School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; Allied Health Clinical Research Office, Eastern Health, Melbourne, Australia.
School of Public Health, Curtin University, Perth, Australia; School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
J Physiother. 2021 Jan;67(1):12-26. doi: 10.1016/j.jphys.2020.12.008. Epub 2020 Dec 24.
What is the effect of multidisciplinary, exercise-based, group oncology rehabilitation programs on healthcare service outcomes and patient-level outcomes, including quality of life and physical and psychosocial function?
Systematic review with meta-analysis of randomised controlled trials.
Adults diagnosed with cancer.
Multidisciplinary, group-based rehabilitation that includes exercise for cancer survivors.
Primary outcomes related to health service delivery, including costs, hospitalisations and healthcare service utilisation. Secondary outcomes were patient-level measures, including: the European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire, 30-second timed sit to stand and the Hospital Anxiety and Depression Scale. The evidence was evaluated using the PEDro Scale and the Grades of Research, Assessment, Development and Evaluation (GRADE) approach.
Seventeen trials (1,962 participants) were included. There was uncertainty about the effect of multidisciplinary, exercise-based rehabilitation on healthcare service outcomes, as only one trial reported length of stay and reported wide confidence intervals (MD 2.4 days, 95% CI -3.1 to 7.8). Multidisciplinary, exercise-based rehabilitation improved muscle strength (1RM chest press MD 3.6 kg, 95% CI 0.4 to 6.8; 1RM leg press MD 19.5 kg, 95% CI 12.3 to 26.8), functional strength (30-second sit to stand MD 6 repetitions, 95% CI 3 to 9) and reduced depression (MD -0.7 points, 95% CI -1.2 to -0.1) compared to usual care. There was uncertainty whether multidisciplinary rehabilitation programs are more effective when delivered early versus late or more effective than exercise alone. Adherence was typically high (mean weighted average 76% sessions attended) with no major and few minor adverse events reported.
Multidisciplinary, exercise-based oncology rehabilitation programs improve some patient-level outcomes compared with usual care. Further evidence from randomised trials to determine their effect at a healthcare service level are required if these programs are to become part of standard care.
PROSPERO CRD42019130593.
多学科、基于运动的团体肿瘤康复计划对医疗服务结果和患者水平结果（包括生活质量以及身体和心理社会功能）有何影响？
随机对照试验的系统评价和荟萃分析。
被诊断患有癌症的成年人。
多学科的团体康复，包括癌症幸存者的运动。
与医疗服务提供相关的主要结果，包括成本、住院和医疗服务利用。次要结果是患者水平的测量，包括欧洲癌症研究与治疗组织生活质量问卷、30 秒定时坐站和医院焦虑抑郁量表。使用 PEDro 量表和研究、评估、发展和评价（GRADE）方法评估证据。
纳入了 17 项试验（1962 名参与者）。多学科、基于运动的康复对医疗服务结果的影响尚不确定，因为只有一项试验报告了住院时间，且报告的置信区间较宽（MD 2.4 天，95%CI-3.1 至 7.8）。多学科、基于运动的康复可改善肌肉力量（1RM 胸推 MD 3.6 公斤，95%CI 0.4 至 6.8；1RM 腿推 MD 19.5 公斤，95%CI 12.3 至 26.8）、功能力量（30 秒坐站 MD 6 次，95%CI 3 至 9）和降低抑郁（MD-0.7 分，95%CI-1.2 至-0.1），与常规护理相比。多学科康复计划是在早期还是晚期实施更有效，或者与单独运动相比是否更有效，尚不确定。依从性通常很高（平均加权平均出席率为 76%），报告的主要不良事件很少，少数为轻微不良事件。
与常规护理相比，基于多学科运动的肿瘤康复计划可改善一些患者水平的结果。如果这些方案要成为标准护理的一部分，需要进一步来自随机试验的证据来确定其在医疗服务层面的效果。
PROSPERO CRD42019130593。
