有氧运动用于乳腺癌根治术后康复期对上肢功能和肺功能及骨密度的影响

Effects of aerobic exercise on upper limb function,lung function and bone mineral density in rehabilitation period after radical mastectomy

目的研究有氧运动用于乳腺癌根治术后康复期对上肢功能、肺功能及骨密度的影响。方法选取2017年1月至2019年6月于本院收治的114例乳腺癌根治术后患者为研究对象,按照随机数表法分为两组,各57例。观察组实施有氧运动+体操锻炼,对照组实施传统功能训练方法锻炼。比较两组锻炼前后患侧上肢肌力、患侧肩关节活动度、患侧上肢容积、肺功能、骨密度、形体指标及生活质量评分。结果锻炼后,两组患侧上肢握力、肱二头肌肌力及患侧肩关节前屈、后伸、外展活动度均显著高于锻炼前(P<0.05),患侧上肢容积与锻炼前比较差异无统计学意义;锻炼后,观察组患侧上肢握力及患侧肩关节前屈活动度均显著高于对照组(P<0.05),患侧肱二头肌肌力、患侧肩关节后伸、外展活动度及患侧上肢容积与对照组比较差异无统计学意义。锻炼后,观察组最大摄氧量、肺活量均显著高于锻炼前(P<0.05),BMI、WHR均显著低于锻炼前(P<0.05),脊柱L2~4及股骨骨密度与锻炼前比较差异无统计学意义;对照组上述指标与锻炼前比较差异均无统计学意义;锻炼后,观察组最大摄氧量、肺活量均显著高于对照组(P<0.05),BMI、WHR均显著低于对照组(P<0.05),脊柱L2~4及股骨骨密度较对照组比较差异无统计学意义。锻炼后,两组躯体状况、附加关注评分均高于锻炼前(P<0.05),社会/家庭状况、情感状况、功能状况评分与锻炼前比较差异无统计学意义;锻炼后,观察组躯体状况、附加关注评分均高于对照组(P<0.05),两组社会/家庭状况、情感状况、功能状况比较差异无统计学意义。结论有氧运动+体操对乳腺癌根治术后患者上肢功能恢复、肺功能改善、患者整体康复具有重要临床价值。

Objective To study the effect of aerobic exercise on upper limb function,lung function and bone mineral density after radical mastectomy.Methods 114 cases of breast cancer patients after radical mastectomy in our hospital from January 2017 to June 2019 were selected as the research objects and divided into two groups according to the random number table method,with 57 cases in each group.The observation group was carried out aerobic exercise+gymnastics Exercise,the control group was trained by traditional functional training methods.The muscle strength of the affected side of the upper limb,the range of motion of the affected side of the shoulder joint,the volume of the affected side of the upper limb,lung function,bone density,physical indicators and quality of life scores were compared between the two groups before and after exercise.Results After exercise,the grip strength of upper limb,biceps muscle strength and shoulder joint flexion,extension and abduction activity of the two groups were significantly higher than those before exercise(P<0.05).There was no significant difference in the volume of affected upper limb before exercise;after exercise,the biceps brachii muscle strength and shoulder flexion range of motion in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in grip strength,shoulder extension,abduction range of motion and upper limb volume between the two groups.The maximum oxygen intake and vital capacity of the observation group were significantly higher than before exercise(P<0.05),BMI and WHR were significantly lower than those before exercise(P<0.05).There was no significant difference in bone mineral density of spine L2-4 and femur before and after exercise;there was no significant difference in the above indexes of the control group before and after exercise;the maximal oxygen uptake and vital capacity of the observation group after exercise were significantly higher than those of the control group(P<0.05),BMI and WHR in the treatment group were significantly lower than those in the control group(P<0.05).There was no significant difference in bone mineral density of L2-4 spine and femur between the two groups.After exercise,the scores of physical condition and additional attention of the two groups were higher than those before exercise(P<0.05),there was no significant difference in social/family status,emotional status and functional status scores before and after exercise;after exercise,the scores of physical condition and additional attention of the observation group were higher than those of the control group(P<0.05),and there was no significant difference in social/family status,emotional status and functional status scores between the two groups.Conclusion Aerobic exercise+gymnastics exercise has important clinical value in the recovery of upper limb function,improvement of lung function and promotion of overall rehabilitation of patients after radical mastectomy.