- 期刊
系統性回顧：高強度間歇訓練對於癌症患者之效益探討
The Efficacy of High Intensity Interval Training on Cancer Survivors: A Systematic Review
摘要
背景與目的：高強度間歇運動最大的優點為在短時間達到心肺耐力訓練的效果，近來開始應用於癌症病人，在介入高強度運動時如何規劃適量且有療效的運動處方，是鼓勵癌症患者選擇多元化運動重要的里程碑。本研究目的為利用系統性回顧來統整國內外高強度間歇運動應用於癌症患者之臨床文獻，探討運動強度之介入策略與效益。方法：搜尋華藝線上圖書館、PubMed、MEDLINE、PEDro (Physiotherapy Evidence Database)和Science Direct等線上資料庫中，2000年1月至2016年4月間出版之臨床試驗文獻。納入條件如下：1.受試者為正接受治療或完成治療之癌症患者；2.受試者接受高強度間歇運動介入，即運動強度須大於70%攝氧量峰值(VO_2 _(Peak))、或大於80%最大心跳數(HR _(max))並有恢復期做比率搭配；3.有詳細的運動劑量說明，包含每週運動頻率、運動強度、運動類型和一次運動時間。結果：本篇共納入七篇相關文獻，研究結果顯示，癌症患者高強度間歇運動處方可分為心肺適能訓練與肌力訓練兩部分，心肺適能的高強度訓練內容為介入週數為6～12週，每週三次，每次15～25分鐘，利用固定式腳踏車訓練、跑步機與戶外慢跑方式，訓練初期建議訓練期與恢復期比率為1:2或3:1進行訓練；再增加強度比率為5:1，以80%～95% HR _(max)或VO_2 _(Peak)為訓練強度；在高強度阻力訓練內容，建議劑量為持續6～12週，每週2～3天，包含六項大肌群動作訓練，強度可為漸增式以70% 1RM漸增至85%1RM，每一組肌肉群執行兩回合，並依強度調整每回合重覆次數，高強度訓練與中低強度訓練對於癌症患者在心肺適能、身體功能、降低癌因性疲憊程度與增進生活品質都有顯著的正面成效，其中高強度比中低強度運動對於研究結束後追蹤期可以維持更高的VO_2 _(Peak) (2.2 v.s. 0.5 ml/kg per/minute, p=0.01)；在運動不良反應中，只有一篇在高強度運動組有發生淋巴水腫的情形，受試者願意繼續參與運動，並沒有症狀加劇的情形。結論與建議：本篇系統性文獻統整相關研究，結果顯示癌症患者執行運動前，在專業人員的指導下進行安全性評估，並監測運動時血壓與心跳，可以安全地進行高強度間歇運動，有效增進心肺適能、心理與身體功能，提高身體活動度，建議未來研究可以依病人嚴重程度的患者，設計其不同的高強度間歇運動劑量，並且了解運動介入的長期效果，進一步探討居家高強度運動模式的可行性。
並列摘要
Recent studies have begun to replace low-intensity exercise with high-intensity interval training (HIIT) to improve physical fitness and health-related quality of life of cancer survivors. To the best of our knowledge, there is no systematic review to investigate the effect of HIIT on cancer survivors. Therefore, the aim of this systematic review study is to summarize relevant randomized controlled trials on the physiologic efficacy of HIIT on cancer survivors, and to establish the clinical intervention principles of HIIT for cancer survivors. The literature review covered online electronic databases (Pubmed, Medline, PEDro, and CEPS) from 2000 to 2016, and searched for RCTs related to HIIT application on cancer patients. Seven RCTs were included in this article. According to the results of studies, the exercise protocol of the HIIT is divided into high intensity cardiopulmonary fitness training (HICFT) and high intensity resistance training (HIRT). HICFT applied three times a week, ranged from 6～12 weeks, 15～25 minuets for each session, work to rest ratio is 1:2 or 3:1 progressively to 5:1. Training intensity suggested 80%～95% peak heart rate or peak oxygen uptake (VO_2 _(peak)). HIRT targeted large muscle groups with a frequency of two sets of 10 repetitions week at 70 %～85 % of 1-RM. The results demonstrated that HIIT and low to moderate intensity exercise could both improve VO_2 _(peak), quality of life, cancer-related fatigue and physical activity level compared to control group. However, the HIIT group maintained VO_2 _(peak) at follow-up period, whereas the low-intensity group regressed (2.2 v.s.0.5 ml/kg per/minute, p=.01). No adverse events related to the HIIT exercise group. In conclusion, the benefit of HIIT is a time-efficient strategy for improving certain aspects of the cancer survivors. The HIIT intervention can significantly reduce cancer related fatigue and improve vitality, aerobic capacity, muscular strength, and physical and functional activity, emotional wellbeing, and quality of life. The safe principles of HIIT clinical implication for cancer patients is to assess pre-exercise physical condition, and monitor completely the participants' vital signs during training sessions. Further researches could investigate the feasibility of a home-based HIIT protocol, and examine the long term effect of HIIT on cancer survivors.