The Effects of Exercise on Patient-Reported Outcomes and Performance-Based Physical Function in Adults With Acute Leukemia Undergoing Induction Therapy: Exercise and Quality of Life in Acute Leukemia (EQUAL)
The Effects of Exercise on Patient-Reported Outcomes and Performance-Based Physical Function in Adults With Acute Leukemia Undergoing Induction Therapy: Exercise and Quality of Life in Acute Leukemia (EQUAL)
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DOI：
10.1177/1534735417699881
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发表时间：
2018-06-01
影响因子：
2.9
通讯作者：
Reeve, Bryce B.
中科院分区：
文献类型：
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作者：
Bryant, Ashley Leak;Deal, Allison M.;Reeve, Bryce B.
导论.疲劳是急性白血病患者的一种令人痛苦的症状，通常会妨碍他们的运动能力。目标. 1)检查为期4周的混合模式监督运动计划（每周4次，每天两次）对接受诱导化疗的急性白血病成人疲劳的影响。2)评估运动计划对认知、焦虑、抑郁和睡眠障碍的影响。3)评估干预对坚持锻炼的影响。方法.在入院后4天内招募了17名年龄为28-69岁的新诊断为急性白血病的成人（8名干预，9名对照）进行诱导治疗。在基线和出院时评估患者报告结局（PRO）（疲劳、认知、焦虑、抑郁、睡眠障碍、心理健康和身体健康）和基于体能表现的指标（定时起床和行走[TUG]、Karnofsky体能状态和综合力量评分）。使用Wilcoxon秩和检验比较两组间PRO和基于体能的身体功能指标从基线至出院时的变化。结果使用PROMIS（患者报告结局测量信息系统）疲劳，我们发现干预组的疲劳中位数变化（-5.95），这实现了被认为具有临床相关性的最小重要差异。干预组的TUG表现减少了1.73秒，而对照组保持相当稳定。一个令人担忧的发现是，在住院期间，两组的认知能力都有所下降。80%的访视坚持完成，平均每周参加6次会议。结论.我们的研究提供了运动对白血病的影响的信息，重点是急性白血病的疲劳和其他心理社会变量。
Introduction. Fatigue is a distressing symptom for adults with acute leukemia, often impeding their ability to exercise. Objectives. 1) Examine effects of a 4-week mixed-modality supervised exercise program (4 times a week, twice a day) on fatigue in adults with acute leukemia undergoing induction chemotherapy. 2) Evaluate effects of exercise program on cognition, anxiety, depression, and sleep disturbance. 3) Evaluate effect of intervention on adherence to exercise. Methods. 17 adults (8 intervention, 9 control), aged 28-69 years, newly diagnosed with acute leukemia were recruited within 4 days of admission for induction treatment. Patient-reported outcomes (PROs) (fatigue, cognition, anxiety, depression, sleep disturbance, mental health, and physical health) and fitness performance-based measures (Timed Up and Go [TUG], Karnofsky Performance Status, and composite strength scoring) were assessed at baseline and at discharge. Changes in PRO and performance-based physical function measures from baseline to time of discharge were compared between groups using Wilcoxon Rank Sum tests. Results. With PROMIS (Patient-Reported Outcomes Measurement Information System) Fatigue, we found a median change in fatigue (-5.95) for the intervention group, which achieved a minimally important difference that is considered clinically relevant. Intervention group reduced their TUG performance by 1.73 seconds, whereas the control group remained fairly stable. A concerning finding was that cognition decreased for both groups during their hospitalization. 80% adherence of visits completed with a mean of 6 sessions attended per week. Conclusions. Our study provides information on the impact of exercise on symptomatology, with focus on fatigue and other psychosocial variables in acute leukemia.