Nebenwirkungsorientierte Behandlungspfade für die bewegungstherapeutische Betreuung onkologischer Patienten

Zusammenfassung

Sport- und bewegungstherapeutische Inhalte haben in der onkologischen Rehabilita­tion in den letzten Jahren immer mehr an Bedeutung gewonnen. Die Therapieplanung in der modernen Rehabilitation orientiert sich dabei an der International Classification of Functioning, Diability and Health (ICF). Dieses System lässt sich in seiner Komplexität allerdings wissenschaftlich nur sehr bedingt darstellen. Hinzu kommt, dass die Forschungslandschaft überwiegend entitätsorientiert ausgerichtet ist und derart homogene Gruppen in der therapeutischen Praxis nicht vorliegen. Aus diesem Grund stellt die Entwicklung von evidenzbasierten, nebenwirkungsorientierten Behandlungspfaden ein wichtiges Bindeglied zwischen notwendiger Evidenzbasierung und therapeutischer Praxis dar.

Abstract

Exercise therapy has gained increasing importance in the field of oncologic rehabilita­tion over the past years. Therapy planning is currently based on ICF although this approach can hardly be evaluated in scientific studies due to its complexity. Further­more, research focuses on certain types of cancer whereas in daily practice, hetero­geneous patient groups exercise together. Therefore, the development of evidence based side effect-oriented exercise therapy pathways appears crucial to close the gap between scientific evidence and daily practice of exercise therapy.

Schlüsselwörter

Krebs - Onkologie - körperliches Training - Rehabilitation - Behandlungspfade

Key words

cancer - oncology - physical activity - rehabilitation - clinical pathways

• Literatur

• 1 Adamsen L, Quist M, Andersen C et al. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ 2009; 339: b3410
• 2 Arbeitsgruppe Bewegungstherapie. Ziele und Aufgaben der Arbeitsgruppe „Bewegungstherapie“ in der Deutschen Gesellschaft für Rehabilitationswissenschaften (DGRW). Rehabilitation 2009; 48: 252-255
• 3 Brown JC, Huedo-Medina TB, Pescatello LS et al. Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2011; 20: 123-133
• 4 Campbell KL, Neil SE, Winters-Stone KM. Review of exercise studies in breast cancer survivors: attention to principles of exercise training. Br J Sports Med 2012; 46: 909-916
• 5 Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012; 11: CD006145
• 6 Haydon AM, MacInnis RJ, English DR et al. Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 2006; 55: 62-67
• 7 Ibrahim EM, Al-Homaidh A. Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol 2011; 28: 753-765
• 8 Jeon J, Sato K, Niedzwiecki D et al. Impact of physical activity after cancer diagnosis on survival in patients with recurrent colon cancer: Findings from CALGB 89803/Alliance. Clin Colorectal Cancer 2013; 12: 233-238
• 9 Kenfield SA, Stampfer MJ, Giovannucci E et al. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol 2011; 29: 726-732
• 10 Lauterbach K, Schrappe M. Gesundheitsökonomie, Qualitätsmanagement und Evidence-based Medicine. 2. Aufl. Stuttgart: Schattauer; 2003
• 11 Mehnert A, Müller D, Lehmann C et al. Die deutsche Version des NCCN Distress-Thermometers. Z Psychiatr Psychol Psychother 2006; 54: 213-223
• 12 Meyerhardt JA, Giovannucci EL, Holmes MD et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 2006; 24: 3527-3534
• 13 Meyerhardt JA, Giovannucci EL, Ogino S et al. Physical activity and male colorectal cancer survival. Arch Intern Med 2009; 169: 2102-2108
• 14 Meyerhardt JA, Heseltine D, Niedzwiecki D et al. Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 2006; 24: 3535-3541
• 15 Mishra SI, Scherer RW, Geigle PM et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 2012; 8: CD007566
• 16 Mishra SI, Scherer RW, Snyder C et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 2012; 8: CD008465
• 17 Purcell A, Fleming J, Bennett S et al. Determining the minimal clinically important difference criteria for the Multidimensional Fatigue Inventory in a radiotherapy population. Support Care Cancer 2010; 18: 307-315
• 18 Schmitz KH, Ahmed RL, Troxel A et al. Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 2009; 361: 664-673
• 19 Schmitz KH, Courneya KS, Matthews C et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010; 42: 1409-1426
• 20 Smets EM, Garssen B, Bonke B et al. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 1995; 39: 315-325
• 21 Weis J, Arraras JI, Conroy T et al. Development of an EORTC quality of life phase III module measuring cancer-related fatigue (EORTC QLQ-FA13). Psychooncol 2013; 22: 1002-1007
• 22 Winters-Stone KM, Dobek J, Nail L et al. Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial. Breast Cancer Res Treat 2011; 127: 447-456
• 23 Winters-Stone KM, Neil SE, Campbell KL. Attention to principles of exercise training: a review of exercise studies for survivors of cancers other than breast. Br J Sports Med 2013; 48: 987-995
• 24 Wiskemann J, Steindorf K. Standards der Sportmedizin: Krafttraining als Supportivtherapie bei onkologischen Patienten [Resistance training as supportive therapy for cancer patients]. Dtsch Z Sportmed 2014; 65: 22-24