Exercícios resistidos em pacientes com câncer: revisão sistemática e metanálise
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Data
2020-02-21
Autores
Rinaldi, Caroline Limeira
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Há evidências que o exercício físico é benéfico em pacientes com câncer, pois fornece independência funcional ao indivíduo. Entretanto pouco se sabe sobre os protocolos de treinamento resistido, intensidade, frequência e quais exercícios podem ser utilizados nesses indivíduos, fazendo-se necessário uma revisão sistemática para reunir estudos que utilizaram esta modalidade de exercício, possibilitando o conhecimento de seus reais efeitos no paciente com câncer. Objetivos: Avaliar a eficácia, viabilidade e segurança do uso de exercícios resistidos no tratamento clínico de pacientes oncológicos, conduzindo uma revisão sistemática de ensaios clínicos randomizados. Método: Foram pesquisadas as bases Pubmed/Medline, Embase, Lilacs, Web of Science e Cochrane para busca de ensaios clínicos randomizados que utilizaram o treinamento de resistência ou exercício resistido como parte do tratamento clínico para pacientes oncológicos. Os desfechos avaliados foram: Força muscular, qualidade de vida, composição corporal, fadiga, adesão, efeitos adversos e sobrevida. Utilizou-se para metanálise o software RevMan 5.3 fornecido pela Colaboração Cochrane. Resultados: Foram avaliados 16 estudos, com um total de 1.201 participantes. O exercício resistido melhorou a força muscular de membros superiores (MD 5,76, IC 95% de 3,97 a 7,55; I²= 0%) e membros inferiores (MD 9,14, IC 95% de 3,76 a 14,52; I²=25%). Não houve diferenças entre as intervenções para qualidade de vida (SMD 0,09, IC 95% -0,04 a 0,21; I² = 0%), gordura corporal (MD -0,91, IC 95% de -2,35 a 0,53; I²=0%), massa gorda (MD -0,51, IC 95% de -2,87 a 1,84; I²=0%), massa magra (MD 0,55, IC 95% de -0,69 a 1,80; I²=0%), peso corporal (MD 0,15, IC 95% de -2,56 a 2,86; I²=0%) e fadiga (SMD -0,09, IC 95% de -0,27 a 0,10; I²=0%). Todos os estudos apresentaram uma boa aderência acima de 70%, e apenas dois estudos relataram efeitos adversos durante a intervenção. O estudo de sobrevida sugeriu uma melhor taxa de sobrevivência entre aqueles que fizeram exercício resistido. Conclusão: O exercício resistido promove melhora na força muscular de pacientes com câncer. No entanto, não houve diferença na qualidade de vida e composição corporal quando comparado às outras intervenções. Consideramos seguro e viável para estes pacientes, podendo ser recomendado como parte do tratamento oncológico. Palavras-chave: Tumor maligno, Neoplasia, Exercício Resistido, Treinamento de resistência, Revisão Sistemática.
Introduction: There is evidence that exercise is beneficial in cancer patients as it provides the individual with functional independence. However, little is known about resistance training protocols, intensity, frequency and which exercises can be used in these individuals, requiring a systematic review to gather studies that used this exercise modality, allowing the knowledge of its real effects on the survivor of the exercise cancer. Objectives: To evaluate the effectiveness, feasibility and safety of the use of resistance exercise in the clinical treatment of cancer patients, conducting a systematic review of randomized clinical trials. Method: Pubmed / Medline, Embase, Lilacs, Web of Science and Cochrane were searched for randomized clinical trials using resistance training or resistance exercise as part of clinical treatment for cancer patients. Outcomes applied were: Muscle strength, quality of life, body composition, fatigue, adherence, adverse effects and survival. Used for meta-analysis or RevMan 5.3 software provided by the Cochrane Collaboration. Results: We evaluated 16 studies, with a total of 1,201 participants. Resistance exercise improved upper limb muscle strength (MD 5.76, 95% CI from 3.97 to 7.55; I² = 0%) and lower limbs (MD 9.14, 95% CI from 3.76 to 14.52; I² = 25%). There were no differences between interventions for quality of life (SMD 0.09, 95% CI -0.04 to 0.21; I² = 0%), body fat (MD -0.91, 95% CI of -2, 35 to 0.53; I² = 0%), fat mass (MD -0.51, 95% CI from -2.87 to 1.84; I² = 0%), lean mass (MD 0.55, IC 95 % from -0.69 to 1.80; I² = 0%), body weight (MD 0.15, 95% CI from 2.56 to 2.86; I² = 0%) and fatigue (SMD -0, 09, 95% CI from -0.27 to 0.10; I² = 0%). All studies had good adherence above 70%, and only two studies reported adverse effects during the intervention. The survival study suggested a better survival rate among those who did resistance exercise. Conclusion: Resistance exercise promotes improvement in muscle strength in cancer patients. However, there was no difference in quality of life and body composition when compared to other interventions. We consider it safe and viable for these patients and can be recommended as part of cancer treatment.
Introduction: There is evidence that exercise is beneficial in cancer patients as it provides the individual with functional independence. However, little is known about resistance training protocols, intensity, frequency and which exercises can be used in these individuals, requiring a systematic review to gather studies that used this exercise modality, allowing the knowledge of its real effects on the survivor of the exercise cancer. Objectives: To evaluate the effectiveness, feasibility and safety of the use of resistance exercise in the clinical treatment of cancer patients, conducting a systematic review of randomized clinical trials. Method: Pubmed / Medline, Embase, Lilacs, Web of Science and Cochrane were searched for randomized clinical trials using resistance training or resistance exercise as part of clinical treatment for cancer patients. Outcomes applied were: Muscle strength, quality of life, body composition, fatigue, adherence, adverse effects and survival. Used for meta-analysis or RevMan 5.3 software provided by the Cochrane Collaboration. Results: We evaluated 16 studies, with a total of 1,201 participants. Resistance exercise improved upper limb muscle strength (MD 5.76, 95% CI from 3.97 to 7.55; I² = 0%) and lower limbs (MD 9.14, 95% CI from 3.76 to 14.52; I² = 25%). There were no differences between interventions for quality of life (SMD 0.09, 95% CI -0.04 to 0.21; I² = 0%), body fat (MD -0.91, 95% CI of -2, 35 to 0.53; I² = 0%), fat mass (MD -0.51, 95% CI from -2.87 to 1.84; I² = 0%), lean mass (MD 0.55, IC 95 % from -0.69 to 1.80; I² = 0%), body weight (MD 0.15, 95% CI from 2.56 to 2.86; I² = 0%) and fatigue (SMD -0, 09, 95% CI from -0.27 to 0.10; I² = 0%). All studies had good adherence above 70%, and only two studies reported adverse effects during the intervention. The survival study suggested a better survival rate among those who did resistance exercise. Conclusion: Resistance exercise promotes improvement in muscle strength in cancer patients. However, there was no difference in quality of life and body composition when compared to other interventions. We consider it safe and viable for these patients and can be recommended as part of cancer treatment.
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Palavras-chave
Tumor maligno, Neoplasias, Exercícios de resistência, Treinamento de resistência, Revisão sistemática