School of Nursing, University of Michigan, Ann Arbor, MI, USA.
J Clin Nurs. 2020 Dec;29(23-24):4482-4504. doi: 10.1111/jocn.15511. Epub 2020 Oct 19.
To identify, appraise and summarise systematic reviews of exercise interventions for surgical lung cancer patients.
Low exercise capacity, reduced pulmonary function, impaired health-related quality of life and postoperative pulmonary complications are common in surgical lung cancer patients. Numerous systematic reviews address these health problems and examine the effects of exercise intervention. However, differences in the quality and scope of the systematic reviews and discordant findings from the reviews make it difficult for decisions-makers to interpret the evidence and establish best practices in the clinical settings.
Overview of systematic reviews.
This overview was conducted following the PRISMA guideline. A literature search of PubMed, CINAHL, EMBASE, Cochrane Library, SPORTDiscus and PEDro was conducted (October 2019). Peer-reviewed systematic reviews of randomised controlled trials focusing on the effects of exercise interventions for lung cancer patients who underwent surgery were included. The methodological quality of included reviews was assessed using AMSTAR 2. The results of reviews with meta-analysis were synthesised and presented by each health outcome.
Seven systematic reviews published between 2013 and 2019 were included. High/moderate-quality evidence showed that postoperative exercise interventions could increase the exercise capacity and muscle strength, and low/very-low-quality evidence showed that postoperative exercise interventions may increase the physical component of health-related quality of life and decease dyspnoea. Low-quality evidence showed that preoperative exercise interventions may increase exercise capacity and pulmonary function, decrease the risk of postoperative pulmonary complications and reduce the length of hospital stay.
Postoperative and preoperative exercises have the potential to improve health outcomes in surgical lung cancer patients. Further research is needed to evaluate the effects of different types of exercise and varying amounts of exercise.
This study provides evidence to support the implementation of exercise interventions for surgical lung cancer patients.
识别、评估和总结针对手术肺癌患者的运动干预的系统评价。
低运动能力、肺功能降低、健康相关生活质量受损和术后肺部并发症是手术肺癌患者常见的问题。许多系统评价都针对这些健康问题，并研究了运动干预的效果。然而，系统评价的质量和范围存在差异，且评价结果不一致，这使得决策者难以解释证据，并在临床实践中制定最佳实践。
系统评价概述。
本综述遵循 PRISMA 指南进行。对 PubMed、CINAHL、EMBASE、Cochrane 图书馆、SPORTDiscus 和 PEDro 进行了文献检索（2019 年 10 月）。纳入了针对接受手术的肺癌患者的运动干预效果的随机对照试验的同行评审系统评价。使用 AMSTAR 2 评估纳入评价的方法学质量。对进行了荟萃分析的评价结果按每个健康结局进行综合和呈现。
纳入了 2013 年至 2019 年期间发表的 7 项系统评价。高质量/中等质量证据表明，术后运动干预可以增加运动能力和肌肉力量，低质量/极低质量证据表明，术后运动干预可能会提高健康相关生活质量的身体成分，并减轻呼吸困难。低质量证据表明，术前运动干预可能会增加运动能力和肺功能，降低术后肺部并发症的风险，并缩短住院时间。
术后和术前运动有潜力改善手术肺癌患者的健康结局。需要进一步研究评估不同类型和不同量的运动的效果。
本研究为手术肺癌患者实施运动干预提供了证据支持。
