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유방암 생존자의 장기간 복합 운동중재에 따른 기능적 체력과 골밀도의 변화

The Change of Functional Fitness and Bone Mineral Density on a Long-Term Combined Exercise Intervention in Breast Cancer Survivors.

  • 발행 : 2008.07.30

초록

본 연구는 유방암 절제술을 받은 40-60대의 기혼 중년을 대상으로 복합운동을 1년간 실시하여 골다공증약과 운동을 병행한 군과 운동군으로 나누어 기능적 체력과 골밀도에 미치는 효과를 분석하고 이에 따른 효과적인 운동프로그램의 기초 자료를 제공하는데 있다. 대상자총 24명을 두군으로 나누어, 이중 18명은 골다공증 범위(T-score=$-2.2{\pm}0.8$)에 있으며 복합운동만을 실시하였다. 나머지 6명은 골다공증진단(T-score=$-4.6{\pm}0.9$)을 받고 골다공증약(Alendronate 70 mg/주 당)을 처방 받아 복용하면서 복합운동을 병행하여 실시하였다. 본 연구 결과, 기능적 체력 요소 중 좌전굴, 악력, 윗몸일으키기에서는 시기간에 유의한 향상을 보였다. 12개월 후, 골 밀도의 변화는 복합운동군(N=18)에서는 변화가 없었으며, 복합운동과 골다공증약 복용(N=6)을 병행하고 있는 그룹은 유의한 개선을 나타냈다. 따라서 하타요가, 탄성밴드 및 볼 운동이 포함된 장기간 점진적 강도의 복합운동프로그램이 유방암절제술 여성의 기능적 체력의 개선 및 골밀도 지연에 효과가 있었고, 특히 운동과 골다공증약을 병행한 그룹에서 골다공증개선에 긍정적인 영향을 미쳤으므로, 유방암 수술 후 회복기 운동프로그램으로 적극 활용할 수 있도록 제안한다. 앞으로 대상자 수를 늘려 골다공증약과 운동과의 병행관계를 심층적으로 연구하고, 유방암 수술 후 운동중재프로그램의 유형 및 강도를 달리하여 유방암과 골밀도 및 운동과의 관련성을 연구 해 볼 필요가 있겠다.

The study was to provide basic data and to examine the effect of combined exercise for 12 months on functional fitness and bone mineral density (BMD) in breast cancer survivors. The subjects of this study were 40 to 60-year-old married women (N=24) who finished their treatments chemotherapy and radiation therapy. They were divided into two groups that exercise group and exercise with alendronate group. Eighteen (T-score=$-2.2{\pm}0.8$) of the 24 women who were diagnosed osteopenia (N=15) and osteoporosis (N=3), participated in combined exercise (EG). The other six (T-score=$-4.6{\pm}0.9$) women who were diagnosed as osteoporosis (EDG), participated in the combined exercise program with osteoporosis drug (Alendronate 70 mg/w). The result of the analysis was as follows: Twelve months after, the participants (N=24) had a significant increase of the items such as sit and reach ups, grip strength (R and L) and sit ups test of functional fitness in the periods. In body composition, FM (fat mass) had significant decrease in periods. In the comparison of BMD, EG (N=18) had no change, while EDG (N=6) had significant improvement in L1, T12 and T-score after 12months. Consequently, complex exercise program (Hatha yoga, elastic band, gym ball) had positive effect on functional fitness and bone mineral density. We suggest that complex exercise program can be applied as recovery program after breast cancer surgery. Further research needs various and repetitive studies from more different targets or methods in the exercise program for its improvement.

키워드

참고문헌

  1. American Cancer Institute. Http://www. cancer. gov/
  2. Anna, L. S., W. S. Kerri and G. Betty. 2007. Exercise effects on bone mineral density in Women with Breast Cancer. Oncology Nursing Forum 34, 627-633. https://doi.org/10.1188/07.ONF.627-633
  3. Bone, H. G., R. W. Downa, J. R., Jr. Tucci, S. T. Harris and A. A. Licata. 1997. Dose response relationships for alendronate treatment in osteoporotic elderly women. J. Clin. Endocrinol. 82, 265-274.
  4. Carol, D. O., M. L. Ada, L. W. Nancy, J. G. Gloria, J. T. Janice, B. Kris, B. Patricia and H. Sharon. 2004. Facilitative strategies, psychological factors, and strength/weight training behaviors in breast cancer survivors who are at risk for osteoporosis. Orthopaedic Nursing 23, 45-52. https://doi.org/10.1097/00006416-200401000-00013
  5. Carole, M. S., A. D. Carolyn and D. C. Susan. 2003. Exercise and cancer recovery. Human Kinetics 55-141.
  6. Cho, D. S., S. P. Ryu and S. C. Lee. 2003. Effects of climbing exercise and alendronate injection on bone mineral density and intensity in glucocorticoid-induced osteoporosis rats. The Korean Journal of Physical Education 42, 669-674.
  7. Creager, C. C. 1994. Therapeutic exercise using the Swiss ball. Executive physical Therapy. Colorado.
  8. Curtis, K. A., T. M. Tyner, L. Zachary, G. Lentell, D. Brink, T. Didyk, K. Gean, J. Hall, H. Hooper, J. Klos, S. Lesina and B. Pacillas. 1999. Effect of a standard exercise protocol on shoulder pain long-term wheelchair users. Spinal Cord. 37, 4.
  9. Dianne, D. 2005. Exercise for osteoporosis. Hatherleigh Press. Long Island Canada.
  10. Frieedenreich, C. M. 2001. Physical activity and cancer prevention: from observational to intervention research. Cancer Epidemiol. Biomarker Prev. 10, 287-391.
  11. International Herald Tribune, 2008. March 8th.
  12. Jang, J. H., S. Hur and K. Y. Hong. 2007. Effects of swiss ball & elastic band exercise for 1 year on body composition, physical fitness and bone mineral density and correlations of psychosocial factors in middle-aged women. The Korean Journal of Physical Education 46, 5, 493-501.
  13. Jee, Y. S., K. J. Yoon, J. J. Byun and M. K. Kim. 2003. The effects of exercise on bone mineral density and relating variables of elderly women with osteoporosis during taking the alendronate. Journal of Sport and Leisure Studies 19, 1455-1466.
  14. Kanis. J. A., E. V. McClosey, T. Powles, A. H. Paterson, S. Ashley and T. Spector. 1999. A high incidence of vertebral fractures in women with breast cancer. Br. J. Cancer 79, 1179-1181. https://doi.org/10.1038/sj.bjc.6690188
  15. McTiernan. A. 2000. Exercise reduces blood estrogens, risk of postmenopausal breast. Cancer weekly 286-291.
  16. Mock, V., M. B. Burke, P. Sheehan, E. M. Creaton, M. L. Winningham, S. Mckenney-Tedder, L. P. Schwager and M. Liebman. 1994. A Nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncol. Nurs. Forum 21, 899-907.
  17. Waltman, N. L., J. J. Twiss, C. D. Ott, G. J. Gross, A. M. Lindsey, J. E. Moore and K. Berg. 2003. Testing an intervention for preventing osteoporosis in postmenopausal breast cancer survivors. J. Nurs. scholarsh. 35, 333-338. https://doi.org/10.1111/j.1547-5069.2003.00333.x
  18. National Cancer Information Center. Http://www.cancer. go.kr.
  19. Rogers, C. J., L. H. Colbert, J. W. Greiner, S. N. Perkin and S. D. Hursting. 2008. Physical activity and cancer prevention: pathways and targets for intervention. Sports Med. 38, 271-296. https://doi.org/10.2165/00007256-200838040-00002
  20. Page, P. and T. S. Ellenbecker. 2003. The scientific and clinical application of elastic resistance. Human kinetics.
  21. Ruhland, J. L. and R. K. Shields. 1997. The effects of a home exercise program on impairment and health-related quality of life in persons with chronic peripheral neuropathies. Physical Therapy 77, 1026-1037. https://doi.org/10.1093/ptj/77.10.1026
  22. Shephard, R. J. and P. N. Shek. 1995. Cancer, immune function, and physical activity. Canadian Journal of Applied Physiology 20, 1-25. https://doi.org/10.1139/h95-001
  23. Skelton, D. A. and A. W. McLaughlin. 1996. Training functional ability in old age. Physiotherapy 82, 159-167. https://doi.org/10.1016/S0031-9406(05)66916-7
  24. So, H. S., Y. H. Noh, N. S. Seo, H, Y. Kim and E. Ko. 2007. Effects of aerobic exercise using a flex-band on a cardiofulmonary function and physical flexibility of breast cancer women undergoing radiation therapy. Global breast cancer conference 2007. 269-270.
  25. The Breast. 2005. Korean Breast Cancer Society. Iljogak Pree, Seoul, 500-501.
  26. Thune, I. and A. S. Furberg. 2001. Physical activity and cancer risk; dose response and cancer, all sites and site-specific. Med. Sci. Sports Exercis 33, S609-610. https://doi.org/10.1097/00005768-200106001-00029
  27. Treiber, F. A. J. Lott, J. Duncan, G. Slavens and H. Davis. 1998. Effects of thera-band and light weight dumbbell training on shoulder rotation torque and serve performance in college tennis players. American Journal of Sports Medicine 26, 510-515. https://doi.org/10.1177/03635465980260040601
  28. Vehmanen, L., I. Elomaa, C. Blomqvist and T. Saarto. 2006. Tamoxifen treatment after adjuvunt chemotherapy has opposite effects on bone mineral density in pre-menopausal patients depending on menstrual status. Journal of Clinical Oncology 24, 675. https://doi.org/10.1200/JCO.2005.02.3515
  29. Watson, P. G. 1990. Cancer rehabilitation: The evolution of a concept. Cancer Nurs 13, 2-12.