Effects of Resistive Exercise on Skeletal Muscle in Marrow Transplant Recipients Receiving Total Parenteral Nutrition

Abstract

Skeletal muscle protein loss occurs during marrow transplantation despite total parenteral nutrition. To determine if muscle atrophy could be minimized with exercise therapy, 30 patients undergoing marrow transplantation for acute leukemia completed a prospective randomized trial to receive: (1) no therapy (controls), (2) physical therapy thrice weekly (PT3), or (3) physical therapy five times weekly (PT5). Patients were studied through 35 days posttransplant. Muscle protein status and turnover was assessed by weekly nitrogen balance, and creatinine and 3-methylhistidine excretion. Results favored a muscle protein-sparing effect of exercise, as a significant decrease in creatinine excretion in controls only suggested muscle protein loss associated with inactivity. Changes in arm muscle area correlated with energy, but not protein intake. Large individual variation, inadequate nutritional support and differences in admission arm muscle area may have clouded these results.

Effect of physical exercise on muscle mass and strength in cancer patients during treatment—A systematic review

“…Of these, three trials used aerobic exercise (AE) alone { [29];Mello, 2003 #17;Monga, 2007 #7}, while seven trials used AE and resistance exercise (RE) in a combined intervention (CAE) [30][31][32][33][34][35][36]. Four trials compared AE or RE against UC [37][38][39][40].One trial compared two different RE interventions (three or five days per week) against usual care [41]. One trial compared RE alone or together with a low fat vegetable diet against a control group.…”

“…No effects were reported in the trials by Cunningham and colleagues [41], comparing two RE groups exercising three or five days per week with UC, the study by Mustian and colleagues [34] comparing a CAE group exercising seven days a week for four weeks with UC, or in the trial by Demark-Wahnefried and colleagues [42] comparing three groups: calcium-rich diet only, calciumrich diet + RE and calcium rich + RE + low fat vegetable diet. In the latter study, patients in the RE groups exercised five days a week for 26 weeks.…”

“…A few trials included some other cancer diagnoses, such as bowel or colon cancer [30, 31, 34, 37-40, 42, 43]. Six trials included patients with various haematological malignancies, mainly acute or chronic leukaemia or lymphomas, undergoing hematopoietic stem cell transplants (HSCT) [29,33,36,41]. Only one trial included patients with advanced stage IV cancer undergoing palliative cancer treatment.…”

“…Muscle mass was reported in only six trials, and except for two trials involving HSCT patients [32,41], these were conducted on patients with breast cancer or prostate cancer [31,34,37,42]. Overall, the tendency in these six trials was that the experimental groups (either AE, RE or CAE) maintained or modestly improved muscle mass from pre to post-test while the CG reduced muscle mass.…”

“…In only two trials blinding was applied [34,40]. Six trials had drop-out rates above > 20% [29,32,35,36,41,44]. In case of three of these trials, it was not reported how missing data were dealt with [32,41,44].…”