Department of Physiotherapy, Melbourne School of Health Sciences; Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Australia; Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
Department of Physiotherapy, Melbourne School of Health Sciences; Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Australia; Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
Semin Oncol Nurs. 2022 Oct;38(5):151330. doi: 10.1016/j.soncn.2022.151330. Epub 2022 Aug 23.
We aim to describe on the role of exercise in preparation for cancer treatments (prehabilitation) that include surgery and neoadjuvant or nonsurgical approaches. We discuss the evidence for the role of exercise and provide guidelines to exercise prescription and examples of the structure of prehabilitation exercise programs.
We use peer-reviewed articles obtained through PubMed searches with search terms: exercise, oncology, cancer surgery, exercise physiology, respiratory exercises, prehabilitation, and behavior change.
The emergence of prehabilitation in preparing patients for cancer care has followed a rapidly upward trajectory over the past 20 years. Exercise prehabilitation remains the cornerstone of management, particularly in patients attending for major surgery. Multimodal approaches to supporting patients before cancer treatment are now well accepted and include screening and individualized treatments of functional, nutritional, and psychological impairments. Respiratory training before surgery and the addition of behavior change strategies to improve adherence to interventions and promote improved longer-term outcomes are now included in many prehabilitation programs. For exercise to be an effective treatment in improving fitness and strength, supervised aerobic and resistance exercises at moderate intensity are recommended. There remains debate regarding the use of higher-intensity exercise, the appropriate outcome to measure efficacy, and the mechanisms driving the efficacy of exercise.
We provide background evidence and knowledge pertaining to the role and provision of exercise prehabilitation. Understanding screening, risk factors, and potential efficacy assists in knowing who to refer for prehabilitation and what the programs include. This enables more effective com munication with patients attending for cancer treatments.
我们旨在描述运动在癌症治疗（康复）准备中的作用，包括手术和新辅助或非手术方法。我们讨论了运动的作用的证据，并提供了运动处方的指南和康复运动方案的结构示例。
我们使用通过 PubMed 搜索获得的同行评议文章，搜索词为：运动、肿瘤学、癌症手术、运动生理学、呼吸练习、康复和行为改变。
在过去的 20 年中，康复在为癌症患者做准备方面的出现呈快速上升趋势。运动康复仍然是管理的基石，特别是在接受重大手术的患者中。现在，支持癌症治疗前患者的多模式方法已被广泛接受，包括对功能、营养和心理障碍进行筛查和个体化治疗。在手术前进行呼吸训练，并增加行为改变策略，以提高对干预措施的依从性并促进改善长期结果，现在已纳入许多康复计划中。为了使运动成为改善健康和力量的有效治疗方法，建议进行适度强度的有氧和阻力运动。关于高强度运动的使用、衡量疗效的适当结果以及运动疗效的机制仍存在争议。
我们提供了与康复运动的作用和提供相关的背景证据和知识。了解筛查、风险因素和潜在疗效有助于了解谁需要康复以及康复计划包括哪些内容。这使参加癌症治疗的患者能够进行更有效的沟通。
