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神经肌肉训练对化疗诱导的神经病的预防作用:一项随机临床试验
Fiona Streckmann1,2,3, Thomas Elter4, Helmar C Lehmann5
1Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
JAMA internal medicine
|July 1, 2024
概括
感官运动训练和全身振动显著降低了化疗诱导的周围神经病变 (CIPN) 的发生率. 这些练习改善了症状和生活质量,为管理这种常见的化疗副作用提供了有希望的方法.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 物理疗法物理治疗
背景情况:
- 化疗诱导的周围神经病变 (CIPN) 是癌症治疗的常见,令人衰弱的副作用,对患者的生活质量产生负面影响.
- 目前对CIPN的管理策略有限,往往需要减少剂量或停止化疗,可能会损害治疗疗效和生存.
研究的目的:
- 研究传感运动训练 (SMT) 和全身振动 (WBV) 在减少CIPN的发病率和症状方面的有效性.
- 评估SMT和WBV对二次结果的影响,包括平衡,体力活动,生活质量和临床结果.
主要方法:
- 一个前性的多中心随机临床试验 (STOP) 涉及158名接受氧沙或葡萄酒类化合物化疗的患者.
- 参与者被随机分为三组:SMT,WBV或通常治疗 (TAU). 干预组每周两次接受监督的培训课程.
- 主要终点是CIPN发病率,次要终点包括神经病症症状,平衡,体力活动和生活质量. 统计分析包括Mantle-Haenszel和费舍尔精确测试.
主要成果:
- 与TAU相比,SMT和WBV都显著降低了CIPN的发生率 (SMT:30.0%,WBV:41.2%与TAU:70.6%,P=.002).
- 每项协议分析显示,与TAU (73.3%) 相比,SMT (28.6%) 和WBV (37.5%) 的CIPN发病率降低甚至更大.
- 与TAU相比,SMT在平衡控制,振动灵敏度,触觉,下腿强度,疼痛减轻和降低死亡率方面表现出显著的改善.
结论:
- 包括SMT和WBV在内的神经肌肉训练提供了初步证据,可以减少化疗诱导的外周神经病变的发病和严重程度.
- 这些培训模式提供了一种有希望的非药物治疗方法来缓解CIPN,可能改善患者的治疗结果和治疗坚持.
- 需要进一步的研究来优化培训方案,并确认在接受化疗的不同患者群体中获得长期益处.
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