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针对高骨折风险脊柱转移癌患者的脊柱稳定训练:DISPO-II训练方案的可行性

Spinal Stabilization Exercises for Cancer Patients with Spinal Metastases of High Fracture Risk: Feasibility of the DISPO-II Training Program.

作者信息

Rosenberger Friederike, Sprave Tanja, Clauss Dorothea, Hoffmann Paula, Welzel Thomas, Debus Jürgen, Rief Harald, Wiskemann Joachim

机构信息

Working Group Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany.

Department of Health Science, German University of Applied Sciences for Prevention and Health Management, 66123 Saarbrücken, Germany.

出版信息

Cancers (Basel). 2021 Jan 8;13(2):201. doi: 10.3390/cancers13020201.

Abstract

Exercise concomitant to radiotherapy for stable spinal metastases was demonstrated to increase bone density and reduce pain. In the DISPO-II study, the feasibility of exercise concomitant to radiotherapy for unstable spinal metastases was investigated. Here, a detailed analysis of the training program is presented. Cancer patients with spinal metastases (Taneichi score ≥ D) were randomly assigned to an intervention group (INT, = 27, 62 ± 9 years) or control group (CON, = 29, 61 ± 9 years). INT performed spinal stabilization exercises ("all fours"/"plank"/"swimmer"/"band exercise"), and CON received relaxation, daily concomitant to radiotherapy. Exercise attendance rate was 90% in INT and 80% in CON ( = 0.126). Within INT, exercise dose increased significantly ( < 0.001). 54% of patients could not perform "swimmer" in some or all sessions. 42% could not perform "plank" in some or all sessions. 13 and 25% could not perform "all fours" and "band exercise" in some sessions. "Plank" holding time increased in INT and remained unchanged in CON with different development between groups ( = 0.022). Handgrip strength did not develop differently between groups ( = 0.397). The exercise intervention demonstrated high acceptability but required frequent modifications due to pain, weakness and immobility to be feasible for the majority of participants. It enhanced specific muscle strength. Larger trials should now investigate exercise effects on health.

摘要

放疗联合运动治疗稳定型脊柱转移瘤被证明可增加骨密度并减轻疼痛。在DISPO-II研究中,对放疗联合运动治疗不稳定型脊柱转移瘤的可行性进行了调查。在此,我们展示了对训练计划的详细分析。脊柱转移瘤患者(谷内评分≥D)被随机分为干预组(INT,n = 27,62±9岁)或对照组(CON,n = 29,61±9岁)。INT组进行脊柱稳定运动(“四足支撑”/“平板支撑”/“游泳者姿势”/“弹力带运动”),CON组在放疗期间每日接受放松训练。INT组的运动出勤率为90%,CON组为80%(P = 0.126)。在INT组中,运动剂量显著增加(P < 0.001)。54%的患者在部分或全部疗程中无法完成“游泳者姿势”。42%的患者在部分或全部疗程中无法完成“平板支撑”。13%和25%的患者在部分疗程中无法完成“四足支撑”和“弹力带运动”。INT组的“平板支撑”保持时间增加,CON组保持不变,两组之间存在不同的变化趋势(P = 0.022)。两组之间握力的变化没有差异(P = 0.397)。运动干预显示出较高的可接受性,但由于疼痛、虚弱和行动不便,需要频繁调整才能使大多数参与者可行。它增强了特定的肌肉力量。现在应该进行更大规模的试验来研究运动对健康的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/877f/7827062/971a0204dcd0/cancers-13-00201-g001.jpg

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