Division of Oncological Sciences, Oregon Health & Science University, Portland, OR.
Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland, OR.
J Clin Oncol. 2023 Jun 20;41(18):3384-3396. doi: 10.1200/JCO.22.01519. Epub 2023 Mar 8.
To compare the efficacy of tai ji quan versus strength training to prevent falls after chemotherapy in older, postmenopaual women.
We conducted a three-arm, single-blind, randomized controlled trial where older (50+ years), postmenopausal women cancer survivors participated in one of three supervised group exercise programs (tai ji quan, strength training, or stretching control) twice weekly for 6 months and were followed up 6 months after training stopped. The primary outcome was the incidence of falls. Secondary outcomes included fall-related injuries, leg strength (1 repetition maximum; kg), and balance (sensory organization [equilibrium score] and limits of stability [LOS; %] tests).
Four hundred sixty-two women were enrolled (mean age, 62 ± 6.3 years). Retention was 93%, and adherence averaged 72.9%. In primary analysis, there was no difference in the incidence of falls between groups after 6 months of training, nor during 6-month follow-up. A post hoc analysis detected a significantly reduced incidence of fall-related injuries within the tai ji quan group over the first 6 months, dropping from 4.3 falls per 100 person-months (95% CI, 2.9 to 5.6) at baseline to 2.4 falls per person-months (95% CI, 1.2 to 3.5). No significant changes occurred during 6-month follow-up. Over the intervention period, leg strength significantly improved in the strength group and balance (LOS) improved in the tai ji quan group, compared with controls ( < .05).
We found no significant reduction in falls for tai ji quan or strength training relative to stretching control in postmenopausal women treated with chemotherapy.
比较太极拳与力量训练预防化疗后老年绝经后妇女跌倒的效果。
我们进行了一项三臂、单盲、随机对照试验,招募了 50 岁以上、绝经后、癌症幸存者的女性参加一项监督的团体运动计划(太极拳、力量训练或拉伸控制),每周两次,持续 6 个月,并在训练停止后 6 个月进行随访。主要结局是跌倒的发生率。次要结局包括跌倒相关损伤、腿部力量(1 次最大重复;kg)和平衡(感觉组织[平衡评分]和稳定性极限[LOS;%]测试)。
共纳入 462 名女性(平均年龄 62 ± 6.3 岁)。保留率为 93%,依从性平均为 72.9%。在主要分析中,在 6 个月的训练后,以及在 6 个月的随访期间,各组之间的跌倒发生率没有差异。事后分析发现在太极拳组中,在最初的 6 个月内,跌倒相关损伤的发生率显著降低,从基线时的每 100 人-月 4.3 次跌倒(95%CI,2.9 至 5.6)降至每 100 人-月 2.4 次跌倒(95%CI,1.2 至 3.5)。在 6 个月的随访期间没有发生显著变化。在干预期间,与对照组相比,力量组的腿部力量显著改善,太极拳组的平衡(LOS)改善(<0.05)。
我们发现,与拉伸控制相比,太极拳或力量训练对接受化疗的绝经后妇女的跌倒发生率没有显著降低。