Benefícios e Segurança dos Exercícios Físicos em Pacientes com Metástases Ósseas: Revisão Sistemática da Literatura e Metanálise

Autores

  • Letícia Antoniolli Siiss Universidade de Passo Fundo (UPF), Hospital de Clínicas de Passo Fundo (HCPF), Programa de Residência Multiprofissional em Atenção ao Câncer. Secretaria Municipal de Saúde de Passo Fundo. Passo Fundo (RS), Brasil. https://orcid.org/0000-0002-2338-0718
  • Amanda Guarda Universidade de Passo Fundo (UPF), Hospital de Clínicas de Passo Fundo (HCPF), Programa de Residência Multiprofissional em Atenção ao Câncer. Secretaria Municipal de Saúde de Passo Fundo. Passo Fundo (RS), Brasil. https://orcid.org/000-0002-5822-8791
  • Daniela Bertol Graeff Universidade de Passo Fundo (UPF), Hospital de Clínicas de Passo Fundo (HCPF), Programa de Residência Multiprofissional em Atenção ao Câncer. Secretaria Municipal de Saúde de Passo Fundo. Passo Fundo (RS), Brasil. https://orcid.org/0000-0002-7182-8855
  • Sheila Cristina Cecagno-Zanini Universidade de Passo Fundo (UPF), Hospital de Clínicas de Passo Fundo (HCPF), Programa de Residência Multiprofissional em Atenção ao Câncer. Secretaria Municipal de Saúde de Passo Fundo. Passo Fundo (RS), Brasil. https://orcid.org/0000-0003-0833-0269

DOI:

https://doi.org/10.32635/2176-9745.RBC.2022v68n4.2520

Palavras-chave:

modalidades de fisioterapia, exercício físico, neoplasias ósseas, metástase neoplásica, ensaio clínico controlado aleatório

Resumo

Introdução: A expectativa de vida de pessoas com câncer metastático está aumentando, mas esse grupo de pacientes corre um risco considerável de apresentar problemas psicológicos e de saúde física. Nesse sentido, o exercício físico tem sido um aliado no tratamento de pacientes com metástases ósseas. Objetivo: Realizar uma revisão sistemática e metanálise sobre a segurança e os benefícios do exercício físico em pacientes com metástases ósseas. Método: Metanálise com pesquisa bibliográfica realizada nas bases eletrônicas: PubMed, LILACS, PEDro e Embase. Resultados: Dos 396 estudos, somente dez foram incluídos, com um total de 531 indivíduos. Não foi observado nenhum efeito adverso musculoesquelético durante a intervenção, sendo significativamente seguro o exercício em indivíduos com metástases ósseas. Não houve melhora considerável na capacidade aeróbica, progressão da doença, qualidade de vida, massa magra e gordura corporal. Três dos estudos incluídos avaliaram a dor durante e após a intervenção, demonstrando melhora no escore de dor, assim como a diminuição do uso do analgésico no grupo intervenção. Conclusão: A terapia com exercícios aeróbicos e isométricos e segura para pacientes com metástases ósseas, além de apresentar melhora da dor, mas sem evolução relevante na capacidade aeróbica, na progressão da doença, na massa corporal e na qualidade de vida.

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Referências

Rosenberger F, Sprave T, Clauss D, et al. Spinal stabilization exercises for cancer patients with spinal metastases of high fracture risk: feasibility of the DISPO-II training program. Cancers (Basel). 2021;13(2):201. doi: https://doi.org/10.3390/cancers13020201

Postigo R. Tumores da coluna vertebral: tumores ósseos [Internet]. Curitiba (PR): AOSpine Latin America; [data desconhecida] [acesso 2021 ago 11]. Programa de formação continua AOSpine. Disponível em: https://www.aolatam.org/ftp/edudatabase/open-files/aos_da_n1m4t1_postigo_prt.pdf

Whyne CM, Hu SS, Lotz JC. Biomechanically derived guideline equations for burst fracture risk prediction in the metastatically involved spine. J Spinal Disord Tech. 2003;16(2):180-5. doi: https://doi.org/10.1097/00024720-200304000-00010

Janjan N, Lutz ST, Bedwinek JM, et al. Therapeutic guidelines for the treatment of bone metastasis: a report from the American College of Radiology Appropriateness Criteria Expert Panel on Radiation Oncology. J Palliat Med. 2009;12(5):417-26. doi: https://doi.org/10.1089/jpm.2009.9633

Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma. Analysis of 1000 autopsied cases. Cancer. 1950;3(1):74-85. doi: https://doi.org/10.1002/1097-0142(1950)3:1%3C74::aid-cncr2820030111%3E3.0.co;2-7

Brown HK, Healey JH. Metastatic cancer to the bone. In: DeVita VT Jr, Hellman S, Rosenberg AS. Principles and practice of oncology. 6th ed. Vol. 1. Philadelphia: Lippincott Raven; 2001. p. 1986-97.

Cramarossa G, Chow E, Zhang L, et al. Predictive factors for overall quality of life in patients with advanced cancer. Support Care Cancer. 2013;21(6):1709-16. doi: https://doi.org/10.1007/s00520-013-1717-7

Mehnert A, Brähler E, Faller H, et al. Four-week prevalence of mental disorders in patients with cancer across major tumor entities. J Clin Oncol. 2014;32(31):3540-6. doi: https://doi.org/10.1200/JCO.2014.56.0086

Javaheri PA, Nekolaichuk C, Haennel R, et al. Feasibility of a pedometer-based walking program for survivors of breast and head and neck cancer undergoing radiation therapy. Physiother Can. 2015;67(2):205-13. doi: https://doi.org/10.3138/ptc.2014-24

Lucas C, Vidal I, Costa J, et al. Caracterização de metástases ósseas em neoplasias ocultas e neoplasias previamente diagnosticadas. Galicia Clin [Internet]. 2016 [acesso 2021 ago 16];77(4):170-2. Disponível em: https://galiciaclinica.info/PDF/38/943.pdf

Beaton R, Pagdin-Friesen W, Robertson C, et al. Effects of exercise intervention on persons with metastatic cancer: a systematic review. Physiother Can. 2009;61(3):141-53. doi: https://doi.org/10.3138/physio.61.3.141

Sheill G, Guinan EM, Peat N, et al. Considerations for exercise prescription in patients with bone metastases: a comprehensive narrative Review. PM R. 2018;10(8):843-64. doi: https://doi.org/10.1016/j.pmrj.2018.02.006

Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243-74. doi: https://doi.org/10.3322/caac.21142

Galvão DA, Taaffe DR, Spry N, et al. Exercise preserves physical function in prostate cancer patients with bone metastases. Med Sci Sports Exerc. 2018;50(3):393-9. doi: https://doi.org/10.1249/MSS.0000000000001454

Centro Cochrane do Brasil [Internet]. São Paulo: Cochrane Brazil; c2022. Como fazer uma Revisão Sistemática Cochrane; [acesso 2021 ago 11]. Disponível em: https://brazil.cochrane.org/como-fazer-uma-revis%C3%A3o-sistem%C3%A1tica-cochrane

Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097

RoB 2: a revised Cochrane risk-of-bias tool for randomized trials [Internet]. London (UK): Cochrane Methods Bias. 2021 – [cited 2021 May 6]. Available from: https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials

Bjerre ED, Weller S, Poulsen MH, et al. Safety and effects of football in skeletal metastatic prostate cancer: a subgroup analysis of the FC prostate community randomised controlled trial. Sports Med Open. 2021;7(1):27. doi: https://doi.org/10.1186/s40798-021-00318-6

Cormie P, Newton RU, Spry N, et al. Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis. 2013;16(4):328-35. doi: https://doi.org/10.1038/pcan.2013.22

Galvão DA, Taaffe DR, Chambers SK, et al. Exercise intervention and sexual function in advanced prostate cancer: a randomised controlled trial. BMJ Support Palliat Care. 2020;12(1):29-32. doi: https://doi.org/10.1136/bmjspcare-2020-002706

Rief H, Omlor G, Akbar M, et al. Feasibility of isometric spinal muscle training in patients with bone metastases under radiation therapy - first results of a randomized pilot trial. BMC Cancer. 2014;14:67. doi: https://doi.org/10.1186/1471-2407-14-67

Rief H, Welzel T, Omlor G, et al. Pain response of resistance training of the paravertebral musculature under radiotherapy in patients with spinal bone metastases--a randomized trial. BMC Cancer. 2014;14:485. doi: https://doi.org/10.1186/1471-2407-14-485

Rief H, Akbar M, Keller M, et al. Quality of life and fatigue of patients with spinal bone metastases under combined treatment with resistance training and radiation therapy- a randomized pilot trial. Radiat Oncol. 2014;9:151. doi: https://doi.org/10.1186/1748-717X-9-151

Rief H, Petersen LC, Omlor G, et al The effect of resistance training during radiotherapy on spinal bone metastases in cancer patients - a randomized trial. Radiother Oncol. 2014;112(1):133-9. doi: https://doi.org/10.1016/j.radonc.2014.06.008

Rief H, Bruckner T, Schlampp I, et al. Resistance training concomitant to radiotherapy of spinal bone metastases - survival and prognostic factors of a randomized trial. Radiat Oncol. 2016;11:97. doi: https://doi.org/10.1186/s13014-016-0675-x

Taneichi H, Kaneda K, Takeda N, et al. Risk factors and probability of vertebral body collapse in metastases of the thoracic and lumbar spine. Spine (Phila Pa 1976). 1997;22(3):239-45. doi: https://doi.org/10.1097/00007632-199702010-00002

Hettinger T. Isometric muscle training. 6 th ed. Landsberg am Lech (DE): Ecomed; 1994.

Nadler MB, Desnoyers A, Langelier DM, et al. The effect of exercise on quality of life, fatigue, physical function, and safety in advanced solid tumor cancers: a meta-analysis of randomized control trials. J Pain Symptom Manage. 2019;58(5):899-908. doi: https://doi.org/10.1016/j.jpainsymman.2019.07.005

Knols R, Aaronson NK, Uebelhart D, et al. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol. 2005;23(16):3830-42. doi: https://doi.org/10.1200/JCO.2005.02.148

Delrieu L, Jacquet E, Segura-Ferlay C, et al. Analysis of the StoRM cohort reveals physical activity to be associated with survival in metastatic breast cancer. Sci Rep. 2020;10(1):10757. doi: https://doi.org/10.1038/s41598-020-67431-6

Gunter MJ, Hoover DR, Yu H, et al. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst. 2009;101(1):48-60. doi: https://doi.org/10.1093/jnci/djn415

McTiernan A. Mechanisms linking physical activity with cancer. Nat Rev Cancer 2008;8(3):205-11. doi: https://doi.org/10.1038/nrc2325

Choudhury F, Bernstein L, Hodis HN, et al. Physical activity and sex hormone levels in estradiol- and placebo-treated postmenopausal women. Menopause. 2011;18(10):1079-86. doi: https://doi.org/10.1097/gme.0b013e318215f7bd

Oh H, Arem H, Matthews CE, et al. Sitting, physical activity, and serum oestrogen metabolism in postmenopausal women: the Women's Health Initiative observational study. Br J Cancer. 2017;117(7):1070-8. doi: https://doi.org/10.1038/bjc.2017.268

Friedenreich CM, Neilson HK, Lynch BM. State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer. 2010;46(14):2593-604. doi: https://doi.org/10.1016/j.ejca.2010.07.028

Jones LW, Courneya KS, Mackey JR, et al. Cardiopulmonary function and age-related decline across the breast cancer survivorship continuum. J Clin Oncol. 2012;30(20):2530-7. doi: https://doi.org/10.1200/JCO.2011.39.9014

Guercio BJ, Zhang S, Ou FS, et al. Associations of physical activity with survival and progression in metastatic colorectal cancer: results from cancer and leukemia group B (Alliance)/SWOG 80405. J Clin Oncol. 2019;37(29):2620-31. doi: https://doi.org/10.1200/JCO.19.01019

Palesh O, Kamen C, Sharp S, et al. Physical activity and survival in women with advanced breast cancer. Cancer Nurs. 2018;41(4):E31-E38. doi: https://doi.org/10.1097/NCC.0000000000000525

Hayes SC, Spence RR, Galvão DA, et al. Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. J Sci Med Sport. 2009;12(4):428-34. doi: https://doi.org/10.1016/j.jsams.2009.03.002

Vina J, Sanchis-Gomar F, Martinez-Bello V, et al. Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol. 2012;167(1):1-12. doi: https://doi.org/10.1111/j.1476-5381.2012.01970.x

Wilk M, Kepski J, Kepska J, et al. Exercise interventions in metastatic cancer disease: a literature review and a brief discussion on current and future perspectives. BMJ Support Palliat Care. 2020;10(40):404-10. doi: https://doi.org/10.1136/bmjspcare-2020-002487

Publicado

2022-10-14

Como Citar

1.
Siiss LA, Guarda A, Graeff DB, Cecagno-Zanini SC. Benefícios e Segurança dos Exercícios Físicos em Pacientes com Metástases Ósseas: Revisão Sistemática da Literatura e Metanálise. Rev. Bras. Cancerol. [Internet]. 14º de outubro de 2022 [citado 12º de dezembro de 2024];68(4):e-062520. Disponível em: https://rbc.inca.gov.br/index.php/revista/article/view/2520

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REVISÃO DE LITERATURA