Efectos de la actividad física en la calidad de vida relacionada con la salud de pacientes con cáncer de próstata: una revisión sistemática

Autor: Quiñones-Muñoz, Diana Rocio
Přispěvatelé: Meneses Echávez, José Francisco
Jazyk: Spanish; Castilian
Rok vydání: 2018
Předmět:
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Repositorio EdocUR-U. Rosario
Universidad del Rosario
instacron:Universidad del Rosario
DOI: 10.48713/10336_18692
Popis: Antecedentes: El cáncer de próstata es una grave preocupación en la salud pública, siendo el segundo cáncer más común en los hombres, lo que representa el 15% de todos los casos de incidentes. La calidad de vida relacionada con la salud en pacientes con cáncer de próstata se ve afectada por factores tales como reducción de masa ósea, masa magra, fuerza muscular, alteraciones de la salud sexual, deterioro de la capacidad funcional y alteraciones psicológicas. Estas muestras clínicas son más evidentes en los pacientes que sufren tratamientos hormonales tales como terapia de la privación del andrógeno, y radioterapia. La actividad física ha sido postulada como una estrategia terapéutica no farmacológica para contrarrestar lo descrito anteriormente. Objetivo: Determinar los efectos de las intervenciones con actividad física en la calidad de vida relacionada con la salud de pacientes con cáncer de próstata. Búsqueda y selección de los estudios: Se realizaron búsquedas en MEDLINE, EMBASE y PsycINFO para identificar ensayos clínicos controlados aleatorios publicados entre 1990 y 2017. La estrategia de búsqueda se construyó con los descriptores MESH: “prostate cancer”, “cancer”, “physical activity” y “exercise”, los cuales se combinaron con los operadores booleanos AND y OR. No se aplicaron restricciones de lenguaje. Se incluyeron todos los ensayos clínicos que compararon diferentes modalidades de actividad física versus la atención habitual o la no intervención. Extracción y análisis de los datos: Una investigadora (DQ) extrajo los datos de los estudios primarios utilizando un formulario estándar diseñado a priori y pilotado en un grupo de cinco estudios incluidos. Los datos fueron registrados en formato Excel y comprobados por un segundo investigador (JM). Las recomendaciones del Cochrane fueron seguidas para realizar el meta-análisis usando el programa RevMan. Resultados: Se incluyeron trece estudios (n = 1070). El tratamiento activo más común fue la terapia androgénica (n = 6). La mayoría de los estudios tenían bajo riesgo de sesgo y alta calidad metodológica. Resultado primario (calidad de vida relacionada con la salud): Los hallazgos mostraron que las intervenciones que combinaban el ejercicio aeróbico (AER) y el entrenamiento de resistencia (RES) demostraron mejoras significativas en: salud general (SMD = 0,18; IC 95%: 0,01 a 0,35), p = 0,04; Vitalidad (MD = 2,84; IC 95%: 0,55 a 5,13), p = 0,01; funcionamiento social (SMD = 0,32; IC 95%: 0,14 a 0,49), p = 0,0003; papel emocional (SMD = 0,22; IC 95%: 0,05 a 0,40), p = 0,01; Salud mental (MD = 2,49; IC 95%: 0,52 a 4,46), p = 0,01; compuesto de salud mental (MD = 3,41; IC 95%: 1,51 a 5,30), p = 0,0004. Por el contrario, la atención habitual mostró mejorías significativas en comparación con el entrenamiento aeróbico + resistencia a la actividad sexual (MD =-7,51; IC el 95%:-14,51 a-0,51), p = 0,04. El entrenamiento de resistencia mostró mejorías significativas en la evaluación funcional de la terapia de cáncer de próstata (FACT-P) (MD = 3,70; IC 95%: 1,37 a 6,03), p = 0,002. El ejercicio aeróbico no mostró diferencias estadísticamente significativas para ningún resultado. Resultados secundarios: AER+RES mostró mejoras significativas para fuerza de tren inferior (SMD = 8,51; IC 95%: 3,98 a 13,04), p = 0,000; y los biomarcadores – testosterona (MD = 0,35; IC 95%: 0,01 a 0,70), p = 0,04. El entrenamiento de resistencia mostró mejoras en composición corporal-masa magra (MD = 2,80; IC 95%: 0,21 a 5,40), p = 0,03. Conclusiones: Trece ensayos de alta calidad sugieren que las intervenciones de actividad física mejoran algunas dimensiones de la calidad de vida relacionada con la salud y el estado físico en pacientes con cáncer de próstata. La mayoría de las pruebas que apoyan estos efectos se aplican a la combinación de entrenamiento aeróbico y entrenamiento de resistencia. Background: Prostate cancer is a serious concern in public health, being the second most common cancer in men, accounting for 15% of all incident cases. Health-related quality of life in patients with prostate cancer is affected by factors such as bone mass reductions, lean mass, muscle strength, sexual health disturbances, deterioration of functional capacity, and psychological disturbances. These clinical signs are more evident in patients undergoing hormonal treatments such as androgen deprivation therapy, and radiotherapy. Physical activity has been postulated as a non-pharmacological therapeutic strategy to counteracting the above described. Objective: To determine the effects of physical activity interventions on the health-related quality of life in patients with prostate cancer. Research and selection of studies: We searched MEDLINE, EMBASE and PsycINFO to identify randomized-controlled clinical trials published between 1990 and 2017. The search strategy was built up with the following Mesh descriptors: “prostate cancer”, “cancer”, “physical activity” and “exercise”, which were combined with the boolean operators AND and OR. Language restrictions were not applied. We included all clinical trials that compared different modalities of physical activity versus usual care or non-intervention. Data extraction and analysis: A researcher (DQ) extracted data from the primary studies by using a standard form designed a priori and piloted in a group of five included studies. The data were recorded in an Excel format and checked by a second researcher (JM). The Cochrane’s recommendations were followed to perform meta-analysis using the RevMan program. Results: Thirteen studies (n=1070) were included. The most common active treatment was androgen therapy (n=6). Most studies had low risk of bias and high methodological quality. Primary outcome (health-related quality of life): The findings showed that interventions combining aerobic exercise (AER) and resistance training (RES) demonstrated significant improvements on: general health (SMD = 0.18; IC 95%: 0.01 to 0.35), p = 0.04; vitality (MD = 2.84; IC 95%: 0.55 to 5.13), p = 0.01; social functioning (SMD = 0.32; IC 95%: 0.14 to 0.49), p = 0.0003; emotional role (SMD = 0.22; IC 95%: 0.05 to 0.40), p = 0.01; mental Health (MD = 2.49; IC 95%: 0.52 to 4.46), p = 0.01; mental health compound (MD = 3.41; IC 95%: 1.51 to 5.30), p = 0.0004. Conversely, usual care showed significant improvements compared to aerobic training + resistance on sexual activity (MD = -7.51; IC 95%:-14.51 to-0.51), p = 0.04. Resistance training showed significant improvements on the functional evaluation of prostate cancer therapy (FACT-P) (MD = 3.70; IC 95%: 1.37 to 6.03), p = 0.002. Aerobic exercise showed no statistically significant differences for any outcome. Secondary outcomes: AER + RES showed significant improvements on lower train force (SMD = 8.51; IC 95%: 3.98 to 13.04), p = 0.000; and testosterone (MD = 0.35; IC 95%: 0.01 to 0.70), p = 0.04. Resistance training showed improvements in body composition-lean mass (MD = 2.80; IC 95%: 0.21 to 5.40), p = 0.03. Conclusions: Thirteen high-quality trials suggest that physical activity interventions improve some dimensions of health-related quality of life and physical status in patients with prostate cancer. Most of the evidence supporting these effects apply for the combination of aerobic training and resistance training. 2020-11-10 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2020-11-09
Databáze: OpenAIRE
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