走路運動介入對癌症病童影響之縱貫性前驅研究

背景：化學療法與放射治療是兒童癌症主要治療，但是對癌症病童身、心健康皆有重大影響，如:體適能、疲憊、睡眠品質以及生活品質皆受影響。實證研究已證實運動可以改善成年癌症病患身、心健康。研究目的：探討走路運動介入對癌症病童的生理指標、疲憊、睡眠品質及生活品質之影響。研究方法：採縱貫性研究設計，於105年1月2日至105年6月31日在南部某醫學中心小兒血液腫瘤科病房及門診共收案18人，鼓勵個案每週至少運動五天，每天運動時間及強度依自己可承受下進行，持續六週。研究工具包含六分鐘走路距離(評估運動耐受力)、生理指標(呼吸、心跳、血壓、血氧濃度)、疲憊、睡眠品質以及生活品質，重複測量七次(基準線、第一週、第二週、第三週、第四週、第五週和第六週)。結果：癌症病童運動執行率為55.5%，癌症病童運動介入後休息一分鐘的生理指標(心跳、呼吸、血壓、血氧飽和濃度)與運動前均無顯著差異。運動介入前後睡眠品質無顯著差異，但是病童運動耐受力顯著增加，疲憊程度在運動介入第三週亦顯著下降，生活品質於第五週達顯著改善。結論與應用：走路運動對於癌症病童是具正向幫助且是可行、可耐受且安全的運動。未來可以對住院和居家大於三歲的癌症病童推廣走路運動。

關鍵字

癌症病童；運動；疲憊；睡眠品質；生活品質

並列摘要

Introduction: Chemotherapy and/or radiation therapy are the main treatments for children with cancer, and its treatment have considerable impact on a child’s physical and mental wellbeing, such as physical fitness, fatigue, sleep quality and quality of life. Physical exercise in adult cancer patients has been reported positive effects on physical fitness and psychosocial health. Purpose: To explore the impacts of an exercise intervention on physiological index, fatigue, sleep quality, and quality of life in Children and adolescents with cancer. Methods: A longitudinal design was used in this study from January 2, 2016 to June 30, 2016. Participants were recruited from the homological and oncological ward and clinics of the southern medical center. 18 participants were included and completed a six-week walking exercise consisting of 5 times per weektime and intensity for daily exercise was according to participants’ tolerance. Instruments included 6-minute walking test (assess the tolerance of exercise), physiological indices(respiration, heart rate, BP, and O2 saturation), fatigue, sleep quality, and quality of Life, repeating measurements for 7 times(baselines, 1st 2nd, 3 rd, 4th,5 th, 6th week). Results: The exercise implementation rate was 55.5%. There were no significant differences in the physiological indicators (heart rate, respiratory, blood pressure, SPO2) between completing exercise and resting for one minute after exercise. No significant difference in quality of sleep was found, but exercise tolerance significantly increased. Fatigue level significantly reduced since third week. The quality of life at 5th week was significantly improved. Conclusions: Walking exercise is a positive, feasible, tolerable and safe exercise for pediatric cancer patients. Walking exercise can be promoted in the hospitalization and at home for over three years old pediatric cancer patients.