已处方运动方案对转移性乳腺癌患者的影响：系统综述
The effects of a prescribed exercise programme in people with metastatic breast cancer: a systematic review
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影响因子:3
分区:医学3区 / 康复医学3区
发表日期:2024 Dec
作者:
Joyce M C V O' Riordan, Ruth McCullagh, Paul J Murphy, Grainne Sheill, Frances Horgan, Helen P French
DOI:
10.1016/j.physio.2024.101423
摘要
旨在综合现有证据，评估已处方运动方案对转移性乳腺癌患者（PwMBC）的影响。检索了Medline、Embase、CINAHL、Web of Science和Scopus数据库，截止至2024年1月。纳入随机对照试验（RCTs），这些试验招募PwMBC进行运动干预。主要结局指标为生活质量（QOL）。次要指标包括身体性能、肌肉健康、癌症相关疲乏（CRF）和身体活动（PA）。由于纳入研究数量较少，无法进行Meta分析。我们计算了效果量（ES）及其95%置信区间（95% CI），并对样本量较小的研究进行了调整。 Cohen的效应大小标准用于界定小（0.2至0.5）、中（0.5至0.8）和大（>0.8）效应。偏倚风险（ROB）使用Cochrane（ROB）第1版工具进行评估。共纳入3项RCT（149名PwMBC）。结果显示在主要结局指标QOL方面组间差异不显著。虽然在两项研究中，运动干预对CRF（ES 1.3，95% CI 0.06至2.35）和PA（ES 0.83，95% CI 0.14至1.42）表现出有利作用，但由于95% CI的下界未达Cohen的阈值，关于治疗效果存在较大不确定性。目前证据不足以支持通过处方运动改善PwMBC的QOL、身体性能、肌肉健康、CRF和PA。需要进一步高质量的试验以验证运动干预的有效性。PROSPERO注册号CRD42022304528。论文贡献。
Abstract
To synthesise available evidence on the effects of a prescribed exercise programme in People with Metastatic Breast Cancer (PwMBC).Medline, Embase, CINAHL, Web of Science and Scopus were searched up to January 2024.Randomised controlled trials (RCTs) recruiting PwMBC to an exercise intervention were included. The primary outcome was Quality of Life (QOL). Secondary outcomes included physical performance, muscle health, cancer-related fatigue (CRF) and physical activity (PA).Meta-analysis was not possible due to the low number of included studies. We calculated the effect size (ES), with 95% confidence intervals (95% CIs) of individual studies, adjusting for small sample size. Cohen's criteria for small (0.2 to 0.5), moderate (0.5 to 0.8) and large (>0.8) describe the size of the effect. Risk of bias (ROB) was assessed using the Cochrane (ROB) version 1 tool.Three RCTs (n = 149 PwMBC) were included. Results showed no significant between-group effects in the primary outcome, QOL. Whilst effects in favour of prescribed exercise were observed in CRF (ES 1.3, 95% CI 0.06 to 2.35) and PA (ES 0.83, 95% CI 0.14 to 1.42) in two separate studies, as the lower bound of the 95% CI did not reach Cohen's threshold, there is considerable uncertainty regarding the treatment effect.There is currently insufficient evidence to support the use of prescribed exercise to improve QOL, physical performance, muscle health, CRF and PA in PwMBC. Further high-quality trials are required to investigate the effectiveness of exercise interventions in PwMBC.PROSPERO CRD42022304528. CONTRIBUTION OF THE PAPER.