"互联网+"运动处方干预对乳腺癌术后居家患者上肢功能与生命质量的影响

Effect of"Internet plus"exercise prescription intervention on upper limb function and quality of life of breast cancer patients at home after surgery

目的探讨"互联网+"运动处方干预对乳腺癌术后居家患者上肢功能与生命质量的影响,为乳腺癌术后居家患者的健康管理提供参考。方法采用前瞻性随机对照试验研究方法,便利抽样法选取2021年11月至2023年1月在厦门大学附属翔安医院乳腺甲状腺外科接受治疗的乳腺癌患者124例为研究对象,按照随机数字表法分为对照组与干预组,每组62例。对照组患者采用常规护理方法,干预组患者术后第1~4周实施常规训练,术后第5周实施"互联网+"运动处方干预。比较2组患者干预前后上肢功能障碍程度、生命质量及运动依从性情况。结果最终共纳入117例患者,均为女性,干预组58例,年龄(51.01±9.77)岁,对照组59例,年龄(51.47±9.85)岁。2组患者干预前上肢功能障碍程度、生命质量比较差异无统计学意义(P>0.05)。干预后,干预组患者上肢功能障碍程度(63.55±7.02)分,低于对照组的(67.13±7.25)分,差异有统计学意义(t=2.71,P<0.01)。干预后,干预组患者生命质量总分及生理状况、社会/家庭状况、情感状况、功能状况及附加关注各维度得分分别为(115.27±17.35)、(22.65±4.53)、(22.79±4.36)、(20.96±3.95)、(19.56±4.22)、(29.31±5.24)分,均高于对照组的(104.28±17.04)、(20.57±4.48)、(20.85±4.23)、(18.75±4.04)、(17.18±4.06)、(26.93±5.21)分,差异均有统计学意义(t值为2.44~3.46,均P<0.05)。干预组乳腺癌患者运动依从性方面,有氧运动完成率为91.38%(53/58)、肌力训练完成率为77.59%(45/58)、拉伸运动完成率为86.21%(50/58)、运动频率为(3.96±1.13)次/周、运动时长为(29.51±7.64)min/次,优于对照组的77.97%(46/59)、57.63%(34/59)、69.49%(41/59)、(3.38±0.94)次/周、(23.96±7.33)min/次,差异均有统计学意义(χ2=4.04、5.31、4.73,t=3.02、4.01,均P<0.05)。结论"互联网+"运动处方干预具有方便、直观、可操作性强的特点,有利于改善乳腺癌术后居家患者上肢功能障碍程度、生命质量及运动依从性,建议临床推广应用。

Objective To explore the effect of"Internet plus"exercise prescription intervention on upper limb dysfunction and quality of life of breast cancer patients at home after surgery,so as to provide reference for health management of breast cancer patients after surgery.Methods Adopting a prospective randomized controlled trial research method.From November 2021 to January 2023,124 breast cancer patients in the breast and thyroid surgery department of Xiang′an Hospital Affiliated to Xiamen University were selected for the study.According to the random number table method,they were randomly divided into an intervention group(62 cases)and a control group(62 cases).The control group patients were given routine training,and the intervention group patients received routine training in the first four weeks after operation,and"Internet plus"exercise prescription intervention in the fifth week after operation.The upper limb dysfunction,quality of life before and after the intervention and motor compliance after the intervention between the two groups were compared.Results A total of 117 patients were ultimately included,and they were all female,with 58 patients in the intervention group aged(51.01±9.77)years old and 59 patients in the control group aged(51.47±9.85)years old.There was no statistically significant difference in upper limb dysfunction and quality of life between the two groups of patients before intervention(P>0.05).After the intervention,the degree of upper limb dysfunction in the intervention group was(63.55±7.02)points,which were lower than that in the control group(67.13±7.25)points,and the difference was statistically significant(t=2.71,P<0.01).After the intervention,the total score of quality of life and the scores of physiological status,social/family status,emotional status,functional status and additional attention of breast cancer patients in the intervention group were(115.27±17.35),(22.65±4.53),(22.79±4.36),(20.96±3.95),(19.56±4.22),(29.31±5.24)points,which were higher than those in the control group(104.28±17.04),(20.57±4.48),(20.85±4.23),(18.75±4.04),(17.18±4.06),(26.93±5.21)points,the differences were statistically significant(t values were 2.44-3.46,all P<0.05).In terms of exercise compliance of breast cancer patients in the intervention group,the aerobic exercise completion rate was 91.38%(53/58),muscle strength training completion rate was 77.59%(45/58),stretching exercise completion rate was 86.21%(50/58),exercise frequency was(3.96±1.13)times/week,exercise duration was(29.51±7.64)min/time,which was superior to 77.97%(46/59),57.63%(34/59),69.49%(41/59),(3.38±0.94)times/week,(23.96±7.33)min/time in the control group,the differences were statistically significant(χ2=4.04,5.31,4.73,t=3.02,4.01,all P<0.05).Conclusions"Internet plus"exercise prescription intervention has the characteristics of convenience,intuition and strong operability,which is conducive to improving the upper limb dysfunction,quality of life and exercise compliance of breast cancer patients at home after surgery.It is recommended to be popularized and applied clinically.