不同运动干预对乳腺癌幸存者睡眠质量的影响——一项随机对照试验的网状Meta分析
Different exercise interventions on quality of sleep in breast cancer survivors-a network meta-analysis of randomized controlled trials.
作者信息
Song Qi, Zhu You-Kang, Liu Hai, Liu Xiao, Jiang Zhang-Dong, Wang Yu-Jia, Xue Li-Yun, Yang Shao-Ying, Liu Xi-Fang
机构信息
Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
School of Physical Education and Health Sciences, Xi'an Physical Education University, Xi'an, China.
出版信息
Front Oncol. 2025 Feb 6;15:1419613. doi: 10.3389/fonc.2025.1419613. eCollection 2025.
INTRODUCTION
Breast cancer is currently the most prevalent cancer globally; however, it generally has a favorable prognosis and is linked to a high survival rate. While effective treatments can extend survival and mitigate associated side effects, not all survivors are exempt from complications. Notably, a significant proportion of survivors experience sleep disorders following surgery, which can severely impact their quality of life. Exercise is frequently recommended as a non-pharmacological intervention to enhance sleep quality among breast cancer survivors and may also play a role in reducing recurrence rates. Recognizing that various forms of exercise may yield different outcomes in addressing sleep disorders in this population, we conducted a network review meta-analysis to assess the effectiveness of diverse exercise modalities for breast cancer survivors suffering from sleep disturbances.
METHODS
We searched four electronic databases for randomized controlled trials of individuals diagnosed breast cancer with sleep disorders by different exercise therapy. The primary outcomes included Yoga, Pilates, Qigong, Tai Chi, Walking, Dance, Resistance training, Football, Virtual reality therapy, Activity change exercise, Software-guided exercises. The methodological quality of the included studies was assessed using the Cochrane Bias risk Assessment tool, and network meta-analysis was performed using Stata15 software. The review was pre-registered (PROSPERO ID: CRD42023442892).
RESULTS
Data on 3083 breast cancer survivors with sleep disturbances from 34 eligible randomized controlled trials were analyzed, with 23 classified as medium risk and 2 as high risk. Network meta-analysis showed that walking exercise [Standard Median Different (SMD) =3.06, 95% Confidence Interval (95%CI)=(-5.89,-0.23)] significantly improved sleep disorder (Surface Under the Cumulative Ranking curve, SUCRA: 84.5%) and reduced Pittsburgh sleep quality index (PSQI) score.
DISCUSSION
Based on the network ranking table, we can conclude that walking exercise offers greater benefits compared to other exercise interventions for improving sleep quality in breast cancer patients. This finding presents a novel perspective on exercise interventions for breast cancer survivors experiencing sleep disorders.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=442892, identifier CRD42023442892.
引言
乳腺癌是目前全球最常见的癌症；然而，它总体预后良好，生存率较高。虽然有效的治疗方法可以延长生存期并减轻相关副作用，但并非所有幸存者都能免于并发症。值得注意的是，相当一部分幸存者在手术后会出现睡眠障碍，这会严重影响他们的生活质量。运动常被推荐为一种非药物干预措施，以提高乳腺癌幸存者的睡眠质量，并且可能在降低复发率方面也发挥作用。鉴于各种形式的运动在解决该人群睡眠障碍方面可能产生不同的结果，我们进行了一项网状综述荟萃分析，以评估不同运动方式对患有睡眠障碍的乳腺癌幸存者的有效性。
方法
我们在四个电子数据库中搜索了通过不同运动疗法诊断为患有睡眠障碍的乳腺癌患者的随机对照试验。主要结果包括瑜伽、普拉提、气功、太极拳、散步、舞蹈、阻力训练、足球、虚拟现实疗法、活动改变运动、软件指导运动。使用Cochrane偏倚风险评估工具评估纳入研究的方法学质量，并使用Stata15软件进行网状荟萃分析。该综述已预先注册（PROSPERO编号：CRD42023442892）。
结果
分析了来自34项符合条件的随机对照试验的3083名患有睡眠障碍的乳腺癌幸存者的数据，其中23项为中度风险，2项为高风险。网状荟萃分析表明，散步运动[标准中位数差异（SMD）=3.06，95%置信区间（95%CI）=（-5.89，-0.23）]显著改善了睡眠障碍（累积排名曲线下面积，SUCRA：84.5%）并降低了匹兹堡睡眠质量指数（PSQI）得分。
讨论
基于网状排名表，我们可以得出结论，与其他运动干预措施相比，散步运动在改善乳腺癌患者睡眠质量方面具有更大的益处。这一发现为经历睡眠障碍的乳腺癌幸存者的运动干预提供了一个新的视角。
系统评价注册
PROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=442892，标识符CRD42023442892。
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