Randomized controlled trial of the effects of high intensity and low-to-moderate intensity exercise on physical fitness and fatigue in cancer survivors: results of the Resistance and Endurance exercise After ChemoTherapy (REACT) study
Randomized controlled trial of the effects of high intensity and low-to-moderate intensity exercise on physical fitness and fatigue in cancer survivors: results of the Resistance and Endurance exercise After ChemoTherapy (REACT) study
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DOI：
10.1186/s12916-015-0513-2
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发表时间：
2015-10-29
期刊：
影响因子：
9.3
通讯作者：
Buffart, Laurien M.
中科院分区：
文献类型：
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作者：
Kampshoff, Caroline S.;Chinapaw, Mai J. M.;Buffart, Laurien M.
背景：国际循证指南建议将体育锻炼作为所有癌症幸存者标准护理的一部分。然而，目前，最佳运动强度尚不清楚。因此，我们旨在评估高强度(HI)和低强度(LMI)抵抗和耐力锻炼计划与等待名单对照组(WLC)在完成包括化疗在内的初级癌症治疗的癌症幸存者混合组的体能和疲劳方面的有效性。方法：总体而言，277名癌症幸存者被随机分为HI锻炼(n=91)、LMI锻炼(n=95)或WLC(n=91)。这两种干预措施在运动类型、持续时间和频率方面是相同的，只是强度不同。在基线(初次治疗后4-6周)和干预后进行测量。主要结果是心肺功能(PeakVO(2))、肌肉力量(握力和30秒坐立测试)和自我报告的疲劳(多维疲劳量表；MFI)。次要结果包括与健康相关的生活质量、体力活动、日常功能、身体成分、情绪和睡眠障碍。结果：在HI组和LMI组中，分别有74%和70%的参与者参加了超过80%的处方运动(P=0.53)。与WLC相比，HI(Beta=2.2；95%CI，1.2-3.1)和LMI(Beta=1.3；95%CI，0.3-2.3)运动对PeakVO2的改善明显更大。HI组的PeakVO2改善幅度大于LMI组(β=0.9；95%CI，-0.1~1.9)，但差异无统计学意义(P=0.08)。握力和30秒坐立测试均未发现干预效果。与WLC相比，HI和LMI运动显著减少了全身和体力疲劳，减少了活动量(MFI子量表)，两种干预措施之间没有显著差异。最后，与WLC相比，我们发现HI运动后的整体生活质量和焦虑程度，HI和LMI运动后的身体功能改善，LMI运动后的工作问题较少。结论：在癌症治疗结束后不久，HI和LMI运动都是安全有效的。运动强度与峰值VO(2)之间可能存在剂量-反应关系，有利于HI运动。Hi运动和LMI运动在减轻全身和身体疲劳方面同样有效。
Background: International evidence-based guidelines recommend physical exercise to form part of standard care for all cancer survivors. However, at present, the optimum exercise intensity is unclear. Therefore, we aimed to evaluate the effectiveness of a high intensity (HI) and low-to-moderate intensity (LMI) resistance and endurance exercise program compared with a wait list control (WLC) group on physical fitness and fatigue in a mixed group of cancer survivors who completed primary cancer treatment, including chemotherapy.Methods: Overall, 277 cancer survivors were randomized to 12 weeks of HI exercise (n = 91), LMI exercise (n = 95), or WLC (n = 91). Both interventions were identical with respect to exercise type, duration and frequency, and only differed in intensity. Measurements were performed at baseline (4-6 weeks after primary treatment) and post-intervention. The primary outcomes were cardiorespiratory fitness (peakVO(2)), muscle strength (grip strength and 30-second chair-stand test), and self-reported fatigue (Multidimensional Fatigue Inventory; MFI). Secondary outcomes included health-related quality of life, physical activity, daily functioning, body composition, mood, and sleep disturbances. Multilevel linear regression analyses were performed to estimate intervention effects using an intention-to-treat principle.Results: In the HI and LMI groups, 74 % and 70 % of the participants attended more than 80 % of the prescribed exercise sessions, respectively (P = 0.53). HI (beta = 2.2; 95 % CI, 1.2-3.1) and LMI (beta = 1.3; 95 % CI, 0.3-2.3) exercise showed significantly larger improvements in peakVO2 compared to WLC. Improvements in peakVO2 were larger for HI than LMI exercise (beta = 0.9; 95 % CI, -0.1 to 1.9), but the difference was not statistically significant (P = 0.08). No intervention effects were found for grip strength and the 30-second chair-stand test. HI and LMI exercise significantly reduced general and physical fatigue and reduced activity (MFI subscales) compared to WLC, with no significant differences between both interventions. Finally, compared to WLC, we found benefits in global quality of life and anxiety after HI exercise, improved physical functioning after HI and LMI exercise, and less problems at work after LMI exercise.Conclusions: Shortly after completion of cancer treatment, both HI and LMI exercise were safe and effective. There may be a dose-response relationship between exercise intensity and peakVO(2), favoring HI exercise. HI and LMI exercise were equally effective in reducing general and physical fatigue.