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Introduction: Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer. Objective: Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training. Methods: This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention. Expected results: The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.
Introducción: El ejercicio terapéutico juega un rol importante en la población con cáncer, ya que mejora la función, la calidad de vida y reduce los síntomas del tratamiento contra el cáncer. Hay poca evidencia clínica sobre los efectos del ejercicio hipopresivo en mujeres con cáncer ginecológico. Objetivo: Evaluar los efectos de cuatro semanas de ejercicio hipopresivo asociado con entrenamiento de fuerza muscular y ejercicios aeróbicos sobre la fatiga, los síntomas de incontinencia urinaria, la función sexual y la calidad de vida en mujeres tratadas por cáncer ginecológico, en comparación con un grupo que realizará entrenamiento convencional. Métodos: El escenario para este estudio de ensayo clínico aleatorizado y simple ciego es el Laboratorio de Investigación Clínica, Departamento de Kinesiología, en una Universidad Chilena. Las pacientes serán asignadas aleatoriamente a un grupo experimental de ejercicios hipopresivos asociados con entrenamiento de fuerza muscular y ejercicios aeróbicos, o a un grupo de control de entrenamiento de fuerza muscular y ejercicios aeróbicos. Se realizarán doce sesiones de telerehabilitación. Participarán mujeres mayores de 18 años con cáncer ginecológico a quienes se les haya indicado radioterapia o quimioterapia. Se evaluarán la fatiga, la calidad de vida, los síntomas de incontinencia urinaria y la función sexual antes y después de la intervención. Resultados: esperados Los resultados de este ensayo clínico tienen importantes implicaciones en términos del tratamiento específico para la población con cáncer y generan nuevas técnicas en la práctica de kinesiólogos especializados en oncología. Se espera que el ejercicio hipopresivo reduzca los síntomas de incontinencia debido a la activación neuromuscular de los músculos del suelo pélvico. Sin embargo, se necesitan más estudios para confirmar los efectos beneficiosos de los ejercicios hipopresivos, ya sea en rehabilitación presencial o a distancia.
Assuntos
Terapia por Exercício , Fadiga , Neoplasias dos Genitais Femininos , Qualidade de Vida , Treinamento Resistido , Incontinência Urinária , Humanos , Feminino , Treinamento Resistido/métodos , Método Simples-Cego , Terapia por Exercício/métodos , Neoplasias dos Genitais Femininos/terapia , Incontinência Urinária/terapia , Incontinência Urinária/reabilitação , Fadiga/terapia , Fadiga/etiologia , Exercício Físico/fisiologia , Força Muscular/fisiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , ChileRESUMO
Introducción: Personas con cáncer colorrectal (CCR) pueden presentar efectos adversos, perjudicando la calidad de vida relacionada a la salud (CVRS). Objetivo: Validar el módulo QLQ CR29 para evaluación de la CVRS, en Chile. Materiales y método: Estudio transversal que incluyó 170 personas con CCR. Se analizaron la consistencia interna y validez de constructo del instrumento con test de hipótesis. Resultados: 117 personas (68,8%) fueron evaluadas antes de la cirugía y 53 (31,2%) después de la cirugía. La consistencia interna del QLQ CR29 fue α = 0,838. Fueron comprobadas las hipótesis planteadas: Los pacientes evaluados antes de la cirugía se quejaron más de "sangre/mucosidad en las heces", "dolor abdominal", "pérdida de cabello" e "hinchazón abdominal", mientras que los pacientes evaluados después presentaron más "incontinencia fecal" (p < 0,05). Antes de la cirugía, los pacientes con cáncer de recto CCR presentaron mayores valores de "frecuencia urinaria", "frecuencia de deposiciones", "dolor en las nalgas", "problemas con el gusto" y "vergüenza"; mientras que aquellos con cáncer de colon que se quejaban más de "sangre/mucosidad en las heces" (p < 0,05). Después de la cirugía, los pacientes con cáncer de recto tenían mayor "frecuencia de deposiciones", "eliminación de gases" y "vergüenza" (p = 0,004) en comparación con los con cáncer de colon (p < 0,05). Los pacientes ostomizados presentaron más "incontinencia fecal" y "vergüenza" (p < 0,001). Fueron observadas correlaciones positivas y negativas bajas entre la mayoría de las dimensiones del QLQ CR29 con las dimensiones del QLQ C30. Conclusión: La versión chilena del módulo QLQ CR29 es adecuada para evaluar la CVRS en personas con CCR.
Introduction: People with colorectal cancer (CRC) can present adverse effects, impairing the quality of life related to health (HRQoL). Objective: To validate the QLQ-CR29 module for the assessment of HRQoL, in Chile. Materials and method: Cross-sectional study that included 170 people with CRC. The internal consistency and construct validity (hypothesis tests) were analyzed. Results: 117 patients (68.8%) were evaluated before surgery and 53 (31.2%) after tumor resection. The internal consistency of the QLQCR29 was α = 0.838. The proposed hypotheses were confirmed: The patients evaluated before surgery complained more of "blood/mucus in the stool", "abdominal pain", "hair loss" and "abdominal swelling", while the patients evaluated after presented more "fecal incontinence" (p < 0.05). Before surgery, patients with rectal cancer presented higher values of "urinary frequency", "frequency of stools", "pain in the buttocks", "taste problems" and "embarrassment"; while those with colon cancer complained more of "blood/mucus in stool" (p < 0.05). After surgery, patients with CCR had higher "stool frequency", "flatus" and "embarrassment" (p = 0.004) compared with those with colon cancer (p < 0.05). Ostomized patients presented more "fecal incontinence" and "embarrassment" (p < 0.001). Low significant correlations were observed between most of the dimensions of the QLQ CR29 with the dimensions of the QLQ C30. Conclusion: The Chilean version of the QLQ CR29 module is adequate to assess HRQoL in people with CRC.
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COVID-19 causes cardiovascular and lung problems that can be aggravated by confinement, but the practice of physical activity (PA) could lessen these effects. The objective of this study was to evaluate the association of maximum oxygen consumption (VËO2max) with vaccination and PCR tests in apparently healthy Chilean adults. An observational and cross-sectional study was performed, in which 557 people from south-central Chile participated, who answered an online questionnaire on the control of COVID-19, demographic data, lifestyles, and diagnosis of non-communicable diseases. VËO2max was estimated with an abbreviated method. With respect to the unvaccinated, those who received the first (OR:0.52 [CI:0.29;0.95], p = 0.019) and second vaccine (OR:0.33 [CI:0.18;0.59], p = 0.0001) were less likely to have an increased VËO2max. The first vaccine was inversely associated with VËO2max (mL/kg/min) (ß:−1.68 [CI:−3.06; −0.3], p = 0.017), adjusted for BMI (ß:−1.37 [CI:−2.71; −0.03], p = 0.044) and by demographic variables (ß:−1.82 [CI:−3.18; −0.46], p = 0.009); similarly occur for the second vaccine (ß: between −2.54 and −3.44, p < 0.001) on models with and without adjustment. Having taken a PCR test was not significantly associated with VËO2max (mL/kg/min). It is concluded that vaccination significantly decreased VËO2max, although it did not indicate cause and effect. There is little evidence of this interaction, although the results suggest an association, since VË O2max could prevent and attenuate the contagion symptoms and effects.
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COVID-19 , Teste de Esforço , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Chile/epidemiologia , Estudos Transversais , Teste de Esforço/métodos , Humanos , Estilo de Vida , Morbidade , Consumo de Oxigênio , Reação em Cadeia da Polimerase , VacinaçãoRESUMO
Resumen Introducción: El cáncer colorrectal (CCR) es el segundo tipo más frecuente de cáncer en el mundo. La cirugía es la intervención terapéutica más común y se asocia con la reducción de 20-40% en la capacidad fisiológica y funcional. Un programa de prehabilitación podría mejorar la condición funcional basal de los pacientes previo a la cirugía. Objetivo: Describir los resultados funcionales de un programa de prehabilitación en personas adultas candidatos a cirugía electiva de CCR. Materiales y Método: Estudio descriptivo, longitudinal y retrospectivo. Se registraron los antecedentes sociodemográficos, clínicos y las variables funcionales como capacidad cardiorrespiratoria, fuerza de presión manual, fatiga, independencia en actividades de la vida diaria (AVDs) y equilibrio dinámico de 50 personas que ingresaron a un programa de prehabilitación entre mayo 2019 y febrero de 2020. Los datos fueron analizados con estadística descriptiva y pruebas de diferencia entre tiempo de evaluación, previo y posterior a la prehabilitación. Resultados: Posterior al programa de prehabilitación, los pacientes mejoraron la capacidad cardiorrespiratoria, fatiga, equilibrio dinámico y fuerza prensil (p 0,05; tamaño de efecto: 0,01). Conclusión: Un programa estructurado de prehabilitación para pacientes candidatos a cirugía electiva de CCR basado en ejercicios y educación, logró cambios significativos en los resultados funcionales en un período de 3 a 4 semanas previo a la cirugía.
Introduction: Colorectal cancer (CRC) is the second most frequent type of cancer in the world. Surgery is the most common therapeutic intervention and is associated with a 20-40% reduction in physiological and functional capacity. A prehabilitation program could improve the baseline functional condition of patients prior to surgery. Aim: To describe the functional results of a prehabilitation program in adults who will undergo elective surgery CCR. Materials and Method: Descriptive, longitudinal and retrospective study. The sociodemographic, clinical and functional variables such as cardiorespiratory capacity, manual pressure force, fatigue, independence in activities of daily living and dynamic balance of 50 people who entered a pre-rehabilitation program between may 2019 and february 2020 were compiled. Data were analyzed with descriptive statistics and difference tests between evaluation time, before and after prehabilitation. Results: After the prehabilitation program, the patients improved cardiorespiratory capacity, fatigue, dynamic balance and grip strength (p 0.05; effect size: 0.01). Conclusión: A structured prehabilitation program for patients who are candidates for elective colorectal cancer surgery based on exercises and education, achieved significant changes in functional results in a period of 3 to 4 weeks prior to surgery.
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Humanos , Masculino , Feminino , Idoso , Neoplasias Colorretais/cirurgia , Exercício Pré-Operatório , Epidemiologia Descritiva , Estudos Retrospectivos , Tamanho da Amostra , FadigaRESUMO
PURPOSE: Breast cancer (BC) is the most common cancer in women worldwide. The main treatment for BC is surgery, which involves an axillary procedure that associates with the development of axillary web syndrome (AWS). The incidence of AWS among Chilean women with BC and its possible predisposing factors are currently unknown. Thus, we aimed to (1) determine the incidence of AWS among Chilean women with BC after surgery and (2) identify possible predisposing factors. METHODS: Within 90 days post-surgery, patients were assessed for AWS, i.e., palpable or visible axillary cords in the axillary region extending down from the mid-axilla to the ipsilateral arm. We then computed the odds ratio with 95% confidence interval (OR [95% CI]) for having AWS considering the following predisposing factors: age, body mass index (BMI), number of lymph nodes removed, axillary procedure, days from surgery to the physical therapy assessment, hospital for the surgery, type of breast surgery, and neoadyuvant chemotherapy. RESULTS: AWS was present in 49 out of 107 patients (45.8%). Younger age and lower BMI appeared as the sole predisposing factors for AWS (age, 0.95 [0.91-0.99]; BMI, normal weight 1.00, overweight 0.35 [0.11-1.12], obesity 0.28 [0.08-0.97]). CONCLUSION: The incidence of AWS among Chilean women with BC was 45.8%. Our study also confirms data from previous reports showing that younger age and low BMI are associated with the development of AWS.