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Del-Rosal-Jurado A, González-Sánchez M, Cuesta-Vargas AI. Effect of therapeutic exercise on peak oxygen consumption in oncological population: a systematic review with meta-analysis. Support Care Cancer 2024; 32:786. [PMID: 39537939 PMCID: PMC11561107 DOI: 10.1007/s00520-024-09004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/08/2024] [Indexed: 11/16/2024]
Abstract
INTRODUCTION Cancer is amongst the leading causes of death worldwide. A total of 19.3 million new cases were diagnosed in 2020. Cardiovascular impairment is the second leading cause of death in patients undergoing cancer treatment. By measuring the maximum rate of oxygen consumption (VO2max) in cancer patients, it is possible to estimate their cardiorespiratory health. This study aims to show how participants' VO2max increases with a therapeutic physical exercise programme. METHODS Four databases were used for the literature search. Twenty-eight studies were analysed using the inclusion and exclusion criteria. The quality of these studies was analysed with the PEDRO scale. The structural characteristics of the articles and the study variable (VO2max) were studied. RESULTS The VO2max of the 2558 patients studied presents some variations by gender, intervention and moment of measurement. For male-associated cancer, the increased VO2max ranged between 1.5 and 4.2% after the intervention. The increase in the maximum VO2max in female-associated cancer was between 0.3 and 53%. Different types of cancer for both genders presented an oscillation between 0.5 and 3.47%. CONCLUSIONS Therapeutic physical exercise is an efficient intervention to improve the VO2max in oncology patients. The results show that a therapeutic physical exercise intervention lasting 12 weeks, 3 days per week with a moderate-vigorous intensity, increases the VO2max in oncology patients.
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Affiliation(s)
- Alicia Del-Rosal-Jurado
- Department of Physiotherapy, Institute of Biomedicine of Málaga (IBIMA), Faculty of Health Sciences, University of Málaga, 29071, Málaga, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Institute of Biomedicine of Málaga (IBIMA), Faculty of Health Sciences, University of Málaga, 29071, Málaga, Spain.
| | - Antonio Ignacio Cuesta-Vargas
- Department of Physiotherapy, Institute of Biomedicine of Málaga (IBIMA), Faculty of Health Sciences, University of Málaga, 29071, Málaga, Spain
- School of Clinical Sciences of the Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4059, Australia
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Zhang Q, Gao Y, Wang W, Zhao X, Yu J, Huang H. Effect of resistance exercise on physical fitness, quality of life, and fatigue in patients with cancer: a systematic review. Front Oncol 2024; 14:1393902. [PMID: 39099690 PMCID: PMC11294253 DOI: 10.3389/fonc.2024.1393902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/20/2024] [Indexed: 08/06/2024] Open
Abstract
OBJECTIVE The purpose of this study is to conduct a systematic review to assess the effects of different forms of resistance exercises (resistance exercise, resistance exercise combined with aerobic exercise, and resistance exercise combined with other exercises) on physical fitness, quality of life (QOL), and fatigue of patients with cancer. METHODS We conducted a systematic review using the Cochrane Handbook for Systematic Reviews of Interventions guidelines. We searched PubMed, Web of Science, and Scopus databases for the studies from the establishment of the database to September 2023, including randomized controlled trials and clinical trials that evaluated the effects of different resistance exercise on physical fitness, QOL, and fatigue in all patients with cancer. Two reviewers independently assessed the quality of all the included studies using the Cochrane Handbook for Systematic Reviews of Interventions and MINORS scale. We divided the intervention into three types: resistance exercise, resistance exercise combined with aerobic exercise, and resistance exercise combined with other exercises. RESULTS In total, 48 studies (3,843 participants) met the inclusion criteria. The three exercise intervention forms have significant effects on physical fitness and QOL, but the improvement effect on fatigue is not clear. A total of 34 studies reported significant and beneficial effects of resistance exercise on physical fitness across all types of cancer. There were 28 studies that reported significant or borderline improvement effects of resistance on QOL, and only 10 studies reported significant effects of resistance exercise interventions on fatigue improvement in patients with cancer. CONCLUSIONS Resistance exercise, resistance exercise combined with aerobic exercise, and resistance exercise combined with other exercises all have a positive effect on improving fitness and QOL in patients with cancer. Resistance exercise has an advantage in improving muscle strength, while combined resistance exercise has an advantage in improving QOL; however, there are no consistent findings in improving fatigue, although low-intensity resistance exercise is effective. SYSTEMATIC REVIEW REGISTRATION www.inplasy.com, identifier INPLASY2023110034.
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Affiliation(s)
- Qiuhua Zhang
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| | - Yanan Gao
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, Fujian, China
| | - Wenjun Wang
- Ningbo New Fitness Health Technology Co., Ltd, Ningbo, Zhejiang, China
| | - Xiaoguang Zhao
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| | - Jiabin Yu
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| | - Huiming Huang
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
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Soares LL, Leite LB, Ervilha LOG, Pelozin BRA, Pereira NP, da Silva BAF, Portes AMO, Drummond FR, de Rezende LMT, Fernandes T, Oliveira EM, Neves MM, Reis ECC, Natali AJ. Resistance exercise training benefits pulmonary, cardiac, and muscular structure and function in rats with stable pulmonary artery hypertension. Life Sci 2023; 332:122128. [PMID: 37769805 DOI: 10.1016/j.lfs.2023.122128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023]
Abstract
AIM We tested the effects of low- to moderate-intensity resistance exercise training (RT) on the structure and function of pulmonary, right ventricle (RV), and skeletal muscle tissues in rats with stable pulmonary artery hypertension (PAH). MAIN METHODS After the first monocrotaline (MCT; 20 mg/kg) injection, male rats were submitted to a RT program (Ladder climbing; 55-65 % intensity), 5 times/week. Seven days later rats received the second MCT dose. Physical effort tolerance test and echocardiographic examination were performed. After euthanasia, lung, heart, and biceps brachii were processed for histological, single myocyte, and biochemical analysis. KEY FINDINGS RT improved survival and physical effort tolerance (i.e., maximum carrying load), mitigated the pulmonary artery resistance increase (i.e., TA/TE), and preserved cardiac function (i.e., fractional shortening, ejection fraction, stroke volume and TAPSE). RT counteracted oxidative stress (i.e., CAT, SOD, GST, MDA and NO) and adverse remodeling in lung (i.e., collapsed alveoli) and in biceps brachii (i.e., atrophy and total collagen) tissues. RT delayed RV adverse remodeling (i.e., hypertrophy, extracellular matrix, collagen types I and III, and fibrosis) and impairments in single RV myocyte contractility (i.e., amplitude and velocity to peak and relaxation). RT improved the expression of gene (i.e., miRNA 214) and intracellular Ca2+ cycling regulatory proteins (i.e., PLBser16); and of pathological (i.e., α/β-MHC and Foxo3) and physiological (i.e., Akt, p-Akt, mTOR, p-mTOR, and Bcl-xL) hypertrophy pathways markers in RV tissue. SIGNIFICANCE Low- to moderate-intensity RT benefits the structure and function of pulmonary, RV, and skeletal muscle tissues in rats with stable pulmonary artery hypertension.
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Affiliation(s)
- Leôncio Lopes Soares
- Universidade Federal de Viçosa, Departamento de Educação Física, Viçosa, Brazil.
| | | | | | | | - Noemy Pinto Pereira
- Universidade de São Paulo, Escola de Educação Física e Esportes, São Paulo, Brazil
| | | | | | | | | | - Tiago Fernandes
- Universidade de São Paulo, Escola de Educação Física e Esportes, São Paulo, Brazil
| | | | | | | | - Antônio José Natali
- Universidade Federal de Viçosa, Departamento de Educação Física, Viçosa, Brazil
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Bloomquist K, Andersen C, Munck S, Lillelund C, Lauritsen J. High-intensity interval training and thromboembolic events during chemotherapy for testicular cancer: a retrospective analysis from the Body & Cancer cohort. Acta Oncol 2023; 62:666-672. [PMID: 37450654 DOI: 10.1080/0284186x.2023.2225145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/07/2023] [Indexed: 07/18/2023]
Abstract
Background: Men with testicular cancer receiving platinum-based chemotherapy have an increased risk of thromboembolic events, with incidence rates between 8-24%. A recent trial evaluating the effect of high-intensity interval training (HIIT) prematurely closed as three out of nine participants (33%) in the intervention group developed a thromboembolic event. The purpose of this retrospective cohort study was: 1) (primary) to evaluate the incidence of thromboembolic events in men receiving chemotherapy for testicular cancer who had participated in HIIT during a 6-week exercise program (Body & Cancer) 2) to describe the feasibility of this program.Material and methods: Forty men who had participated in at least one HIIT session from February 2007 to February 2020 were included. Electronic medical records were searched for incident thromboembolic events (arterial and venous) during Body & Cancer and up to one-year post-chemotherapy. Attendance, cardiorespiratory fitness (VO2-peak), and upper and lower extremity muscular strength (1 repetition maximum (RM)) were obtained from the Body & Cancer database.Results: One participant developed a thromboembolic event during Body & Cancer. No participants developed a thromboembolic event in the follow-up period. In all, data represent 160 HIIT sessions with a median attendance of eight sessions [range 1-19]. Statistically significant increases in upper and lower extremity strength were observed (8.6 (4.2 to 13.0) and 26.0 (14.9 to 37.0) kg, respectively). No significant increase in cardiorespiratory fitness was found (0.14 (-0.03 to 0.31) l/min).Conclusion: While conclusions on the safety of HIIT cannot be drawn, data from the present study do not support previous findings cautioning avoidance of HIIT due to a possible added risk of thromboembolic events in men receiving platinum-based chemotherapy for testicular cancer. Considering the potential for positive effects on cardiovascular outcomes associated with HIIT, future studies with robust design should be performed in this population to confirm these observations.
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Affiliation(s)
- Kira Bloomquist
- University Hospitals Center for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christina Andersen
- University Hospitals Center for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stine Munck
- University Hospitals Center for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Lillelund
- University Hospitals Center for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jakob Lauritsen
- Department of Oncology 5073, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Buro AW, Crowder SL, Rozen E, Stern M, Carson TL. Lifestyle Interventions with Mind-Body or Stress-Management Practices for Cancer Survivors: A Rapid Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3355. [PMID: 36834048 PMCID: PMC9964062 DOI: 10.3390/ijerph20043355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
This rapid review examined current evidence on lifestyle interventions with stress-management or mind-body practices that assessed dietary and/or physical activity outcomes among cancer survivors. Searches were conducted in PubMed, Embase, and PsycINFO based on Cochrane Rapid Reviews Methods Group rapid review recommendations using the keywords "diet," "physical activity," "mind-body," "stress," and "intervention." Of the 3624 articles identified from the initial search, 100 full-text articles were screened, and 33 articles met the inclusion criteria. Most studies focused on post-treatment cancer survivors and were conducted in-person. Theoretical frameworks were reported for five studies. Only one study was tailored for adolescent and young adult (AYA) cancer survivors, and none included pediatric survivors. Nine studies reported race and/or ethnicity; six reported that ≥90% participants were White. Many reported significant findings for diet and/or physical activity-related outcomes, but few used complete, validated dietary intake methods (e.g., 24-h recall; n = 5) or direct measures of physical activity (e.g., accelerometry; n = 4). This review indicated recent progress on evaluating lifestyle interventions with stress-management or mind-body practices for cancer survivors. Larger controlled trials investigating innovative, theory-based, personalized interventions that address stress and health behaviors in cancer survivors-particularly racial/ethnic minority and pediatric and AYA populations-are needed.
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Affiliation(s)
- Acadia W. Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Sylvia L. Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Emily Rozen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Tiffany L. Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
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Olsen AP, Vinther A, Ragle AM, Dolin TG, Johansen JS, Vistisen K, Nielsen DL, Lund CM. Physical exercise program to older frail patients receiving chemotherapy for colorectal cancer - feasibility and experiences from the GERICO study. J Geriatr Oncol 2023; 14:101382. [PMID: 36328878 DOI: 10.1016/j.jgo.2022.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Older and frail patients with cancer are at high risk of physical and functional decline during chemotherapy. Exercise interventions can often counteract chemotherapy related toxicity and may help patients to improve or retain physical function and quality of life. Studies evaluating feasibility and the effect of exercise in older patients are lacking. The aim of this study was to investigate the feasibility and effect of an exercise intervention in older frail patients during chemotherapy for colorectal cancer (CRC). MATERIALS AND METHODS This is a secondary analysis from the GERICO study investigating the effect of geriatric interventions in frail patients ≥70 years receiving chemotherapy for CRC. All patients in the present analysis were patients randomized to geriatric interventions and who were found physically frail (low handgrip strength or slow 10 m gait speed) and therefore offered referral to the exercise program for twelve weeks. We evaluated reasons for dropping out and feasibility of an individually tailored exercise program twice a week for twelve weeks. Each 60 min session comprised warm-up followed by progressive resistance training and cool-down followed by an oral protein supplement. Baseline characteristics and the effect of exercise for patients with high and low adherence (attendance of <50% of exercise sessions) were compared. RESULTS Of 71 patients in the intervention group, 47 (66%) were found physically frail and were offered referral to the exercise program. Seven patients were referred to municipal physiotherapy before study start. In the remaining population (N = 40) 19 had exercise adherence >50% and 21 had no or low exercise adherence. Baseline characteristics were similar between patients with high and low/no adherence, except for sex (68% and 33% were men in high and low/ no adherence group, respectively). Patients with >50% attendance had significant improvements in physical tests after twelve weeks of exercise. DISCUSSION Low adherence to the exercise program was seen due to lack of energy and/or treatment related adverse events. Patients with high adherence benefitted from exercise during chemotherapy but did not differ from patients with low adherence at baseline. Consequently, exercise should be offered to all older frail patients receiving chemotherapy for CRC.
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Affiliation(s)
- Anne Pries Olsen
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark.
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark; Hospital Secretariat and Communications, Research, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Anne-Mette Ragle
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Troels Gammeltoft Dolin
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark; CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Denmark
| | - Julia Sidenius Johansen
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark; Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark
| | - Kirsten Vistisen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
| | - Dorte L Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark
| | - Cecilia Margareta Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark; CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark
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Figueiredo VC, McCarthy JJ. Targeting cancer via ribosome biogenesis: the cachexia perspective. Cell Mol Life Sci 2021; 78:5775-5787. [PMID: 34196731 PMCID: PMC11072391 DOI: 10.1007/s00018-021-03888-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/03/2021] [Accepted: 06/18/2021] [Indexed: 12/14/2022]
Abstract
Cancer cachexia afflicts many advanced cancer patients with many progressing to death. While there have been many advancements in understanding the molecular mechanisms that contribute to the development of cancer cachexia, substantial gaps still exist. Chemotherapy drugs often target ribosome biogenesis to slow or blunt tumor cell growth and proliferation. Some of the most frequent side-effects of chemotherapy are loss of skeletal muscle mass, muscular strength and an increase in fatigue. Given that ribosome biogenesis has emerged as a main mechanism regulating muscle hypertrophy, and more recently, also implicated in muscle atrophy, we propose that some chemotherapy drugs can cause further muscle wasting via its effect on skeletal muscle cells. Many chemotherapy drugs, including the most prescribed drugs such as doxorubicin and cisplatin, affect ribosomal DNA transcription, or other pathways related to ribosome biogenesis. Furthermore, middle-aged and older individuals are the most affected population with cancer, and advanced cancer patients often show reduced levels of physical inactivity. Thus, aging and inactivity can themselves affect muscle ribosome biogenesis, which can further worsen the effect of chemotherapy on skeletal muscle ribosome biogenesis and, ultimately, muscle mass and function. We propose that chemotherapy can accelerate the onset or worsen cancer cachexia via its inhibitory effects on skeletal muscle ribosome biogenesis. We end our review by providing recommendations that could be used to ameliorate the negative effects of chemotherapy on skeletal muscle ribosome biogenesis.
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Affiliation(s)
- Vandré Casagrande Figueiredo
- College of Health Sciences, University of Kentucky, Lexington, KY, USA.
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, USA
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA
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Kamel FH, Basha MA, Alsharidah AS, Salama AB. Resistance Training Impact on Mobility, Muscle Strength and Lean Mass in Pancreatic Cancer Cachexia: A Randomized Controlled Trial. Clin Rehabil 2020; 34:1391-1399. [DOI: 10.1177/0269215520941912] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: To determine the efficacy of a three-month resistance training programme on the mobility, muscle strength and lean body mass of patients with pancreatic cancer-induced cachexia. Design: Randomized controlled trial. Setting: Elsahel Teaching Hospital, outpatient clinic of the Faculty of Physical Therapy, Cairo, Egypt. Participants: Patients with pancreatic cancer-induced cachexia. Interventions: Participants were randomized to the resistance training group ( n = 20) and control group ( n = 20). Main measures: Outcomes including mobility, muscle strength and lean body mass were measured at baseline, three months after surgical resection and 12 weeks after intervention. Results: The mean (SD) age was 51.9 (5.03) years and body mass index was 21.1 (1.13) kg/m²; 65% of patients were male. Compared to the control group, the resistance training group showed significant improvement in mobility: 400-m walk performance (270.3–256.9 seconds vs 266.4–264.2 seconds, respectively) and chair rise (13.82–12.53 seconds vs 13.77–13.46 seconds, respectively). Similarly, muscle strength was also significantly improved in the resistance training group than in the control group; we observed increase in peak torque of knee extensors ( P = 0.004), elbow flexors ( P = 0.001) and elbow extensors, improvement in lean mass of the upper limb (6.28–6.46 kg vs 6.31–6.23 kg, respectively) and lower limb (16.31–16.58 kg vs 16.4–16.31 kg, respectively). Conclusion: A three-month resistance training improved the mobility of patients with pancreatic cancer-induced cachexia. Muscle strength and lean body mass also improved.
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Affiliation(s)
- FatmaAlzahraa H Kamel
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraidah, Qassim, Saudi Arabia
| | - Maged A Basha
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraidah, Qassim, Saudi Arabia
| | - Ashwag S Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraidah, Qassim, Saudi Arabia
| | - Amr B Salama
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Department of Medical Rehabilitation, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
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Bredahl EC, Busekrus RB, Hydock DS. The combined effect of creatine and resistance training on doxorubicin-induced muscle dysfunction. Nutr Cancer 2019; 72:939-947. [PMID: 31588781 DOI: 10.1080/01635581.2019.1670852] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Doxorubicin (DOX) is associated with profound skeletal muscle dysfunction. Resistance training (RT) and creatine (Cr) monohydrate have been independently shown to protect against DOX-induced muscle dysfunction. However, no investigation has examined their combined effects on DOX-induced muscle dysfunction. Methods: Male Sprague-Dawley rats were randomly assigned to a RT or sedentary group. After 6 wk of training, the soleus (SOL) and extensor digitorum longus (EDL) were excised and placed in a tissue bath containing Krebs buffer (K) or a K containing Cr (25 mM) for 30 min. The buffers were refreshed with new K or K containing DOX (24 μM) and incubated for 30 min. Muscles were then subjected to maximal twitch and fatigue testing.Results: DOX-induced fatigue occurred at 40 s in the SOL and EDL. RT delayed DOX-induced fatigue by 20 s in the SOL and 10 s in the EDL. Cr treatment delayed the onset of DOX-induced fatigue by 10 s in the EDL. The combination of RT and Cr delayed DOX-induced fatigue by 50 s in the SOL and 20 s in the EDL.Conclusion: This study showed that a combined treatment with RT and Cr minimized DOX-induced fatigue in the SOL and EDL.
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Affiliation(s)
- Eric C Bredahl
- Department of Exercise Science and Pre-Health Professions, Creighton University, Omaha, Nebraska, USA
| | - Raquel B Busekrus
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorfado, USA.,Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, Colorado, USA
| | - David S Hydock
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorfado, USA.,Rocky Mountain Cancer Rehabilitation Institute, University of Northern Colorado, Greeley, Colorado, USA
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Bao Y, Chen S, Jiang R, Li Y, Chen L, Li F, Tai J. The physical activity of colorectal cancer survivors during chemotherapy : Based on the theory of planned behavior. Support Care Cancer 2019; 28:819-826. [PMID: 31154534 DOI: 10.1007/s00520-019-04873-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/14/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate the physical activity (PA) of colorectal cancer (CRC) survivors during chemotherapy and to explain it based on the theory of planned behavior (TPB). In addition, the effects of planning, past physical activity (P-PA), and self-efficacy on the PA of CRC survivors were analyzed. METHODS CRC survivors were recruited in a third-grade hospital of Changchun via a convenience sampling method. All survivors were asked to complete self-report questionnaires assessing medical and demographic variables, PA, constructs from the TPB, P-PA, planning, and self-efficacy. RESULTS A total of 174 CRC survivors were included in this study. Only 7.5% (13) of these CRC survivors had sufficient PA, and 32.2% (56) of CRC survivors were completely sedentary. Gender, education level, working status, residential location, method of payment for medical expenses, and cancer stage were all associated with PA in these patients (P < 0.05). The path model was able to explain 54% (R2 = 0.54) of the PA variance in these CRC survivors. P-PA had the greatest impact on PA during chemotherapy, and P-PA affected PA both directly and indirectly through planning. CONCLUSIONS Insufficient PA in CRC survivors was associated with a variety of factors, with P-PA having the greatest impact on this outcome. The results of this study suggest that attention must be paid to survivors who had exhibited insufficient PA prior to initial diagnosis.
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Affiliation(s)
- Yinan Bao
- School of Nursing, Jilin University, Changchun, Jilin province, China.,School of Nursing, Inner Mongolia Medical College, Hohhot, Inner Mongolia, China
| | - Si Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Ruxin Jiang
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Lei Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin province, China.
| | - Jiandong Tai
- The First Hospital of Jilin University, Changchun, Jilin province, China.
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Heywood R, McCarthy AL, Skinner TL. Efficacy of Exercise Interventions in Patients With Advanced Cancer: A Systematic Review. Arch Phys Med Rehabil 2018; 99:2595-2620. [DOI: 10.1016/j.apmr.2018.04.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/13/2018] [Accepted: 04/07/2018] [Indexed: 12/14/2022]
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12
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Dewhurst S, Tigue R, Sandsund C, Mein G, Shaw C. Factors influencing people's ability to maintain their activity levels during treatment for soft tissue sarcoma - A qualitative study. Physiother Theory Pract 2018; 36:923-932. [PMID: 30216104 DOI: 10.1080/09593985.2018.1519622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE Soft tissue sarcoma (STS) is a rare connective tissue cancer treated with chemotherapy in the advanced stages. Emerging evidence suggests that physical activity (PA) improves symptom management and quality of life for people undergoing chemotherapy for advanced cancer. However, little research reports their perspective. Method: Semi-structured interviews were used within a phenomenological approach to explore factors that affect people's ability to be physically active while undergoing treatment. Six participants were recruited with purposive sampling. Thematic analysis was used to analyze the data. Results: Three themes identified that PA was seen as an indicator of a persons' own sense of normality; a feeling of loss and uncertainty for the future had impacts on peoples' ability to be physically active, and finally, participants found it challenging to recognize their support needs as their activity levels reduced. Motivation to remain active was individual, and numerous barriers affected participants' ability to remain active as their disease advanced; this included a lack of specific guidance while undergoing chemotherapy. Participants expressed uncertainty generally in identifying and expressing their support needs as they faced multiple complex issues. Conclusion: Health professionals should be proactive in exploring possibilities for PA to mitigate the expected physical decline, and support symptom management while undergoing palliative chemotherapy.
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Affiliation(s)
- Sarah Dewhurst
- Department of Rehabilitation, The Royal Marsden NHS Foundation Trust , London, UK
| | - Ruth Tigue
- Department of Rehabilitation, The Royal Marsden NHS Foundation Trust , London, UK
| | - Cathy Sandsund
- Department of Rehabilitation, The Royal Marsden NHS Foundation Trust , London, UK
| | - Gill Mein
- Department of Health and Wellbeing, Faculty of Health, Social Care and Education, St George's University of London and Kingston University , London, UK
| | - Clare Shaw
- Department of Rehabilitation, The Royal Marsden NHS Foundation Trust , London, UK
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Rudolph I, Schmidt T, Wozniak T, Kubin T, Ruetters D, Huebner J. Ballroom dancing as physical activity for patients with cancer: a systematic review and report of a pilot project. J Cancer Res Clin Oncol 2018; 144:759-770. [PMID: 29423728 DOI: 10.1007/s00432-018-2606-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 02/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical activity has positive effects on cancer patients. Dancing addresses diverse bio-psycho-social aspects. Our aim was to assess the evidence on ballroom dancing and to develop the setting for a pilot project. METHODS We performed a systematic review, extracted the data and designed a pilot training based on standard curricula. We included cancer patients during or after therapy. Training duration was 90 min with one regular pause and individual pauses as needed. RESULTS We retrieved two systematic reviews and six controlled studies. Types of dancing varied. Only one study used ballroom dancing. Dance training might improve well-being, physical fitness, fatigue and coping during and after therapy. Yet, evidence is scarce and data to derive the effect size are lacking; 27 patients and their partners took part in the pilot training. Patients and partners needed more time to learn the steps than is planned in regular ballroom classes. Participants were very satisfied with the adaptation of the training to their physical strength and estimated the training in a sheltered group. No side effects occurred. In spite of a high rate of participants reporting fatigue, 90 min of physical activity with only a few minutes of rest were manageable for all participants. CONCLUSION Ballroom dancing may offer benefits for patients with respect to quality of life. Cancer patients prefer sheltered training setting and curricula of regular ballroom classes must be adapted for cancer patients. Strict curricula might reduce motivation and adherence and exclude patients with lower or variable fitness.
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Affiliation(s)
- Ivonne Rudolph
- Deutsche Krebsgesellschaft, Kuno-Fischer-Str. 8, 14057, Berlin, Germany
| | - Thorsten Schmidt
- Krebszentrum Nord, CCC, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 14, 24105, Kiel, Germany
| | - Tobias Wozniak
- Arbeitsgemeinschaft Prävention und Integrative Onkologie, Deutsche Krebsgesellschaft, Kuno-Fischer-Str. 8, 14057, Berlin, Germany
| | - Thomas Kubin
- Abt. für Hämatologie, Onkologie und Palliativmedizin, Kliniken Südostbayern AG, Klinikum Traunstein, Cuno-Niggl-Str. 3, 83278, Traunstein, Germany
| | - Dana Ruetters
- Deutsche Krebsgesellschaft, Kuno-Fischer-Str. 8, 14057, Berlin, Germany
| | - Jutta Huebner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
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Hofmann P. Cancer and Exercise: Warburg Hypothesis, Tumour Metabolism and High-Intensity Anaerobic Exercise. Sports (Basel) 2018; 6:sports6010010. [PMID: 29910314 PMCID: PMC5969185 DOI: 10.3390/sports6010010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/24/2018] [Accepted: 01/29/2018] [Indexed: 12/22/2022] Open
Abstract
There is ample evidence that regular moderate to vigorous aerobic physical activity is related to a reduced risk for various forms of cancer to suggest a causal relationship. Exercise is associated with positive changes in fitness, body composition, and physical functioning as well as in patient-reported outcomes such as fatigue, sleep quality, or health-related quality of life. Emerging evidence indicates that exercise may also be directly linked to the control of tumour biology through direct effects on tumour-intrinsic factors. Beside a multitude of effects of exercise on the human body, one underscored effect of exercise training is to target the specific metabolism of tumour cells, namely the Warburg-type highly glycolytic metabolism. Tumour metabolism as well as the tumour–host interaction may be selectively influenced by single bouts as well as regularly applied exercise, dependent on exercise intensity, duration, frequency and mode. High-intensity anaerobic exercise was shown to inhibit glycolysis and some studies in animals showed that effects on tumour growth might be stronger compared with moderate-intensity aerobic exercise. High-intensity exercise was shown to be safe in patients; however, it has to be applied carefully with an individualized prescription of exercise.
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Affiliation(s)
- Peter Hofmann
- Institute of Sports Sciences, Exercise Physiology, Training & Training Therapy Research Group, University of Graz, Max Mell Allee 11, Graz 8010, Austria.
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Toohey K, Pumpa K, McKune A, Cooke J, Semple S. High-intensity exercise interventions in cancer survivors: a systematic review exploring the impact on health outcomes. J Cancer Res Clin Oncol 2018; 144:1-12. [PMID: 29210001 DOI: 10.1007/s00432-017-2552-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/27/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE There is an increasing body of evidence underpinning high-intensity exercise as an effective and time-efficient intervention for improving health in cancer survivors. The aim of this study was to, (1) evaluate the efficacy and (2) the safety of high-intensity exercise interventions in improving selected health outcomes in cancer survivors. METHODS Design Systematic review. Data sources Google Scholar and EBSCO, CINAHL Plus, Computers and Applied Sciences Complete, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition, MEDLINE, Web of Science and SPORTDiscuss from inception up until August 2017. Eligibility criteria Randomized controlled trials of high-intensity exercise interventions in cancer survivors (all cancer types) with health-related outcome measures. The guidelines adopted for this review were the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS The search returned 447 articles, of which nine articles (n = 531 participants mean, age 58 ± 9.5 years) met the eligibility criteria. Exercise interventions of between 4 and 18 weeks consisting of high-intensity interval bouts of up to 4-min were compared with a continuous moderate intensity (CMIT) intervention or a control group. High-intensity exercise interventions elicited significant improvements in VO2 max, strength, body mass, body fat and hip and waist circumference compared with CMIT and/or control groups. The studies reviewed showed low risk in participating in supervised high-intensity exercise interventions. Mixed mode high-intensity interventions which included both aerobic and resistance exercises were most effective improving the aerobic fitness levels of cancer survivors by 12.45-21.35%, from baseline to post-intervention. CONCLUSION High-intensity exercise interventions improved physical and physiological health-related outcome measures such as cardiovascular fitness and strength in cancer survivors. Given that high-intensity exercise sessions require a shorter time commitment, it may be a useful modality to improve health outcomes in those who are time poor. The risk of adverse events associated with high-intensity exercise was low.
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Affiliation(s)
- Kellie Toohey
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia.
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia.
- Health Research Institute, University of Canberra, Canberra, Australia.
| | - Kate Pumpa
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Andrew McKune
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Julie Cooke
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Stuart Semple
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
- Health Research Institute, University of Canberra, Canberra, Australia
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Fairman CM, Hyde PN, Focht BC. Resistance training interventions across the cancer control continuum: a systematic review of the implementation of resistance training principles. Br J Sports Med 2016; 51:677-685. [DOI: 10.1136/bjsports-2016-096537] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 11/03/2022]
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Martin EA, Battaglini CL, Hands B, Naumann F. Higher-Intensity Exercise Results in More Sustainable Improvements for VO2peak for Breast and Prostate Cancer Survivors. Oncol Nurs Forum 2016; 42:241-9. [PMID: 25901376 DOI: 10.1188/15.onf.42-03ap] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine peak volume of oxygen consumption (VO2peak) changes after a high- or low-intensity exercise intervention. DESIGN Experimental trial comparing two randomized intervention groups with control. SETTING An exercise clinic at a university in Australia. SAMPLE 87 prostate cancer survivors (aged 47-80 years) and 72 breast cancer survivors (aged 34-76 years). METHODS Participants enrolled in an eight-week exercise intervention (n = 84) or control (n = 75) group. Intervention participants were randomized to low-intensity (n = 44, 60%-65% VO2peak, 50%-65% of one repetition maximum [1RM]) or high-intensity (n = 40, 75%-80% VO2peak, 65%-80% 1RM) exercise groups. Participants in the control group continued usual routines. All participants were assessed at weeks 1 and 10. The intervention groups were reassessed four months postintervention for sustainability. MAIN RESEARCH VARIABLES VO2peak and self-reported physical activity. FINDINGS Intervention groups improved VO2peak similarly (p = 0.083), and both more than controls (p < 0.001). The high-intensity group maintained VO2peak at follow-up, whereas the low-intensity group regressed (p = 0.021). The low-intensity group minimally changed from baseline to follow-up by 0.5 ml/kg per minute, whereas the high-intensity group significantly improved by 2.2 ml/kg per minute (p = 0.01). Intervention groups always reported similar physical activity levels. CONCLUSIONS Higher-intensity exercise provided more sustainable cardiorespiratory benefits than lower-intensity exercise. IMPLICATIONS FOR NURSING Survivors need guidance on exercise intensity, because a high volume of low-intensity exercise may not provide sustained health benefits.
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Affiliation(s)
- Eric A Martin
- Department of Kinesiology at California State University, Monterey Bay, in Seaside, CA
| | - Claudio L Battaglini
- Department of Exercise and Sport Science at the University of North Carolina- Chapel Hill
| | - Beth Hands
- Institute for Health Research at the University of Notre Dame Australia in Fremantle, Western Australia
| | - Fiona Naumann
- School of Exercise and Nutrition Sciences at Queensland University of Technology, Australia, in Brisbane
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18
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Comparison of the effects of a supervised exercise program and usual care in patients with colorectal cancer undergoing chemotherapy. Cancer Nurs 2015; 37:E21-9. [PMID: 23357886 DOI: 10.1097/ncc.0b013e3182791097] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although exercise has been addressed as a promising therapy for cancer adverse effects, few studies have evaluated the beneficial effects of exercise for colorectal cancer (CRC) patients during chemotherapy. OBJECTIVE The purpose of this study was to compare the effects of supervised-exercise intervention with those of usual care on cardiorespiratory fitness, muscle strength, fatigue, emotional distress, sleep quality, and quality of life (QoL) in patients with CRC undergoing chemotherapy. METHODS Patients with stage II or III CRC admitted for adjuvant chemotherapy were allocated to either a supervised-exercise group that received a combined aerobic and resistance exercise program or a "usual care" control group for 12 weeks. The outcomes, QoL, muscle strength, cardiorespiratory fitness, emotional distress, physical activity, fatigue, and sleep quality, were assessed at baseline and after intervention. RESULTS Significant interactions between intervention and time were observed for the role functioning and pain subscales of QoL and physical activity level. The time main effects were significant for the secondary outcomes: hand-grip strength, cardiorespiratory fitness, physical activity level, and physical functioning, role functioning, social functioning, fatigue, and pain subscales of QoL. CONCLUSION Compared with usual care, the supervised exercise demonstrated larger effects than usual care on physical activity level and role functioning and pain subscales of QoL. IMPLICATIONS FOR PRACTICE Supervised-exercise program is suggested to be incorporated as part of supportive care to promote the cardiorespiratory fitness, muscle strength, physical activity level, and QoL of patients with CRC undergoing chemotherapy.
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Quist M, Langer SW, Rørth M, Christensen KB, Adamsen L. "EXHALE": exercise as a strategy for rehabilitation in advanced stage lung cancer patients: a randomized clinical trial comparing the effects of 12 weeks supervised exercise intervention versus usual care for advanced stage lung cancer patients. BMC Cancer 2013; 13:477. [PMID: 24124893 PMCID: PMC3816603 DOI: 10.1186/1471-2407-13-477] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 10/03/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer death in North America and Western Europe. Patients with lung cancer in general have reduced physical capacity, functional capacity, poor quality of life and increased levels of anxiety and depression. Intervention studies indicate that physical training can address these issues. However, there is a lack of decisive evidence regarding the effect of physical exercise in patients with advanced lung cancer. The aim of this study is to evaluate the effects of a twelve weeks, twice weekly program consisting of: supervised, structured training in a group of advanced lung cancer patients (cardiovascular and strength training, relaxation). METHODS/DESIGN A randomized controlled trial will test the effects of the exercise intervention in 216 patients with advanced lung cancer (non-small cell lung cancer (NSCLC) stage IIIb-IV and small cell lung cancer (SCLC) extensive disease (ED)). Primary outcome is maximal oxygen uptake (VO₂peak). Secondary outcomes are muscle strength (1RM), functional capacity (6MWD), lung capacity (Fev1) and patient reported outcome (including anxiety, depression (HADS) and quality of life (HRQOL)). DISCUSSION The present randomized controlled study will provide data on the effectiveness of a supervised exercise intervention in patients receiving systemic therapy for advanced lung cancer. It is hoped that the intervention can improve physical capacity and functional level, during rehabilitation of cancer patients with complex symptom burden and help them to maintain independent function for as long as possible. TRIAL REGISTRATION http://ClinicalTrials.gov, NCT01881906.
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Affiliation(s)
- Morten Quist
- The University Hospitals Centre for Health Research (UCSF), Copenhagen, Denmark
- Centre for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
| | - Seppo W Langer
- Centre for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
- Department of Oncology, Copenhagen University Hospital Rigshospitalet, 5073 Copenhagen, Denmark
| | - Mikael Rørth
- Centre for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
- Department of Oncology, Copenhagen University Hospital Rigshospitalet, 5073 Copenhagen, Denmark
| | - Karl Bang Christensen
- Centre for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Lis Adamsen
- The University Hospitals Centre for Health Research (UCSF), Copenhagen, Denmark
- Centre for Integrated Rehabilitation of Cancer Patients (CIRE), Copenhagen, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
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20
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Wonders KY, Loy H, Holt B, Bohachek K, Wise R. Examining the relationship between physical fitness and spiritual fitness in cancer patients: A pilot study. World J Transl Med 2013; 2:22-26. [DOI: 10.5528/wjtm.v2.i2.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 07/19/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To examine the relationship between spiritual fitness and overall physical fitness, and their resulting impact on feelings of depression and anxiety in individuals being treated for cancer.
METHODS: Thirty patients completed the McGill Quality of Life questionnaire and the Spiritual Fitness Assessment survey, and were asked to classify themselves as “Religious” or “Non-Religious”. After the questionnaires were completed, each patient underwent a comprehensive fitness assessment, which included assessments for VO2max, muscular strength and endurance, flexibility, and body composition, as well as height, weight, and resting heart rate and blood pressure. The data collected were averaged and analyzed using a one-way ANOVA test at the 0.05 level of significance.
RESULTS: Of the 30 participants, 17 classified themselves as “religious” (R) and 13 classified themselves as “non-religious” (NR). The R group had a higher body fat percentage and a lower VO2max than the NR group. However, these results were not significant. It was also determined that the R group scored themselves significantly higher than the NR group on the Spiritual Fitness questionnaire, but reported significantly higher levels of depression and anxiety than their non-religious counterparts.
CONCLUSION: Health beliefs did not necessarily back up health practice; specifically, those respondents who classified themselves as “religious” reported that their beliefs positively influenced their health behaviors, yet physiological and psychological data did not support this claim.
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21
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Gould DW, Lahart I, Carmichael AR, Koutedakis Y, Metsios GS. Cancer cachexia prevention via physical exercise: molecular mechanisms. J Cachexia Sarcopenia Muscle 2013; 4:111-24. [PMID: 23239116 PMCID: PMC3684702 DOI: 10.1007/s13539-012-0096-0] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 11/14/2012] [Indexed: 01/09/2023] Open
Abstract
Cancer cachexia is a debilitating consequence of disease progression, characterised by the significant weight loss through the catabolism of both skeletal muscle and adipose tissue, leading to a reduced mobility and muscle function, fatigue, impaired quality of life and ultimately death occurring with 25-30 % total body weight loss. Degradation of proteins and decreased protein synthesis contributes to catabolism of skeletal muscle, while the loss of adipose tissue results mainly from enhanced lipolysis. These mechanisms appear to be at least, in part, mediated by systemic inflammation. Exercise, by virtue of its anti-inflammatory effect, is shown to be effective at counteracting the muscle catabolism by increasing protein synthesis and reducing protein degradation, thus successfully improving muscle strength, physical function and quality of life in patients with non-cancer-related cachexia. Therefore, by implementing appropriate exercise interventions upon diagnosis and at various stages of treatment, it may be possible to reverse protein degradation, while increasing protein synthesis and lean body mass, thus counteracting the wasting seen in cachexia.
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Affiliation(s)
- Douglas W Gould
- School of Sport, Performing Arts and Leisure, Department of Physical Activity, Exercise and Health, University of Wolverhampton, Walsall, West Midlands, UK,
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Zimmer P, Baumann FT, Ebel J, Zopf EM, Bloch W, Elter T. Feasibility of an Isometric Maximal Voluntary Contraction Test in Hematological Cancer Patients during Thrombocytopenia. JOURNAL OF SPORTS MEDICINE (HINDAWI PUBLISHING CORPORATION) 2013; 2013:470489. [PMID: 26464879 PMCID: PMC4590891 DOI: 10.1155/2013/470489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 02/25/2013] [Indexed: 11/19/2022]
Abstract
Introduction. Resistance training is rarely offered to hemato-oncological patients in the daily clinical routine due to its potential harmful impact on the cardiovascular system and the long periods of thrombocytopenia experienced by these patients. Therefore, it is important to determine a valid assessment to define and control resistance training. In this study, the feasibility of a maximal voluntary contraction (MVC) test was investigated in hemato-oncological patients. This inexpensive assessment may be a practicable alternative to the one repetition maximum test which is currently described as the gold standard. Methods. 29 hemato-oncological patients with platelet counts between 30000/μL and 70000/μL were recruited for this pilot study. Complications like petechial bleedings, muscle convulsion, and pain were assessed using the Brief Pain Inventory before and 48 hours after the MVC test, which was performed unidirectionally for the quadriceps muscle. Results. We did not detect any statistically significant test-related exacerbations or pain development. Discussion. MVC testing seems to be a feasible method to control a resistance training program in hemato-oncological patients. Further studies need to extend their methods and, for example, compare the MVC test with the one repetition maximum test.
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Affiliation(s)
- Philipp Zimmer
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany
| | - Freerk T. Baumann
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany
| | - Janis Ebel
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany
| | - Eva Maria Zopf
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Köln, Germany
| | - Thomas Elter
- Department I of Internal Medicine, Center for Integrated Oncology Köln Bonn, University of Cologne, Kerpener Straße 62, 50937 Köln, Germany
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Physical activity, physical fitness and the effect of exercise training interventions in lymphoma patients: a systematic review. Ann Hematol 2013; 92:1007-21. [DOI: 10.1007/s00277-013-1689-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/24/2013] [Indexed: 11/24/2022]
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Andersen C, Rørth M, Ejlertsen B, Stage M, Møller T, Midtgaard J, Quist M, Bloomquist K, Adamsen L. The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue. Eur J Oncol Nurs 2012; 17:331-9. [PMID: 23084254 DOI: 10.1016/j.ejon.2012.09.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 08/23/2012] [Accepted: 09/13/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Cancer related fatigue (CRF) is a common problem for cancer patients across diagnoses during chemotherapy and is associated with physical inactivity, lower functional level and lack of energy. Few RCT exercise intervention studies have included cancer patients undergoing chemotherapy. The objective of this study is to evaluate whether a six-week supervised multimodal exercise intervention, adjunct to chemotherapy and standard care, can reduce the patient's CRF level. METHODS Data is based on analyses of a prospective randomised controlled trial 'The Body & Cancer Trial'. 213 cancer patients with different diagnoses were randomised into an intervention group or wait-list control group. The primary outcome, Fatigue score (CRF), was evaluated by the Functional Assessment of Cancer Therapy-Anaemia Questionnaire (FACT-An-) (FACT-G score & FACT-An Anemia subscale). INTERVENTION Supervised exercise, comprising high-intensity cardiovascular and heavy resistance training, relaxation- and body awareness training and massage, 9 h weekly for 6 weeks. RESULTS CRF was significantly reduced in the intervention group, corresponding to a Fatigue score reduction of 3.04 (effect size of 0.44, 95% CI 0.17-0.72) (P = .002), the FACT-An score by 5.40 (P = .015), the FACT-An Toi score by 5.22 (P = .009) and the Anaemia-ANS by 3.76 (P = .002). There was no statistically significant effect on the General Quality of Life score (FACT-G) or on any of the individual wellbeing scores; Physical (P = .13), Emotional (P = .87), Social (P = .83) and Functional (P = .26). CONCLUSION In summary, this six-week supervised multimodal exercise intervention can lead to significant reduction in self-reported CRF in cancer patients undergoing chemotherapy.
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Affiliation(s)
- Christina Andersen
- The University Hospital Centre for Nursing and Care Research (UCSF), Department 9701, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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Wiggins MS, Simonavice EM. Cancer prevention, aerobic capacity, and physical functioning in survivors related to physical activity: a recent review. Cancer Manag Res 2010; 2:157-64. [PMID: 21188106 PMCID: PMC3004575 DOI: 10.2147/cmar.s7461] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Indexed: 11/23/2022] Open
Abstract
According to recent published reports, over 12 million new cases of cancer were estimated worldwide for 2007. Estimates from 2008 predict that cancer will account for 22.8% of all deaths in the US. Another report stated 50% to 75% of cancer deaths in the US are related to smoking, poor dietary choices, and physical inactivity. A 2004 report indicated obesity and/or a sedentary lifestyle increases the risk of developing several types of cancer. Conversely, several large-scale cohort studies point to the positive relationship between physical activity and a reduction in cancer risk. In addition, research over the last few years has clearly shown cardiorespiratory benefits, increases in quality of life (QOL), and increases in physical functioning for cancer survivors who engage in exercise programs. Thus, the purpose of this review is to highlight three areas related to cancer and physical activity. First, information concerning the prevention of cancer through physical activity is addressed. Second, recent studies identifying changes in volume of oxygen uptake (VO(2)) and/or cardiorespiratory functioning involving exercise with cancer survivors is presented. Third, studies identifying changes in cancer survivors' physical functional capacity and QOL are presented. Finally, a summary of the review is offered.
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Affiliation(s)
- Matthew S Wiggins
- Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
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Rørth M, Madsen KR, Burmølle SH, Midtgaard J, Andersen C, Nielsen B, Stage M, Adamsen L. Effects of Darbepoetin Alfa with exercise in cancer patients undergoing chemotherapy: an explorative study. Scand J Med Sci Sports 2010; 21:369-77. [PMID: 20136754 DOI: 10.1111/j.1600-0838.2009.01066.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Fatigue is frequent in cancer patients undergoing chemotherapy. Erythropoietins (EPO) have shown well-documented effects on these patients, and administered in pharmacological doses, may reduce the need for transfusion of blood cells and improve quality of life (QoL). An explorative, descriptive, non-randomised intervention study using semi-structured interviews was conducted with the aim to gain an insight into the effects and experiences associated with EPO treatment in combination with a structured 6-week physical exercise intervention. Sixteen cancer patients with evidence of disease, who had received at least one cycle chemotherapy, participated. Participants received 500 μg Darbepoetin Alfa (DA) every 3 weeks during the intervention. Four typologies of patients were identified with regard to DA effects. The interviews revealed that eleven patients experienced some kind of immediate improvement in cognitive and emotional functioning, and subjective daily well-being. Furthermore physical improvement and changes in QoL outcomes showed no significant differences between the study group and a reference group. A significant increase in the hemoglobin concentration (7.14-7.87 mmol/L, P<0.05) was found in the study group. The future use of EPO in cancer patients is hampered by the reported negative influence of EPO on the prognosis in some diagnoses and should be based on randomized studies.
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Affiliation(s)
- M Rørth
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark.
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Adamsen L, Quist M, Andersen C, Møller T, Herrstedt J, Kronborg D, Baadsgaard MT, Vistisen K, Midtgaard J, Christiansen B, Stage M, Kronborg MT, Rørth M. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ 2009; 339:b3410. [PMID: 19826172 PMCID: PMC2762035 DOI: 10.1136/bmj.b3410] [Citation(s) in RCA: 328] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease. DESIGN Randomised controlled trial. SETTING Two university hospitals in Copenhagen, Denmark. PARTICIPANTS 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow-up. INTERVENTION Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. MAIN OUTCOME MEASURES European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Medical Outcomes Study Short Form (MOS SF-36), Leisure Time Physical Activity Questionnaire, muscular strength (one repetition maximum), maximum oxygen consumption (Vo(2)max). Statistical methods The general linear model was used for continuous outcome while analysis of associates between categorical outcomes was performed as analysis of marginal homogeneity in contingency tables. RESULTS Adjusted for baseline score, disease, and demographic covariates, the intervention group showed an estimated improvement at six weeks for the primary outcome, fatigue, of -6.6 points (95% confidence interval -12.3 to -0.9, P=0.02; effect size=0.33, 0.04 to 0.61). Significant effects were seen on vitality (effect size 0.55, 95% CI 0.27 to 0.82), physical functioning (0.37, 0.09 to 0.65), role physical (0.37, 0.10 to 0.64), role emotional (0.32, 0.05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P<0.0001) and for muscular strength (leg press) was 29.7 kg (23.4 to 34.9, P<0.0001). No significant effect was seen on global health status/quality of life. CONCLUSION A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced disease. The intervention reduced fatigue and improved vitality, aerobic capacity, muscular strength, and physical and functional activity, and emotional wellbeing, but not quality of life. TRIAL REGISTRATION Current Controlled trials ISRCTN05322922.
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Affiliation(s)
- Lis Adamsen
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Evans ES, Battaglini CL, Groff DG, Hackney A. Aerobic Exercise Intensity in Breast Cancer Patients: A Preliminary Investigation. Integr Cancer Ther 2009; 8:139-47. [DOI: 10.1177/1534735409335506] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose: This study compared the heart rate (HR), rate of perceived exertion (RPE), and blood lactate (BL) responses to aerobic exercise between posttreated breast cancer patients and apparently healthy, age-matched controls. Methods: Seven patients and 7 control subjects underwent a submaximal treadmill test for the estimation of Vo2max. Exercise intensities of 40%, 60%, and 70% of Vo2max were calculated from the treadmill test and randomly examined between groups during three 9-minute exercise bouts on 3 different days. Independent samples t tests were used to examine the HR, RPE, and BL responses at each intensity between groups. Results: No significant differences were observed between the control and patient groups for HR, RPE, and BL at 40% (101 ± 9 vs 101 ± 11 bpm, P = .979; 8 ± 1 vs 9 ± 3, P = .237; and 1.11 ± 0.73 vs 1.26 ± 0.64 mmol/L, P = .188, respectively) and 60% (127 ± 17 vs 117 ± 13 bpm, P = .523; 12 ± 2 vs 11 ± 3, P = .267, and 3.83 ± 2.48 vs 2.23 ± 1.65 mmol/L, P = .237, respectively) of Vo2max . At 70% of Vo2max, no significant differences were found for HR (151 ± 27 vs 135 ± 13 bpm, P = .704) and RPE (14 ± 1 vs 13 ± 3, P = .181), but lower BL responses were observed in the patient group (7.70 ± 1.62 vs 3.29 ± 1.08 mmol/L, P < .0005). Conclusions: The results suggest similar HR, RPE, and BL responses between patients and control subjects at 40%, 60%, and 70% of Vo2max , except for BL at 70% of Vo2max. The lower BL response in the patient group at 70% of Vo2max was somewhat unexpected. Further research is needed to confirm or refute the results of this study to allow for a clearer understanding of the physiological responses of breast cancer patients to aerobic exercise at moderate or higher intensities so that safer aerobic exercise prescriptions can be developed for this population.
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Affiliation(s)
- Elizabeth S. Evans
- Department of Exercise and Sport Science, , University of North Carolina at Chapel Hill, North Carolina,
| | - Claudio L. Battaglini
- Department of Exercise and Sport Science, , University of North Carolina at Chapel Hill, North Carolina, Lineberger Comprehensive Cancer Center, , University of North Carolina at Chapel Hill, North Carolina
| | - Diane G. Groff
- Department of Exercise and Sport Science, , University of North Carolina at Chapel Hill, North Carolina
| | - A.C. Hackney
- Department of Exercise and Sport Science, , University of North Carolina at Chapel Hill, North Carolina, Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina
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de Lima C, Alves LE, Iagher F, Machado AF, Bonatto SJ, Kuczera D, de Souza CF, Pequito DC, Muritiba AL, Nunes EA, Fernandes LC. Anaerobic exercise reduces tumor growth, cancer cachexia and increases macrophage and lymphocyte response in Walker 256 tumor-bearing rats. Eur J Appl Physiol 2008; 104:957-64. [DOI: 10.1007/s00421-008-0849-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2008] [Indexed: 10/21/2022]
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Bacurau AVN, Belmonte MA, Navarro F, Moraes MR, Pontes FL, Pesquero JL, Araújo RC, Bacurau RFP. Effect of a high-intensity exercise training on the metabolism and function of macrophages and lymphocytes of walker 256 tumor bearing rats. Exp Biol Med (Maywood) 2008; 232:1289-99. [PMID: 17959841 DOI: 10.3181/0704-rm-93] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Epidemiologic studies suggest that moderately intense training promotes augmented immune function, whereas strenuous exercise can cause immunosupression. Because the combat of cancer requires high immune function, high-intensity exercise could negatively affect the host organism; however, despite the epidemiologic data, there is a lack of experimental evidence to show that high-intensity training is harmful to the immune system. Therefore, we tested the influence of high-intensity treadmill training (10 weeks, 5 days/week, 30 mins/day, 85% VO(2)max) on immune system function and tumor development in Walker 256 tumor-bearing Wistar rats. The metabolism of glucose and glutamine in lymphocytes and macrophages was assessed, in addition to some functional parameters such as hydrogen peroxide production, phagocytosis, and lymphocyte proliferative responses. The metabolism of Walker 256 cells was also investigated. Results demonstrated that high-intensity training increased the life span of tumor-bearing rats, promoted a reduction in tumor mass, and prevented indicators of cachexia. Several changes, such as a reduction in body weight and food intake and activation of glutamine metabolism in macrophages and lymphocytes induced by the presence of Walker 256 tumor, were prevented by high intensity training. The reduction in tumor growth was associated with an impairment of tumor cell glucose and glutamine metabolism. These data suggest that high-intensity exercise training may be a viable strategy against tumors.
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Adamsen L, Andersen C, Midtgaard J, Møller T, Quist M, Rørth M. Struggling with cancer and treatment: young athletes recapture body control and identity through exercise: qualitative findings from a supervised group exercise program in cancer patients of mixed gender undergoing chemotherapy. Scand J Med Sci Sports 2008; 19:55-66. [PMID: 18266788 DOI: 10.1111/j.1600-0838.2007.00767.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cancer and treatment can negatively affect the body's performance and appearance. Exercise has been tested in a few studies for altered body image among middle-aged women with breast cancer. The aim of the study was to explore how young pre-cancer athletes of both genders experience disease- and treatment-related physical fitness and appearance changes while undergoing chemotherapy and participating in a 6-week group exercise intervention. A prospective, explorative study using semi-structured interviews was conducted before and at termination of the intervention. The study included 22 cancer patients (median age 28 years). The young athletes experienced a change from a high level of physical activity, body satisfaction and a positive self-identity to a low level of physical activity, body denial and a negative self-identity. In the program, the patients experienced increased physical strength and recapture of certain aspects of their former positive body perception. Deterioation of muscle functions caused by chemotherapy was particularly painful to these patients, independent of gender and age. Young physically active patients are heavily dependent on their physical capacity, body satisfaction and self-identity. This should be taken into account when designing programs to rehabilitate and encourage these patients through the often-strenuous antineoplastic treatments.
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Affiliation(s)
- L Adamsen
- Department 7331, The University Hospital's Centre for Nursing and Care Research, Copenhagen University Hospital, Copenhagen, Denmark.
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Abstract
OBJECTIVES To review the literature and summarize the findings of exercise intervention research for patients with cancer undergoing treatment. DATA SOURCES Electronic databases of the Ovid Medline and CINAHL from 1980 to present. Reference lists from retrieved articles were reviewed and relevant articles included. CONCLUSION Exercise programs have been primarily aerobic. Participants exercised anywhere from 3 to 7 days a week, for 2 to 52 weeks, 10 to 45 minutes per session, at 50% to 85% of heart rate reserve. Exercise has shown to improve almost all aspects of physiologic and psychological functioning. IMPLICATIONS FOR NURSING PRACTICE Nurses can confidently suggest exercise as part of a patient's therapy and guide the patient to a safe program.
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