Cypress College, Cypress, CA, USA.
Michigan State University, East Lansing, MI, USA.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420969816. doi: 10.1177/1534735420969816.
Cardiotoxicity as a result of cancer treatment contributes to autonomic dysfunction and decreased cardiorespiratory fitness among cancer survivors. These deleterious cardiovascular outcomes reduce the survival prognosis for cancer patients and contribute to poor quality of life among survivors. Exercise interventions have been shown as effective in mitigating treatment-related side effects. However, previously published interventions have not explored the potential for improvement in autonomic dysfunction (heart rate variability, HRV). This study examined cardiovascular adaptations in cancer survivors (n = 76) who participated in a 26-week intervention consisting of combined aerobic and resistance training (CART). The most noteworthy improvements occurred during the first 13 weeks of training and were maintained throughout the end of the 26-week period. HR improved from baseline (PRE) to the midpoint (MID) ( = .036) and from PRE to POST timepoints ( = .029). HRV and VO did not initially appear to change in response to CART. However, after stratification on time since treatment, participants who were 5 or more years from their last treatment experienced improvements (ie increase) in the HRV characteristic of HF power ( = .050) and also in VO ( =.043), when compared to those experiencing less than 5 years of time since their last treatment. These findings highlight a need for more attention to address the cardiorespiratory deficits experienced by those who have recently completed cancer treatment. In conclusion, the CART intervention is effective in improving cardiorespiratory fitness and autonomic dysfunction. The structure of the intervention is feasible for cancer survivors to continue with at home, using minimal resources, and without supervision. This at-home model may be even more acceptable to recent survivors that may be homebound immediately following treatment.
癌症治疗导致的心脏毒性会导致癌症幸存者自主神经功能障碍和心肺功能下降。这些有害的心血管结果降低了癌症患者的生存预后,并导致幸存者生活质量下降。运动干预已被证明可有效减轻治疗相关的副作用。然而,以前发表的干预措施并未探讨改善自主神经功能障碍(心率变异性,HRV)的潜力。本研究检查了参加 26 周联合有氧和阻力训练(CART)干预的癌症幸存者(n=76)的心血管适应情况。最显著的改善发生在训练的前 13 周,并且在 26 周结束时仍保持不变。HR 从基线(PRE)到中点(MID)( = .036)和从 PRE 到 POST 时间点( = .029)都有所改善。HRV 和 VO 最初似乎没有因 CART 而改变。然而,根据治疗后时间进行分层后,那些距离最后一次治疗 5 年或以上的参与者经历了 HRV 特征 HF 功率的改善( = .050),并且 VO 也有所改善( =.043),与那些经历不到 5 年时间的参与者相比。这些发现强调需要更加关注那些最近完成癌症治疗的人的心肺呼吸缺陷。总之,CART 干预措施可有效改善心肺功能和自主神经功能障碍。该干预措施的结构对于癌症幸存者在家中继续进行,使用最少的资源且无需监督是可行的。这种家庭模式可能对那些可能在治疗后立即居家的最近的幸存者更具吸引力。
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