Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis.
Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis.
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DOI：
10.1158/1055-9965.epi-11-0634
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发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Courneya KS
中科院分区：
文献类型：
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作者：
Craft LL;Vaniterson EH;Helenowski IB;Rademaker AW;Courneya KS
抑郁症是癌症及其治疗的一种令人痛苦的副作用。在一般人群中，运动是一种有效的抗抑郁药。我们进行了一项系统回顾和荟萃分析，以确定运动对癌症幸存者的抗抑郁作用。2011年5月，我们检索了MEDLINE、PsycInfo、EMBASE、CINAHL、CDSR、CENTRAL、AMED、Biosis Previews和Sport Discus，以及相关论文和综述的引文。我们纳入了随机对照试验（RCT），比较运动干预与癌症幸存者的常规护理，利用自我报告清单或临床医生评级来评估抑郁症状，并报告干预前后的症状。确定并筛选了7，042项研究标题，包括15项RCT。效应量（ES）报告为平均变化评分。采用Q检验评价ES的异质性。通过检查散点图和Wilcoxon秩和或Kruskal-Wallis检验评价潜在的调节变量。在随机效应模型下，总体ES为-0.22（CI-0.43，-0.09，p = 0.04）。显著调节变量（ps <.05）为运动地点、运动监督和运动持续时间。只有一项研究将抑郁症确定为主要终点。运动对抑郁症状有适度的积极影响，对监督或部分监督，不在家里进行，并且持续时间至少30分钟的项目有较大的影响。我们的研究结果补充了其他研究，这些研究表明运动与减轻疼痛和疲劳以及改善癌症幸存者的生活质量有关。
Depression is a distressing side effect of cancer and its treatment. In the general population, exercise is an effective antidepressant. We conducted a systematic review and meta-analysis to determine the antidepressant effect of exercise in cancer survivors. In May, 2011, we searched MEDLINE, PsycInfo, EMBASE, CINAHL, CDSR, CENTRAL, AMED, Biosis Previews, and Sport Discus, and citations from relevant papers and reviews. We included randomized controlled trials (RCTs) comparing exercise interventions to usual care in cancer survivors, utilizing a self-report inventory or clinician rating to assess depressive symptoms, and reporting symptoms pre- and post-intervention. 7,042 study titles were identified and screened, with 15 RCTs included. Effect sizes (ES) were reported as mean change scores. The Q test was conducted to evaluate heterogeneity of ES. Potential moderator variables were evaluated with examination of scatter plots and Wilcoxon rank-sum or Kruskal-Wallis tests. The overall ES, under a random effects model, was −0.22 (CI −0.43, −0.09, p = 0.04). Significant moderating variables (ps < .05) were exercise location, exercise supervision, and exercise duration. Only one study identified depression as the primary endpoint. Exercise has modest positive effects on depressive symptoms with larger effects for programs that were supervised or partially supervised, not performed at home, and at least 30 minutes in duration. Our results complement other studies showing that exercise is associated with reduced pain and fatigue and with improvements in quality of life among cancer survivors.