乳癌存活者漸進性阻力訓練的安全性與療效：系統性回顧與統合分析

Safety and Efficacy of Progressive Resistance Training for Breast Cancer Survivors: Systematic Review and Meta-analysis

林慧芬(Heui-Fen Lin) ； 蕭淑芳(Shu-Fang Hsiao) ； 曹昭懿(Jau-Yih Tsauo)

《物理治療》 34卷2期 (2009/04) Pp. 81-94

摘要

目的：由相關文獻回顧與分析，探討對於乳癌存活者施以漸進性阻力訓練的安全性與效果。方法：以電子資料庫及人工檢索收集所有有關乳癌存活者接受包含漸進性阻力訓練(progressive resistance training)之相關文獻，進行系統性回顧與統合分析(meta analysis)。結果：共找到六個隨機對照試驗(randomized controlled trial)發表在八篇文獻中，研究品質在中等以上；以及一篇非隨機對照試驗(non-randomized controlled trial)、四篇單一實驗組研究。共五篇評量手臂周長或體積的研究顯示運動訓練不會增加淋巴水腫風險。統合分析結果在肌力(muscle strength)、肌耐力(muscle endurance)、身體組成中瘦肉重(lean mass)、體脂肪比(body fat %)、腰圍及癌症生活品質量表中身體功能分項分數之進步有達統計上顯著效益；在代謝相關生化值、體重、體脂肪重及心肺適能等之改善則未達統計上顯著效益。結論：包含漸進性阻力訓練的運動計畫是安全而且有效增進肌肉適能、改善身體組成與身體功能。研究的受試者普遍過少及結果評量項目分歧多樣因而資料不足，可能是造成效果不彰的原因。需要進一步嚴謹臨床試驗，長期的效果亦有待進一步探討。

關鍵字

乳癌 ； 阻力運動訓練 ； 統合分析

並列摘要

Background and purpose: Increasing evidence of physical training improving physical, psychological function and quality of life on breast cancer patients. Safety and efficacy of progressive resistance training (PRT) for breast cancer survivors need to be evaluated. Method: Literature published till October 2008 was searched from electronic database and hand search. Systematic review and meta-analysis were performed for evaluating safety and efficacy of exercise program including progressive resistance training. Results: Six randomized controlled trials (RCTs) published in eight articles with moderate study quality, 1 non-RCT, and 4 single group pre-post design were identified. Only one RCT underwent pure weight training program, the others were combined aerobic and PRT. The exercise frequency was 2 to 3 sessions per-week, and 50-90 minutes with moderate intensity for each session. The durations of exercise training were between 8 weeks and 6 months. Outcome measures were various across the 6 RCTs. Evidence showed arm volume or arm circumferences did not change after PRT. Meta-analysis showed exercise program including PRT significantly improved muscle fitness including muscle strength and endurance. Exercise training significantly decreased lean mass, body fat %, waist circumference and improved physical functioning domain of quality of life. No significant effects on metabolic profile, body weight, body fat mass and cardiopulmonary fitness were found. Conclusion: PRT was safe and effective for breast cancer survivors in muscle fitness, improving body composition and physical functioning. Limited evidence on some of outcomes may be due to insufficient data and small sample size. Further robustly designed RCTs on PRT training with larger sample size and standardized outcome measures are needed. Evaluation of long term effect was also needed.

並列關鍵字

Breast cancer ； Resistance training ； Meta-analysis