PDF(Pubmed)
Abstract：
OBJECTIVE: To synthesise evidence evaluating non-pharmacological interventions targeting mobility among people with advanced cancer, considering the type, efficacy and contextual factors that may influence outcome.
METHODS: Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies.
RESULTS: 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies.
CONCLUSIONS: Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.
METHODS: Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies.
RESULTS: 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies.
CONCLUSIONS: Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.
摘要：
目的：综合评估针对晚期癌症患者行动的非药物干预措施的证据，考虑到类型，可能影响结果的疗效和环境因素。
方法：对成人（≥18岁）晚期（III-IV期）癌症非药物干预研究的系统评价，并使用临床或患者报告的结果指标评估移动性。在三个电子数据库(MEDLINE，EMBASE和CINAHL）截至2024年6月。使用JoannaBriggs研究所工具评估方法质量，并通过复杂干预框架的背景和实施评估环境因素。由于纳入研究的临床异质性，进行了叙述性综合。
结果：纳入了包括2,464名参与者的38项研究。最常见的移动性结果测量是6分钟步行测试（26/38研究）。运动是最常见的干预措施，（33项研究：27项有氧和抗性，5有氧，在21/33个结果中发现了1个阻力与有氧训练）和活动能力的改善。在3/5的研究中，电疗干预导致了移动性的显着改善。地理因素(如距离、运输,停车要求)可能限制参与18/38研究。人群中缺乏种族多样性是显而易见的，语言能力是12项研究的纳入标准。
结论：运动和神经肌肉电刺激似乎可以改善晚期癌症的运动结果。针对流动性的其他非药物干预措施的评估应考虑获取和包容性，并适应这些人口的需求。
方法：对成人（≥18岁）晚期（III-IV期）癌症非药物干预研究的系统评价，并使用临床或患者报告的结果指标评估移动性。在三个电子数据库(MEDLINE，EMBASE和CINAHL）截至2024年6月。使用JoannaBriggs研究所工具评估方法质量，并通过复杂干预框架的背景和实施评估环境因素。由于纳入研究的临床异质性，进行了叙述性综合。
结果：纳入了包括2,464名参与者的38项研究。最常见的移动性结果测量是6分钟步行测试（26/38研究）。运动是最常见的干预措施，（33项研究：27项有氧和抗性，5有氧，在21/33个结果中发现了1个阻力与有氧训练）和活动能力的改善。在3/5的研究中，电疗干预导致了移动性的显着改善。地理因素(如距离、运输,停车要求)可能限制参与18/38研究。人群中缺乏种族多样性是显而易见的，语言能力是12项研究的纳入标准。
结论：运动和神经肌肉电刺激似乎可以改善晚期癌症的运动结果。针对流动性的其他非药物干预措施的评估应考虑获取和包容性，并适应这些人口的需求。
