PDF(Pubmed)
Abstract：
Exercise-based, multimodal rehabilitation programming similar to that used in the existing models of cardiac or pulmonary rehabilitation or prehabilitation is a holistic potential solution to address the range of physical, psychological, and existential (e.g., as their diagnosis relates to potential death) stressors associated with a cancer diagnosis and subsequent treatment. The purpose of this study was to systematically evaluate the structure and format of any type of exercise-based, multimodal rehabilitation programs used in individuals with cancer and the evidence base for their real-world effectiveness on metrics of physical (e.g., cardiorespiratory fitness, blood pressure) and psychological (e.g., health-related quality of life) health. Very few of the 33 included exercise-based, multimodal rehabilitation programs employed intervention components, education topics, and program support staff that were multi-disciplinary or cancer-specific. In particular, a greater emphasis on nutrition care, and the evaluation and management of psychosocial distress and CVD risk factors, with cancer-specific adaptations, would broaden and maximize the holistic health benefits of exercise-based rehabilitation. Despite these opportunities for improvement, exercise-based, multimodal rehabilitation programs utilized under real-world settings in individuals with cancer produced clinically meaningful and large effect sizes for cardiorespiratory fitness (VO2peak, ±2.9 mL/kg/min, 95% CI = 2.6 to 3.3) and 6-minute walk distance (+47 meters, 95% CI = 23 to 71), and medium effect sizes for various measures of cancer-specific, health-related quality of life. However, there were no changes to blood pressure, body mass index, or lung function. Overall, these findings suggest that exercise-based, multimodal rehabilitation is a real-world therapy that improves physical and psychological health among individuals with cancer, but the holistic health benefits of this intervention would likely be enhanced by addressing nutrition, psychosocial concerns, and risk factor management through education and counselling with consideration of the needs of an individual with cancer.
摘要：
以锻炼为基础,多模式康复程序类似于现有的心脏或肺部康复或康复模型中使用的程序是一种整体的潜在解决方案，以解决物理范围，心理,和存在的(例如，因为他们的诊断与潜在的死亡有关）与癌症诊断和后续治疗相关的应激源。这项研究的目的是系统地评估任何类型的基于运动的结构和格式，用于癌症患者的多模式康复计划及其在物理指标上的真实世界有效性的证据基础(例如，心肺健康，血压)和心理(例如，与健康相关的生活质量)健康。33人中很少有包括基于锻炼的，多模式康复计划采用干预成分，教育主题，以及多学科或癌症特异性的项目支持人员。特别是,更加重视营养护理，以及心理社会困扰和心血管疾病危险因素的评估和管理，与癌症特异性适应，将扩大并最大限度地发挥基于运动的康复的整体健康益处。尽管有这些改进的机会，以锻炼为基础，在现实世界中使用的多模式康复计划在癌症患者中产生了临床上有意义的大效果大小的心肺健康（VO2peak，±2.9mL/kg/min,95%CI=2.6至3.3)和6分钟步行距离(+47米，95%CI=23至71)，和中等效应大小的癌症特异性的各种措施，与健康相关的生活质量。然而,血压没有变化,身体质量指数,或肺功能。总的来说,这些发现表明，基于运动的，多模式康复是一种现实世界的疗法，可以改善癌症患者的身心健康，但是通过解决营养问题，这种干预措施的整体健康益处可能会得到增强，心理社会问题，以及通过教育和咨询进行风险因素管理，同时考虑到癌症患者的需求。
