最佳运动剂量反应可改善癌症幸存者的健康相关生活质量：一项随机对照试验的系统评价和贝叶斯网络荟萃分析
Optimal exercise dose-response improves health-related quality of life in cancer survivors: a systematic review and Bayesian network meta-analysis of RCTs.
作者信息
Xiong Zhiyu, Yuan Yuan, Yang Yong, Qiu Bopeng, Bai Ying, Wang Tao, Wang Junyu, Zhang Lin, Li Yawen
机构信息
The School of Physical Education and Health, East China Jiaotong University, Nanchang, China.
The School of Physical Education, Kunsan National University, Kunsan-si, Jeollabuk-do, Republic of Korea.
出版信息
Front Oncol. 2024 Dec 16;14:1510578. doi: 10.3389/fonc.2024.1510578. eCollection 2024.
OBJECTIVE
Cancer survivors often face significant health-related quality of life (HRQoL) challenges. Although exercise has been proven to improve HRQoL in cancer survivors, the optimal dose and intensity of exercise for this population has not been fully determined. Adherence to exercise may vary based on exercise intensity, affecting results. This study explored the dose-response relationship of different exercise types and intensities to better understand their impact on HRQoL in cancer survivors.
METHODS
We searched five databases-PubMed, Embase, the Cochrane Library, Web of Science, and Scopus-from their inception until 1 December 2023. Data analysis was performed using R software with the MBNMA and RJAGS packages. Due to combining data from different scales, effect sizes were reported as standardized mean differences (SMD) with 95% credible intervals (95% CrI). The risk of bias was assessed independently by three reviewers using the RoB2 tool.
RESULTS
A total of 48 studies involving 3050 cancer survivors. Across all exercise types, the most beneficial exercise dose was identified to be 850 metabolic equivalents of task (METs)-min/week (SMD: 0.753, 95%Crl: 0.463 to 1.096), with diminishing returns observed beyond 1,100 METs-min/week. Among the various types of exercises, mixed training (MT) emerged as the optimal choice, demonstrating its efficacy at 970 METs-min/week (SMD: 0.883, 95% Crl: 0.455 to 1.345). Aerobic exercise (AE) at a dose of 430 METs-min/week (SMD: 0.681, 95% Crl: 0.206 to 1.099) and resistance training (RT) at 450 METs-min/week (SMD: 0.695, 95% Crl: 0.227 to 1.203) also showed significant benefits. Additionally, mind-body exercises, such as tai chi, qigong, or yoga, exhibited optimal effects at a dose of 390 METs-min/week (SMD: 0.672, 95% Crl: 0.259 to 1.087).
CONCLUSION
Our study sheds light on the intricate relationship between exercise interventions and health-related quality of life in cancer survivors, as elucidated through a systematic review and Bayesian network meta-analysis. The identified optimal exercise dose of 850 METs-min/week resulted in a significant improvement in health-related quality of life, underscoring the importance of regular exercise in cancer survivorship. MT emerged as the most effective modality, closely followed by RT, AE, and MBE.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=493328, identifier CRD42024493328.
目的
癌症幸存者常常面临与健康相关的生活质量（HRQoL）方面的重大挑战。尽管运动已被证明能改善癌症幸存者的HRQoL，但该人群运动的最佳剂量和强度尚未完全确定。运动依从性可能因运动强度而异，从而影响结果。本研究探讨了不同运动类型和强度的剂量反应关系，以更好地了解其对癌症幸存者HRQoL的影响。
方法
我们检索了五个数据库——PubMed、Embase、Cochrane图书馆、科学引文索引和Scopus，检索时间从各数据库创建至2023年12月1日。使用R软件以及MBNMA和RJAGS软件包进行数据分析。由于合并了不同量表的数据，效应量以标准化均数差（SMD）及95%可信区间（95%CrI）报告。由三位评审员使用RoB2工具独立评估偏倚风险。
结果
共有48项研究涉及3050名癌症幸存者。在所有运动类型中，最有益的运动剂量被确定为每周850代谢当量任务（METs）-分钟（SMD：0.753，95%CrI：0.463至1.096），每周超过1100 METs-分钟时收益递减。在各类运动中，混合训练（MT）是最佳选择，每周970 METs-分钟时显示出其有效性（SMD：0.883，95%CrI：0.455至1.345）。每周430 METs-分钟的有氧运动（AE）（SMD：0.681，95%CrI：0.206至1.099）和每周450 METs-分钟的抗阻训练（RT）（SMD：0.695，95%CrI：0.227至1.203）也显示出显著益处。此外，身心运动，如太极拳、气功或瑜伽，在每周390 METs-分钟的剂量时表现出最佳效果（SMD：0.672，95%CrI：0.259至1.087）。
结论
通过系统评价和贝叶斯网络荟萃分析，我们研究揭示了癌症幸存者运动干预与健康相关生活质量之间的复杂关系。确定的每周850 METs-分钟的最佳运动剂量使健康相关生活质量得到显著改善，突出了规律运动在癌症康复中的重要性。MT是最有效的运动方式，其次是RT、AE和MBE。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=493328，标识符CRD42岁024493328 。
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