背景:癌症是世界范围内的重大公共卫生问题。治疗如手术,化疗,放射治疗经常引起心理和生理副作用,影响患者的功能能力和生活质量。身体活动对癌症康复至关重要,改善身体功能和生活质量,减少癌症相关的疲劳。然而,由于社会经济因素,许多患者在获得癌症康复方面面临障碍,交通问题,和时间限制。远程康复可以通过远程提供康复来克服这些障碍。
目的:确定远程医疗如何用于癌症患者的康复。
方法:这个范围审查遵循公认的框架。我们在PubMed上对2015年1月至2023年5月之间发表的研究进行了电子文献检索。纳入标准是报告癌症患者物理治疗远程康复干预的研究,包括随机和非随机对照试验,可行性研究,和可用性研究。21项研究符合标准,并被纳入最终审查。
结果:我们的搜索产生了37篇文章,最终审查中包括21个。随机对照试验占研究的47.6%(10/21),可行性研究为33.3%(7/21),可用性研究为19.0%(4/21)。在57.1%(12/21)的报告中,样本量通常为50名或更少的参与者。参与者通常年龄在65岁或以下(81.0%,17/21),性别分布均衡。器官特异性癌症是66.7%(14/21)的文章的焦点,而28.6%(6/21)包括治疗后患者。基于Web的系统是最常用的技术(61.9%,13/21),其次是基于电话/短信的系统(42.9%,9/21)和移动应用程序(23.8%,5/21)。锻炼计划主要以家庭为基础(90.5%,19/21),包括有氧(90.5%,19/21),电阻(61.9%,13/21),和灵活性训练(33.3%,7/21).成果包括功能能力的改进,认知功能,和生活质量(47.6%,10/21);疼痛和住院时间减少;疲劳增强,身体和情感上的幸福,和焦虑。对可行性的积极影响(14.3%,3/21),可接受性(38.1%,8/21),和成本效益(9.5%,2/21)也被注意到。经常评估功能结果(71.4%,19/21)使用6分钟步行测试和握力测试等工具。
结论:远程康复治疗癌症患者是有益和可行的,研究设计的方法多种多样,技术,练习,和结果。未来的研究应该集中在开发标准化的方法上,纳入客观措施,探索虚拟现实等新兴技术,可穿戴或非接触式传感器,和人工智能来优化远程康复干预。解决这些领域可以增强临床实践并改善远程康复患者的预后。
背景:
BACKGROUND: Cancer is a significant public health issue worldwide. Treatments such as surgery, chemotherapy, and radiation therapy often cause psychological and physiological side effects, affecting patients\' ability to function and their quality of life (QoL). Physical activity is crucial to cancer rehabilitation, improving physical function and QoL and reducing cancer-related fatigue. However, many patients face barriers to accessing cancer rehabilitation due to socioeconomic factors, transportation issues, and time constraints. Telerehabilitation can potentially overcome these barriers by delivering rehabilitation remotely.
OBJECTIVE: The aim of the study is to identify how telemedicine is used for the rehabilitation of patients with cancer.
METHODS: This scoping review followed recognized frameworks. We conducted an electronic literature search on PubMed for studies published between January 2015 and May 2023. Inclusion criteria were studies reporting physical therapy telerehabilitation interventions for patients with cancer, including randomized and nonrandomized controlled trials, feasibility studies, and usability studies. In total, 21 studies met the criteria and were included in the final review.
RESULTS: Our search yielded 37 papers, with 21 included in the final review. Randomized controlled trials comprised 47% (n=10) of the studies, with feasibility studies at 33% (n=7) and usability studies at 19% (n=4). Sample sizes were typically 50 or fewer participants in 57% (n=12) of the reports. Participants were generally aged 65 years or younger (n=17, 81%), with a balanced gender distribution. Organ-specific cancers were the focus of 66% (n=14) of the papers, while 28% (n=6) included patients who were in the posttreatment period. Web-based systems were the most used technology (n=13, 61%), followed by phone call or SMS text messaging-based systems (n=9, 42%) and mobile apps (n=5, 23%). Exercise programs were mainly home based (n=19, 90%) and included aerobic (n=19, 90%), resistance (n=13, 61%), and flexibility training (n=7, 33%). Outcomes included improvements in functional capacity, cognitive functioning, and QoL (n=10, 47%); reductions in pain and hospital length of stay; and enhancements in fatigue, physical and emotional well-being, and anxiety. Positive effects on feasibility (n=3, 14%), acceptability (n=8, 38%), and cost-effectiveness (n=2, 9%) were also noted. Functional outcomes were frequently assessed (n=19, 71%) with tools like the 6-minute walk test and grip strength tests.
CONCLUSIONS: Telerehabilitation for patients with cancer is beneficial and feasible, with diverse approaches in study design, technologies, exercises, and outcomes. Future research should focus on developing standardized methodologies, incorporating objective measures, and exploring emerging technologies like virtual reality, wearable or noncontact sensors, and artificial intelligence to optimize telerehabilitation interventions. Addressing these areas can enhance clinical practice and improve outcomes for remote rehabilitation with patients.