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多模式治疗对乳腺癌癌因性疲劳患者静息/活动和自主神经调节的影响:一项具有综合队列设计的三中心试验的结果。

Influence of Multimodal Treatment on Rest/Activity and Autonomic Regulation in Breast Cancer Patients with Cancer-Related Fatigue: Results of a Tri-Centre Trial with a Comprehensive Cohort Design.

机构信息

Research Institute Havelhöhe (FIH), Berlin, Germany.

Department of Internal Medicine, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany.

出版信息

Complement Med Res. 2023;30(2):115-129. doi: 10.1159/000527354. Epub 2022 Oct 13.

DOI:10.1159/000527354
PMID:36228577
Abstract

INTRODUCTION

Breast cancer patients with cancer-related fatigue (BC-CRF) often have lower physical activity. To investigate how this could be improved, we evaluated a multimodal treatment (MT) and a combination of MT with aerobic training (CT) and compared these with aerobic training (AT) regarding rest/activity rhythm and state autonomic regulation (State aR).

METHODS

In this pragmatic comprehensive cohort design study, the explorative analysis focused on actigraphy and State aR including the rest/activity regulation subscale (State aR-R/A) which were assessed at baseline (T0), after 10 weeks of intervention (T1), and State aR additionally 6 months later (T2).

STATISTICS

General linear modelling including propensity scores.

RESULTS

65 BC-CRF were randomized, and 61 were allocated by preference to the treatment arms. 105 patients started the intervention. At T1, State aR-R/A improved the most in MT (+3.49, CI [2.42; 4.55]) compared to AT (+1.59, CI [0.13; 3.06]) and CT (+1.68, CI [0.83; 2.52]), showing superiority of MT to AT (p = 0.048). At T2 MT was sustainably superior to AT regarding State aR-R/A (+3.61, CI [2.38; 4.83] p < 0.01) and State aR also showed superiority of MT to AT (p = 0.006). AT T1 24-h activity was higher in MT compared to AT (p = 0.029).

CONCLUSIONS

MT was superior to AT regarding State aR total score after 6 months, State aR-R/A after 10 weeks, and after 6 months. Actigraphically measured total activity also improved after 10 weeks.

摘要

简介

患有癌因性疲乏(BC-CRF)的乳腺癌患者通常体力活动较少。为了研究如何改善这种情况,我们评估了一种多模式治疗(MT)和有氧运动训练(CT)与 MT 联合治疗,并将这些治疗与有氧运动训练(AT)进行了比较,比较了它们对休息/活动节律和自主状态调节(State aR)的影响。

方法

在这项实用综合队列设计研究中,探索性分析侧重于活动记录仪和 State aR,包括状态自主调节子量表(State aR-R/A),在基线(T0)、干预 10 周后(T1)和 State aR 后 6 个月(T2)进行评估。

统计

包括倾向评分的一般线性模型。

结果

65 名 BC-CRF 患者被随机分组,61 名患者根据偏好分配到治疗组。105 名患者开始接受干预。在 T1 时,与 AT(+1.59,CI [0.13;3.06])和 CT(+1.68,CI [0.83;2.52])相比,MT 对 State aR-R/A 的改善最大(+3.49,CI [2.42;4.55]),表明 MT 比 AT 更优越(p = 0.048)。在 T2 时,MT 在 State aR-R/A 方面持续优于 AT(+3.61,CI [2.38;4.83],p < 0.01),并且 State aR 也显示 MT 比 AT 优越(p = 0.006)。在 T1 时,与 AT 相比,MT 的 24 小时活动量更高(p = 0.029)。

结论

在 6 个月后,MT 在 State aR 总分、10 周后 State aR-R/A 和 6 个月后 State aR-R/A 方面均优于 AT。10 周后,活动记录仪测量的总活动量也有所改善。

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Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue.乳腺癌幸存者癌因性疲乏三臂部分随机对照研究的疲劳和睡眠质量四年随访结果。
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