Feasibility and efficacy of a 12-week supervised exercise intervention for colorectal cancer survivors

Abstract

Exercise training improves health-related physical fitness and patient-reported outcomes in cancer survivors, but few interventions have targeted colorectal cancer (CRC) survivors. This investigation aimed to determine the feasibility and efficacy of a 12-week supervised exercise training program for CRC survivors. Feasibility was assessed by tracking participant recruitment, loss to follow-up, assessment completion rates, participant evaluation, and adherence to the intervention. Efficacy was determined by changes in health-related physical fitness. Over a 1-year period, 72 of 351 (21%) CRC survivors screened were eligible for the study and 29 of the 72 (40%) were enrolled. Two participants were lost to follow-up (7%) and the completion rate for all study assessments was ≥93%. Mean adherence to the exercise intervention was 91% (standard deviation = ±18%), with a median of 98%. Participants rated the intervention positively (all items ≥ 6.6/7) and burden of testing low (all tests ≤ 2.4/7). Compared with baseline, CRC survivors showed improvements in peak oxygen uptake (mean change (MC) = +0.24 L·min(-1), p < 0.001), upper (MC = +7.0 kg, p < 0.001) and lower (MC = +26.5 kg, p < 0.001) body strength, waist circumference (MC = -2.1 cm, p = 0.005), sum of skinfolds (MC = -7.9 mm, p = 0.006), and trunk forward flexion (MC = +2.5 cm, p = 0.019). Exercise training was found to be feasible and improved many aspects of health-related physical fitness in CRC survivors that may be associated with improved quality of life and survival in these individuals.

The influence of exercise intensity on insulin sensitivity and the insulin-like growth factor axis in colorectal cancer survivors

“…Compared to the findings of Sellar et al (144), the absolute improvement in VO 2 peak of 5.3ml/kg/min reported for the present HIE group may have been due to the higher exercise intensity employed.…”

“…The absolute increase in VO 2 peak of 5.3 mL/kg/min for the HIE group in our study is greater than improvements reported previously in colorectal cancer survivors (144). As described by Sellar et al…”

The use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial with embedded feasibility study

“…142 Given that it is very rare for young people to have a CRC diagnosis, we can confidently assume that a lower age criterion does not have a decisive influence on eligibility rates. Nine studies (including CRIB) included language restriction as a criterion, 44,49,142,143,145,146,149,150 suggesting a bias towards people who speak a country's first language and thereby potentially limiting generalisability of the study findings to other groups of the population. In CRIB, no patients with CRC were excluded because they were unable to speak English, suggesting that this criterion did not have any bearing on the eligibility rate.…”

“…Six studies specifically mentioned that people with metastatic disease would be excluded or only people with local disease would be included. 49,143,145,146,[148][149][150] Thus, there appears to be a bias towards people with early-stage disease, thereby limiting generalisability of findings to people with metastatic disease.…”

“…Only one study was specifically designed for people who were on active treatment (i.e. receiving adjuvant chemotherapy); 148 one study (CRIB) included people on or off active treatment, seven studies made it clear that people on active treatment would be excluded, 49,[142][143][144]147,149,150 and it was not clear in four studies if people on active treatment were included or not. 44,[144][145][146] We are aware of only one current physical activity intervention trial for people with CRC on active treatment.…”