康复科研博士团：运动康复核心期刊论文导读2025-2

新刊速递

每月带您读英文核心，这个月英文文献分享刚刚开始！

本文内容较长，为了优化阅读体验，欢迎大家点击标题展开相应内容。

1.《British Journal of Sports Medicine 》  

JCR：Q1；IF：11.6

Firing up the rehabilitation: a holistic approach emphasising complex 

practice environments to change exercise behaviour

启动康复：一个整体的方法，强调复杂的练习环境，以改变运动行为

【Abstract】

Rehabilitation, covering areas such as injury, cardiac, pulmonary and mental health, is evolving toward patient-centred care.1 However, motivating patients to maintain exercise habits remains challenging,2 with a disconnect between programme design, behavioural change theories and professionals’ ability to apply behavioural change techniques.3 The aim of this editorial is to emphasise the need for rehabilitation programmes that move beyond traditional treatments by integrating holistic, patient-centred approaches. This includes fostering emotional, psychological and social growth alongside physical recovery.

【摘要】  

康复，包括伤害、心脏、肺和精神健康等领域，正在向以病人为中心的护理发展然而，激励患者保持锻炼习惯仍然具有挑战性，因为在项目设计、行为改变理论和专业人员应用行为改变技术的能力之间存在脱节这篇社论的目的是强调康复规划的必要性，通过整合以病人为中心的整体方法，超越传统治疗。这包括在身体恢复的同时促进情感、心理和社会的成长。

Association of muscle strength and cardiorespiratory fitness with all-cause

 and cancer-specific mortality in patients diagnosed with cancer: a systematic review with meta-analysis

在诊断为癌症的患者中，肌肉力量和心肺健康与全因死亡率和癌症特异性死亡率的关系：一项荟萃分析的系统综述

【Abstract】

Objective：To examine the association between muscle strength and cardiorespiratory fitness (CRF) with all-cause and cancer-specific mortality in patients diagnosed with cancer, and whether these associations are affected by type and/or stage of cancer.

Method：A systematic review with meta-analysis was carried out. Five bibliographic databases were searched to August 2023.

Results：Forty-two studies were included (n=46 694). Overall, cancer patients with high muscle strength or CRF levels (when dichotomised as high vs low) had a significant reduction in risk of all-cause mortality by 31–46% compared with those with low physical fitness levels. Similarly, a significant 11% reduction was found for change per unit increments in muscle strength. In addition, muscle strength and CRF were associated with an 8–46% reduced risk of all-cause mortality in patients with advanced cancer stages, and a 19–41% reduced risk of all-cause mortality was observed in lung and digestive cancers. Lastly, unit increments in CRF were associated with a significant 18% reduced risk of cancer-specific mortality.

Conclusion：High muscle strength and CRF were significantly associated with a lower risk of all-cause mortality. In addition, increases in CRF were associated with a reduced risk of cancer-specific mortality. These fitness components were especially predictive in patients with advanced cancer stages as well as in lung and digestive cancers. This highlights the importance of assessing fitness measures for predicting mortality in cancer patients. Given these findings, tailored exercise prescriptions to improve muscle strength and CRF in patients with cancer may contribute to reducing cancer-related mortality.

【摘要】  

目的：探讨肌肉力量和心肺功能（CRF）与癌症诊断患者全因死亡率和癌症特异性死亡率之间的关系，以及这些关系是否受到癌症类型和/或分期的影响。

方法：采用系统评价和meta分析。检索5个书目数据库至2023年8月。

结果：共纳入42项研究（n=46 694）。总体而言，与身体健康水平较低的癌症患者相比，肌肉力量或CRF水平高的癌症患者的全因死亡率显著降低31-46%。同样，肌肉力量每单位增量的变化显著减少11%。此外，肌肉力量和CRF与晚期癌症患者全因死亡率降低8-46%相关，肺癌和消化道癌症患者全因死亡率降低19-41%。最后，CRF的单位增量与癌症特异性死亡风险显著降低18%相关。

结论：高肌力和CRF与较低的全因死亡风险显著相关。此外，CRF的增加与癌症特异性死亡率的降低有关。这些健康成分在晚期癌症患者以及肺癌和消化道癌症患者中尤其具有预测性。这突出了评估健康指标对预测癌症患者死亡率的重要性。鉴于这些发现，量身定制的运动处方可以改善癌症患者的肌肉力量和CRF，可能有助于降低癌症相关的死亡率。

2.《Journal of Physiotherapy》

JCR：Q1；IF：9.7

Cognitive behavioural therapy with best-evidence pain management was 

not superior to best-evidence pain management alone for patients with 

chronic spinal pain and insomnia

对于慢性脊柱疼痛和失眠患者，认知行为疗法与最佳证据疼痛管理并不优于最佳证据疼痛管理

【Abstract】

Question: Is cognitive behavioural therapy for insomnia (CBTi) integrated with best-evidence pain management (BEPM) superior to BEPM alone in patients with non-specific chronic spinal pain and insomnia? 

Design: Parallel-group randomised controlled trial with concealed group allocation and blinded participants and assessors. 

Setting: Two university hospitals in Belgium. 

Participants: People aged 18 to 65 years seeking care, reporting ≥ 3 months with non-specific chronic spinal pain ≥ 3 days/week, having insomnia (ie, > 30 minutes of sleep latency and/or minutes awake after sleep onset for > 3 days/week for > 6 months). Main exclusion criteria were: severe underlying sleep pathology, neuropathic pain, chronic widespread pain syndromes, shift work, pregnancy, thoracic pain in the absence of neck or low back pain, history of spinal surgery, body mass index > 30 and current doctor-diagnosed clinical depression. A 1:1 randomisation of 123 participants allocated 61 to the CBTi-BEPM group and 62 to the BEPM-control group. 

Interventions: Both groups received 18 treatment sessions over 14 weeks. The CBTi-BEPM group received six CBTi and 12 BEPM sessions, of which three involved pain neuroscience education and nine involved exercise therapy. The BEPM group received 18 sessions with BEPM, of which three involved pain neuroscience education and 15 involved exercise therapy. 

Outcome measures: The primary outcome was mean pain intensity in the last 24 hours measured with the Brief Pain Inventory (0 to 10, where 0 = no pain). Secondary outcomes included other measures of pain, central sensitisation, sleep-related outcomes, fatigue, depressive symptoms, anxiety, objective physical activity recording and health-related quality of life. Assessments took place at baseline, post-treatment, and at 3-, 6- and 12-month follow-ups.

 Results: A total of 114 participants (93%) completed the 12-month assessment. At 12 months there was no important between-group difference in pain intensity change (MD 0.97 points; 95% CI −0.05 to 1.99). 

Conclusion: Adding CBTi to BEPM did not improve pain intensity reduction for patients with non-specific chronic spinal pain and insomnia more than BEPM alone, but showed positive effects on insomnia severity and sleep quality.

【摘要】

问题：对于非特异性慢性脊柱疼痛和失眠患者，认知行为疗法（CBTi）结合最佳证据疼痛管理（BEPM）是否优于单独BEPM ？

设计：平行组随机对照试验，隐藏分组分配，盲法参与者和评估者。环境：比利时的两所大学医院。

参与者：年龄在18 - 65岁的求诊患者，报告≥3个月的非特异性慢性脊柱疼痛≥3天/周，有失眠（即，睡眠潜伏期≥30分钟和/或睡眠后醒来数分钟，连续> 3天/周，连续> 6个月）。主要排除标准为：严重的潜在睡眠病理、神经性疼痛、慢性广泛疼痛综合征、轮班工作、妊娠、无颈部或腰痛的胸痛、脊柱手术史、体重指数bbb30和目前医生诊断的临床抑郁症。123名参与者按1:1随机分配，61名参与者被分配到CBTi-BEPM组，62名参与者被分配到bepm对照组。

干预措施：两组在14周内接受了18次治疗。cbt -BEPM组接受6次cbt和12次BEPM治疗，其中3次涉及疼痛神经科学教育，9次涉及运动治疗。BEPM组接受了18次BEPM治疗，其中3次涉及疼痛神经科学教育，15次涉及运动治疗。

结果测量：主要结果是用简短疼痛量表测量的过去24小时的平均疼痛强度（0至10,0 =无疼痛）。次要结果包括疼痛、中枢致敏、睡眠相关结果、疲劳、抑郁症状、焦虑、客观身体活动记录和与健康相关的生活质量。在基线、治疗后以及3、6、12个月随访时进行评估。

结果：共有114名参与者（93%）完成了12个月的评估。12个月时，两组疼痛强度变化无显著差异(MD 0.97分；95% CI为−0.05 ~ 1.99)。

结论：与单纯BEPM相比，BEPM对非特异性慢性脊柱痛失眠患者疼痛强度减轻的改善作用不如CBTi，但对失眠严重程度和睡眠质量有积极影响。

3.《Journal of Sport and Health Science》

JCR：Q1；IF：9.7

Effects of short- and long-term exercise training on cancer cells in vitro: Insights into the mechanistic associations

短期和长期运动训练对体外癌细胞的影响：机制关联的见解

【Abstract】

Exercise is a therapeutic approach in cancer treatment, providing several benefits. Moreover, exercise is associated with a reduced risk for developing a range of cancers and for their recurrence, as well as with improving survival, even though the underlying mechanisms remain unclear. Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro. This suppression is potentially due to altered concentrations of hormones (e.g., insulin) and cytokines (e.g., tumor necrosis factor alpha and interleukin 6) after exercise. These factors, known to be involved in tumorigenesis, may explain why exercise is associated with reduced cancer incidence, recurrence, and mortality. However, the effects of short- (<8 weeks) and long-term (≥8 weeks) exercise programs on cancer cells have been reported with mixed results. Although more research is needed, it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients. Although speculative, these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior, low muscle mass, and excess fat mass in cancer patients. Taken together, such interventions could alter the systemic levels of suppressive circulating factors, leading to a less favorable environment for tumorigenesis. While regular exercise and a healthy diet may establish a more cancer-suppressive environment, each acute bout of exercise provides a further “dose” of anticancer medicine. Therefore, integrating regular exercise could potentially play a significant role in cancer management, highlighting the need for future investigations in this promising area of research.

【摘要】  

运动是治疗癌症的一种治疗方法，它提供了几个好处。此外，尽管其潜在机制尚不清楚，但锻炼与降低患一系列癌症和复发的风险以及提高生存率有关。临床前和临床证据表明，单次锻炼的急性效应可以抑制体外多种癌细胞系的生长。这种抑制可能是由于运动后激素（如胰岛素）和细胞因子（如肿瘤坏死因子α和白细胞介素6）浓度的改变。这些已知与肿瘤发生有关的因素可以解释为什么运动与降低癌症发病率、复发率和死亡率有关。然而，短期（<8周）和长期（≥8周）运动计划对癌细胞的影响已经报道，结果不一。虽然还需要更多的研究，但似乎结合运动和饮食的干预措施似乎对表面上健康的受试者和癌症患者的癌细胞生长都有更大的抑制作用。虽然是推测性的，但这些对癌细胞的抑制作用可能是由体重和组成的变化以及与癌症患者久坐行为、低肌肉量和过量脂肪量相关的低度炎症的减少所驱动的。综上所述，这些干预措施可能改变抑制循环因子的系统水平，导致不利于肿瘤发生的环境。虽然有规律的运动和健康的饮食可以建立一个更抑制癌症的环境，但每一次剧烈的运动都是抗癌药物的进一步“剂量”。因此，整合定期锻炼可能在癌症管理中发挥重要作用，强调了在这一有前途的研究领域进行未来研究的必要性。