有氧运动对乳腺癌治疗后上肢功能的有效性：一项系统评价和荟萃分析。

Effectiveness of aerobic exercise on upper limb function following breast cancer treatment: a systematic review and meta-analysis.

作者信息

Yang Yuling, Gu Danfeng, Qian Yuan, Wang Huihong, Chai Xiaoying

机构信息

Department of Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China.

Nursing Department, Affiliated Hospital of Jiangnan University, Wuxi, China.

出版信息

Ann Palliat Med. 2021 Mar;10(3):3396-3403. doi: 10.21037/apm-20-2616. Epub 2021 Mar 17.

DOI:10.21037/apm-20-2616

PMID:33752433

Abstract

BACKGROUND

Aerobic exercise is currently considered to be an effective method of rehabilitation in breast cancer patients. Studies have shown that aerobic exercise after breast cancer surgery can improve upper limb function, cardiopulmonary function, and quality of life. Breast cancer rehabilitation guidelines encourage patients to actively participate in aerobic exercise to promote rehabilitation, the current study is to evaluate the effectiveness of aerobic exercise on upper limb muscle strength and range of motion (ROM) following breast cancer treatment.

METHODS

Electronic databases (Cochrane Library, PubMed, Web of Science, EBSCO and Embase) were searched for randomized controlled trials (RCTs) published before September 1, 2019, using the search terms "aerobic exercise", "exercise", "breast cancer", "muscle strength", "strength", "flexibility" and "function". Grip strength and shoulder joint ROM were used to evaluate upper limb strength and upper limb flexibility respectively. All statistical tests were performed using RevMan5.3 software.

RESULTS

Nine RCTs (421 patients) were included for analysis, with JBI scores ranging from 19 to 23, and bias grade B for all studies among which, there were six studies reported change in grip strength, and five studies reported change in shoulder joint ROM. Meta-analysis showed a statistically significant difference in shoulder flexion ROM (MD =4.97, 95% CI: 0.47-9.46, P=0.03), shoulder abduction ROM (MD =8.95, 95% CI: 0.99-16.91, P=0.03), shoulder internal rotation ROM (MD =3.45, 95% CI: 1.80-5.09, P<0.0001), shoulder external rotation ROM (MD =7.69, 95% CI: 0.06-15.32, P=0.05) between the intervention and control groups following completion of the aerobic exercise intervention, while there were no significant improvement with respect to grip strength and shoulder extension ROM (P>0.05).

CONCLUSIONS

Aerobic exercise could improve shoulder joint ROM in breast cancer survivors, but shows no obvious effect on the improvement of upper limb strength.

摘要

背景

有氧运动目前被认为是乳腺癌患者康复的有效方法。研究表明，乳腺癌手术后进行有氧运动可改善上肢功能、心肺功能和生活质量。乳腺癌康复指南鼓励患者积极参与有氧运动以促进康复，本研究旨在评估有氧运动对乳腺癌治疗后上肢肌肉力量和关节活动范围（ROM）的有效性。

方法

检索电子数据库（Cochrane图书馆、PubMed、Web of Science、EBSCO和Embase），查找2019年9月1日前发表的随机对照试验（RCT），检索词为“有氧运动”“运动”“乳腺癌”“肌肉力量”“力量”“柔韧性”和“功能”。握力和肩关节ROM分别用于评估上肢力量和上肢柔韧性。所有统计分析均使用RevMan5.3软件进行。

结果

纳入9项RCT（421例患者）进行分析，JBI评分在19至23之间，所有研究的偏倚等级为B。其中，6项研究报告了握力变化，5项研究报告了肩关节ROM变化。Meta分析显示，有氧运动干预完成后，干预组与对照组在肩关节前屈ROM（MD =4.97，95%CI：0.47 - 9.46，P =0.03）、肩关节外展ROM（MD =8.95，95%CI：0.99 - 16.91，P =0.03）、肩关节内旋ROM（MD =3.45，95%CI：1.80 - 5.09，P <0.0001）、肩关节外旋ROM（MD =7.69，95%CI：0.06 - 15.32，P =0.05）方面存在统计学显著差异，而在握力和肩关节后伸ROM方面无显著改善（P>0.05）。