确定结直肠癌手术前后短期无监督运动干预对自我评估的身体恢复的影响。术前运动干预可以帮助改善结直肠癌手术后的恢复，目前是推荐的。

一项在瑞典六所大学或地区医院进行的随机、平行、开放标签试验。纳入标准为年龄20岁和计划选择性结直肠癌手术。参与者被随机分配到术前2周和术后4周进行有氧运动和吸气肌训练的体力活动干预或常规护理。主要结局指标是术后4周自我评估身体恢复情况。根据治疗意向进行分析。由于干预的性质，参与者和物理治疗师都被告知干预结果评估者。

2015年1月22日至2020年5月28日期间，招募了761名参与者，并将其分配到干预(I)组(n = 379)或对照组(C)组(n = 382)。排除后668名受试者(I = 317, C = 351)纳入初步分析。干预对主要结局指标没有影响(调整后的优势比0.84,95%置信区间0.62-1.15)，分别有13%和15%的参与者在I和C阶段感觉身体完全恢复。没有不良事件的报道。在结直肠癌手术前后进行身体活动干预对短期自我评估的身体恢复没有影响。本研究的结果要求重新考虑当前的术前体育活动干预建议。

Abstract

Objective: To determine the effect of a short-term, unsupervised exercise intervention before and after colorectal cancer surgery on self-assessed physical recovery.

Summary of background data: Preoperative exercise interventions could help improve recovery after colorectal cancer surgery and is currently recommended.

Methods: A randomized, parallel, open-label trial in six university or regional hospitals in Sweden. Inclusion criteria were age ≥20 years and planned elective colorectal cancer surgery. Participants were randomized to either a physical activity intervention with aerobic activity and inspiratory muscle training 2 weeks pre- and 4 weeks postoperatively or usual care. The primary outcome measure was self-assessed physical recovery 4 weeks postoperatively. Analyses were performed according to intention to treat. Outcome assessors were masked regarding the intervention while both participants and physiotherapists were informed due to the nature of the intervention.

Results: Between January 22, 2015, and May 28, 2020, 761 participants were recruited and assigned to either intervention (I) (n = 379) or control (C) (n = 382). After exclusions 668 participants (I = 317, C = 351) were included in the primary analysis. There was no effect from the intervention on the primary outcome measure (adjusted odds ratio 0.84, 95% confidence interval 0.62-1.15) with 13% and 15% of participants feeling fully physically recovered in I and C, respectively. There were no reported adverse events.

Conclusions: There was no effect from a physical activity intervention before and after colorectal cancer surgery on short-term self-assessed physical recovery. The results from this study call for reconsiderations regarding current recommendations for preoperative physical activity interventions.

原文链接

pubmed.ncbi.nlm.nih.gov/33843798/

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