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多模式再教育计划对呼吸困难癌症患者的功能、身体表现和功能能力的影响:一项随机实验研究。

Impact of a multimodal effort re-education programme on functionality, physical performance, and functional capacity in cancer patients with dyspnoea: a randomised experimental study.

机构信息

Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain.

Medical Oncology Service, University Hospital of Salamanca, Salamanca, Spain.

出版信息

Support Care Cancer. 2024 Sep 6;32(10):639. doi: 10.1007/s00520-024-08852-1.

Abstract

BACKGROUND

In recent years, there has been a significant increase in the survival rates of cancer patients. However, this has also led to an increase in side effects, such as dyspnoea, which can negatively impact of patients. We propose a programme for re-educating effort. The main objective is to test the effectiveness of this programme in improving respiratory symptoms and functionality in cancer patients.

METHODOLOGY

Experimental, prospective, longitudinal, randomised study with a parallel fixed-assignment scheme (CG-IG). The patients were selected from the Medical Oncology Service of the University Hospital Complex of Salamanca (CAUSA), Spain. Two parallel intervention programmes were designed for the two study groups (Conventional Clinical Practice-Effort Re-education Programme). Primary variables: dyspnoea (MRC), functionality (Barthel); secondary variables: physical performance (SPPB) and functional capacity (ECOG) and the socio-demographic variables (age, sex, anatomopathological diagnosis, and number of treatment lines).

RESULTS

The study sample consisted of 182 patients, with 12 excluded, resulting in a final sample size of n = 170. Sex distribution (CG: 52.9% male and 47.1% female; IG: 49.4% male and 50.6% female). The primary oncological diagnosis was lung cancer, and the most frequent tumour stages were III and IV. Statistically significant differences were found between the IG and CG scores (p < 0.001, d = 0.887, 95% CI) and between the IG and CG scores (p = 0.004, d = 0.358, 95% CI), indicating that the IG performed better.

CONCLUSION

The results of this study support the beneficial effects of an exercise re-education programme, carried out by an interdisciplinary team in improving the autonomy of oncology patients with dyspnoea.

TRIAL REGISTRATION

The clinical trial was registered in ClinicalTrials.gov (NCT04186754). (03 September 2019).

摘要

背景

近年来,癌症患者的生存率显著提高。然而,这也导致了副作用的增加,如呼吸困难,这会对患者产生负面影响。我们提出了一个重新教育努力的方案。主要目标是测试该方案在改善癌症患者呼吸症状和功能方面的有效性。

方法

实验性、前瞻性、纵向、随机研究,采用平行固定分配方案(CG-IG)。患者从西班牙萨拉曼卡大学医院综合医学肿瘤科(CAUSA)中选取。为两个研究组设计了两个平行的干预方案(常规临床实践-努力再教育方案)。主要变量:呼吸困难(MRC)、功能(Barthel);次要变量:身体表现(SPPB)和功能能力(ECOG)以及社会人口统计学变量(年龄、性别、解剖病理诊断和治疗线数)。

结果

研究样本包括 182 名患者,其中 12 名被排除在外,最终样本量为 n=170。性别分布(CG:52.9%男性和 47.1%女性;IG:49.4%男性和 50.6%女性)。主要的肿瘤诊断是肺癌,最常见的肿瘤阶段是 III 期和 IV 期。IG 和 CG 评分之间存在统计学显著差异(p<0.001,d=0.887,95%CI)和 IG 和 CG 评分之间存在统计学显著差异(p=0.004,d=0.358,95%CI),表明 IG 表现更好。

结论

这项研究的结果支持了由跨学科团队进行的运动再教育方案对改善有呼吸困难的肿瘤患者自主性的有益效果。

试验注册

该临床试验在 ClinicalTrials.gov 注册(NCT04186754)。(2019 年 9 月 3 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b330/11377624/6185150fc0b5/520_2024_8852_Fig1_HTML.jpg

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