Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: a randomized trial
Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: a randomized trial
复制标题
DOI：
10.1080/0284186x.2019.1643916
复制
发表时间：
2019-07-26
期刊：
影响因子：
3.1
通讯作者：
Moller, Tom
中科院分区：
文献类型：
--
作者：
Bloomquist, Kira;Adamsen, Lis;Moller, Tom
背景：由于长期以来人们担心举重可能会增加患淋巴水肿的风险，因此建议乳腺癌幸存者不要进行大负荷的抗阻运动。这项研究前瞻性地评估了大负荷阻力运动对接受乳腺癌化疗的女性淋巴水肿发展的影响。材料和方法：接受乳腺癌辅助化疗的身体活动不足的女性 (n = 153) 被随机分为 HIGH（监督下的多模式运动，包括大负荷阻力运动：85-90% 1 次最大重复次数 [RM]，三组，每组 5-8 次重复）与 LOW（计步器和一对一咨询）为期 12 周的干预组。结果（基线、12 周和 39 周）包括淋巴水肿状态（细胞外液 [生物阻抗谱] 和臂间体积百分比差异 [双能 X 射线吸收测定法]、淋巴水肿症状 [数字评定量表 0-10]）、上肢力量 (1 RM) 和生活质量领域 (EORTC-BR23)。使用线性混合模型来评估各组之间淋巴水肿结果的等效性（L-Dex、％差异和症状量表的等效裕度：分别为+/- 5、+/- 3％和+/- 1）。对肌肉力量和生活质量领域进行了优越性分析。结果：干预后，细胞外液（0.4；90% CI -2.5至3.2）和沉重症状（-0.2；-0.6至0.2）、紧绷感（-0.1；-0.8至0.6）和肿胀（0.2；-0.4至0.8）症状之间存在等效性。发现臂间体积百分比差异（-3.5%；-17.3 至 10.3）和疼痛（-0.7；-1.3 至 0）不相等，有利于 HIGH。高组的力量增益优于低组（3 kg；1 至 5，p < .05）。此外，HIGH 组中还发现乳房（-11；-15 至 -7）和手臂（-6；-10 至 -1）症状的临床相关减少。结论：研究结果表明，身体不活跃的乳腺癌幸存者可以从化疗期间受监督的大负荷阻力运动中受益，而不会增加淋巴水肿风险。
Background: Due to long-standing concerns that heavy-load lifting could increase the risk of developing lymphedema, breast cancer survivors have been advised to refrain from resistance exercise with heavy loads. This study prospectively evaluated the effect of heavy-load resistance exercise on lymphedema development in women receiving chemotherapy for breast cancer. Material and Methods: Physically inactive women receiving adjuvant chemotherapy for breast cancer (n = 153) were randomized to a HIGH (supervised, multimodal exercise including heavy-load resistance exercise: 85-90% 1 repetition maximum [RM], three sets of 5-8 repetitions) versus LOW (pedometer and one-on-one consultations) 12-week intervention. Outcomes (baseline, 12 and 39 weeks) included lymphedema status (extracellular fluid [bioimpedance spectroscopy] and inter-arm volume % difference [dual-energy X-ray absorptiometry], lymphedema symptoms [numeric rating scale 0-10]), upper-extremity strength (1 RM), and quality of life domains (EORTC- BR23). Linear mixed models were used to evaluate equivalence between groups for lymphedema outcomes (equivalence margins for L-Dex, % difference and symptoms scale: +/- 5, +/- 3% and +/- 1, respectively). Superiority analysis was conducted for muscle strength and quality of life domains. Results: Postintervention equivalence between groups was found for extracellular fluid (0.4; 90% CI -2.5 to 3.2) and symptoms of heaviness (-0.2; -0.6 to 0.2), tightness (-0.1; -0.8 to 0.6) and swelling (0.2; -0.4 to 0.8). Nonequivalence was found for inter-arm volume % difference (-3.5%; -17.3 to 10.3) and pain (-0.7; -1.3 to 0), favoring HIGH. Strength gains were superior in the HIGH versus LOW group (3 kg; 1 to 5, p < .05). Further, clinically relevant reductions in breast (-11; -15 to -7) and arm (-6; -10 to -1) symptoms were found in the HIGH group. Conclusion: Findings suggest that physically inactive breast cancer survivors can benefit from supervised heavy-load resistance exercise during chemotherapy without increasing lymphedema risk.