Maya El-Zahed, Lou-Anne Laura Carsault, Madison Lee Grande, Jasmin Espinoza-Alvarado, Brandon Cotton, Jordan Langille, Holly Edward, Jenna Smith-Turchyn
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引用次数: 0
摘要
目的：运动可以改善身体虚弱和癌症患者的功能结果，但尚不清楚运动如何影响身体虚弱和癌症患者的功能。这项系统综述旨在确定身体虚弱的成年癌症患者参加锻炼项目是否比不参加锻炼项目的人有更好的功能预后。方法：从OVID Medline、Embase、CINAHL、EMCARE和Ageline这5个数据库中检索了从成立到2024年3月调查运动对虚弱且≥18岁的癌症患者功能结局影响的随机对照试验。题目/摘要、全文审阅和数据提取一式两份。采用Cochrane ROB2评价偏倚风险和GRADE评价结果的确定性。结果：本综述纳入了11项随机对照试验，共1419名受试者。荟萃分析未发现干预组和对照组在次最大步行测试（95% CI 0.24(- 0.05-0.53)）、短时体能测试（95% CI - 0.50(- 1.15-0.15)）和握力（95% CI 1.83(- 0.75 - 4.41)）方面存在显著差异。然而，积极的趋势出现在那些参加运动项目的人，与次最大步行测试、握力、坐立比、SPPB和TUG得分有关。结论：在这一人群中调查运动的随机对照试验很少，现有干预措施具有高度异质性。这导致了当前研究结果的不确定性。对癌症幸存者的影响：癌症幸存者和患者需要进行虚弱筛查，并进行适当的锻炼。对于这一人群，应该进一步研究运动干预的适当参数。
Effectiveness of exercise interventions on functional outcomes in frail adults with a previous or current diagnosis of cancer: a systematic review and meta-analysis.
Purpose: Exercise improves functional outcomes in individuals with frailty and individuals with cancer, but it is unknown how exercise impacts function in individuals with both cancer and frailty. This systematic review aimed to determine if adults with cancer who are frail and participate in an exercise program have better functional outcomes compared to those who do not.
Methods: Five databases (OVID Medline, Embase, CINAHL, EMCARE, and Ageline) were searched from inception to March 2024 for RCTs that investigated the impact of exercise on functional outcomes in individuals with cancer who are frail and ≥ 18 years. Title/abstract, full text review, and data extraction were done in duplicate. Cochrane ROB2 was used to assess risk of bias and GRADE for certainty of results.
Results: Eleven RCTs with 1419 participants were included in this review. Meta-analysis did not find a significant difference between intervention and control groups for submaximal walking tests (95% CI 0.24 (- 0.05-0.53), Short Physical Performance Battery (95% CI - 0.50 (- 1.15-0.15)), and grip strength (95% CI 1.83 (- 0.75 to 4.41). However, positive trends emerged for those participating in exercise programs related to submaximal walking test, grip strength, sit to stand, SPPB, and TUG scores.
Conclusion: There are few RCTs investigating exercise in this population, with high heterogeneity of existing interventions. This leads to low certainty in the results of the current study.
Implications for cancer survivorship: Cancer survivors and patients need to be screened for frailty and be engaged in appropriate exercise. Further work should be done investigating appropriate parameters of exercise interventions for this population.
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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