Background:Despite evidence supporting exercise in cancer care, adherence remains low. Nordic Walking (NW), a pole-assisted outdoor activity, may overcome barriers and improve fitness. However, a comprehensive synthesis of its effects on physical fitness in cancer patients is lacking.Objective:To evaluate NW’s effects on physical fitness, health-related quality of life (HRQoL), adherence, and safety in patients living with and beyond cancer, compared with no intervention or other exercise programs.Methods:This PRISMA-compliant systematic review and meta-analysis (PROSPERO: CRD42024551608) included randomized or quasi-randomized trials. Five databases were searched through November 2024. Risk of bias (Joanna Briggs Institute) and evidence certainty (GRADE) were assessed.Results:This systematic review included six RCTs comparing NW with no intervention. NW significantly improved overall muscle strength (Std. MD = 0.46, 95%CI:0.14–0.78; low-certainty) and self-reported physical activity (MD = 3181.51 MET-min/week, 95%CI:2085–4278; moderate-certainty). Cardiorespiratory fitness (6-min walk) showed no significant improvement in random-effects modeling (MD = 84.78 m, 95%CI:−35.6–205.19; very low-certainty). HRQoL data were insufficient for meta-analysis. Adherence exceeded 90% in supervised sessions, with no serious intervention-related adverse events.Conclusions:When compared with no intervention NW is feasible and safe, potentially improving muscle strength and physical activity in patients with cancer. Evidence for cardiorespiratory endurance and HRQoL remains inconclusive. To date, no studies have compared NW with other structured exercise programs. Higher-quality RCTs with diverse populations are needed.
背景：尽管有证据支持运动在癌症治疗中的作用，但患者的依从性仍然较低。北欧式健走作为一种借助手杖进行的户外活动，可能有助于克服障碍并改善体能。然而，目前缺乏关于其对癌症患者体能影响的全面综合分析。 目的：评估与不干预或其他运动方案相比，北欧式健走对癌症患者及康复期患者体能、健康相关生活质量、依从性及安全性的影响。 方法：本系统综述与荟萃分析遵循PRISMA指南（PROSPERO注册号：CRD42024551608），纳入随机或半随机试验。检索截至2024年11月的五个数据库，采用乔安娜·布里格斯研究所工具评估偏倚风险，使用GRADE标准评估证据质量。 结果：本系统综述纳入六项比较北欧式健走与不干预的随机对照试验。北欧式健走显著改善整体肌肉力量（标准化均数差=0.46，95%置信区间：0.14–0.78；证据质量低）和自我报告体力活动水平（均数差=3181.51 MET-分钟/周，95%置信区间：2085–4278；证据质量中等）。心肺适能（6分钟步行测试）在随机效应模型中未显示显著改善（均数差=84.78米，95%置信区间：−35.6–205.19；证据质量极低）。健康相关生活质量数据不足，无法进行荟萃分析。监督训练课程的依从率超过90%，且未发生与干预相关的严重不良事件。 结论：与不干预相比，北欧式健走对癌症患者具有可行性和安全性，可能改善肌肉力量与体力活动水平。其对心肺耐力与健康相关生活质量影响的证据尚不明确。迄今尚无研究比较北欧式健走与其他结构化运动方案的效果。未来需要针对更广泛人群开展更高质量的随机对照试验。
Effects of Nordic Walking on Physical Fitness in Patients with Cancer: A Systematic Review
肿瘤(癌症)患者之家