Effects of a physical activity programme to prevent physical performance decline in onco‐geriatric patients: a randomized multicentre trial

Abstract

Background Older adults with cancer experience negative long‐term functional effects of both cancer and treatments. Exercise may minimize their age‐related and cancer‐related functional decline. Methods We conducted a multicentre open‐label 12 month randomized clinical trial with two parallel arms including participants aged ≥70 years with lymphoma or carcinoma requiring curative treatment. The study started at the beginning of any phase of cancer treatment (surgery, chemotherapy, or radiotherapy). The usual care group (UCG) received the current national recommendations in physical activity (a guideline without specific counselling). The intervention group (IG) received 1 year phoned physical activity advice individually adapted to physical assessment (twice a month during the first 6 months and then monthly). The primary outcome was the proportion of subjects with a 1 year decreased short physical performance battery (SPPB) score of 1 point or more. Physical, cognitive, and clinical secondary outcomes were also investigated. Results We allocated 301 participants (age 76.7 ± 5.0, female 60.6%) to each group. At baseline, the median SPPB was 10/12 in both groups. Breast was the most frequent tumour site (35.7%). After 1 year, 14.0% of participants in the UCG and 18.7% in the IG had a decrease in SPPB score of 1 point or more ( P = 0.772). At 2 years, there was no difference in SPPB, gait speed, International Physical Activity Questionnaire score, and verbal fluency. Subgroup analyses after 2 years showed a decline in SPPB for 29.8% of UCG and 5.0% of IG breast cancer participants ( P = 0.006), in 21.7% of UCG and 6.2% of IG female participants ( P = 0.019), and in 24.5% of UCG and 11.1% of IG normal nutritional status participants ( P = 0.009). Falls, hospitalization, institutionalization, and death rates were similar in both groups. Conclusions Personalized phoned physical activity advice had not reduced functional decline at 1 year but provided preliminary evidence that may prevent physical performance decline at 2 years in older adults with breast cancer.

Sarcopenia in aging, obesity, and cancer

“…Studies have suggested that interventions employing only aerobic exercise have been less successful in maintaining muscle mass in older cancer survivors. For example, a French study randomized 301 cancer patients over the age of 70 who were initiating treatment (surgery, chemotherapy or radiation) to a 12-month telephone-based aerobic physical activity intervention or usual care control ( 115 ). After 1 year, there was no difference in SPPB scores between groups (P=0.772).…”

The effect of exercise-based interventions on health-related quality of life and physical function in older patients with cancer receiving medical antineoplastic treatments: a systematic review

“…The design and setup of the included studies are summarized in Table 1 . The studies were conducted in France [ 30 ], Canada [ 31 ], USA [ 32 ], and Japan [ 33 ], and published from 2014 to 2019. The studies were all RCTs, however, one study was a pilot RCT [ 32 ].…”

“…Two studies excluded patients who were already physically active [ 31 , 32 ], and two excluded patients with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) > 1 [ 33 ] and > 2 [ 30 ], respectively.…”

“…Sample sizes in the included studies ranged from 14 to 301 parti-cipants. The primary outcome was physical function in two studies [ 30 , 32 ], and cognitive functioning in one study [ 33 ]. In these three studies, power calculations were presented [ 30 , 32 , 33 ].…”

Long-term effects of a food pattern on cardiovascular risk factors and age-related changes of muscular and cognitive function

“…The sample size calculation was performed with nQuery Advisor V7.0. From the literature, [ 64 – 71 ] the cut-off values for the primary endpoint were selected such that in each component, an incidence of 10% to 15% is expected over 3 years. Depending on the correlation of the events, this may lead to a proportion of event-free patients of about 27% to 80% at the end of the observation period.…”