The effect of home-based walking exercise on physical fitness in patients after major gastrointestinal surgery
| Autor: | Wei-Jung Tsai, 蔡瑋容 |
|---|---|
| Rok vydání: | 2015 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 103 Background: The major gastrointestinal(GI) diseases include: stomach cancer, benign GI tumors, esophageal cancer, pancreatic cancer and colorectal cancer. Surgical intervention is a common treatment in these diseases. Surgery and adjuvant chemoradiotherapy can induce physiological side effects including weight loss, malnutrition, decreased strength, lower physical fitness, and an overall decrease in quality of life. Although exercise can be an effective tool in the rehabilitation of cancer patients, to date, most studies on the effects of exercise on cancer survivors have examined the use of moderate- or high-intensity exercise. There is limited study focusing on GI cancer survivors or patients after major GI surgery, and little evidence related to the effect of a home-based walking exercise program immediately following discharge. Purposes: To investigate the effectiveness of a home-based walking exercise intervention on physical fitness and body composition in patients after an operation for a major GI disease, and to identify potential factors that might obstruct home-based walking exercise intervention outcomes. Methods: This was a randomized controlled trial. Study participants were recruited if they had undergone surgery for a major GI disease, and were between 20 and 65 years old. The participants were randomly assigned to the intervention or control groups. The participants in the intervention group participated in a 12-week, home-based walking exercise program (7000-10000 steps a day) and usual care. The participants in the control group maintained usual care. The participants’ fitness and body composition were evaluated at three time points: before the intervention, 12 weeks after discharge, and 24 weeks after discharge. The fitness assessments included cardiopulmonary fitness by six-minute walk test, muscular fitness by grip strength and 30 second sit-to-stand test. Body composition including the muscle mass and percentage of body fat were measured by bioimpedance analysis. Two-way repeated measures ANOVA was used to compare the change before and after intervention. The statistical significant level was set at 0.05. Results: Sixty subjects (50.4±10.7 years old, 63.3% male) were recruited, average length of hospital stay were 9 days. 23 intervention group and 32 control group subjects completed the intervention and assessments. The basic characteristics and baseline values were similar in both group except significantly higher tumor staging and chemotherapy percentage in the intervention group. There were significantly improvement on the fitness and body composition through the time course after discharge in both groups. At 12 weeks after discharge, the change of grip force in the intervention group was significantly increased. Among the subgroup of patients without chemotherapy, in addition, the grip force value increased more significantly in the intervention group than in the control group at 12 and 24 weeks after discharge. In addition, the body fat percentage decreased more significantly in the intervention group without chemotherapy than in the control group before the intervention and at 12 weeks after discharge. Conclusions: A 12-week, home-based walking exercise program could exhibit a positive effect on the muscle fitness and body composition of post-operational patients with major GI disease. Chemotherapy would affect the intervention outcomes on fitness and body composition. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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