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支持渐进式抗阻运动训练以对抗机器人辅助根治性前列腺切除术的不良反应:一项随机对照试验。

Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial.

机构信息

Department of Sport, Outdoor and Exercise Science, University of Derby, Derby, UK.

Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.

出版信息

Support Care Cancer. 2021 Aug;29(8):4595-4605. doi: 10.1007/s00520-021-06002-5. Epub 2021 Jan 23.

Abstract

PURPOSE

To investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP).

METHODS

This study was a single-site, two-arm randomised controlled trial, with 40 participants randomised to either the intervention or control group over a 10-month period. In addition to receiving usual care, the intervention group completed three weekly RET sessions using resistance bands for 6 months. Participants performed 3 sets of 12-15 repetitions for each exercise, targeting each major muscle group. The control group received usual care only. Brachial artery flow-mediated dilatation (FMD) was the primary outcome and assessed at baseline, 3 and 6 months. Secondary outcomes included body weight, body fat, aerobic fitness, strength and blood-borne biomarkers associated with cardiometabolic risk.

RESULTS

There was no significant difference between the groups in FMD at 3 or 6 months. However, there were improvements in aerobic exercise capacity (P < 0.01) and upper- (P < 0.01) and lower-limb (P = 0.01) strength in favour of the RET group at 6 months, accompanied by greater weight loss (P = 0.04) and a reduction in body fat (P = 0.02). Improvements in HRQoL were evident in the RET group at 3 and 6 months via the PCa-specific component of the FACT-P questionnaire (both P < 0.01). Five adverse events and one serious adverse event were reported throughout the trial duration.

CONCLUSION

This study demonstrates that home-based RET is an effective and safe mode of exercise that elicits beneficial effects on aerobic exercise capacity, muscular strength and HR-QoL in men who have undergone RARP.

TRIAL REGISTRATION

ISRCTN10490647.

摘要

目的

研究基于家庭支持的渐进式抗阻训练(RET)方案对机器人辅助根治性前列腺切除术(RARP)治疗后的前列腺癌(PCa)患者心血管健康指数、肌肉力量和健康相关生活质量(HR-QoL)的影响。

方法

这是一项单中心、双臂随机对照试验,40 名参与者在 10 个月的时间内随机分为干预组或对照组。除了接受常规护理外,干预组还使用阻力带进行每周三次的 RET 训练,持续 6 个月。每个运动目标每个主要肌肉群,参与者完成 3 组 12-15 次重复。对照组仅接受常规护理。肱动脉血流介导的扩张(FMD)是主要结局,在基线、3 个月和 6 个月时进行评估。次要结局包括体重、体脂、有氧健身能力、力量和与心血管代谢风险相关的血液生物标志物。

结果

两组在 3 个月或 6 个月时 FMD 无显著差异。然而,在 6 个月时,RET 组的有氧运动能力(P<0.01)和上肢(P<0.01)和下肢(P=0.01)力量均有所改善,同时体重减轻(P=0.04)和体脂减少(P=0.02)。在 3 个月和 6 个月时,RET 组通过 FACT-P 问卷的 PCa 特定组成部分明显改善了 HRQoL(均 P<0.01)。整个试验过程中报告了 5 起不良事件和 1 起严重不良事件。

结论

本研究表明,基于家庭的 RET 是一种有效且安全的运动方式,可提高接受 RARP 治疗后的男性有氧运动能力、肌肉力量和 HR-QoL。

试验注册

ISRCTN8220333。

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