and 8 of 10 participants improved Global quality of life. Perceived benefits included improved mobility and muscle strength.
Neuromuscular electrical stimulation appears safe and feasible in advanced cancer and may improve physical and HR-QoL outcomes. Future prospective trials are warranted to confirm these findings prior to clinical implementation in an advanced cancer setting.
同时进行的神经肌肉电刺激（NMES），包括亚强直低频和强直高频刺激，旨在提高有氧和肌肉适应性，是癌症康复中传统运动的一种潜在替代方法。然而，其在晚期癌症患者中的安全性和可行性尚不清楚。本可行性研究的目的是确定同时进行NMES后晚期癌症且身体状况较差的个体的安全性和可行性，并评估其功能和健康相关生活质量（HR-QoL）结果的变化。这些结果应有助于为未来研究的设计提供信息。
招募了晚期癌症且身体状况较差（东部肿瘤协作组量表≥2）的参与者（n = 18）。干预措施包括在4周内实施的新型NMES干预。在干预前后，通过6分钟步行试验（6MWT）、30秒坐立试验（30STS）和欧洲癌症研究与治疗组织生活质量问卷核心30（EORTC QLQ C30）测量功能运动能力、下肢肌肉耐力和HR-QoL。无法完成6分钟步行试验的参与者完成了计时起立行走试验。通过半结构化访谈调查了参与者的体验以及干预对日常生活的影响。
18名参与者中有10名完成了干预。未报告不良事件。8名参与者中有7名6MWT表现有所改善（2名计时起立行走试验的参与者有所改善），10名参与者中有8名30STS有所改善，10名参与者中有8名整体生活质量有所改善。感知到的益处包括活动能力和肌肉力量的提高。
神经肌肉电刺激在晚期癌症患者中似乎是安全可行的，并且可能改善身体和HR-QoL结果。在晚期癌症环境中临床实施之前，有必要进行未来的前瞻性试验以证实这些发现。
