有氧運動對於乳癌接受化療病人心肺及身體功能之系統性文獻回顧

Effects of Aerobic Exercise on Physical and Cardiopulmonary Function Among Patients With Breast Cancer Undergoing Chemotherapy: A Systematic Review

陳姿廷(Tzu-Ting Chen) ； 陳俞琪(Yu-Chi Chen)

《榮總護理》 40卷2期 (2023/06) Pp. 180-189

https://doi.org/10.6142/VGHN.202306_40(2).0009

摘要

乳癌為我國婦女發生率首位之癌症，許多乳癌病人因化療後發生心臟毒性副作用，導致心肺功能變差，進而影響身體功能而危及生命。有氧運動常被提到可以改善心臟功能強化身體活動量，但目前成效的實證證據仍顯不足。本文從PubMed、Cochrane library、Embase、華藝線上圖書館及台灣期刊論文索引系統資料庫進行系統性文獻搜尋，關鍵字包含分別為P=乳癌化療病人（Breast Cancer AND Chemotherapy），I=有氧運動（Aerobic Exercise），C=日常活動（Usual Care），O=心肺功能及身體功能（Cardiopulmonary Functions、Physical Functional Performance）。搜尋1985至2023年1月間中英文文獻，納入隨機對照試驗，並依據Joanna Briggs Institute（JBI）隨機對照試驗檢核表（Joanna Briggs Institute, 2020）進行文獻評析最後納入五篇文獻。依據有氧運動模組彙整實證研究中訓練持續時間、頻率、強度、介入方式，以及心肺及身體功能相關指標如心輸出量、靜態心律、最大攝氧量、周邊血管阻力、疲憊及步行距離等改善情況。建議未來宜進行更多介入研究，追蹤有氧運動對於改善化療心臟毒性於提升心肺與身體功能之成效。

關鍵字

乳癌 ； 化療 ； 有氧運動 ； 心臟功能 ； 身體功能

並列摘要

Among the cancers affecting women in Taiwan, the incidence of breast cancer is the highest. Numerous patients with breast cancer experience the deterioration of their physical and cardiopulmonary function due to the side effects of chemotherapy. Aerobic exercise is associated with improvements in cardiorespiratory function. This article explored the effects of aerobic exercise on the physical and cardiopulmonary function of patients undergoing breast cancer chemotherapy This study examined systematic review research from 1985 to January 2023 and involved randomized controlled trials that excluded other measures with aerobic exercise. Data were collected from several databases, namely the Airiti Library, PubMed, Cochrane Library, and Embase. The patient/population, intervention, comparison, and outcomes model was used to identify the following keywords: P = Breast cancer AND Chemotherapy; I = Aerobic Exercise; C = Usual Care; and O = Cardiopulmonary Function and Physical Functional Performance. On the basis of the data retrieved from the identified randomized trials and in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis (The Joanna Briggs Institute, 2020), five studies were determined to be associated with the scope of this study. Because of the incongruence between the studies in terms of intervention period, assessment tools, and tracking period, the collective research results could not be collaborated. Through the aerobic exercise model employed in this study, training duration, frequency, intensity, intervention method, and other correlative indicators of cardiopulmonary and physical function (e.g., cardiac output, resting heart rate, VO2 max, reduced peripheral resistance, and 6-min walk test results) were all revealed to be significantly improved as a result of aerobic exercise. Studies should further investigate the effects of aerobic exercise on physical and cardiopulmonary function by focusing on cardiotoxicity-related improvements in patients undergoing chemotherapy.

並列關鍵字

breast cancer ； chemotherapy ； aerobic exercise ； heart function ； body function

參考文獻

蔡佳玲、黃心樹(2021)．瑜珈輔助療法改善思覺失調症病人正性和負性症狀之系統性文獻回顧暨統合分析．源遠護理，15(3)，54-65。

Kirkham, A. A. & Davis, M. K. (2015). Exercise prevention of cardiovascular disease in breast cancer survivors. Journal of Oncology, 2015, 917606.

Taso, C. J., Lin, H. S., Lin, W. L., Chen, S. M., Huang, W. T., & Chen, S. W. (2014). The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: A randomized controlled trial. The Journal of Nursing Research, 22(3), 155-164.

Adams, S. C., DeLorey, D. S., Davenport. M. H., Stickland, M. K., Fairey, A. S., North, S., Szczotka, A., & Courneya, K. S. (2017). Effects of high-intensity aerobic interval training on cardiovascular disease risk in testicular cancer survivors: A phase 2 randomized controlled trial. Cancer, 123(20), 4057-4065.

Beaudry, R. I., Liang, Y., Boyton, S. T., Tucker, W. J., Brothers, R.M., Daniel, K. M., Rao, R., & Haykowsky, M. J. (2018). Meta-analysis of exercise training on vascular endothelial function in cancer survivors. Integrative Cancer Therapies, 17(2), 192-199.