Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Olympic Training Centre Berlin, Berlin, Germany.
BMC Palliat Care. 2024 Feb 28;23(1):58. doi: 10.1186/s12904-024-01388-5.
BACKGROUND: Recent exercise intervention studies have shown promising results in improving quality of life (QoL) and physical function (PF) in diverse chronic disease and advanced cancer patients. However, the effects of structured exercise in palliative care patients, having different therapeutic needs, lower life expectancies and PFs remain unknown. This study primarily aimed to assess the feasibility of an exercise intervention with follow-up by analysing recruitment numbers, screening procedures, acceptability, preferences, and safety of the exercise intervention as well as retention in follow-up. Our secondary aims related to changes in QoL and PF. METHODS: This study comprised of a one-arm design without a control group. Over 6 months, every in-hospital palliative care unit (PCU) patient was screened for eligibility. Eligible patients were asked to participate in a 2-week exercise intervention consisting of resistance training and/or endurance training with moderate or high intensity based on personal preferences and a 4-week follow-up. Before and after the exercise intervention, QoL and PF were assessed and a qualitative interview after the intervention addressed expectations and experiences of the exercise intervention. For follow-up, patients were provided with information on independent training and after 1 and 4 weeks a QoL assessment and qualitative interview were conducted. RESULTS: Of 124 patients screened, 10 completed the intervention with an adherence rate of (80 ± 25%), of which 6 patients completed follow-up. Endurance training was the most performed training type and only a few minor adverse events occurred in certain or likely connection to the exercise intervention. While physical QoL and PF measured by arm curl strength and time up and go performance improved, mental QoL and the other PF tests remained unchanged. CONCLUSION: Despite the challenges that were faced in our screening and testing process, that are specific to the palliative patient population with their unique therapeutic requirements and varying mental-/ physical capabilities, we discovered the 2-week exercise intervention to be feasible, safe, and well tolerated by palliative care patients. Moreover, it seems that short-term improvements in QoL and PF are possible. Further full scale studies are required to confirm our findings. TRIAL REGISTRATION: The study was retrospectively registered on 25.01.2022 in the German Clinical Trials Register (DRKS00027861).
背景:最近的运动干预研究表明,在改善不同慢性疾病和晚期癌症患者的生活质量(QoL)和身体功能(PF)方面取得了有希望的结果。然而,对于治疗需求不同、预期寿命和 PF 较低的姑息治疗患者,结构性运动的效果仍不清楚。本研究主要旨在评估一项运动干预的可行性,通过分析招募人数、筛选程序、可接受性、偏好以及运动干预的安全性和随访保留率来评估。我们的次要目标与 QoL 和 PF 的变化有关。
方法:本研究采用无对照组的单臂设计。在 6 个月内,对每个住院姑息治疗病房(PCU)的患者进行筛选,以确定其是否符合条件。符合条件的患者被要求参加为期 2 周的运动干预,包括根据个人喜好进行的阻力训练和/或耐力训练,强度为中等或高强度,并进行 4 周的随访。在运动干预前后评估 QoL 和 PF,并在干预后进行定性访谈,了解对运动干预的期望和体验。在随访期间,为患者提供了有关独立训练的信息,并在 1 周和 4 周后进行了 QoL 评估和定性访谈。
结果:在筛选的 124 名患者中,有 10 名完成了干预,依从率为(80±25%),其中 6 名完成了随访。耐力训练是最常进行的训练类型,只有少数轻微的不良事件发生在与运动干预有一定或可能的联系。虽然手臂卷曲力量和起身行走时间等身体 QoL 和 PF 有所改善,但心理 QoL 和其他 PF 测试保持不变。
结论:尽管我们在筛选和测试过程中遇到了挑战,这些挑战是姑息治疗患者群体特有的,他们有独特的治疗需求和不同的心理/身体能力,但我们发现 2 周的运动干预对姑息治疗患者是可行的、安全的且耐受性良好的。此外,短期改善 QoL 和 PF 似乎是可能的。需要进一步的全面研究来证实我们的发现。
试验注册:该研究于 2022 年 1 月 25 日在德国临床试验注册中心(DRKS00027861)进行了回顾性注册。
BMC Palliat Care. 2024-2-28
Mult Scler. 2016-10
Cochrane Database Syst Rev. 2022-2-1
Cochrane Database Syst Rev. 2017-8-24
Curr Treat Options Oncol. 2023-2
CA Cancer J Clin. 2021-1
J Pain Symptom Manage. 2020-8