Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Support Care Cancer. 2023 Apr 11;31(5):254. doi: 10.1007/s00520-023-07716-4.
Pain is a common side effect of cancer or cancer treatment that negatively impacts biopsychosocial wellbeing and quality of life. Exercise is a potential intervention to manage pain that is safe and has multiple benefits. The objective was to determine the role of exercise in cancer pain management.
We completed a systematic review and meta-analysis of exercise interventions in adults with any type or stage of cancer by searching Ovid MEDLINE®, Embase, APA PsycInfo, the Cochrane Central Register of Controlled Trials, CINAHL, and SPORTDiscus. We included experimental and quasi-experimental designs where pain was measured as an outcome. Data synthesis included narrative and tabular summary. A meta-analysis was performed on studies powered to detect the effect of exercise on pain. Study quality was evaluated using the Cochrane risk of bias tool and certainty of evidence was evaluated using the GRADE tool.
Seventy-six studies were included. Studies were predominantly conducted in breast cancer and exercise usually included a combination of aerobic and strength training. Ten studies were included in the meta-analysis demonstrating a significant effect for exercise in decreasing pain (estimated average standard mean difference (SMD) was g = - 0.73 (95% CI: - 1.16 to - 0.30)); however, the overall effect prediction interval was large. Overall risk of bias for most studies was rated as some concerns and the grading of evidence certainty was low.
There are limitations in the evidence for exercise to manage cancer-related pain. Further research is needed to understand the role of exercise in a multimodal pain management strategy.
疼痛是癌症或癌症治疗的常见副作用，会对生物心理社会健康和生活质量产生负面影响。运动是一种安全且具有多种益处的潜在干预措施，可以用来缓解疼痛。本研究旨在确定运动在癌症疼痛管理中的作用。
我们通过检索 Ovid MEDLINE、Embase、APA PsycInfo、Cochrane 对照试验中心注册库、CINAHL 和 SPORTDiscus，对任何类型或阶段的癌症成人患者的运动干预措施进行了系统评价和荟萃分析。我们纳入了将疼痛作为结局指标的实验和准实验设计研究。数据综合包括叙述性和表格总结。对有足够效能检测运动对疼痛影响的研究进行荟萃分析。使用 Cochrane 偏倚风险工具评估研究质量，使用 GRADE 工具评估证据确定性。
共纳入 76 项研究。这些研究主要在乳腺癌患者中开展，运动通常包括有氧运动和力量训练的组合。10 项研究纳入荟萃分析，结果显示运动可显著减轻疼痛（估计平均标准均数差（SMD）为 g = -0.73（95%CI：-1.16 至-0.30））；然而，总体效应预测区间较大。大多数研究的总体偏倚风险被评为存在一些关注，证据确定性的评级为低。
目前关于运动缓解癌症相关疼痛的证据存在局限性。需要进一步研究以了解运动在多模式疼痛管理策略中的作用。
