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化疗分期以最大限度地提高肿瘤患者的抗阻训练适应性。

Chemotherapy periodization to maximize resistance training adaptations in oncology.

机构信息

Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Rodovia Celso Garcia Cid, Pr 445 Km 380, Campus Universitário, Londrina, Paraná, Brazil.

出版信息

Cancer Chemother Pharmacol. 2023 Nov;92(5):357-367. doi: 10.1007/s00280-023-04576-x. Epub 2023 Aug 15.

Abstract

INTRODUCTION

Engaging in exercise programs during cancer treatment is challenging due to the several chemotherapy-induced side effects. Using a pre-clinical model that mimics chemotherapy treatment, we investigated if a periodized-within-chemotherapy training strategy can maximize resistance training (RT) adaptations such as increasing muscle mass and strength.

METHODS

Swiss mice were randomly allocated into one of the following five groups (n = 14): control (C), resistance training (RT), chemotherapy-treated non-exercised group (Ch), resistance training chemotherapy treated (RTCh), and resistance training periodized-within-chemotherapy (RTPCh). Doxorubicin (i.p.) was weekly injected for a total of 3 weeks (total dose of 12 mg/kg). Resistance training consisted of ladder climbing with progressive intensity, three times a week for 3 weeks, during chemotherapy treatment. RTPCh prescriptions considered "bad day" adjustments while RTCh did not. "Bad day" adjustments considered the presence or absence of clinical signs (e.g., severe weight loss, diarrhea, mice refusing to train) to replace RT sessions. At the end of the third week, animals were euthanized.

RESULTS

Weekly doxorubicin injection promoted progressive body weight loss, muscle atrophy, strength loss, local oxidative stress, and elevated inflammatory mediators, such as TNF-α and IL-6. Non-periodized-within-chemotherapy RT promoted mild protection against doxorubicin-induced skeletal muscle disturbances; moreover, when periodized-within-chemotherapy was applied, RT prevented elevated skeletal muscle inflammatory mediators and oxidative damage markers and promoted muscle mass and strength gains.

CONCLUSION

Considering chemotherapy-induced side effects is a crucial aspect when prescribing resistance exercise during cancer, it will maximize the effectiveness of exercise in enhancing muscle mass and strength.

摘要

简介

由于化疗引起的多种副作用,在癌症治疗期间进行运动计划具有挑战性。我们使用模拟化疗治疗的临床前模型,研究了在化疗期间进行周期性训练策略是否可以最大限度地提高阻力训练(RT)适应能力,例如增加肌肉质量和力量。

方法

瑞士小鼠被随机分配到以下五个组之一(n = 14):对照组(C)、阻力训练组(RT)、化疗未运动组(Ch)、阻力训练化疗组(RTCh)和阻力训练化疗周期性组(RTPCh)。每周腹腔注射多柔比星(i.p.),共 3 周(总剂量为 12 mg/kg)。在化疗期间,RT 包括使用渐进强度的爬梯,每周 3 次,共 3 周。RTPCh 处方考虑了“糟糕的一天”调整,而 RTCh 则没有。“糟糕的一天”调整考虑了是否存在临床症状(例如,体重明显减轻、腹泻、老鼠拒绝训练),以替代 RT 课程。在第 3 周结束时,处死动物。

结果

每周多柔比星注射导致体重逐渐减轻、肌肉萎缩、力量下降、局部氧化应激和炎症介质(如 TNF-α和 IL-6)升高。非周期性化疗 RT 轻度保护多柔比星引起的骨骼肌紊乱;此外,当应用周期性化疗时,RT 可预防骨骼肌炎症介质和氧化损伤标志物升高,并促进肌肉质量和力量增加。

结论

考虑化疗引起的副作用是在癌症期间规定阻力运动的关键方面,这将最大限度地提高运动增强肌肉质量和力量的效果。

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