Henriksson Anna, Johansson Birgitta, Radu Calin, Berntsen Sveinung, Igelström Helena, Nordin Karin
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Acta Oncol. 2021 Jan;60(1):96-105. doi: 10.1080/0284186X.2020.1851046. Epub 2020 Dec 18.
Few studies have systematically evaluated the risk of adverse events (AEs) among persons exercising during oncological treatment. We aimed to describe incidence and types of AEs during exercise for persons undergoing oncological treatment, and associations to exercise intensity, exercise adherence, chemotherapy treatment, initial aerobic fitness. A second aim was to compare incidence of lymphedema, periphery inserted central catheter (PICC) complications, and other new medical conditions (any illness or injury occurred during the exercise trial) between high-intensity vs low-to-moderate exercise and usual care (UC).
This descriptive, comparative study was based on data from an observational study including patients in an UC setting ( = 90) and a randomized exercise trial ( = 577) in which participants exercised at high-intensity (HI) or low-moderate intensity (LMI). Persons with breast, prostate, or colorectal cancer undergoing neo/adjuvant treatment were included. AEs were reported by exercise coaches, participants, and identified in medical records, as were lymphedema, PICC-complications, and new medical conditions.
Coaches reported AEs for 20% of the participants, while 28% of participants self-reported AEs. The most common coach- and participant reported AEs were musculoskeletal and the majority (97%) were considered minor. HI had higher likelihood of AEs than LMI, according to both coaches (OR: 1.9 [95%CI 1.16-3.21], =.011) and participants (OR: 3.36 [95%CI 2.00-5.62], .001). Lymphedema rates were low (4-9%) and PICC complications ranged from 15% in LMI to 23% in UC and there were no statistically significant differences between HI, LMI, and UC. There were no statistically significant differences between HI and LMI regarding new medical conditions.
Exercise during treatment is safe for these patient groups in this setting, even HI exercise can be recommended if no medical contraindications are present. Similar to healthy populations, a higher risk of having minor AEs when exercising at HI in comparison to LMI may exist.
很少有研究系统地评估肿瘤治疗期间运动人群发生不良事件（AE）的风险。我们旨在描述肿瘤治疗期间运动人群AE的发生率和类型，以及与运动强度、运动依从性、化疗治疗、初始有氧适能的关联。第二个目的是比较高强度运动与低至中等强度运动及常规护理（UC）之间淋巴水肿、外周静脉穿刺中心静脉置管（PICC）并发症及其他新发病症（运动试验期间发生的任何疾病或损伤）的发生率。
这项描述性比较研究基于一项观察性研究的数据，该观察性研究包括UC组的患者（n = 90）和一项随机运动试验（n = 577），其中参与者进行高强度（HI）或低至中等强度（LMI）运动。纳入接受新辅助/辅助治疗的乳腺癌、前列腺癌或结直肠癌患者。运动教练、参与者报告AE，并在医疗记录中识别淋巴水肿、PICC并发症和新发病症。
教练报告20%的参与者发生AE，而28%的参与者自我报告发生AE。教练和参与者报告的最常见AE是肌肉骨骼方面的，且大多数（97%）被认为是轻微的。根据教练（OR：1.9 [95%CI 1.16 - 3.21]，P = 0.011）和参与者（OR：3.36 [95%CI 2.00 - 5.62]，P < 0.001）的报告，HI组发生AE的可能性高于LMI组。淋巴水肿发生率较低（4 - 9%），PICC并发症发生率在LMI组为15%，UC组为23%，HI组、LMI组和UC组之间无统计学显著差异。在新发病症方面，HI组和LMI组之间无统计学显著差异。
在这种情况下，治疗期间运动对这些患者群体是安全的，如果没有医学禁忌，甚至可以推荐进行HI运动。与健康人群类似，与LMI运动相比，HI运动时发生轻微AE的风险可能更高。
