多模态运动在早中期胃腺癌相关衰弱患者中的应用研究

Application of multimodal exercise in management of frailty among early to mid-stage gastric adenocarcinoma patients:a randomized controlled trial

目的本研究旨在评估多模态运动在早中期胃腺癌相关衰弱患者中的应用效果,特别是在生理指标、功能性测试和医疗支出方面的影响。方法本研究为临床随机对照实验,选取2020年1月-2021年1月河南省肿瘤医院收治的140例早中期胃癌术后合并衰弱或预衰患者。对照组接受健康教育干预,试验组接受多模态运动干预,每组各70例,持续12个月。在试验前,第3、6、9、12个月进行了随访,评估了生理指标(总体水分、脂肪质量、脂肪自由质量、基础代谢率和身体质量指数)和功能性测试(握力、坐立起测试、步行测试和六分钟步行测试)。结果研究结果显示,对照组与试验组在基线时的生理指标和功能性测试间差异无统计学意义(P>0.05)。随着时间的推移,试验组总体水、脂肪质量和BMI水平低于对照组,而在脂肪自由质量、基础代谢率和相位角水平则高于对照组(P<0.05)。在功能性测试方面,试验组的握力、坐立起测试和六分钟步行测试水平高于对照组,步行测试低于对照组(P<0.05)。试验组在肌肉疼痛和疲劳发生率上高于对照组,但心理应激发生率低于对照组(P<0.05)。在医疗支出方面,试验组的统筹支付费用低于对照组(P<0.05)。结论多模态运动在早中期胃腺癌相关衰弱患者中的应用可以改善生理指标和功能性测试表现,尽管可能伴随轻微的不良反应,如肌肉疼痛和疲劳。此外,该干预可能有助于降低医疗支出。这些发现支持了多模态运动作为早中期胃腺癌患者康复干预的有效性和可行性。

Objective This study aimed to evaluate the effectiveness of multimodal exercise in patients with frailty related to early to mid-stage gastric adenocarcinoma,focusing on its impact on physiological indicators,functional tests,and healthcare expenditures.Methods This study is a randomized controlled clinical experiment.Totally 140 patients with early and middle stage gastric cancer who were admitted to Henan Provincial Cancer Hospital from January 2020 to January 2021 and complicated with frailty or pre-failure after surgery were selected.The control group received health education interventions,while the experimental group underwent a 12-month multimodal exercise intervention.Follow-ups were conducted at baseline,and at the 3rd,6th,9th,and 12th months,assessing physiological indicators(total body water,fat mass,fat-free mass,basal metabolic rate,and body mass index)and functional tests(grip strength,sit-to-stand test,walking test,and six-minute walk test).Results At baseline,there were no significant differences between the control and experimental groups in physiological indicators and functional tests(P>0.05).Over time,the experimental group showed lower levels of total body water,fat mass,and bmi,but higher levels of fat-free mass,basal metabolic rate,and phase angle compared to the control group(P<0.05).In terms of functional tests,the experimental group demonstrated higher levels in grip strength,sit-to-stand test,and six-minute walk test,but lower in the walking test(P<0.05).The experimental group experienced higher rates of muscle pain and fatigue,but lower rates of psychological stress(P<0.05).Regarding healthcare expenditures,the experimental group incurred lower costs in consolidated payments compared to the control group(P<0.05).Conclusion The application of multimodal exercise in patients with frailty related to early to mid-stage gastric adenocarcinoma can improve physiological indicators and functional test performance,despite potential minor adverse reactions such as muscle pain and fatigue.Additionally,this intervention may contribute to reduced healthcare expenditures.These findings support the effectiveness and feasibility of multimodal exercise as a rehabilitation intervention for patients with early to mid-stage gastric adenocarcinoma.