Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Arch Phys Med Rehabil. 2022 Dec;103(12):2391-2397. doi: 10.1016/j.apmr.2022.05.019. Epub 2022 Jun 26.
To determine the effects of multimodal rehabilitation initiated immediately after esophageal cancer surgery on physical recovery compared with conventional pulmonary rehabilitation.
Retrospective study.
Private quaternary care hospital.
Fifty-nine inpatients (N=59) who participated in either conventional pulmonary rehabilitation (n=30) or in multimodal rehabilitation (n=29) after esophageal cancer surgery were included.
Both groups performed pulmonary exercises, including deep breathing, chest expansion, inspiratory muscle training, coughing, and manual vibration. In the conventional pulmonary rehabilitation group, light-intensity mat exercise, stretching, and walking were performed. The multimodal rehabilitation group performed resistance exercises and moderate- to high-intensity aerobic interval exercises using a bicycle.
The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 (EORTC QLQ-C30), pain, 6-minute walk test (6MWT), 30-second chair stand test, and grip strengths were assessed before and after the rehabilitation programs.
Symptom scales of pain, dyspnea, and insomnia in the EORTC QLQ-C30 as well as 6MWT improved significantly after each program (P<.05). 6MWT (73.1±52.6 vs 28.4±14.3, P<.001, d=1.15), 30-second chair stand test (3.5±3.9 vs 0.35±2.0, P<.001, d=1.06), and left grip strength (1.2±1.3 vs 0.0±1.5, P=.002, d=0.42) improved significantly in the multimodal rehabilitation group compared with the pulmonary rehabilitation group. While right grip strength also showed more improvement for those undergoing the multimodal program, the mean strength difference was not clinically meaningful.
A multimodal inpatient rehabilitation program instituted early after esophageal cancer surgery improved endurance for walking more than conventional pulmonary rehabilitation as measured by the 6MWT and the 30-second chair stand test.
比较食管癌手术后即刻开始的多模式康复与常规肺康复对身体恢复的影响。
回顾性研究。
私立四级保健医院。
共纳入 59 名住院患者（N=59），他们分别参加了食管癌手术后的常规肺康复（n=30）或多模式康复（n=29）。
两组均进行了肺部锻炼，包括深呼吸、胸廓扩张、吸气肌训练、咳嗽和手动振动。在常规肺康复组中，进行了低强度垫上运动、伸展和行走。多模式康复组则使用自行车进行了阻力训练和中高强度的有氧间歇运动。
在康复计划前后，采用欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）评估欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）、疼痛、6 分钟步行试验（6MWT）、30 秒椅站试验和握力。
EORTC QLQ-C30 的疼痛、呼吸困难和失眠症状量表以及 6MWT 在每个方案后均显著改善（P<.05）。6MWT（73.1±52.6 比 28.4±14.3，P<.001，d=1.15）、30 秒椅站试验（3.5±3.9 比 0.35±2.0，P<.001，d=1.06）和左握力（1.2±1.3 比 0.0±1.5，P=.002，d=0.42）在多模式康复组中较肺康复组有显著改善。尽管右侧握力在多模式康复组中也有更大的改善，但平均差异没有临床意义。
与常规肺康复相比，食管癌手术后即刻开始的多模式住院康复方案通过 6MWT 和 30 秒椅站试验更能提高步行耐力。
