期刊论文详细信息
Trials
Telehealth system (e-CUIDATE) to improve quality of life in breast cancer survivors: rationale and study protocol for a randomized clinical trial
Manuel Arroyo-Morales2  Rosario Del-Moral-Avila3  Carmen Sánchez-Salado1  Marta Legerén-Alvarez4  Lourdes Díaz-Rodríguez5  Carolina Fernández-Lao2  Irene Cantarero-Villanueva2  Angelica Ariza-García6  Noelia Galiano-Castillo2 
[1] Breast Oncology Unit, Hospital Virgen de las Nieves, Granada, Spain;Department Physical Therapy, University of Granada, Granada, Spain;Radiotherapy Oncology Unit, Hospital Virgen de las Nieves, Granada, Spain;Medical Oncology Unit, Clinico Universitario San Cecilio Hospital, Andalusian Health Service, Granada, Spain;Nursing Department, University of Granada, Granada, Spain;Physical Medicine and Rehabilitation Department, Clinico Universitario San Cecilio Hospital, Andalusian Health Service, Granada, Spain
关键词: Exercise;    Telerehabilitation;    Neoplasm;    Breast;   
Others  :  1093616
DOI  :  10.1186/1745-6215-14-187
 received in 2013-04-11, accepted in 2013-06-04,  发布年份 2013
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【 摘 要 】

Background

Breast cancer survivors suffer physical impairment after oncology treatment. This impairment reduces quality of life (QoL) and increase the prevalence of handicaps associated to unhealthy lifestyle (for example, decreased aerobic capacity and strength, weight gain, and fatigue). Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival. Nowadays, technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional. It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective resource to improve fitness and reduce musculoskeletal disorders of these women.

Methods / Design

This study will use a two-arm, assessor blinded, parallel randomized controlled trial design. People will be eligible if: their diagnosis is of stages I, II, or IIIA breast cancer; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence; and they have an interest in improving lifestyle. Participants will be randomized into e-CUIDATE or usual care groups. E-CUIDATE give participants access to a range of contents: planning exercise arranged in series with breathing exercises, mobility, strength, and stretching. All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs. The control group will be asked to maintain their usual routine. Study endpoints will be assessed after 8 weeks (immediate effects) and after 6 months. The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life questionnaire. The secondary outcomes: pain (algometry, Visual Analogue Scale, Brief Pain Inventory short form); body composition; physical measurement (abdominal test, handgrip strength, back muscle strength, and multiple sit-to-stand test); cardiorespiratory fitness (International Fitness Scale, 6-minute walk test, International Physical Activity Questionnaire-Short Form); fatigue (Piper Fatigue Scale and Borg Fatigue Scale); anxiety and depression (Hospital Anxiety and Depression Scale); cognitive function (Trail Making Test and Auditory Consonant Trigram); accelerometry; lymphedema; and anthropometric perimeters.

Discussion

This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer. If this treatment option is effective, telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase.

Trial registration

ClinicalTrials.gov Identifier: NCT01801527

【 授权许可】

   
2013 Galiano-Castillo et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Chen X, Lu W, Zheng W, Gu K, Matthews CE, Chen Z, Zheng Y, Shu XO: Exercise after diagnosis of breast cancer in association with survival. Cancer Prev Res (Phila) 2011, 4:1409-1418.
  • [2]Hayes S, Rye S, Battistutta D, Yates P, Pyke C, Bashford J, Eakin E: Design and implementation of the Exercise for Health trial - a pragmatic exercise intervention for women with breast cancer. Contemp Clin Trials 2011, 32:577-585.
  • [3]Smith SL, Singh-Carlson S, Downie L, Payeur N, Wai ES: Survivors of breast cancer: patient perspectives on survivorship care planning. J Cancer Surviv 2011, 5:337-344.
  • [4]Knols RH, de Bruin ED, Shirato K, Uebelhart D, Aaronson NK: Physical activity interventions to improve daily walking activity in cancer survivors. BMC Cancer 2010, 10:406. BioMed Central Full Text
  • [5]Schmitz KH: Balancing lymphedema risk: exercise versus deconditioning for breast cancer survivors. Exerc Sport Sci Rev 2010, 38:17-24.
  • [6]Kim SH, Son BH, Hwang SY, Han W, Yang JH, Lee S, Yun YH: Fatigue and depression in disease-free breast cancer survivors: prevalence, correlates, and association with quality of life. J Pain Symptom Manage 2008, 35:644-655.
  • [7]Cantarero-Villanueva I, Fernández-Lao C, Fernández-de-las-Peñas C, Díaz-Rodríguez L, Sánchez-Cantalejo E, Arroyo-Morales M: Associations among musculoskeletal impairments, depression, body image and fatigue in breast cancer survivors within the first year after treatment. Eur J Cancer Care (Engl) 2011, 20:632-639.
  • [8]Campbell KL, Neil SE, Winters-Stone KM: Review of exercise studies in breast cancer survivors: attention to principles of exercise training. Br J Sports Med 2012, 46:909-916.
  • [9]Lauridsen MC, Overgaard M, Overgaard J, Hessov IB, Cristiansen P: Shoulder disability and late symptoms following surgery for early breast cancer. Acta Oncol 2008, 47:569-575.
  • [10]Fernández-Lao C, Cantarero-Villanueva I, Fernández-de-las-Peñas C, Del-Moral-Ávila R, Arendt-Nielsen L, Arroyo-Morales M: Myofascial trigger points in neck and shoulder muscles and widespread pressure pain hypersensitivity in patients with postmastectomy pain: evidence of peripheral and central sensitization. Clin J Pain 2010, 26:798-806.
  • [11]Lelieveld OT, Armbrust W, Geertzen JH, de Graaf I, van Leeuwen MA, Sauer PJ, van Weert E, Bouma J: Promoting physical activity in children with juvenile idiopathic arthritis through an internet-based program: results of a pilot randomized controlled trial. Arthritis Care Res (Hoboken) 2010, 62:697-703.
  • [12]Carmichael AR, Daley AJ, Rea DW, Bowden SJ: Physical activity and breast cancer outcome: a brief review of evidence, current practice and future direction. Eur J Surg Oncol 2010, 36:1139-1148.
  • [13]Duijts SF, Faber MM, Oldenburg HS, van Beurden M, Aaronson NK: Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors-a meta-analysis. Psychooncology 2011, 20:115-126.
  • [14]Harrison SA, Hayes SC, Newman B: Age-related differences in exercise and quality of life among breast cancer survivors. Med Sci Sports Exerc 2010, 42:67-74.
  • [15]Chan DN, Lui LY, So WK: Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic review. J Adv Nurs 2010, 66:1902-1914.
  • [16]Hack TF, Kwan WB, Thomas-Maclean RL, Towers A, Miedema B, Tilley A, Chateau D: Predictors of arm morbidity following breast cancer surgery. Psychooncology 2010, 19:1205-1212.
  • [17]Nesvold IL, Fosså SD, Holm I, Naume B, Dahl AA: Arm/shoulder problems in breast cancer survivors are associated with reduced health and poorer physical quality of life. Acta Oncol 2010, 49:347-353.
  • [18]McNeely ML, Campbell K, Ospina M, Rowe BH, Dabbs K, Klassen TP, Mackey J, Courneya K: Exercise interventions for upper-limb dysfunction due to breast cancer treatment. Cochrane Database Syst Rev 2010., 6CD005211
  • [19]Loprinzi PD, Cardinal BJ: Effects of physical activity on common side effects of breast cancer treatment. Breast Cancer 2012, 19:4-10.
  • [20]Haines TP, Sinnamon P, Wetzig NG, Lehman M, Walpole E, Pratt T, Smith A: Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation. Breast Cancer Res Treat 2010, 124:163-175.
  • [21]McCue M, Fairman A, Pramuka M: Enhancing quality of life through telerehabilitation. Phys Med Rehabil Clin N Am 2010, 21:195-205.
  • [22]Kairy D, Lehoux P, Vincent C, Visintin M: A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disabil Rehabil 2009, 31:427-447.
  • [23]Dlugonski D, Motl RW, McAuley E: Increasing physical activity in multiple sclerosis: replicating Internet intervention effects using objective and self-report outcomes. J Rehabil Res Dev 2011, 48:1129-1136.
  • [24]Gautam AP, Maiya AG, Vidyasagar MS: Effect of home-based exercise program on lymphedema and quality of life in female postmastectomy patients: pre-post intervention study. J Rehabil Res Dev 2011, 48:1261-1268.
  • [25]Davies NJ, Batehup L, Thomas R: The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer 2011, Suppl 1:S52-S73.
  • [26]Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JCJM, Kaasa S, Klee MC, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw KCA, Sullivan M, Takeda F: The European Organisation for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993, 85:365-376.
  • [27]Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A: The EORTC QLQ-C30 Scoring Manual. 3rd edition. Brussels: European Organisation for Research and Treatment of Cancer; 2001.
  • [28]Sprangers MA, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, Franzini L, Williams A, de Haes HC, Hopwood P, Cull A, Aaronson NK: The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol 1996, 14:2756-2768.
  • [29]Vanderweeën L, Oostendorp RA, Vaes P, Duquet W: Pressure algometry in manual therapy. Man Ther 1996, 1:258-265.
  • [30]Fernández-Lao C, Cantarero-Villanueva I, Fernández-de-las-Peñas C, Del-Moral-Ávila R, Menjón-Beltrán S, Arroyo-Morales M: Widespread mechanical pain hypersensitivity as a sign of central sensitization after breast cancer surgery: comparison between mastectomy and lumpectomy. Pain Med 2011, 12:72-78.
  • [31]Chesterton LS, Sim J, Wright CC, Foster NE: Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters. Clin J Pain 2007, 23:760-766.
  • [32]Jones DH, Kilgour RD, Comtois AS: Test-retest reliability of pressure pain threshold measurements of the upper limb and torso in young healthy women. J Pain 2007, 8:650-656.
  • [33]Cleeland CS, Ryan KM: Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 1994, 23:129-138.
  • [34]The Brief Pain Inventory. User Guide. http://www.mdanderson.org/education-and-research/departments-programs-and-labs/departments-and-divisions/symptom-research/symptom-assessment-tools/BPI_UserGuide.pdf webcite
  • [35]Badia X, Muriel C, Gracia A, Núñez-Olarte JM, Perulero N, Gálvez R, Carulla J, Cleeland CS: Validación española del cuestionario Brief Pain Inventory en pacientes con dolor de causa neoplásica. Med Clin (Barc) 2003, 120:52-59.
  • [36]McQuade KJ, Turner JA, Buchner DM: Physical fitness and chronic low back pain. An analysis of the relationships among fitness, functional limitations, and depression. Clin Orthop Relat Res 1988, 233:198-204.
  • [37]Ruiz-Ruiz J, Mesa JL, Gutiérrez A, Castillo MJ: Hand size influences optimal grip span in women but not in men. J Hand Surg Am 2002, 27:897-901.
  • [38]España-Romero V, Ortega FB, Vicente-Rodríguez G, Artero EG, Rey JP, Ruiz JR: Elbow position affects handgrip strength in adolescents: validity and reliability of Jamar, DynEx, and TKK dynamometers. J Strength Cond Res 2010, 24:272-277.
  • [39]Imagama S, Matsuyama Y, Hasegawa Y, Sakai Y, Ito Z, Ishiguro N, Hamajima N: Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males. Eur Spine J 2011, 20:954-961.
  • [40]Netz Y, Ayalon M, Dunsky A, Alexander N: The multiple-sit-to-stand field test for older adults: what does it measure? Gerontology 2004, 50:121-126.
  • [41]Ritchie C, Trost SG, Brown W, Armit C: Reliability and validity of physical fitness field tests for adults aged 55 to 70 years. J Sci Med Sport 2005, 8:61-70.
  • [42]Ortega FB, Ruiz JR, España-Romero V, Vicente-Rodriguez G, Martínez-Gómez D, Manios Y, Béghin L, Molnar D, Widhalm K, Moreno LA, Sjöström M, Castillo MJ: The International Fitness Scale (IFIS): usefulness of self-reported fitness in youth. Int J Epidemiol 2011, 40:701-711.
  • [43]Ortega FB, Sánchez-López M, Solera-Martínez M, Fernández-Sánchez A, Sjöström M, Martínez-Vizcaino V: Self-reported and measured cardiorespiratory fitness similarly predict cardiovascular disease risk in young adults. Scand J Med Sci Sportsin press
  • [44]Laskin JJ, Bundy S, Marron H, Moore H, Swanson M, Blair M, Humphrey R: Using a treadmill for the 6-minute walk test: reliability and validity. J Cardiopulm Rehabil Prev 2007, 27:407-410.
  • [45]Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003, 35:1381-1395.
  • [46]Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM: The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 1998, 25:677-684.
  • [47]Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982, 14:377-381.
  • [48]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67:361-370.
  • [49]Herrero MJ, Blanch J, Peri JM, De Pablo J, Pintor L, Bulbena A: A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry 2003, 25:277-283.
  • [50]Spreen O, Strauss E: A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. New York: Oxford University Press; 1998.
  • [51]Carbonell-Baeza A, Ruiz JR, Aparicio VA, Ortega FB, Munquía-Izquierdo D, Alvarez-Gallardo IC, Segura-Jiménez V, Camiletti-Moirón D, Romero A, Estévez-López F, Samos B, Casimiro AJ, Sierra Á, Latorre PA, Pulido-Martos M, Femia P, Pérez-López IJ, Chillón P, Girela-Rejón MJ, Tercedor P, Lucía A, Delgado-Fernández M: Land- and water-based exercise intervention in women with fibromyalgia: the al-Andalus physical activity randomised controlled trial. BMC Musculoskelet Disord 2012, 13:18. BioMed Central Full Text
  • [52]Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, Prieto Merino D, Mayoral Del Moral O, Cerezo Téllez E, Minayo Mogollón E: Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ 2010, 340:b5396.
  • [53]Karges JR, Mark BE, Stikeleather SJ, Worrell TW: Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume. Phys Ther 2003, 83:134-145.
  • [54]Taylor R, Jayasinghe UW, Koelmeyer L, Ung O, Boyages J: Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther 2006, 86:205-214.
  • [55]Torres Lacomba M, Yuste Sánchez MJ, Prieto Merino D: Estudio de fiabilidad y reproducibilidad de las medidas cirtométricas en miembros superior e inferior sanos. Cuest fisioter 2010, 39:166-178.
  • [56]Franquelo Morales P, Serrano Martínez S, Moya Martínez P, Buendía Bermejo J, Sánchez López M, Solera Martínez M, Notario Pacheco B: Asociación entre distintas medidas de Composición Corporal y Factores de Riesgo Cardiovascular en población adulta. Rev Clín Med Fam 2008, 2:149-155.
  • [57]Osoba D, Rodrigues G, Myles J, Zee B, Pater J: Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 1998, 16:139-144.
  • [58]Fernández-Lao C, Cantarero-Villanueva I, Ariza-García A, Courtney CA, Fernández-de-las-Peñas C, Arroyo-Morales M: Water versus land-based multimodal exercise program effects on body composition in breast cancer survivors: a controlled clinical trial. Support Care Cancer 2013, 21:521-530.
  • [59]Cramp F, Byron-Daniel J: Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012., 11CD006145
  • [60]Cantarero-Villanueva I, Fernández-Lao C, Del Moral-Avila R, Fernández-de-Las-Peñas C, Feriche-Fernández-Castanys MB, Arroyo-Morales M: Effectiveness of core stability exercises and recovery myofascial release massage on fatigue in breast cancer survivors: a randomized controlled clinical trial. Evid Based Complement Alternat Med 2012, 2012:620619.
  • [61]Baili P, Hoekstra-Weebers J, Van Hoof E, Bartsch HH, Travado L, Garami M, Di Salvo F, Micheli A, Veerus P: Cancer rehabilitation indicators for Europe. Eur J Cancer 2013, 49:1356-1364.
  • [62]Gatta G, van der Zwan JM, Casali PG, Siesling S, Dei Tos AP, Kunkler I, Otter R, Licitra L, Mallone S, Tavilla A, Trama A, Capocaccia R: Rare cancers are not so rare: the rare cancer burden in Europe. Eur J Cancer 2011, 47:2493-2511.
  • [63]Kesavadev J, Shankar A, Pillai PB, Krishnan G, Jothydev S: Cost-effective use of telemedicine and self-monitoring of blood glucose via Diabetes Tele Management System (DTMS) to achieve target glycosylated hemoglobin values without serious symptomatic hypoglycemia in 1,000 subjects with type 2 diabetes mellitus--a retrospective stu. Diabetes Technol Ther 2012, 14:772-776.
  • [64]Isetta V, Lopez-Agustina C, Lopez-Bernal E, Amat M, Vila M, Valls C, Navajas D, Farre R: Cost-effectiveness of a new internet-based monitoring tool for neonatal post-discharge home care. J Med Internet Res 2013, 15:e38.
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