Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial.
Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial.
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DOI：
10.1136/bmj.b3410
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发表时间：
2009-10-13
期刊：
影响因子：
--
通讯作者：
Rørth M
中科院分区：
文献类型：
--
作者：
Adamsen L;Quist M;Andersen C;Møller T;Herrstedt J;Kronborg D;Baadsgaard MT;Vistisen K;Midtgaard J;Christiansen B;Stage M;Kronborg MT;Rørth M
目的评估多模式团体运动干预作为常规护理的辅助手段对正在接受辅助化疗或晚期疾病治疗的癌症患者的疲劳、体能、总体健康、体力活动和生活质量的影响。设计随机对照试验。设置两所大学医院在哥本哈根，丹麦。参与者269例癌症患者; 73例男性，196例女性，平均年龄47岁（范围20-65），代表21种诊断。主要排除标准为脑或骨转移。235例患者完成随访。干预监督运动包括高强度的心血管和阻力训练，放松和身体意识训练，按摩，每周9小时，持续6周，除了常规护理，与常规护理相比。主要结局指标欧洲癌症研究和治疗组织生活质量问卷（EORTC QLQ-C30）、医学结局研究简表（MOS SF-36）、休闲时间体力活动问卷、肌肉力量（最多重复一次）、最大耗氧量（Vo 2 max）。统计方法连续结局采用一般线性模型，分类结局之间的关联分析采用列联表中的边际同质性分析。根据基线评分、疾病和人口统计学协变量调整后，干预组在6周时的主要结局疲劳估计改善了-6.6分（95%置信区间为-12.3至-0.9，P=0.02;效应量=0.33，0.04至0.61）。观察到对活力（效应量0.55，95% CI 0.27至0.82）、身体功能（0.37，0.09至0.65）、身体角色（0.37，0.10至0.64）、情感角色（0.32，0.05至0.59）和心理健康（0.28，0.02至0.56）评分的显著影响。体力改善：两组之间最大耗氧量的估计平均差异为0.16 l/min（95% CI 0.1 - 0.2，P<0.0001），肌肉力量（腿部推举）的估计平均差异为29.7 kg（23.4 - 34.9，P<0.0001）。未观察到对全球健康状况/生活质量的显著影响。结论在接受辅助化疗或晚期疾病治疗的各种癌症患者中，包括高强度和低强度成分的监督多模式运动干预是可行的，并且可以安全地使用。干预减少了疲劳，改善了活力，有氧能力，肌肉力量，身体和功能活动，以及情绪健康，但没有生活质量。试验注册当前对照试验ISRCTN 05322922。
Objective To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease. Design Randomised controlled trial. Setting Two university hospitals in Copenhagen, Denmark. Participants 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow-up. Intervention Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. Main outcome measures European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Medical Outcomes Study Short Form (MOS SF-36), Leisure Time Physical Activity Questionnaire, muscular strength (one repetition maximum), maximum oxygen consumption (Vo2max). Statistical methods The general linear model was used for continuous outcome while analysis of associates between categorical outcomes was performed as analysis of marginal homogeneity in contingency tables. Results Adjusted for baseline score, disease, and demographic covariates, the intervention group showed an estimated improvement at six weeks for the primary outcome, fatigue, of −6.6 points (95% confidence interval −12.3 to −0.9, P=0.02; effect size=0.33, 0.04 to 0.61). Significant effects were seen on vitality (effect size 0.55, 95% CI 0.27 to 0.82), physical functioning (0.37, 0.09 to 0.65), role physical (0.37, 0.10 to 0.64), role emotional (0.32, 0.05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P<0.0001) and for muscular strength (leg press) was 29.7 kg (23.4 to 34.9, P<0.0001). No significant effect was seen on global health status/quality of life. Conclusion A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced disease. The intervention reduced fatigue and improved vitality, aerobic capacity, muscular strength, and physical and functional activity, and emotional wellbeing, but not quality of life. Trial registration Current Controlled trials ISRCTN05322922.
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影响因子：
2.1
作者：
Adamsen, L;Midtgaard, J;Roerth, M
通讯作者：
Roerth, M
影响因子：
3.1
作者：
Dimeo, F;Schwartz, S;Thiel, E
通讯作者：
Thiel, E
影响因子：
3.5
作者：
King, MT
通讯作者：
King, MT
DOI：
10.1093/jnci/85.5.365
发表时间：
1993-03-03
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
AARONSON, NK;AHMEDZAI, S;TAKEDA, F
通讯作者：
TAKEDA, F
影响因子：
--
作者：
FENTEM, P
通讯作者：
FENTEM, P