ABSTRACT
BACKGROUND: Patients living with and beyond breast cancer frequently exhibit several side effects that can impact quality of life and physical functioning way beyond diagnosis and cancer therapies. Traditional on-land exercise has shown to be effective in reducing several symptoms of BC but little is known about the role of water-based exercise in improving physical and psychological well-being. OBJECTIVES: To compare land- vs. water-based exercise training for BC survivors to improve Health-Related Quality of Life (HRQoL), cancer-related fatigue (CRF), physical functioning, body composition and physical activity in patients with BC. METHODS: A randomised, parallel group (1:1) controlled trial was conducted between 2020 and 2022. Patients were randomly allocated to complete a similar exercise training twice weekly during 12 weeks either on land (LG) using traditional gym equipment or in a swimming pool (WG) using body-weight exercises and water-suitable accessories. Both groups were supervised and monitored by an experienced physiotherapist. Main outcome was HRQoL (EORTC QLQ C30 and B23 module) and CRF measured with the Piper Scale. Secondary variables included functional capacity with the 6 Minutes Walking Test (6MWT), upper and lower body strength (handgrip strength and 30â³ Sit-to-Stand (STS) test), body composition and objectively measured physical activity. RESULTS: 28 patients were assessed and randomised during the study period. One patient did not receive the allocated intervention due to skin issues and one patient was dropped out during the intervention. A significant effect of time was found for both symptom severity (F(2,52) = 6.46, p = 0.003) and overall functioning (F1.67,43.45 = 5.215, p =0 .013) but no interaction was found between group and time. No effects were reported for CRF. Similar findings were reported for functional capacity (time effect F1.231,32.019 = 16.818, p < 0.001) and lower body strength (time effect F2,52 = 15.120, p < 0.001) as well as fat mass (time effect F2,52 = 4.38, p = 0.017). Notably, a significant time per group interaction was reported for physical activity (F2,52 = 6.349, p =0.003) with patients in the WG significantly improving PA levels over time while patients in the LG exhibited a marked decreased. CONCLUSIONS: Exercise training either in water or on land can decrease symptom severity and improve functionality and body composition. Water-based training seems more effecting than land-based exercise to improve physical activity patterns over time.
ABSTRACT
El cáncer de pulmón constituye una de las principales causas de muerte en los países desarrollados. Los tratamientos utilizados frecuentemente conducen a un deterioro en la calidad de vida y la capacidad funcional de los pacientes. Las principales bases de datos han sido revisadas entre febrero y marzo de 2012 para evaluar el papel que ejercen los programas de rehabilitación pulmonar (RP) en el preoperatorio de cirugía torácica y sus efectos sobre el postoperatorio inmediato. De los 425 artículos identificados, finalmente 9 cumplieron los criterios de inclusión establecidos. De los datos extraídos, podemos concluir que los programas de RP son efectivos para mejorar la tolerancia al esfuerzo en los pacientes, aunque son necesarios más estudios controlados para establecer diferencias significativas en otros aspectos como la función pulmonar o la calidad de vida (AU)
Lung cancer is considered as one of the leading causes of death in developed countries. The therapies used for the treatment often lead to a deterioration in the patients quality of life and functional capacity. The main data bases were searched between February and March 2012 in order to evaluate the role of pulmonary rehabilitation (PR) programs during the thoracic surgery preoperative period and their effects on the immediate post-surgery period. Finally, 9 out of the 425 papers identified met the inclusion criteria. Based on the data obtained, we can conclude that the PR programs are effective to improve tolerance to exercise in lung cancer patients. However, more randomized controlled trials are needed to establish significant differences in other aspects such as lung function or quality of life (AU)
