Cancer patients frequently experience considerable loss of physical capacity and general wellbeing when diagnosed and treated for their disease. The aim of this study was to evaluate the feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients during advanced stages of disease who are undergoing adjuvant or high-dose chemotherapy. The supervised program included high- and low-intensity activities (physical exercise, relaxation, massage, and body-awareness training). A total of 23 patients between 18 and 65 years of age (median 40 years) participated in groups of seven to nine patients for 9 h weekly for 6 weeks. Physical capacity in terms of repetition maximum (RM) and maximal oxygen uptake (VO(2)max), physical activity level and psychosocial wellbeing (EORTC QLQ-C30, SF-36, HAD) were compared prior to and after completion of the program. The program was safe and well tolerated. The completion rate was 85.2%. Highly significant increases in physical capacity (1RM, VO(2)max) and an improved level of physical activity were achieved. Quality of life and general wellbeing assessments indicated improvements in several measures, but without reaching significance. It is concluded that an exercise program, which combines high- and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy.
The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity; one-repetition maximum (1RM) and maximum oxygen uptake (VO2Max), activity level, general well-being and quality of life in cancer patients undergoing chemotherapy. The intervention comprised resistance and fitness training, massage, relaxation and body-awareness training. Eighty-two cancer patients, with or without evidence of residual disease, were included: 66 patients with 13 different types of solid tumours and 16 patients with 6 types of haematological malignancies. The patients trained in mixed groups for 9 h weekly for 6 weeks. Physical capacity, physical activity level and psychosocial well-being as measured by the Medical Outcomes Study 36-item Short-Form Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 were assessed pre- and post-intervention. Highly significant increases were achieved in muscular strength (p<0.001), physical fitness (p<0.001) and physical activity levels (p<0.001). The patients reported significant reduction in treatment-related symptoms, i.e., fatigue (p=0.006) and pain (p=0.03). Highly significant improvements were observed in physical functioning (p<0.001) and role functioning (p<0.001). Even patients with advanced disease were able to improve their results after 6 weeks. It is concluded that a multidimensional exercise intervention, including resistance training, may be beneficial for cancer patients undergoing chemotherapy. This study indicates significant clinical meaningful improvements. The exact role of the intervention has to be defined in a randomized controlled design. A clinically controlled trial including 250 patients is currently being carried out.
The positive attitudes in this sample towards maximum physical capacity open the possibility of introducing physical testing early in the treatment process. However, the patients were self-referred and thus highly motivated and as such are not necessarily representative of the whole population of cancer patients treated with chemotherapy.
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