有氧运动结合抗阻运动对恶性肿瘤患儿干预效果的Meta分析

doi:10.3761/j.issn.0254-1769.2021.12.015

摘要/Abstract

摘要：

目的评价有氧运动结合抗阻运动在恶性肿瘤患儿中的干预效果。方法计算机检索万方、维普、中国知网、中国生物医学文献数据库、Web of Science、Cochrane Library、PubMed、Embase、CINAHL数据库中关于有氧运动结合抗阻运动对恶性肿瘤干预效果的随机对照试验,检索时限为建库至2021年5月。由2名经过培训的研究人员独立对文献进行筛选、质量评价和资料提取,采用RevMan 5.4软件进行Meta分析。结果共纳入7篇文献,总计452例恶性肿瘤患儿。Meta分析结果显示,运动干预后试验组癌因性疲乏得分低于对照组[SMD=-1.07,95%CI（-1.60,-0.53）,P<0.01]、6 min步行距离远于对照组[SMD=0.83,95%CI（0.47,1.19）,P<0.01],差异具有统计学意义;在峰值摄氧量[SMD=-0.08,95%CI（-0.42,0.26）,P=0.63]、健康相关生活质量[SMD=-0.09,95%CI（-0.44,0.26）,P=0.62]方面,差异无统计学意义。结论有氧运动结合抗阻运动能缓解恶性肿瘤患儿癌因性疲乏,增强其心肺功能,但仍需更多高质量的随机对照试验进一步证实。

关键词: 肿瘤, 儿童, 有氧运动, 抗阻运动, Meta分析, 护理

Abstract:

Objective To evaluate the effect of aerobic combined resistance exercise in children with malignant tumors. Methods We searched databases including Wanfang,VIP,CNKI,CBM,Web of Science,Cochrane Library,PubMed,Embase and CINAHL,from inception to May 2021,and we included randomized controlled trials（RCTs） reporting the effectiveness of aerobic combined resistance exercise in children with malignant tumors. 2 trained researchers screened the literature,evaluated the quality and extracted the data independently,and the meta-analysis was implemented with RevMan 5.4. Results Totally 7 RCTs involving 452 children were included. The results of meta-analysis showed that after exercise intervention,the cancer-related fatigue[SMD=-1.07,95%CI（-1.60,-0.53）,P<0.01] and 6-minute walk test[SMD=0.83,95%CI（0.47,1.19）,P<0.01] of children in the experimental group are better than those in the control group. There were no statistically significant differences in peak oxygen uptake [SMD=-0.08,95%CI（-0.42,0.26）,P=0.63] and health-related quality of life[SMD=-0.09,95%CI（-0.44,0.26）,P=0.62]. Conclusion Aerobic combined with resistance exercise can alleviate cancer-related fatigue in children with malignant tumors and enhance their cardiopulmonary function. However,the conclusion of this study needs to be confirmed by further high quality research.

Key words: Neoplasm, Child, Aerobic Exercise, Resistance Exercise, Meta-Analysis, Nursing Care

沈晓雯, 郑小芬, 董宁, 周红花, 张惠惠, 张春梅. 有氧运动结合抗阻运动对恶性肿瘤患儿干预效果的Meta分析[J]. 中华护理杂志, 2021, 56(12): 1846-1851.

SHEN Xiaowen, ZHENG Xiaofen, DONG Ning, ZHOU Honghua, ZHANG Huihui, ZHANG Chunmei. The effect of aerobic combined resistance exercise in children with malignant tumor：a meta-analysis[J]. Chinese Journal of Nursing, 2021, 56(12): 1846-1851.

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参考文献 21

[1]	Fadel SA, Boschi-Pinto C, Yu SC, et al. Trends in cause-specific mortality among children aged 5-14 years from 2005 to 2016 in India,China,Brazil,and Mexico:an analysis of nationally representative mortality studies[J]. Lancet, 2019, 393(10176):1119-1127. DOI URL
[2]	孟晴, 陈伟, 张明, 等. 有氧联合抗阻运动对2型糖尿病患者的效果[J]. 中国康复理论与实践, 2018, 24(12):1465-1470.
	Meng Q, Chen W, Zhang M, et al. Effect of aerobic and resistance exercise for patients with type 2 diabetes mellitus[J]. Chin J Rehabilitation Theory Pract, 2018, 24(12):1465-1470.
[3]	邢双双, 顾则娟, 蒋秀美. 造血干细胞移植患者运动锻炼的研究进展[J]. 中华护理杂志, 2018, 53(2):242-247.
	Xing SS, Gu ZJ, Jiang XM. Research progress of exercise in patients underwent hematopoietic stem cell transplantation[J]. Chin J Nurs, 2018, 53(2):242-247.
[4]	Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, et al. Aerobic and resistance exercise improves physical fitness,bone health,and quality of life in overweight and obese breast cancer survivors:a randomized controlled trial[J]. Breast Cancer Res, 2018, 20(1):124. DOI PMID
[5]	Green S, Higgins JP. Preparing a cochrane review[M]// Coch-rane Handbook for Systematic Reviews of Interventions. Chi-chester,UK:John Wiley & Sons,Ltd, 2008:11-30.
[6]	Braam KI, van Dijk-Lokkart EM, Kaspers GJL, et al. Effects of a combined physical and psychosocial training for children with cancer:a randomized controlled trial[J]. BMC Cancer, 2018, 18(1):1289. DOI URL
[7]	Manchola-González JD, Bagur-Calafat C, Girabent-Farrés M, et al. Effects of a home-exercise programme in childhood survivors of acute lymphoblastic leukaemia on physical fitness and physical functioning:results of a randomised clinical trial[J]. Support Care Cancer, 2020, 28(7):3171-3178. DOI PMID
[8]	Fiuza-Luces C, Padilla JR, Soares-Miranda L, et al. Exercise intervention in pediatric patients with solid tumors:the physical activity in pediatric cancer trial[J]. Med Sci Sports Exerc, 2017, 49(2):223-230.
[9]	Senn-Malashonak A, Wallek S, Schmidt K, et al. Psychophysical effects of an exercise therapy during pediatric stem cell transplantation:a randomized controlled trial[J]. Bone Marrow Trans-plant, 2019, 54(11):1827-1835.
[10]	Stössel S, Neu MA, Wingerter A, et al. Benefits of exercise training for children and adolescents undergoing cancer treatment:results from the randomized controlled MUCKI trial[J]. Front Pediatr, 2020, 8:243. DOI PMID
[11]	Li WHC, Ho KY, Lam KKW, et al. Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors:a randomized controlled trial[J]. Int J Nurs Stud, 2018, 83:65-74. DOI URL
[12]	Lam KKW, Li WHC, Chung OK, et al. An integrated experiential training programme with coaching to promote physical activity,and reduce fatigue among children with cancer:a randomised controlled trial[J]. Patient Educ Couns, 2018, 101(11):1947-1956. DOI URL
[13]	Hilfiker R, Meichtry A, Eicher M, et al. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment:a systematic review incorporating an indirect-comparisons meta-analysis[J]. Br J Sports Med, 2018, 52(10):651-658. DOI URL
[14]	刘树佳, 邢俊俊, 董霜, 等. 造血干细胞移植患者疲乏的影响因素与干预研究进展[J]. 中国护理管理, 2019, 19(1):156-160.
	Liu SJ, Xing JJ, Dong S, et al. Research progress of influencing factors and interventions of fatigue in hematopoietic stem cell transplant patients[J]. Chin Nurs Manag, 2019, 19(1):156-160.
[15]	Marchese VG, Chiarello LA, Lange BJ. Effects of physical the-rapy intervention for children with acute lymphoblastic leukemia[J]. Pediatr Blood Cancer, 2004, 42(2):127-133. DOI URL
[16]	Palisano RJ. Validity of Goal Attainment Scaling in infants with motor delays[J]. Phys Ther, 1993, 73(10):651-658. PMID
[17]	荆志成. 六分钟步行距离试验的临床应用[J]. 中华心血管病杂志, 2006, 34(4):381-384.
	Jing ZC. 6 clinical application of the six-minute walking distance trial[J]. Chin J Cardiol, 2006, 34(4):381-384.
[18]	Morales JS, Valenzuela PL, Herrera-Olivares AM, et al. Reply:letter to the editor:exercise interventions and cardiovascular health in childhood cancer:a meta-analysis[J]. Int J Sports Med, 2020, 41(9):629. DOI PMID
[19]	Braam KI, van der Torre P, Takken T, et al. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer[J]. Cochrane Database Syst Rev, 2016, 3:CD008796.
[20]	Morales JS, Santana-Sosa E, Santos-Lozano A, et al. Inhospital exercise benefits in childhood cancer:a prospective cohort study[J]. Scand J Med Sci Sports, 2020, 30(1):126-134. DOI URL
[21]	苏媛媛, 张伟宏, 宋晓月, 等. 抗阻运动对心血管疾病患者心脏康复作用的研究进展[J]. 中华护理杂志, 2017, 52(2):154-157.
	Su YY, Zhang WH, Song XY, et al. Research progress of resistance exercise on cardiac rehabilitation in patients with cardiovascular diseases[J]. Chin J Nurs, 2017, 52(2):154-157.