Robyn Brennen, Kuan Yin Lin, Linda Denehy, Sze-Ee Soh, Thomas Jobling, Orla M McNally, Simon Hyde, Helena Frawley
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引用次数: 0
Abstract
Introduction and hypothesis: This study investigated physical activity (PA) levels and health-related quality-of-life (HRQoL) before and after, and associations between pelvic floor disorders (PFD) and PA/HRQoL after, hysterectomy for gynecological cancer.
Methods: Secondary analysis of a longitudinal cohort study, with assessments before, 6 weeks, and 3 months after hysterectomy for gynecological cancer. The International Physical Activity Questionnaire-short form was used to assess PA and European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30 (QLQ-C30) to assess HRQoL. Changes over time were analyzed using generalized estimating equations or linear mixed models. Associations between PFD with PA and HRQoL were analyzed using logistic regressions and analyses of variance.
Results: Of 126 participants, median age 63 years, most had endometrial (69%) and/or stage 1 cancer (72%) and underwent total hysterectomy (65%). Pre-surgery, 39% met PA guidelines, increasing to 53% 3 months post-surgery (+14%, 95% CI 2-25). Mean global health status/QoL domain scores from the QLQ-C30 did not change significantly (+4.4/100 points, 95% CI -0.8 to 9.6). Three months post-surgery, whether participants met PA guidelines was not associated with PFD. Participants with anal incontinence or double incontinence had lower global health status/QoL scores than participants without these symptoms (mean (SD) AI 61.4 (17.8) vs no AI 72.5 (18.7), p = 0.006; DI 61.5 (17.9) vs no DI 71.7 (18.8), p = 0.019).
Conclusion: PA levels were low pre- and post-surgery but worse preoperatively. This presents an opportunity for prehabilitation interventions to optimize physical function. There was no association between meeting PA guidelines and PFD. Global health status/QoL was slightly below population norms pre- and post-surgery. Lower HRQoL was associated with some symptoms of PFD.
前言和假设：本研究调查了妇科癌症子宫切除术前后的身体活动（PA）水平与健康相关生活质量（HRQoL），以及盆底疾病（PFD）与PA/HRQoL之间的关系。方法：对一项纵向队列研究进行二次分析，对妇科肿瘤子宫切除术前、6周和3个月进行评估。采用国际体育活动问卷（简称问卷）评估PA，采用欧洲癌症研究与治疗组织生活质量问卷（QLQ-C30）评估HRQoL。使用广义估计方程或线性混合模型分析随时间的变化。采用logistic回归和方差分析分析PFD与PA和HRQoL之间的关系。结果：126名参与者，中位年龄63岁，大多数患有子宫内膜（69%）和/或1期癌症（72%），并接受了全子宫切除术（65%）。术前，39%符合PA指南，术后3个月增加到53% （+14%,95% CI 2-25）。QLQ-C30的平均整体健康状态/生活质量域得分没有显著变化（+4.4/100分，95% CI -0.8至9.6）。术后3个月，受试者是否符合PA指南与PFD无关。有肛门失禁或双侧失禁的受试者总体健康状况/生活质量评分低于无这些症状的受试者(平均（SD） AI 61.4 (17.8) vs无AI 72.5 (18.7), p = 0.006；DI 61.5 （17.9) vs无DI 71.7 (18.8), p = 0.019）。结论：术前、术后PA水平均较低，术前更差。这为康复干预优化身体功能提供了机会。符合PA指南和PFD之间没有关联。术前和术后的全球健康状况/生活质量略低于人群标准。较低的HRQoL与PFD的一些症状相关。
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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