Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial

Objective

To evaluate the effect of a combined hospital plus home exercise programme following curative surgery for non-small cell lung cancer (NSCLC).

Design

Randomised controlled trial.

Setting

Teaching hospital.

Participants

One hundred and thirty-one subjects with NSCLC admitted for curative surgery.

Interventions

Participants were randomised to usual care or a hospital plus home exercise programme.

Outcomes

The primary outcome was the between-group difference in physical activity 4 weeks after surgery. Secondary outcomes were the difference in quadriceps strength, exercise tolerance and quality of life [Short Form-36 (SF-36) and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-LC13] from pre-operatively (baseline) to 4 weeks after surgery.

Results

The participants (n = 131) had a mean age of 68 [standard deviation (SD) 11] years and mean forced expiratory volume in 1 second of 2.4 (SD 1.1) l. There were no significant differences in physical activity between the groups 4 weeks after surgery [mean difference adjusted for baseline 12 minutes/day, 95% confidence interval (CI) −20.2 to 44.1]. In addition, there were no significant differences in total SF-36 or EORTC QLQ-LC13 scores from baseline to 4 weeks after surgery. Both groups had recovered their pre-operative walking distance 4 weeks after surgery, and there were no differences between the groups (mean difference in Incremental Shuttle Walk Test from baseline to 4 weeks after surgery (−26 m, 95% CI −94.2 to 42.3).

Conclusions

A hospital plus home exercise programme showed little benefit in unselected patients with NSCLC following surgery. Regardless of group allocation, the patients had recovered their pre-operative exercise tolerance levels by 4 weeks after surgery.     

有氧运动对喉癌术后患者癌因性疲乏状况的影响

目的探讨有氧运动对喉癌术后患者癌因性疲乏状况的影响。方法将56例喉癌术后患者随机分为干预组和对照组,各28例,对照组出院后根据患者身体状况自行运动;干预组按护士为其制定的运动处方进行规律运动,分别在患者干预前（出院时）及术后2个月采用中文版的Piper疲乏修订量表对患者癌因性疲乏状况进行评定。结果两组患者干预前（出院时）的疲乏评分比较差异无统计学意义（P〉0．05）;干预后两组患者的疲乏评分比较差异有统计学意义（P〈0．05或P〈0．01）。结论有氧运动可以消除或缓解患者的疲乏程度,提高生存质量。     

渐进性肌肉放松训练对肺癌脑转移患者生活质量的影响

目的探讨渐进性肌肉放松训练对肺癌脑转移患者生活质量的影响。方法选取苏州大学附属第一医院2017年9月至2019年2月收治的80例肺癌伴脑转移患者为研究对象,采用随机数字表法分成两组。对照组(40例)患者给予常规护理;观察组(40例)实施常规护理+渐进性肌肉放松训练。观察两组患者脑卒中患者神经功能缺损评估量表(NIHSS)、生活质量量表评分及护理满意度的变化。结果护理干预前两组患者NIHSS及生活质量量表评分差异均无统计学意义(P>0.05)。干预6周后,两组患者NIHSS评分均呈不同程度降低,但对照组干预前后NIHSS评分差异无统计学意义(P>0.05),而观察组明显低于对照组及干预前(P<0.05);观察组生活质量量表评分除社会/家庭状况方面,其他方面评分均较干预前及对照组高(P<0.05);观察组护理满意度(95.0%)较对照组(80.0%)高(P<0.05)。结论渐进性肌肉放松训练有助于改善肺癌脑转移患者NIHSS评分及生活质量,提高护理满意度。     

对肠易激综合征患者实施渐进性肌肉放松训练的效果观察

目的 观察渐进性肌肉放松训练对肠易激综合征患者的护理干预效果.方法 将60例肠易激综合征患者随机分为观察组和对照组各30例,对照组采用常规治疗及护理,观察组在此基础上,采用渐进性肌肉放松训练.结果 治疗12周后,观察组抑郁自评量表(SDS)评分(39.96±6.68)分,焦虑自评量表(SAS)的评分(38.9±2.53)分,显著低于对照组(P<0.01),肠道症状严重指数(1.93±0.63)、症状频率指数(2.73±0.75),均低于对照组(P<0.05).结论 渐进性肌肉放松训练能明显改善肠易激综合征患者的负性情绪、降低应激水平、减轻肠道症状,是一种有效的护理干预措施.     

正念减压配合渐进式肌肉放松训练对肺癌化疗患者护理效果分析

目的 探讨正念减压(MBSR)配合渐进式肌肉放松训练对肺癌化疗患者的护理效果.方法 抽取2017年6月至2019年5月间于江南大学附属医院确诊并接受同种化疗方案的肺癌患者112例作为研究对象,按照双色球法随机分为两组各56例.对照组化疗期间行常规护理,研究组在常规护理基础上行MBSR配合渐进式肌肉放松训练干预,连续干预...     

Effect of self-tailored high-intensity interval training versus moderate-intensity continuous exercise on cardiorespiratory fitness after myocardial infarction: A randomised controlled trial

BackgroundWhether high-intensity interval training (HIIT) is more efficient than moderate-intensity continuous exercise (MICE) to increase cardiorespiratory fitness in patients with acute coronary syndrome at moderate-to-high cardiovascular risk is controversial. The best approach to guide training intensity remains to be determined.ObjectiveWe aimed to assess intensities achieved with self-tailored HIIT and MICE according to perceived exertion and to compare the effect on cardiorespiratory fitness in patients early after ST-elevation myocardial infarction (STEMI).MethodsWe included 69 males starting cardiac rehabilitation within 4 weeks after STEMI. After a 3-week run-in phase with MICE, 35 patients were randomised to 9 weeks of HIIT (2 × HIIT and 1 × MICE per week) and 34 patients to MICE (3 × MICE). Training workload for MICE was initially set at the patients’ first ventilatory threshold (VT). HIIT consisted of 4 × 4-min intervals with a workload above the second VT in high intervals. Training intensity was adjusted weekly to maintain the perceived exertion (Borg score 13–14 for MICE, ≥ 15 for HIIT). Session duration was 38 min in both groups. Peak oxygen consumption (VO₂) was measured by cardiopulmonary exercise testing pre- and post-intervention.ResultsBoth groups improved peak VO₂ (ml/kg/min) (HIIT +1.9, P < 0.001; MICE +3.2, P < 0.001, Cohen's d ?0.4), but changes in VO₂ were not significantly different between groups (P = 0.104). Exercise regimes did not differ between groups in terms of energy expenditure or training time, but perceived exertion was higher with HIIT.ConclusionsSelf-tailored HIIT was feasible in patients early after STEMI. It was more strenuous but not superior nor more time-efficient than MICE in improving peak VO₂.The trial was registered at ClinicalTrial.gov (NCT02627586).     

渐进式肌肉放松训练对乳腺癌高致吐方案化疗所致恶心呕吐的效果观察

目的 探讨渐进式肌肉放松训练对乳腺癌高致吐方案化疗所致恶心呕吐(CINV)的治疗效果。方法 收集我院2017年1月-2017年6月行表阿霉素联合环磷酰胺(EC)方案化疗的乳腺癌患者68例,按照随机数字表法分为观察组和对照组,每组各34例。对照组给予托烷司琼注射液、地塞米松治疗;观察组在此基础上进行渐进式肌肉放松训练,比较两组对预防CINV的临床疗效。结果 急性期两组恶心、呕吐发生率、恶心缓解率及呕吐频次比较,差异均无统计学意义(P>0.05);延迟期两组恶心发生率比较,差异无统计学意义(P>0.05),观察组呕吐发生率、呕吐频次明显低于对照组,恶心缓解率明显高于对照组,差异有统计学意义(P<0.05)。结论 渐进式肌肉放松训练能显著降低乳腺癌高致吐方案化疗延迟期呕吐发生率、呕吐频次和恶心程度,简便易行,可用于临床防治乳腺癌高致吐方案化疗所致CINV。     

放松训练对肺癌患者康复效果的影响

目的：探讨围术期放松训练对肺癌患者康复效果的影响。方法选择2010年1月至2012年12月我院肺科肺癌患者120例,按随机数字表法随机分为干预组和对照组,各60例。对照组进行常规护理,干预组在常规护理的基础上采取音乐疗法、渐进性肌肉放松及引导性想象等放松训练方法。干预后比较两组患者的生理、心理状况及疼痛度。结果干预前,两组患者状态焦虑问卷得分差异无统计学意义（P＞0.05）,干预后干预组患者的状态焦虑问卷得分明显低于对照组,差异有显著统计学意义（ P＜0.01）。干预前,两组患者Rotterdam症状检测量表的生理纬度、心理纬度及总计得分差异无统计学意义（ P＞0.05）,干预后干预组患者的Rotterdam症状检测量表的生理纬度、心理纬度及总计得分明显低于对照组,差异有显著统计学意义（ P＜0.01）。结论放松训练可有效缓解患者的焦虑情绪,降低身体的不适感及疼痛度。     

肌肉放松训练对乳腺癌患者围手术期生活质量的影响

目的探讨渐进性肌肉放松训练对围手术期乳腺癌患者抑郁、焦虑和生活质量的影响。方法选取西安市两所综合三级甲等医院围手术期的乳腺癌患者200名为研究对象,将其随机分为观察组和对照组各100名,对照组患者给予常规护理,观察组患者在常规护理基础上进行5周的渐进性肌肉放松训练,采用乳腺癌患者生命质量测定量表(FACT-B)、抑郁自评量表(SDS)与焦虑自评量表(SAS),分别在入院第1天及干预后第5周后测评研究对象的生活质量和抑郁及焦虑变化情况。结果观察组患者经5周的肌肉放松训练后,生活质量得分、抑郁及焦虑评分较对照组患者有显著改善,差异有统计学意义(P0.05)。结论渐进性肌肉放松训练能有效改善围手术期乳腺癌患者的生活质量,缓解其抑郁与焦虑等不良心理状态,应广泛应用到乳腺癌患者的术后康复护理中。     

认知疗法联合放松训练对胶原酶溶盘术患者焦虑的影响

目的 探讨认知疗法联合逐渐性肌肉放松训练(CTPRT)对胶原酶溶盘术患者手术焦虑的影响.方法 将120例行胶原酶溶盘术的患者随机分成实验组和对照组各60例,对照组实施常规护理.实验组在常规护理基础上实施CTPRT,观察2组患者手术前后的焦虑状况、腰腿疼痛程度、心率、血压以及术后睡眠和排尿情况.结果 实验组患者的焦虑程度和术后疼痛程度显著低于对照组(P<0.01);手术前30 min及术后回病房的血压、心率值实验组亦显著低于对照组(P<0.01);术后睡眠和排尿情况实验组优于对照组,P<0.05.结论 认知疗法联合逐渐性肌肉放松训练可有效减轻胶原酶溶盘术患者的焦虑情绪,缓解疼痛,改善睡眠.     

Effect of Benson and progressive muscle relaxation techniques on sleep quality after coronary artery bypass graft: A randomized controlled trial

ObjectiveThis study aimed to investigate the effect of Benson relaxation (BR) and progressive muscle relaxation (PMR) techniques on the sleep quality of patients undergoing coronary artery bypass graft (CABG) surgery.MethodThis study was a three-arm, parallel, randomized controlled trial. 120 patients who underwent CABG surgery at two academic hospitals in an urban area of Iran were randomly allocated into three groups (40 per group): the BR, PMR, and control groups. Patients in the BR and the PMR groups performed relevant exercises twice a day for four weeks. Sleep quality was measured before and immediately after the intervention using Pittsburgh Sleep Quality Index.ResultsWithin-group comparison in the BR (t = 3.51, p = 0.001) and the PMR (t = 4.58, p < 0.001) group showed that the overall sleep quality showed a significant improvement after the intervention when compared to baseline. The between-group comparison showed that both the BR and PMR groups showed significant improvements in subjective sleep quality (F = 3.75, p = 0.02), habitual sleep efficiency (F = 4.81, p = 0.01), and overall sleep quality (F = 5.53, p = 005) when compared to the control group after the intervention. However, no statistically significant differences were identified among the three study groups in terms of sleep latency, sleep duration, sleep disturbances, sleeping medication, and daytime dysfunction after the intervention (p > 0.05).ConclusionThe study showed that a four-week program of both PMR and BR can be effective in the overall improvement of sleep quality in patients following CABG. Further research is required to replicate the findings of the present study.     

Effectiveness of a combined exercise training and home-based walking programme on physical activity compared with standard medical care in moderate COPD: a randomised controlled trial

Objective

To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD).

早期居家有氧运动对结直肠癌化疗患者癌因性疲乏的干预效果

目的:探讨早期居家有氧运动对结直肠癌化疗患者癌因性疲乏的干预效果.方法:将72例存在癌因性疲乏症状的结直肠癌化疗患者作为研究对象,按研究时间分为两组,对照组(36例)接受医院常规护理,试验组(36例)在接受医院常规护理的基础上,接受24周的居家有氧运动干预.于干预前、第4、8、12、16、20和第24周对患者进行癌因性疲乏量表测定.结果:试验组的疲乏分数在有氧运动干预第4、8、12、16、20、24周较之对照组呈显著性下降趋势.结论:实施早期居家有氧运动可延缓化疗导致的癌因性疲乏加重.     

食管癌手术患者癌因性疲乏与生存质量调查

目的 研究食管癌手术患者的癌因性疲乏与生存质量的相互关系,为护理干预提供依据。方法 应用《癌症疲乏量表》与《世界卫生纽织生存质量测定量表简表》、《癌症疼痛及生存质量调查表》对65例食管癌患者分别于术前、术后1w、术后3个月进行测评。以分析癌因性疲乏与生存质量的相互关系。结果 食管癌患者手术后对自身生存质量及自身健康状况不满意者占半数以上,食管癌患者手术后生存质量明显下降（P〈0．01）。癌因性疲乏与生存质量呈负相关（P〈0．05）,手术后3个月接近手术前水平。结论 食管癌患者的癌因性疲乏与手术前后生存质量两者相互影响,针对患者手术前后不同病期给予心理支持、健康教育、舒适护理及康复指导等干预措施,可消除或缓解食管癌患者的癌因性疲乏程度,提高患者生存质量。     

Effect of 4 weeks of whole-body vibration training in treating stress urinary incontinence after prostate cancer surgery: a randomised controlled trial

BackgroundStress urinary incontinence is common in men after prostate cancer surgery. Rehabilitative interventions incorporate pelvic floor muscle training, biofeedback, electrical stimulation, lifestyle changes, or a combination of these strategies. However, little is known about the physiological impact of whole-body vibration for stress urinary incontinence after radical prostatectomy.ObjectiveTo investigate the effect of whole-body vibration training on stress urinary incontinence after prostate cancer surgery.DesignRandomised controlled trial.SettingTertiary university hospitals.ParticipantsSixty-one patients with mild stress urinary incontinence after radical prostatectomy.InterventionGroup 1 included 30 patients who performed pelvic floor muscle training and whole-body vibration training with a frequency and amplitude of 20 Hz/2 mm for the first two sessions and 40 Hz/4 mm for the rest of the intervention. Group 2 included 31 patients who performed pelvic floor muscle training alone. The intervention in both groups was conducted three times per week for 4 weeks.Main outcomesIncontinence Visual Analogue Scale (I-VAS) score, International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) score and 24-hour pad test result.ResultsI-VAS score, ICIQ-UI-SF score and 24-hour pad test result showed significant within-group differences at each assessment with the exception of the baseline and post-intervention I-VAS score in Group 2. For example, Group 1 I-VAS score had a median difference of 3.9 cm [95% confidence interval (CI) ?4.0 to ?3.8] from baseline to first follow-up, and a median difference of ?2.0 cm (95% CI ?2.2 to ?1.8) at 4-week follow-up. Comparisons between the groups demonstrated significant differences in favour of Group 1 after 4 weeks of intervention and at follow-up for all measured parameters.ConclusionWhole-body vibration training is an effective modality for treating patients with stress urinary incontinence after prostatectomy.
Trial registrationClinicaltrial.gov (NCT03325660).     

Effect of aerobic exercise training frequency on arterial stiffness in middle-aged and elderly females

[Purpose] This study aimed to determine the effects of aerobic exercise training frequency on arterial stiffness in postmenopausal females. [Participants and Methods] This study included 45 postmenopausal females randomly assigned to one of the following three groups: 1) low-frequency training group (aerobic exercise training twice per week); 2) high-frequency training group (aerobic exercise training four times per week); and 3) control group (no training). Each group was subjected to an 8-week intervention period. Both traditional and newer indexes were measured immediately before and after the 8-week intervention period. [Results] In the low-frequency training group, carotid-femoral pulse wave velocity and arterial velocity pulse index decreased post 8 weeks compared with those at baseline. In the high-frequency training group, carotid-femoral, brachial-ankle, and heart-brachial pulse wave velocities and arterial velocity pulse and arterial pressure-volume indexes decreased post 8 weeks compared to those at baseline. In the control group, no change in any indices post 8 weeks compared to those at baseline was observed. [Conclusion] Carotid-femoral pulse wave velocity was lower after aerobic training than before training in both the exercise groups. Thus, aerobic exercise training might have a beneficial effect on aortic stiffness, regardless of the training frequency in this population.     

The effects of exercise training on fatigue and dyspnea in heart failure

BACKGROUND: Physiological benefits of exercise training for heart failure (HF) patients have been demonstrated, however little is known about the effects of training on the symptoms of fatigue and dyspnea. AIM: The purpose of this study was to examine HF symptoms of fatigue and dyspnea in response to a 24-week exercise training intervention. METHODS: This pilot study was a randomized, two-group repeated measures design. Fifteen subjects in the intervention group completed a combination of aerobic and resistance training three times per week in a standard cardiac rehabilitation setting. The control group consisted of 6 subjects who were instructed not to begin any formal exercise program during the 24-week intervention. RESULTS: Subjects (19 males and 2 females) had a mean age of 66.2+/-10.2 years and mean ejection fraction (EF) of 28.4+/-7.4%. Non-parametric Friedman Analysis of Variance by Ranks showed the exercise group significantly decreased sensory fatigue (Piper Fatigue Scale) over time (chi(2)=6.49, p=.04) while the control group did not change (chi(2)=0.93, p=.63). Dyspnea showed a non-significant decrease over time for the exercise group (chi(2)=4.16, p=.13) while the control group showed a decrease from baseline to 12 weeks but an increase to above baseline values by week 24 (chi(2)=0.18, p=.91). CONCLUSION: These results provide support for the beneficial effects of exercise training on symptoms of fatigue and dyspnea in HF patients. Larger studies to evaluate symptom response to exercise are needed.     

放松训练联合局麻药减轻动静脉内瘘患者穿刺疼痛的效果评价

目的 探讨渐进性放松训练和局麻药复方利多卡因乳膏对血液透析患者动静脉内瘘穿刺疼痛的影响,为进行有效疼痛管理提供依据.方法 将96例规律性血液透析动静脉内瘘穿刺患者随机分为放松训练干预组(A组)、局麻药干预组(B组)、放松训练联合局麻药干预组(C组)和空白对照组(D组)各24例.A组和C组患者在动静脉内瘘穿刺前分别进行渐进性放松训练,B组和C组患者在穿刺前1h采用复方利多卡因乳膏涂抹,D组进行常规穿刺护理.采用视觉模拟标尺法(VAS)在穿刺后10 min内评价各组患者穿刺疼痛状况.结果 渐进性放松训练组患者疼痛评分为(3.042±-0.999)分,复方利多卡因乳膏组患者疼痛评分为(2.500±0.978)分,渐进性放松训练加局麻药组疼痛评分为(1.333± 0.817)分,空白对照组疼痛评分为(5.042±1.122)分;析因设计方差分析结果显示:渐进性放松训练组和局麻药复方利多卡因乳膏组各自的主效应差异均有统计学意义,二者之间的交互作用差异均有统计学意义.结论 渐进性放松训练联合局麻药可有效缓解血液透析患者动静脉内瘘穿刺引起的疼痛,优于放松训练和局麻药单独使用,为临床开展药物-心理干预镇痛提供了借鉴,值得在血液透析患者疼痛管理中应用和推广.     

个体化护理对肺癌患者化疗后疲乏及生活质量的影响

目的：探讨个体化护理对肺癌患者化疗后疲乏及生活质量的影响。方法选择2012年8月—2013年11月某院收治的肺癌化疗患者80例,采用简单随机抽样法分为观察组和对照组各40例,对照组给予常规护理,观察组在常规护理的基础之上,给予个体化护理干预。采用简易疲乏量表( BFI)、匹兹堡睡眠质量指数量表(PSQI)、生活质量核心量表(EORCT QLQ-C30)评价干预前后两组患者疲乏、睡眠情况及生活质量。结果干预前,两组患者的BFI、PSQI、EORCT QLQ-C30评分差异无统计学意义(P>0.05)。经过6周的护理干预,观察组中、重度疲乏患者12例,对照组20例,两组比较差异有统计学意义(Z=1.859,P<0.05);观察组PSQI评分>7分患者11例,对照组21例,两组比较差异有统计学意义(χ2=5.208,P<0.05);观察组患者EORCT QLQ-C30整体生活质量评分(17.6±5.6)分,对照组为(12.6±4.8)分,两组比较差异有统计学意义(t=4.287,P<0.01)。结论个体化护理作为一种全方位的护理,可以最大限度解决患者疲乏,改善睡眠情况,提高其生活质量。