Emine Elif ÖZKAN, Feray SOYUPEK, Zeynep TÜREN

MEME KANSERİ HASTALARINDA RADYOTERAPİ SIRASINDA DENETİMLİ BİREYSEL EGZERSİZ PROGRAMININ PSİKOLOJİK VE FİZİKSEL FAYDALARI: RANDOMİZE BİR ÇALIŞMA

Amaç Meme kanserindenkurtulan hastalarda uzun dönem tedavi yan etkileri yaşam kalitesi üzerinde olumsuz etkilere yol açmaktadır. Egzersizin, bu hastaların fiziksel ve psikolojik durumları üzerindeki olumlu etkisi bilinmektedir. Bu çalışmada, meme kanseri tanısıyla radyoterapi alan hastalarda tedavi sırasında egzersizin fiziksel ve psikolojik duruma etkisini araştırmayı amaçladık. Gereç ve Yöntem Çalışma, randomize kontrollü olarak rehabilitasyon polikliniğinde yapıldı. Adjuvan radyoterapi için sevk edilen histolojik olarak kanıtlanmış evre I - III meme kanseri hastaları, denetimli bir aerobik ve güçlendirme egzersiz programı veya egzersiz eğitimi olmaksızın standart tıbbi bakım olmak üzere iki gruba randomize edildi. Birincil sonuç parametreleri Rosenberg Benlik Saygısı Ölçeği (RSES), Kısa Form-36 (SF_36) Yaşam Kalitesi, Başa Çıkma Stratejileri Anketi (COPE Envanteri), Yorgunluk Şiddeti Ölçeği (FSS), Beck Depresyon Envanteri (BDI), Beck Anksiyete Envanteri ( BAI) olarak belirlendi. Bu parametreler 6 haftalık egzersiz antrenmanından 1 hafta önce ve 1 hafta sonra değerlendirildi. Bulgular Tekrarlanan ölçüm analizinde egzersiz grubunda BAI ve FSS skorları azalmış, genel sağlık (GH) ve enerji/ yorgunluk (E) skorları egzersiz grubunda artmış (p=0.045, Cohen d=0.757 BAI için, p= 0.02, Cohen d=0.863, p=0.010, Cohen d =1.02 GH için, p=0.032, Cohen d=0.801 E için) olarak bulundu. Kontrol grubunda probleme dayalı başa çıkma puanının ise azaldığı saptandı (p=0.049, Cohen d=0.641). BDI ve RSES puanlarında anlamlı fark bulunmadı (p>0.05). Sonuç Sonuç olarak, adjuvan radyoterapi sırasında denetimli egzersiz eğitiminin anksiyete, yorgunluk, enerji, genel sağlık algılarını iyileştirdiği ve etkili baş etme stratejilerinin kullanılmasında azalmayı önlediği görüldü.

Anahtar Kelimeler:

Başa çıkma, Çalışma hızı, Denetimli egzersiz, Maksimal oksijen uptake, Meme radyoterapisi, Yorgunluk, Breast cancer radiotherapy, Fatigue, Coping, Maximal oxygen uptake, Supervised exercise, Work rate

THE PSYCHOLOGICAL AND PHYSICAL BENEFITS OF THE SUPERVISED INDIVIDUAL EXERCISE PROGRAM DURING RADIOTHERAPY IN BREAST CANCER PATIENTS: A RANDOMIZED STUDY

Objective Treatment side effects lead to a negative impact on the quality of life in breast cancer survivors. Exercise is reported to improve the physical and psychological status of these patients. We aimed to investigate the effect of exercise during radiotherapy on physical and psychological status in breast cancer patients. Material and Method A randomized controlled study was set in outpatient rehabilitation clinic. Histologically proven stage I-III breast cancer patients referred for adjuvant radiotherapy were randomly assigned to a supervised aerobic and strengthening exercise program or usual medical care without exercise training. The primary outcome parameters were Rosenberg Self Esteem Scale (RSES), Short Form-36 (SF_36) Quality of life, Coping Strategies Questionnaire (COPE Inventory), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI). End points were assessed 1 week prior to and 1 week following 6 weeks of exercise training. Results In the repeated measured analysis, BAI and FSS scores decreased, general health (GH) and energy/ fatigue (E) scores of SF-36 increased in the exercise group (p=0.045, Cohen d=0.757 for BAI, p=0.02, Cohen d=0.863, p=0.010, Cohen d =1.02 for GH, p=0.032, Cohen d=0.801 for E), while the use of problem-based coping score decreased in the control group (p=0.049, Cohen d=0.641). No significant differences were found in scores for BDI and RSES (p>0.05). Conclusion In conclusion, supervised comined exercise training during adjuvant radiotherapy improved anxiety, fatigue, energy, general health perceptions and prevented decreasing in using effective coping strategies.

Keywords:

Breast cancer radiotherapy, Fatigue, Coping, Maximal oxygen uptake, Supervised exercise, Work rate,

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