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Alves I, Moreira AP, Sousa T, Teles P, Magalhães BM, Goncalves F, Fernandes CS. Impact of Exergames on the Rehabilitation of Cancer Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Trial. Cancer Nurs 2025; 48:239-244. [PMID: 38417129 DOI: 10.1097/ncc.0000000000001331] [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] [Indexed: 03/01/2024]
Abstract
BACKGROUND Exergames can be an appealing strategy that is integrated into post-abdominal surgery rehabilitation. OBJECTIVE The aim of this study was to assess the effectiveness of exergame rehabilitation in improving independence in activities of daily living (ADLs) and patient balance after abdominal cancer surgery. METHODS A randomized control-group study was carried out in an oncological hospital in Portugal. Seventy postoperative patients were included, and data collection took place between January 2023 and May 2023. The patients were randomly assigned to either an exergame rehabilitation program (n = 35) or a traditional rehabilitation program (n = 35). The assessed outcomes were the Barthel and Berg scales, and data collection occurred at 3 different time points: admission, 48 hours postoperatively, and on the seventh day after surgery. RESULTS At the third assessment, a statistically significant difference was observed between the 2 groups for both indicators, ADLs and balance. CONCLUSIONS There was an improvement in ADLs and balance in the exergames group. By the seventh day after surgery, the intervention group showed improvement in balance and ADLs compared with the control group. IMPLICATIONS FOR PRACTICE The use of exergames can be a solution to the challenges of traditional rehabilitation methods after abdominal surgery for cancer for postoperative patients. This is the first study carried out in this specific population.
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Affiliation(s)
- Isabel Alves
- Author Affiliations: Portuguese Institute of Oncology (Mss Alves, Moreira, and Sousa), Porto; School of Economics, University of Porto (Dr Teles); School of Health, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal (Dr Magalhães); and Oncology Nursing Research Unit IPO Porto Research Center (CI-IPOP), and Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal (Dr Magalhães); Clinical Academic Centre of Trás-os-Montes and Alto Douro (CACTMAD), Vila Real, Portugal (Dr Magalhães); University of A Coruña Faculty of Health Sciences, A Coruña, Spain (Mr Goncalves); and APELA - Portuguese Amyotrophic Lateral Sclerosis Association (Mr Goncalves); CINTESIS@RISE (Dr Fernandes); Porto Higher School of Nursing (Dr Fernandes); and ADITGames Association (Dr Fernandes), Porto, Portugal
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Sattar S, Haase KR, Tejero I, Bradley C, Cobbing S, Pathak N, Callow JH, Lam JA, Perlon C, Del Socorro KJ, Nadler MB, Alibhai SMH, Campbell KL, Papadopoulos E. Exercise interventions for older adults with advanced cancer: A scoping review. J Geriatr Oncol 2025; 16:102237. [PMID: 40199228 DOI: 10.1016/j.jgo.2025.102237] [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: 12/16/2024] [Revised: 03/24/2025] [Accepted: 03/27/2025] [Indexed: 04/10/2025]
Abstract
INTRODUCTION The feasibility, safety, acceptability, and perceptions of exercise in older adults with advanced disease are not well understood due to the scarcity of evidence. This scoping review aimed to (1) summarize evidence on the feasibility, acceptability, and safety of exercise interventions for older adults with advanced cancer and (2) explore this population's perceptions on participating in exercise programs. MATERIALS AND METHODS A systematic search was conducted by an expert research librarian in Medline, CINAHL, EMBASE, Cochrane CENTRAL, and SPORTDiscus (inception through November 2023). Eligible studies included older adults with advanced (stage IV or receiving treatment with non-curative intent) solid cancers and intervention or qualitative studies on physical activity/exercise in older adults pertaining to our objectives. RESULTS A total of 36 studies were included: 28 (78 %) intervention studies, seven (19 %) qualitative studies, and one (3 %) cross-sectional study. The Frequency/Intensity/Time/Type (FITT) principle was described in 18 studies (64 %). Feasibility was examined in 15 of the 28 intervention studies (54 %) using various definitions. Four studies had predetermined feasibility thresholds, yielding mixed results. One intervention study reported on two intervention-related severe adverse events. Nineteen of the 28 intervention studies (68 %) examined acceptability, reporting high levels of participant satisfaction. Qualitative data revealed several barriers and facilitators to exercise. DISCUSSION Exercise appears to be feasible, acceptable, and safe in older adults with advanced cancer. Consistent reporting on the FITT principle and feasibility operationalization are areas of improvement in exercise studies in older adults with advanced disease.
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Affiliation(s)
- Schroder Sattar
- College of Nursing, University of Saskatchewan, Health Science Building - 1A10, Box 6 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada.
| | - Kristen R Haase
- Faculty of Applied Science, School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada; BC Cancer Research Institute, Cancer Control, 675 W 10th Ave, Vancouver, BC V5Z 1L3, Canada
| | - Isabel Tejero
- Department of Geriatrics, Hospital del Mar, Pg. Marítim de la Barceloneta, 25, 29, Ciutat Vella, 08003 Barcelona, Spain
| | - Cara Bradley
- Library, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
| | - Saul Cobbing
- Department of Medicine, University Health Network; 190 Elizabeth St, Toronto, ON M5G 2C4, Canada
| | - Neha Pathak
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada
| | - Joanne H Callow
- Faculty of Applied Science, School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Jee A Lam
- Faculty of Physical Therapy, University of Toronto, Rehabilitation Sciences Building, 8/F, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Chloe Perlon
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada
| | - Kristine Jones Del Socorro
- College of Nursing, University of Saskatchewan, Health Science Building - 1A10, Box 6 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Michelle B Nadler
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada
| | - Shabbir M H Alibhai
- Department of Medicine, University Health Network; 190 Elizabeth St, Toronto, ON M5G 2C4, Canada; Department of Medicine, Institute of Health Policy, Management, and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada
| | - Kristin L Campbell
- BC Cancer Research Institute, Cancer Control, 675 W 10th Ave, Vancouver, BC V5Z 1L3, Canada; Department of Physical Therapy, University of British Columbia, 212 Friedman Building, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Efthymios Papadopoulos
- School of Kinesiology, Louisiana State University, Huey P Long Field House, 112 Long Fieldhouse, Baton Rouge, LA 70802, USA
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Alves I, Moreira AP, Sousa T, Teles P, Goncalves F, Magalhães BM, Fernandes CS. Exergames rehabilitation program for postoperative cancer patients undergoing abdominal surgery: A quasi-experimental study. ENFERMERIA CLINICA (ENGLISH EDITION) 2025:502212. [PMID: 40204240 DOI: 10.1016/j.enfcle.2025.502212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 01/21/2025] [Accepted: 01/23/2025] [Indexed: 04/11/2025]
Abstract
OBJECTIVES This study aimed to describe and test a program implemented by a nurse for cancer patients in the postoperative period of abdominal surgery using Wii Fit games. It explored the relationship between the type of game, its duration, and the score obtained with variables such as quality of life, fatigue, balance, anxiety, and depression. METHODS A quasi-experimental project was conducted using a one-group pretest-posttest design to assess the effects of a rehabilitation program utilizing Nintendo Wii Fit. The games included were Wii Fit Aerobics - Basic Step, Wii Fit - Balance Games Penguin Slide, Wii Fit Training Plus - Birds Eye Bulls Eye, and Wii Fit - Hula Hoop. Data were collected 48h post-surgery and on the 7th day post-surgery. RESULTS Thirty-five patients participated in the study. The evaluation revealed that the scores and durations of the games had significantly related to the outcomes on the scales, with the "Wii Fit Aerobics - Basic Step" and "Wii Fit - Hula Hoop" games having the most significant impact across multiple aspects. CONCLUSIONS The study demonstrated that the rehabilitation program had a positive effect on the study population, administered by a rehabilitation nurse. The use of exergames may offer a viable solution to the challenges of traditional rehabilitation methods, particularly for cancer patients in the postoperative period.
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Affiliation(s)
- Isabel Alves
- Portuguese Institute of Oncology, Porto, Portugal
| | | | - Teresa Sousa
- Portuguese Institute of Oncology, Porto, Portugal
| | - Paulo Teles
- School of Economics, University of Porto, Portugal
| | - Filipe Goncalves
- University of A Coruña, Faculty of Health Sciences, Coruña, Spain; APELA - Portuguese Amyotrophic Lateral Sclerosis Association, Portugal
| | - Bruno Miguel Magalhães
- Porto Higher Health School of Health, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal; Comprehensive Cancer Centre (Porto.CCC) RISE@CI-IPOP (Health Research Network), Porto, Portugal
| | - Carla Sílvia Fernandes
- CINTESIS@RISE, Portugal; Porto Higher School of Nursing, Porto, Portugal; ADITGames Association, Portugal.
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Liang M, Liu Z, Zhang R, Zhang N. Effect of exercise based on the ACSM recommendations on fatigue in patients with digestive tumors: a meta-analysis of randomized controlled trials. J Cancer Surviv 2025:10.1007/s11764-025-01780-x. [PMID: 40184021 DOI: 10.1007/s11764-025-01780-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Accepted: 03/12/2025] [Indexed: 04/05/2025]
Abstract
OBJECTIVE Fatigue is the most common side effect in cancer and cancer treatment. This study aimed to investigate the effect of different amounts of exercise on fatigue in patients with digestive tumors. METHODS We searched articles published to March 2024 in the PubMed, Embase, Web of Science, and Cochrane databases. The amount of exercise was evaluated according to the American College of Sports Medicine (ACSM) and divided into high compliance and low compliance. The effect of compliance on fatigue in patients with digestive tumors was compared using standardized mean difference and 95% confidence intervals (95% CI). RESULTS A total of 18 articles were included, and we found that exercise had beneficial effects on cancer-related fatigue (CRF) in patients with digestive tumors. Fifteen studies that met the ACSM recommendations were grouped eventually. Eight studies were classified as high compliance and 7 studies as low compliance. The CRF was improved significantly in the high compliance (- 1.89; 95% [CI], - 2.93 to - 0.86) compared with the low compliance (- 1.43; 95% [CI], - 2.25 to - 0.61). CONCLUSION Exercise intervention with high compliance showed a more significant improvement in fatigue in patients with digestive tumors compared with low compliance. However, these studies have not yet been fully uniform for the scoring tool for CRF, and further studies are needed to validate these findings. IMPLICATIONS FOR CANCER SURVIVORS Compared with low compliance, exercise intervention with high compliance has shown a more significant improvement in fatigue among patients with digestive tumors. In addition, the beneficial effects of high compliance with exercise intervention on fatigue in patients with digestive tumors also provide important implications for cancer survivors. Regular exercise that conforms to the American College of Sports Medicine (ACSM) recommendations, especially maintaining high compliance, can serve as an effective strategy to alleviate cancer-related fatigue and improve the quality of life of survivors. However, these studies have not yet been fully unified in the scoring tools for cancer-related fatigue (CRF), and further research is needed to validate these findings.
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Affiliation(s)
- Meng Liang
- Department of Hepatobiliary Surgery, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Zheng Liu
- Department of Gastroenterology, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Rui Zhang
- Department of Hepatobiliary Surgery, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Nan Zhang
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Lianchi District, No. 212, Yuhua East Road, Baoding, 071000, Hebei, China.
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Shibahashi H, Ohno K, Ikeda S, Seike Y. Healthcare Service Disparities in Cancer Rehabilitation and Treatment Costs in Japan: A Cross-Sectional Analysis of National Data. Cureus 2025; 17:e80100. [PMID: 40190928 PMCID: PMC11970921 DOI: 10.7759/cureus.80100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND Cancer rehabilitation is essential for addressing the physical, psychological, and social challenges associated with cancer treatment. It plays a crucial role in mitigating functional impairment and enhancing recovery. However, the patterns of its utilization in relation to different cancer treatment modalities remain insufficiently understood. This study aimed to analyze the utilization of cancer rehabilitation in Japan and examine its association with surgery, chemotherapy, and radiation therapy. METHODS A cross-sectional study was conducted using standardized claims data ratio (SCR) scores from Japan's National Database (NDB) between 2017 and 2021. SCRs for surgery, chemotherapy, radiotherapy, and cancer rehabilitation costs were analyzed across regions. Statistical analyses included repeated-measures analysis of variance (ANOVA) and a mixed-effects model to assess the influence of treatment type on rehabilitation costs. RESULTS Surgery showed significant year-to-year differences (p < 0.05), whereas rehabilitation, radiotherapy, and chemotherapy did not. Radiotherapy (p = 0.03) and chemotherapy (p = 0.01) increased rehabilitation costs, whereas the interactions between surgery and chemotherapy (p = 0.03) and between chemotherapy and radiotherapy (p = 0.01) significantly reduced costs, suggesting the potential cost-mitigating potential of multimodal treatment strategies. CONCLUSIONS This study demonstrated that although individual cancer treatments increase rehabilitation costs, treatment interactions can help mitigate these financial burdens, highlighting the importance of integrated care. Our findings support the incorporation of rehabilitation, including multidisciplinary approaches, into cancer survivorship care. Further research is needed to optimize rehabilitation planning based on treatment interactions to improve cost-efficiency and clinical outcomes.
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Affiliation(s)
- Hirotomo Shibahashi
- Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, JPN
| | - Kanta Ohno
- Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, JPN
| | - Shinpei Ikeda
- Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, JPN
| | - Yosuke Seike
- Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, JPN
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Borsati A, Murri A, Natalucci V, Cerulli C, Barbieri E, Lucertini F, Lanza M, Parisi A, Galvani C, Buono P, Mancini A, Fischetti F, Poli L, Di Blasio A, Iannaccone A, Avancini A, Mauri C, Ferri Marini C, Grazioli E. The Effect of Exercise-Based Interventions on Health-Related Quality of Life of Patients with Hematological Malignancies: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2025; 13:467. [PMID: 40077029 PMCID: PMC11898443 DOI: 10.3390/healthcare13050467] [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: 01/10/2025] [Revised: 02/18/2025] [Accepted: 02/18/2025] [Indexed: 03/14/2025] Open
Abstract
Background/Objectives: Hematological cancers encompass a collection of heterogeneous conditions. The need for repeated treatments and prolonged hospitalization leads to a decrease in health-related quality of life. This systematic review and meta-analysis evaluate the effect of exercise interventions on functioning scales, global health status, and symptoms in patients with hematological cancers. Methods: PubMed, Web of Science, and Scopus databases were systematically screened, and randomized controlled trials were included. The primary outcome was health-related quality of life assessed through the European Organization for Research and Treatment of Cancer Quality of Life questionnaire. Meta-analysis was performed using a random-effects model and 95% confidence intervals. Results: A total of 14 trials involving 837 patients with mixed cancer types were included. Most studies evaluated exercise interventions during hospitalization, with aerobic and resistance training at moderate intensity being the most common modalities and adherence rates ranging from 28% to 100%. Exercise programs significantly improved physical (SMD 0.23; 95% CI: 0.06 to 0.40; p = 0.008), emotional (SMD 0.19; 95% CI: 0.03 to 0.36; p = 0.020) and cognitive functioning (SMD 0.20; 95% CI: 0.02 to 0.37; p = 0.026), and global health status (SMD 0.24; 95% CI: 0.03 to 0.46; p = 0.027). Significant reductions were observed in fatigue (SMD -0.33; 95% CI: -0.52 to -0.14; p = 0.001), pain (SMD -0.34; 95% CI: -0.53 to -0.15; p = 0.000), and insomnia (SMD -0.22; 95% CI: -0.41 to -0.03; p = 0.024). Heterogeneity was minimal across most domains, suggesting consistent findings. Conclusions: Exercise interventions are effective in enhancing functioning scales and global health status and reducing symptom burden in patients receiving intensive treatments. Future research is required to explore the long-term effects of exercise and develop tailored programs for specific hematologic malignancies and treatment settings.
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Affiliation(s)
- Anita Borsati
- Biomedical, Clinical and Experimental Sciences, Department of Medicine, University of Verona, 37129 Verona, Italy;
- Department of Neurosciences, Biomedicine and Movement, University of Verona, 37129 Verona, Italy; (M.L.); (A.A.)
| | - Arianna Murri
- Department of Movement, Human and Health Science, University of Rome “Foro Italico”, 00135 Roma, Italy; (A.M.); (C.C.); (A.P.); (C.M.)
| | - Valentina Natalucci
- Department of Pathophysiology and Transplantation, University of Milan, 20133 Milan, Italy;
| | - Claudia Cerulli
- Department of Movement, Human and Health Science, University of Rome “Foro Italico”, 00135 Roma, Italy; (A.M.); (C.C.); (A.P.); (C.M.)
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (E.B.); (F.L.)
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; (E.B.); (F.L.)
| | - Massimo Lanza
- Department of Neurosciences, Biomedicine and Movement, University of Verona, 37129 Verona, Italy; (M.L.); (A.A.)
| | - Attilio Parisi
- Department of Movement, Human and Health Science, University of Rome “Foro Italico”, 00135 Roma, Italy; (A.M.); (C.C.); (A.P.); (C.M.)
| | - Christel Galvani
- Exercise & Sport Science Laboratory, Department of Psychology, Università Cattolica del Sacro Cuore, 20162 Milan, Italy;
| | - Pasqualina Buono
- Department of Medical, Human Movement and Well-Being Sciences, University Parthenope, 80133 Napoli, Italy; (P.B.); (A.M.)
- CEINGE-Biotecnologie Avanzate “Franco Salvatore”, 80131 Naples, Italy
| | - Annamaria Mancini
- Department of Medical, Human Movement and Well-Being Sciences, University Parthenope, 80133 Napoli, Italy; (P.B.); (A.M.)
- CEINGE-Biotecnologie Avanzate “Franco Salvatore”, 80131 Naples, Italy
| | - Francesco Fischetti
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70121 Bari, Italy; (F.F.); (L.P.)
| | - Luca Poli
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70121 Bari, Italy; (F.F.); (L.P.)
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66013 Chieti, Italy;
| | - Alice Iannaccone
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy;
| | - Alice Avancini
- Department of Neurosciences, Biomedicine and Movement, University of Verona, 37129 Verona, Italy; (M.L.); (A.A.)
- Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37129 Verona, Italy
| | - Caterina Mauri
- Department of Movement, Human and Health Science, University of Rome “Foro Italico”, 00135 Roma, Italy; (A.M.); (C.C.); (A.P.); (C.M.)
| | - Carlo Ferri Marini
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, 9713 AV Groningen, The Netherlands;
| | - Elisa Grazioli
- Department of Movement, Human and Health Science, University of Rome “Foro Italico”, 00135 Roma, Italy; (A.M.); (C.C.); (A.P.); (C.M.)
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Li L, Wei L, Zhang J, Pu JC, Lv XM, Huang MW. Progressive functional training in patients who underwent jaw defect reconstruction using vascularized iliac flaps: A randomized controlled trial. Oral Oncol 2025; 161:107150. [PMID: 39754999 DOI: 10.1016/j.oraloncology.2024.107150] [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: 09/12/2024] [Revised: 11/18/2024] [Accepted: 12/17/2024] [Indexed: 01/06/2025]
Abstract
OBJECTIVE This trial was aimed at investigating the effects of progressive functional training on hip mobility, lower-limb stability, quality of life, and hip complications in patients who have undergone jaw defect reconstruction using vascularized iliac flaps. METHODS Patients who underwent reconstruction surgery with vascularized iliac flaps were randomly divided into control and training groups. The control group, according to routine nursing practice, only received activity and safety guidance after the operation. The training group received progressive functional training for functional exercise. The primary outcomes were donor area function-Harris hip score and the timed "Up and Go" test. Secondary outcomes were patients' quality of life, the hip visual analog scale, and other complications. Observations and evaluations were performed before the surgery and on postoperative day 7 and at months 1, 3, 6, and 12. RESULTS The donor area function and quality of life of the patients in the training group were significantly improved at 1, 3, 6, and 12 months after surgery, and the differences were statistically significant. The load-dependent pain in the training group was significantly reduced compared with that in the control group. The incidence rates of gait disturbance at postoperative months 3, and 6 in the training group were significantly lower than the corresponding rates in the control group (P < 0.05). CONCLUSION Progressive functional training can accelerate the restoration of hip function and stability of lower-limb movement, alleviate gait disorders, relieve pain, and improve patients' quality of life.
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Affiliation(s)
- Li Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
| | - Li Wei
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
| | - Jie Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
| | - Jin-Chan Pu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
| | - Xiao-Ming Lv
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
| | - Ming-Wei Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
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Wang J, Lv M, Li H, Guo D, Chu X. Effects of Exercise in Adults With Cancer Pain: A Systematic Review and Network Meta-Analysis. J Pain Symptom Manage 2025; 69:82-101. [PMID: 39218125 DOI: 10.1016/j.jpainsymman.2024.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/12/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
CONTEXT Pain is one of the most common symptoms of cancer patients, affecting the patient's physical, psychological, behavioral, social relations and other aspects. Previous studies have demonstrated that exercise is effective for cancer pain, and the optimal exercise is still unknown. OBJECTIVES This study aimed to compare the effects of different exercise interventions on cancer pain in adults. METHODS Randomized control trials identified from medical literature databases that reported effects of exercise in adults with cancer pain were included in this study. Literature screening and data extraction were conducted independently by 2 researchers. Cochrane Bias Assessment 2.0 was used to assess the quality of the literature, and Stata 15.0 software was used for Network meta-analysis. RESULTS Forty-one studies were included, involving 3537 patients with cancer pain. The types of exercise involved included aerobic exercise, medium intensity continuous training, high-intensity interval training, resistance exercise, mind-body exercise and comprehensive exercise program (CEP). The results suggested that CEP was more effective than the usual care in relieving pain intensity in cancer patients [SMD = -1.96,95% CI (-3.47, -0.44)] (SUCRA = 97.9%). Mind-body exercise outperformed usual care in reducing pain interference in cancer patients [SMD = -0.65, 95% CI (-1.21, -0.09)] (SUCRA = 83.8%). CONCLUSION Current evidence shows that CEP is the best way to relieve the pain intensity of cancer patients, and mind-body exercise is the best way to reduce pain interference of cancer patients. Due to the limited number and quality of the included studies, the above conclusions need to be further verified by more high-quality studies.
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Affiliation(s)
- Jie Wang
- School of Nursing (J.W., M.L.), Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Meiling Lv
- School of Nursing (J.W., M.L.), Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongpeng Li
- School of Sport Science (H.L.), Beijing Sport University, Beijing, China
| | - Dongqing Guo
- School of Nursing (J.W., M.L.), Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Chu
- Department of Nursing (X.C.), Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu , China.
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Warlo LS, El Bardai S, de Vries A, van Veelen ML, Moors S, Rings EH, Legerstee JS, Dierckx B. Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases: Systematic Review and Meta-Analysis. JMIR Serious Games 2024; 12:e55034. [PMID: 39419502 PMCID: PMC11528177 DOI: 10.2196/55034] [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: 12/14/2023] [Revised: 04/11/2024] [Accepted: 05/31/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Fatigue is a common and debilitating side effect of chronic diseases, significantly impacting patients' quality of life. While physical exercise and psychological treatments have been shown to reduce fatigue, patients often struggle with adherence to these interventions in clinical practice. Game-based eHealth interventions are believed to address adherence issues by making the intervention more accessible and engaging. OBJECTIVE This study aims to compile empirical evidence on game-based eHealth interventions for fatigue in individuals with chronic diseases and to evaluate their effectiveness in alleviating fatigue. METHODS A comprehensive literature search was performed across Embase, MEDLINE ALL, PsycINFO, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar in August 2021. Study characteristics and outcomes from the included studies were extracted, and a random-effects meta-analysis was conducted. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity. RESULTS Of 1742 studies identified, 17 were included in the meta-analysis. These studies covered 5 different chronic diseases: multiple sclerosis (n=10), cancer (n=3), renal disease (n=2), stroke (n=1), and Parkinson disease (n=1). All but 1 study used exergaming interventions. The meta-analysis revealed a significant moderate effect size in reducing fatigue favoring the experimental interventions (standardized mean difference [SMD] -0.65, 95% CI -1.09 to -0.21, P=.003) compared with control conditions consisting of conventional care and no care. However, heterogeneity was high (I2=85.87%). Subgroup analyses were conducted for the 2 most prevalent diseases. The effect size for the multiple sclerosis subgroup showed a trend in favor of eHealth interventions (SMD -0.47, 95% CI -0.95 to 0.01, P=.05, I2=63.10%), but was not significant for the cancer group (SMD 0.61, 95% CI -0.36 to 1.58, P=.22). Balance exercises appeared particularly effective in reducing fatigue (SMD -1.19, 95% CI -1.95 to -0.42, P=.002). CONCLUSIONS Game-based eHealth interventions appear effective in reducing fatigue in individuals with chronic diseases. Further research is needed to reinforce these findings and explore their impact on specific diseases. Additionally, there is a lack of investigation into interventions beyond exergaming within the field of game-based learning.
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Affiliation(s)
- Leonie S Warlo
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Souraya El Bardai
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Andrica de Vries
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Marie-Lise van Veelen
- Department of Neurosurgery, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Suzan Moors
- Department of Physiotherapy, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Edmond Hhm Rings
- Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry and Specialized Youth Care, Amsterdam, Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
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Ee C, Kay S, Reynolds A, Lovato N, Lacey J, Koczwara B. Lifestyle and integrative oncology interventions for cancer-related fatigue and sleep disturbances. Maturitas 2024; 187:108056. [PMID: 38981156 DOI: 10.1016/j.maturitas.2024.108056] [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: 12/18/2023] [Revised: 03/19/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024]
Abstract
Fatigue, insomnia and sleep disturbances are common after cancer diagnosis, and have a negative impact on quality of life and function. This narrative review synthesised evidence on lifestyle and integrative oncology interventions for cancer-related fatigue, insomnia and sleep disturbances in cancer survivors. There is strong evidence in support of aerobic and strength exercise for the relief of cancer-related fatigue. Yoga, massage therapy, acupuncture, Tai Chi and qigong can also be recommended for cancer-related fatigue. The evidence on yoga, acupuncture and massage therapy for sleep disturbances in cancer is mixed, while exercise appears to have a modest favourable effect. There is insufficient evidence on nutrient supplements or dietary interventions for cancer-related fatigue or insomnia and other sleep disturbances after cancer. Beyond alleviating cancer-related fatigue and insomnia-related symptoms, integrative oncology and lifestyle interventions have potential to effect multiple other benefits, such as improvement in symptoms such as pain and menopausal symptoms. There is a need for well-designed randomised controlled trials of interventions, particularly in the areas of diet and nutrient supplements, and for implementation studies of interventions already supported by evidence.
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Affiliation(s)
- Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse, PO Box M33, Missenden Road, Camperdown, NSW 2050, Australia; Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Translational Health Institute, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia.
| | - Shelley Kay
- Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse, PO Box M33, Missenden Road, Camperdown, NSW 2050, Australia.
| | - Amy Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Adelaide Institute for Sleep Health, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.
| | - Nicole Lovato
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Adelaide Institute for Sleep Health, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.
| | - Judith Lacey
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse, PO Box M33, Missenden Road, Camperdown, NSW 2050, Australia; School of Medicine, University of Sydney, NSW 2006, Australia.
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Department of Medical Oncology, Flinders Medical Centre, Flinders Drive, Bedford Park 5042, South Australia, Australia.
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He D, Zhang C, Li R, Zhang X. Baduanjin exercise for negative emotion of patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer 2024; 32:608. [PMID: 39172232 DOI: 10.1007/s00520-024-08804-9] [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: 05/24/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION Baduanjin was also called Eight Brocades (EB), a branch of Qigong exercise, is classified as a mild-to-moderate intensity aerobic exercise. It has been theorized that regular practice of EB can alleviate anxiety and depression in patients undergoing chemotherapy; however, there are currently no comprehensive quantitative reviews on the efficacy of EB for this population. Therefore, this meta-analysis aims to investigate the effects of EB on chemotherapy-treated patients. METHODS Eight electronic databases were searched from their inception until February 15, 2024, to identify relevant studies. The inclusion and exclusion criteria were applied to filter the retrieved studies. Outcomes were various quantitative assessments. This systematic review was registered in the PROSPERO Registry (registration number CRD42023466630). RESULTS Nine randomized controlled trials (RCTs) met eligibility criteria (n = 704). The meta-analysis results demonstrated that EB significantly reduced levels of anxiety and depression. Subgroup analysis revealed that the intervention frequency of 1 time/day had a greater effect on the improvement of negative emotions, compared with 2 times/day and 5 times/week. The intervention duration of 4 weeks showed more efficacy in reducing depression scores than 12 weeks or 16 weeks; however, no statistical difference was observed for anxiety scores. CONCLUSION EB exercise can reduce depression and anxiety symptoms in chemotherapy-treated patients. However, the results should be interpreted with caution as existing methodological limitations. The findings provided insights into the development of public health initiatives to improve the negative emotion among chemotherapy-treated patients by EB exercise.
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Affiliation(s)
- Dongwan He
- Jilin Province Tumor Hospital, Changchun, China.
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12
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Corso-Amado C, Muñoz-Rodríguez D, Hormiga-Sánchez C. [Self-sense and experiences of physical activity in breast cancer survivors: Qualitative evidence synthesis]. Rehabilitacion (Madr) 2024; 58:100851. [PMID: 38703489 DOI: 10.1016/j.rh.2024.100851] [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: 02/05/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 05/06/2024]
Abstract
Breast cancer has a high incidence rate and a negative impact on women's lives. The practice of physical activity (PA) has shown strong evidence in controlling the side effects associated with the disease and its treatment. However, having an active lifestyle is influenced by socio-health inequities. The objective was to analyze the categories related to the meanings and perceived experiences with PA in breast cancer survivors (BCS). Protocol https://osf.io/7fwbs/. Articles describing the meanings of PA in BCS published after 2010 were included. Fourteen articles were analyzed using line-by-line coding. The emerging categories were: 1)PA as a strategy to re-signify and empower the body. 2)Cancer means a change in PA trajectories. 3)PA is a tool for a healthy and functional body in everyday life.
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Affiliation(s)
- C Corso-Amado
- Facultad de Medicina, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia.
| | - D Muñoz-Rodríguez
- Facultad de Fisioterapia, Universidad CES, Medellín, Antioquia, Colombia
| | - C Hormiga-Sánchez
- Facultad de Medicina, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
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Baumann FT, Jensen W, Berling-Ernst A, Theurich S, Leitzmann M, Götte M. Exercise Therapy in Oncology—the Impact on Quality of Life and Side Effects. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:331-337. [PMID: 38509786 PMCID: PMC11413772 DOI: 10.3238/arztebl.m2024.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The diagnosis and treatment of cancer are highly stressful. Exercise therapy is often used to mitigate the adverse effects of treatment. But how good is the evidence base, and what has changed in recent years? In this narrative review, we present the current data and what it implies for the care of adults with cancer. METHODS This review is based on data from meta-analyses and systematic reviews concerning 16 relevant clinical endpoints (outcomes) of exercise therapy for cancer patients. RESULTS The literature evaluated for this paper reveals that targeted exercise therapy is feasible and safe under appropriate supervision. It is highly effective for improving eight endpoints (anxiety, depression, fatigue, quality of life, physical function, secondary lymphedema after breast cancer, urinary incontinence, post-mastectomy pain syndrome in breast cancer) and may also have a beneficial effect on sleep quality, cardiotoxicity, and cognitive function. Less conclusive studies are currently available with respect to chemotherapy-induced polyneuropathy, nausea/vomiting, and bone health. There is currently insufficient data to suggest any benefit with respect to sexual function and risk factors for falling. CONCLUSION The data shows that exercise therapy for cancer patients is safe and has manifold effects on selected clinically relevant parameters. Further studies should be performed regarding the possible utility of exercise therapy against treatment-related side effects for which the evidence is currently insufficient. On the basis of the currently available and already existing recommendations, quality-assured exercise therapy can be recommended to cancer patients suffering from a wide range of neoplastic conditions.
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Affiliation(s)
- Freerk T. Baumann
- Working Group Oncological Exercise Medicine, Department I of Internal Medicine, University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Cologne
| | - Wiebke Jensen
- Universitätsklinikum Hamburg-Eppendorf, Hubertus Wald Tumor Center, University Cancer Center Hamburg (UCCH)
| | - Anika Berling-Ernst
- Working Group Oncological Exercise Medicine, Department I of Internal Medicine, University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Cologne
| | - Sebastian Theurich
- Department of Medicine III, University Hospital, Ludwig Maximilians University (LMU) Munich, Cancer and Immunometabolism Research Group, Munich, Gene Center, Munich
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg
| | - Miriam Götte
- West German Cancer Center, University Hospital Essen
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Xin X, Huang L, Pan Q, Zhang J, Hu W. The effect of self-designed metabolic equivalent exercises on cancer-related fatigue in patients with gastric cancer: A randomized controlled trial. Cancer Med 2024; 13:e7085. [PMID: 38716637 PMCID: PMC11077428 DOI: 10.1002/cam4.7085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 02/02/2024] [Accepted: 02/26/2024] [Indexed: 05/12/2024] Open
Abstract
AIMS To investigate the effect of Self-designed Metabolic Equivalent Exercises (SMEE) on cancer-related fatigue in patients with gastric cancer. METHODS 130 patients with gastric cancer admitted to Department of Oncology of a tertiary hospital in Shanghai were enrolled and assessed for eligibility. After excluding 1 patient who declined to participate, 129 eligible patients were randomly assigned into SMEE (n = 65) and control (n = 64) groups. The Revised Piper Fatigue Scale (RPFS) and EORTC QLQ-C30 Quality of Life Scale were used to measure cancer-caused fatigue and quality of life, respectively, in both groups at the first admission and after 3 months. RESULTS After excluding patients who did not receive allocated intervention due to medical (n = 3) and personal (n = 2) reasons, those who were lost to follow-up (n = 3), and those who had discontinued intervention (n = 2), 119 patients (64 in the SMEE group and 55 in the control group) were included for analysis. There were no statistically significant differences in the RPFS or QLQ-C30 score between the two groups at baseline. After 3 months, the total RPFS score of the SMEE group was significantly lower than that of the control group (2.86 ± 1.75 vs. 4.65 ± 1.29, p = 0.009), with significant improvements in affective meaning (0.83 ± 0.92 vs. 1.13 ± 0.77, p = 0.044) and sensory (0.70 ± 0.71 vs. 1.00 ± 0.54, p < 0.001) subscales; in the SMEE group, QLQ-C30 scores in somatic (2.00 ± 0.27 vs. 1.31 ± 0.26, p < 0.001), emotional (2.67 ± 0.58 vs. 2.07 ± 0.48, p < 0.001), and social (3.23 ± 0.58 vs. 1.64 ± 0.51, p < 0.001) functioning were significantly higher than those in the control group, with significant improvements in fatigue (p < 0.001), nausea/vomiting (p = 0.014), shortness of breath (p < 0.001), constipation (p < 0.001), and diarrhea (p = 0.001) dimensions. CONCLUSION The self-programmed metabolic equivalent manipulation as an exercise intervention could effectively reduce the degree of cancer-caused fatigue and improve quality of life in patients with gastric cancer.
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Affiliation(s)
- Xiao Xin
- Medical Center on Aging of Ruijin Hospital, MCARJH, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Huang
- Medical Center on Aging of Ruijin Hospital, MCARJH, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Pan
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiguo Hu
- Medical Center on Aging of Ruijin Hospital, MCARJH, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Fernández-Sánchez J, Trujillo-Colmena D, Rodríguez-Castaño A, Lavín-Pérez AM, Del Coso J, Casado A, Collado-Mateo D. Effects of exercise on life satisfaction of people diagnosed with cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:297. [PMID: 38637349 PMCID: PMC11026230 DOI: 10.1007/s00520-024-08486-3] [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: 12/13/2023] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE A cancer diagnosis is commonly associated with a decline in patient's life satisfaction and more pessimistic expectations about the future. The identification of strategies to improve life satisfaction in patients with cancer is of great interest to health practitioners since it may be associated with a better prognosis of cancer and higher survival rates. Previous meta-analyses and reviews concluded that exercise could significantly improve health-related quality of life in this population, but the effects of exercise on life satisfaction are still not well-known. This review aims to analyse the effects of exercise programs on life satisfaction in people with cancer and individuals who have overcome cancer. METHODS The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A thorough search of databases including Web of Science and PubMed/MEDLINE was carried out. Six studies (535 participants) in which the effect of an exercise program was compared to a non-exercise program control condition in patients with cancer were considered eligible. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI). RESULTS Exercise intervention improved satisfaction with life compared with a control condition (SMD = 1.28; p = 0.02 with a 95% CI of 0.22 to 2.34). CONCLUSION Exercise could be considered an effective tool to improve life satisfaction in patients with cancer. Hence, professionals might consider the possibility of integrating physical exercise into strategies aimed at enhancing the low life satisfaction often experienced by patients. PROSPERO CRD42023438146.
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Affiliation(s)
| | | | | | - Ana Myriam Lavín-Pérez
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain.
- GO fitLAB, Ingesport, Madrid, Spain.
| | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Arturo Casado
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Daniel Collado-Mateo
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
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Munsie C, Ebert J, Joske D, Collins J, Ackland T. The potential impact of exercise upon symptom burden in adolescents and young adults undergoing cancer treatment. Support Care Cancer 2024; 32:293. [PMID: 38632192 PMCID: PMC11023984 DOI: 10.1007/s00520-024-08497-0] [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: 07/21/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Adolescents and young adults (AYAs) experience vast symptom burden resulting from cancer treatment-related toxicities (TRTs). Evidence supports integrated exercise to mitigate several TRTs in other cohorts; however, evidence in AYAs is lacking. Conventional reporting of TRTs adopts a maximum grade approach failing to recognise the trajectory over time, of persistent, or lower grade toxicities. Alternatively, longitudinal analysis of toxicities over time (ToxT) may provide clinically meaningful summaries of this data. We evaluated the longitudinal impact of an exercise intervention on TRTs in AYAs undergoing cancer treatment. METHODS A prospective, randomised trial allocated participants to a 10-week exercise intervention (EG) or control group (CG) undergoing usual care. Detailed information on TRTs was collected throughout the intervention. All TRTs were graded per the Common Terminology Criteria for Adverse Events (CTCAE v5.0). RESULTS Forty-three (43) participants (63% male, mean age 21.1 years) were enrolled. When categorised to reflect the maximal worst grade experienced (Grade 0, Grade 1-2 and ≥ Grade 3), the CG reported an increased incidence of severe fatigue (≥ Grade 3) compared with the EG (p = 0.05). No other differences between groups were evident (p > 0.05). ToxT analysis of the four most common toxicities (fatigue, pain, nausea and mood disturbances) demonstrated no difference in the mean grade of each over time (p > 0.05). CONCLUSION A 10-week exercise intervention reduces the severity of fatigue in AYAs undergoing treatment. While the ToxT approach provided insight into the toxicity profile, adequately powered studies are needed to better understand these differences within a homogenous sample. TRIAL REGISTRATION (ACTRN12620000663954) 10th June 2020.
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Affiliation(s)
- Claire Munsie
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.
- WA Youth Cancer Service, Locked Bag 2012, Nedlands, Perth, Western Australia, 6009, Australia.
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
| | - Jay Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - David Joske
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Jo Collins
- WA Youth Cancer Service, Locked Bag 2012, Nedlands, Perth, Western Australia, 6009, Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Timothy Ackland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
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Austin PD, Lee W, Costa DSJ, Ritchie A, Lovell MR. Efficacy of aerobic and resistance exercises on cancer pain: A meta-analysis of randomised controlled trials. Heliyon 2024; 10:e29193. [PMID: 38623224 PMCID: PMC11016720 DOI: 10.1016/j.heliyon.2024.e29193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/19/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
Purpose To evaluate effects of aerobic and resistance exercises for cancer-related pain in adults with and surviving cancer. Secondary objectives were to a) evaluate the effect of exercise on fatigue, psychological function, physical function, b) assess fidelity to exercise. Design A systematic search of MEDLINE, EMBASE, AMED, CINAHL and Cochrane Central Register of Controlled Trials was conducted to identify randomised controlled trials (RCTs) comparing aerobic and/or resistance exercise to control groups. The primary endpoint were changes in cancer-related pain intensity from baseline to post intervention. Meta-regression analysis evaluated predictors for heterogeneity between study findings. Tolerability was defined as reporting of exercise-induced adverse events while fidelity evaluated by reported intervention dropout. Results Twenty-three RCTs including 1954 patients (age 58 ± 8.5 years; 78 % women); 1087 (56 %) and 867 (44 %) allocated to aerobic/resistance exercise therapy and control group, respectively. Exercise therapy was associated with small to moderate decreases in cancer-related pain compared to controls (SMD = 0.38, 95 % CI: 0.17, 0.58). Although there was significant heterogeneity between individual and pooled study effects (Q = 205.25, p < 0.0001), there was no publication bias. Meta-regression including supervision, age, duration and exercise type as moderators showed no significant differences in reported outcomes. Analysis of secondary outcomes revealed a moderate effect for improvements in physical function, fatigue and psychological symptoms. Conclusions Aerobic and resistance exercises are tolerable and effective adjunct therapies to reduce cancer-related pain while also improving physical function, fatigue and mood. Future RCTs of dose, frequency, compliance and exercise type in specific cancer settings are required.
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Affiliation(s)
- Philip D. Austin
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
| | - Wei Lee
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
- Improving Care for Palliative Aged, and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Daniel SJ. Costa
- Sydney Medical School-Northern, University of Sydney, Sydney, New South Wales, Australia
- Kolling Institute, Northern Sydney Local Health District, Sydney, NSW, Australia
- School of Psychology, University of Sydney, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Alison Ritchie
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
| | - Melanie R. Lovell
- Department of Palliative Care, HammondCare, Greenwich Hospital, Sydney, New South Wales, Australia
- Sydney Medical School-Northern, University of Sydney, Sydney, New South Wales, Australia
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Moraitis AM, Iacob E, Wong B, Beck SL, Echeverria C, Donaldson G, Mooney K. Pairing automated exercise coaching with patient-reported symptom monitoring: A way to nudge exercise uptake during cancer treatment? Support Care Cancer 2024; 32:258. [PMID: 38558321 DOI: 10.1007/s00520-024-08450-1] [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: 11/22/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Symptoms during cancer treatment cause burden, diminished physical functioning, and poor quality of life. Exercise is recommended during treatment to mitigate symptoms; however, interventions are difficult to translate into clinical care due to the lack of patient uptake and clinical implementation barriers. We evaluated the uptake, acceptability, and impact of an automated ePRO exercise module triggered by three patient-reported symptoms: nausea/vomiting, fatigue, and anxiety, during chemotherapy. METHODS We conducted a secondary analysis of an exercise module intervention imbedded in the cancer symptom monitoring and management platform, Symptom Care at Home (SCH). Utilizing behavioral economics principles, the exercise module was triggered when any of the three symptoms were reported. Once triggered, participants were coached on exercise benefits for symptom reduction and then offered the opportunity to set weekly exercise goals plus tracking of the goal outcomes and receive further encouragement. We examined uptake, exercise goal setting and attainment, and symptom impact. RESULTS Of 180 SCH participants receiving the SCH intervention, 170 (94.4%) triggered the exercise module and 102 of the 170 (60%) accepted the module, setting goals on average for 6.3 weeks. Of 102 participants, 82 (80.4%) achieved one or more exercise goals, exercising on average 79.8 min/week. Participants who achieved a higher proportion of goals had statistically significant lower overall symptom severity and lower severity of the triggered symptom. CONCLUSION An automated mHealth exercise coaching intervention, aimed to nudge those receiving chemotherapy to initiate an exercise routine had significant uptake, is acceptable and may reduce symptom severity. TRIAL REGISTRATION NCT01973946.
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Affiliation(s)
- Ann Marie Moraitis
- Dana Farber Cancer Institute, Department of Pediatric Oncology, Boston, MA, USA.
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Susan L Beck
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Gary Donaldson
- Pain Research Center, Department of Anesthesiology, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Kathi Mooney
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
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Su CC, Guo SE, Kuo YW. Effects of internet-based digital health interventions on the physical activity and quality of life of colorectal cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2024; 32:168. [PMID: 38374448 DOI: 10.1007/s00520-024-08369-7] [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: 07/07/2023] [Accepted: 02/11/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE The recent trend of Internet-based digital health interventions has driven researchers to implement them to promote physical activity (PA) and improve patients' health outcomes. This systematic review and meta-analysis aim to evaluate the effects of Internet-based digital health interventions on PA and quality of life (QoL) in colorectal cancer (CRC) survivors. METHODS We searched for relevant studies investigating the effects of internet-based digital health interventions published until Dec. 2022 in electronic databases (PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and CEPS) according to PRISMA guidelines. The Joanna Briggs Institute critical appraisal checklist was used to examine the quality of the included studies. We performed the fixed and random effects model for meta-analysis. RESULTS Among 746 identified studies, eight published between 2018 and 2022 were included. These covered 991 internet-based digital health interventions and 875 controls. After 6 months of internet-based digital health interventions, CRC survivors' performance in PA (standardized mean difference (SMD) = 0.23, 95% confidence interval [CI] = 0.09-0.38) and QoL (SMD = 0.11, 95% CI = 0.01-0.22) indicators improved significantly. CONCLUSIONS Internet-based digital health improved the PA behaviour and QoL of patients with CRC. Because of differences in intervention outcomes, additional randomized controlled trials are warranted to provide suggestions for clinical practice. Internet-based digital health interventions are promising for promoting PA in CRC survivors.
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Affiliation(s)
- Ching-Ching Su
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan
- Department of Hematology and Oncology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan
| | - Su-Er Guo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan.
- Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, No. 84 Gungjuan Rd., Taishan Dist., New Taipei City, 24301, Taiwan.
| | - Ya-Wen Kuo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Department of Neurology, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan.
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Ispoglou T, McCullough D, Windle A, Nair S, Cox N, White H, Burke D, Kanatas A, Prokopidis K. Addressing cancer anorexia-cachexia in older patients: Potential therapeutic strategies and molecular pathways. Clin Nutr 2024; 43:552-566. [PMID: 38237369 DOI: 10.1016/j.clnu.2024.01.009] [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: 11/03/2022] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Cancer cachexia (CC) syndrome, a feature of cancer-associated muscle wasting, is particularly pronounced in older patients, and is characterised by decreased energy intake and upregulated skeletal muscle catabolic pathways. To address CC, appetite stimulants, anabolic drugs, cytokine mediators, essential amino acid supplementation, nutritional counselling, cognitive behavioural therapy, and enteral nutrition have been utilised. However, pharmacological treatments that have also shown promising results, such as megestrol acetate, anamorelin, thalidomide, and delta-9-tetrahydrocannabinol, have been associated with gastrointestinal and cardiovascular complications. Emerging evidence on the efficacy of probiotics in modulating gut microbiota also presents a promising adjunct to traditional therapies, potentially enhancing nutritional absorption and systemic inflammation control. Additionally, low-dose olanzapine has demonstrated improved appetite and weight management in older patients undergoing chemotherapy, offering a potential refinement to current therapeutic approaches. This review aims to elucidate the molecular mechanisms underpinning CC, with a particular focus on the role of anorexia in exacerbating muscle wasting, and to propose pharmacological and non-pharmacological strategies to mitigate this syndrome, particularly emphasising the needs of an older demographic. Future research targeting CC should focus on refining appetite-stimulating drugs with fewer side-effects, specifically catering to the needs of older patients, and investigating nutritional factors that can either enhance appetite or minimise suppression of appetite in individuals with CC, especially within this vulnerable group.
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Affiliation(s)
| | | | - Angela Windle
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK; School of Medicine, University of Leeds, Leeds, UK
| | | | - Natalie Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Helen White
- School of Health, Leeds Beckett University, Leeds, UK
| | - Dermot Burke
- School of Medicine, University of Leeds, Leeds, UK
| | | | - Konstantinos Prokopidis
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
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21
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Rosebrock K, Sinn M, Uzunoglu FG, Bokemeyer C, Jensen W, Salchow J. Effects of Exercise Training on Patient-Specific Outcomes in Pancreatic Cancer Patients: A Scoping Review. Cancers (Basel) 2023; 15:5899. [PMID: 38136443 PMCID: PMC10741570 DOI: 10.3390/cancers15245899] [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: 10/31/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND International guidelines have already highlighted the beneficial effects of exercise in common cancer entities. However, specific recommendations for pancreatic cancer are still missing. This scoping review aimed to evaluate the impact of exercise training on patient-specific outcomes in pancreatic cancer patients. METHODS A literature search was undertaken using PubMed, Web of Science, and Cochrane Library. We included randomized controlled trials (RCTs) published before August 2023 with structured exercise interventions during or after pancreatic cancer treatment. RESULTS Seven articles that prescribed home-based or supervised exercise with aerobic or resistance training or both were reviewed. The results indicate that exercise is feasible and safe in pancreatic cancer patients. Furthermore, exercise was associated with improved quality of life, cancer-related fatigue, and muscle strength. Concerning other outcomes, heterogeneous results were reported. We identified a lack of evidence, particularly for patients with advanced pancreatic cancer. CONCLUSION Exercise interventions in pancreatic cancer patients are feasible and can lead to improved quality of life, cancer-related fatigue, and muscle strength. However, further studies with larger sample sizes are needed to clarify the potential of exercise in pancreatic cancer, in particular for advanced stages.
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22
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Sturgeon KM, Kok DE, Kleckner IR, Guertin KA, McNeil J, Parry TL, Ehlers DK, Hamilton A, Schmitz K, Campbell KL, Winters‐Stone K. Updated systematic review of the effects of exercise on understudied health outcomes in cancer survivors. Cancer Med 2023; 12:22278-22292. [PMID: 38018376 PMCID: PMC10757127 DOI: 10.1002/cam4.6753] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/22/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION The American College of Sports Medicine provided guidelines for exercise prescriptions in cancer survivors for specific cancer- and treatment-related health outcomes. However, there was insufficient evidence to generate exercise prescriptions for 10 health outcomes of cancer treatment. We sought to update the state of evidence. METHODS We conducted a systematic review of these 10 understudied health outcomes (bone health, sleep, cardiovascular function, chemotherapy-induced peripheral neuropathy (CIPN), cognitive function, falls and balance, nausea, pain, sexual function, and treatment tolerance) and provided an update of evidence. RESULTS While the evidence base for each outcome has increased, there remains insufficient evidence to generate exercise prescriptions. Common limitations observed across outcomes included: variability in type and quality of outcome measurement tools, variability in definitions of the health outcomes, a lack of phase III trials, and a majority of trials investigating breast or prostate cancer survivors only. CONCLUSION We identified progress in the field of exercise oncology for several understudied cancer- and treatment-related health outcomes. However, we were not able to generate exercise prescriptions due to continued insufficient evidence base. More work is needed to prescribe exercise as medicine for these understudied health outcomes, and our review highlights several strategies to aid in research acceleration within these areas of exercise oncology.
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Affiliation(s)
- Kathleen M. Sturgeon
- Department of Public Health SciencesCollege of Medicine, Penn State UniversityHersheyPennsylvaniaUSA
| | - Dieuwertje E. Kok
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Ian R. Kleckner
- Department of Pain & Translational Symptom Science, School of NursingUniversity of Maryland BaltimoreBaltimoreMarylandUSA
| | - Kristin A. Guertin
- Department of Public Health SciencesUniversity of Connecticut HealthStorrsConnecticutUSA
| | - Jessica McNeil
- Department of Kinesiology, School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNorth CarolinaUSA
| | - Traci L. Parry
- Department of Kinesiology, School of Health and Human SciencesUniversity of North Carolina at GreensboroGreensboroNorth CarolinaUSA
| | - Diane K. Ehlers
- Division of Epidemiology, Department of Quantitative Health SciencesMayo Clinic ArizonaPhoenixArizonaUSA
| | - Andrew Hamilton
- Oregon Health & Science University, LibraryPortlandOregonUSA
| | - Kathryn Schmitz
- Division of Hematology/Oncology, University of Pittsburgh School of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kristin L. Campbell
- Department of Physical TherapyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Kerri Winters‐Stone
- Division of Oncological Sciences, School of MedicineOregon Health & Science UniversityPortlandOregonUSA
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23
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Van Dijck S, De Groef A, Kothari J, Dams L, Haenen V, Roussel N, Meeus M. Barriers and facilitators to physical activity in cancer survivors with pain: a systematic review. Support Care Cancer 2023; 31:668. [PMID: 37922014 DOI: 10.1007/s00520-023-08141-3] [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: 05/31/2023] [Accepted: 10/23/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE Pain post-treatment is a debilitating symptom in the growing population of cancer survivors. While physical activity is an integral part of pain management, low levels of physical activity are often observed in this population. The aim of this systematic review is to gain insight into the barriers and facilitators to physical activity in cancer survivors afflicted with pain. METHODS In December 2021, a systematic search was conducted using PubMed and Web of Science. All studies exploring barriers and/or facilitators to physical activity in cancer survivors with pain were included. The methodological quality of the evidence was appraised with the Mixed Methods Appraisal Tool (version 2018). RESULTS Six articles were included. Current literature was limited and mostly focused on female breast cancer survivors. The identified barriers and facilitators could be categorized into six different domains: the logistical, symptoms, cognitive, clinical, social, and knowledge domain. The barrier of pain was reported as a barrier on its own that is closely linked to other barriers in this specific population. CONCLUSION Barriers and facilitators to physical activity were categorized in six different domains. The barrier of pain distinguishes itself and brings along additional obstacles such as anxiety, fear, and avoidance behavior. Current evidence is limited and focuses mostly on female breast cancer survivors. Further research in larger cohorts representing various subsets of cancer survivors with pain is warranted, as well as studies that implement these insights in physical activity interventions.
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Affiliation(s)
- Sophie Van Dijck
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium.
- Pain in Motion International Research Group, Brussels, Belgium.
| | - An De Groef
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Louvain, Belgium
| | - Janan Kothari
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Lore Dams
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Louvain, Belgium
| | - Vincent Haenen
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Louvain, Belgium
| | - Nathalie Roussel
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
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24
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Wang L, Quan M, Nieman DC, Li F, Shi H, Bai X, Xiong T, Wei X, Chen P, Shi Y. Effects of High-Intensity Interval Training and Combined High-Intensity Interval Training Programs on Cancer-Related Fatigue and Cancer Pain: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2023; 55:1620-1631. [PMID: 37126034 DOI: 10.1249/mss.0000000000003191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE This systematic review and meta-analysis assessed the effectiveness of high-intensity interval training (HIIT) alone and combined HIIT programs compared with usual care on cancer-related fatigue (CRF) and pain related to cancer or cancer-related treatments. METHODS Articles published prior to January 2023 were searched in the following digital databases: PubMed, Cochrane Database of Systematic Reviews and Cochrane Controlled Clinical Trials (CENTRAL), Web of Science, Scopus and ScienceDirect. Randomized controlled trials were included that met the following criteria: (i) adult cancer patients and survivors (>18 yr old); (ii) HIIT or combined HIIT programs versus usual care; (iii) assessment of fatigue and pain. Cochrane tool was used for assessing Risk of Bias (RoB) and Review Manager (RevMan 5.2) was used for data analysis. RESULTS Based on limited number (12) of studies included, we found HIIT and combined HIIT interventions have significant effect sizes on reducing both CRF (standardized mean difference, 0.63; 95% confidence interval, 0.42-0.84; P < 0.001) and cancer-associated pain (standardized mean difference, 0.44; 95% confidence interval, 0.25-0.63; P < 0.001). CONCLUSIONS This systematic review and meta-analysis indicate that HIIT and combined HIIT programs can reduce CRF and pain.
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Affiliation(s)
- Lezheng Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, CHINA
| | - Minghui Quan
- School of Kinesiology, Shanghai University of Sport, Shanghai, CHINA
| | - David C Nieman
- North Carolina Research Campus, Appalachian State University, Kannapolis, NC
| | - Fei Li
- School of Athletics, Shanghai University of Sport, Shanghai, CHINA
| | - Hui Shi
- Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, CHINA
| | - Xinyue Bai
- School of Kinesiology, Shanghai University of Sport, Shanghai, CHINA
| | - Ting Xiong
- School of Kinesiology, Shanghai University of Sport, Shanghai, CHINA
| | - Xingyi Wei
- School of Kinesiology, Shanghai University of Sport, Shanghai, CHINA
| | - Peijie Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai, CHINA
| | - Yue Shi
- School of Athletics, Shanghai University of Sport, Shanghai, CHINA
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Yenson VM, Amgarth-Duff I, Brown L, Caperchione CM, Clark K, Cross A, Good P, Landers A, Luckett T, Philip J, Steer C, Vardy JL, Wong AK, Agar MR. Defining research priorities and needs in cancer symptoms for adults diagnosed with cancer: an Australian/New Zealand modified Delphi study. Support Care Cancer 2023; 31:436. [PMID: 37395859 DOI: 10.1007/s00520-023-07889-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE This study asked consumers (patients, carers) and healthcare professionals (HCPs) to identify the most important symptoms for adults with cancer and potential treatment interventions. METHODS A modified Delphi study was conducted involving two rounds of electronic surveys based on prevalent cancer symptoms identified from the literature. Round 1 gathered information on participant demographics, opinions and/or experience on cancer symptom frequency and impact, and suggestions for interventions and/or service delivery models for further research to improve management of cancer symptoms. In Round 2, respondents ranked the importance of the top ten interventions identified in Round 1. In Round 3, separate expert panels of consumers and healthcare professionals (HCPs) attempted to reach consensus on the symptoms and interventions previously identified. RESULTS Consensus was reached for six symptoms across both groups: fatigue, constipation, diarrhoea, incontinence, and difficulty with urination. Notably, fatigue was the only symptom to reach consensus across both groups in Round 1. Similarly, consensus was reached for six interventions across both groups. These were the following: medicinal cannabis, physical activity, psychological therapies, non-opioid interventions for pain, opioids for breathlessness and cough, and other pharmacological interventions. CONCLUSIONS Consumers and HCPs prioritise differently; however, the symptoms and interventions that reached consensus provide a basis for future research. Fatigue should be considered a high priority given its prevalence and its influence on other symptoms. The lack of consumer consensus indicates the uniqueness of their experience and the need for a patient-centred approach. Understanding individual consumer experience is important when planning research into better symptom management.
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Affiliation(s)
- Vanessa M Yenson
- University of Technology Sydney, Sydney, NSW, Australia.
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia.
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia.
| | - Ingrid Amgarth-Duff
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Linda Brown
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Cristina M Caperchione
- University of Technology Sydney, Sydney, NSW, Australia
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Katherine Clark
- University of Technology Sydney, Sydney, NSW, Australia
- Northern Sydney Local Health District Supportive and Palliative Care Network, St Leonards, Sydney, NSW, Australia
- Northern Clinical School, The University of Sydney, St Leonards, Sydney, NSW, Australia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Andrea Cross
- Consumer Advocate, Cancer Symptom Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Phillip Good
- University of Technology Sydney, Sydney, NSW, Australia
- Palliative and Supportive Care, Mater Misericordiae, South Brisbane, QLD, Australia
- Department of Palliative Care, St Vincent's Private Hospital, Brisbane, QLD, Australia
- Mater Research - University of Queensland, South Brisbane, QLD, Australia
| | - Amanda Landers
- University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Tim Luckett
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Jennifer Philip
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of Melbourne, Palliative Medicine, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Palliative Care, Melbourne, VIC, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Christopher Steer
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of New South Wales Rural Clinical Campus, Albury-Wodonga, NSW, Australia
- Border Medical Oncology, Albury-Wodonga Regional Cancer Centre, Albury-Wodonga, NSW, Australia
| | - Janette L Vardy
- Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Aaron K Wong
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- University of Melbourne, Palliative Medicine, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Palliative Care, Melbourne, VIC, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Meera R Agar
- University of Technology Sydney, Sydney, NSW, Australia
- IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia
- Cancer Symptom Trials (CST), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- Palliative Care Clinical Studies Collaborative (PaCCSC), IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Management Advisory Committee, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- CST Scientific Advisory Committee, Cancer Symptoms Trials, IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
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Chen X, Li J, Chen C, Zhang Y, Zhang S, Zhang Y, Zhou L, Hu X. Effects of exercise interventions on cancer-related fatigue and quality of life among cancer patients: a meta-analysis. BMC Nurs 2023; 22:200. [PMID: 37312185 DOI: 10.1186/s12912-023-01363-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
PURPOSE In this study, exercise interventions were evaluated for their effects on cancer-related fatigue (CRF) and quality of life (QoL) among cancer patients. DESIGN A meta-analysis was performed. METHODS We systematically searched the PubMed/Medline, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, and CINAHL databases, and gray literature sources including the Virginia Henderson International Nursing Library and Google Scholar. This study only included randomized controlled trials (RCTs) examining how exercise interventions affect CRF and QoL among cancer patients. Based on the Cochrane Risk-of-Bias Assessment Tool, version 2 (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the methodological quality of the included studies was evaluated. In addition, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were applied to assess the intervention effect with respect to CRF and QoL. Data analysis was performed using Review Manager (version 5.4). RESULTS There were a total of 1573 participants in the 28 included articles. According to the meta-analysis, CRF (SMD = -0.35, 95% CI: -0.63 to -0.07, p = 0.01) and QoL (SMD = 0.36, 95% CI: 0.20 to 0.53, p < 0.01) were positively affected by exercise interventions. Subgroup analyses revealed considerable improvements in CRF (SMD = -0.54, 95% CI: -1.00 to -0.09, p = 0.02) and QoL (SMD = 0.38, 95% CI: 0.16 to 0.59, p < 0.01) from aerobic exercise. An intervention duration less than 12 weeks had a better effect on CRF (SMD = -0.80, 95% CI: -1.43 to -0.17, p = 0.01) and QoL (SMD = 0.53, 95% CI: 0.21 to 0.85, p < 0.01), and three times per week was the most effective frequency in improving QoL (SMD = 0.69, 95% CI: 0.28 to 1.11, p < 0.01). Exercise intervention was more successful in improving CRF (SMD = -0.66, 95% CI: -1.10 to -0.21, p < 0.01) and QoL (SMD=-0.50, 95% CI: 0.23 to 0.78, p < 0.01) in female cancer patients. Sensitivity analyses showed that the pooled outcomes were reliable and stable. CONCLUSION Exercise interventions are a workable approach to improve CRF and QoL among cancer patients. An aerobic exercise intervention of less than 12 weeks might be most effective in improving CRF and QoL, and three times per week might be the most appropriate frequency. Exercise might have a more positive effect on improving CRF and QoL in female cancer patients. Additionally, a larger number of high-quality RCTs should be conducted to further confirm the efficacy of exercise interventions on CRF and QoL among cancer patients. REGISTRATION NUMBER CRD42022351137.
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Affiliation(s)
- Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Chongcheng Chen
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China.
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Cuthbert C, Twomey R, Bansal M, Rana B, Dhruva T, Livingston V, Daun JT, Culos-Reed SN. The role of exercise for pain management in adults living with and beyond cancer: a systematic review and meta-analysis. Support Care Cancer 2023; 31:254. [PMID: 37039883 PMCID: PMC10088810 DOI: 10.1007/s00520-023-07716-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Pain is a common side effect of cancer or cancer treatment that negatively impacts biopsychosocial wellbeing and quality of life. Exercise is a potential intervention to manage pain that is safe and has multiple benefits. The objective was to determine the role of exercise in cancer pain management. METHODS We completed a systematic review and meta-analysis of exercise interventions in adults with any type or stage of cancer by searching Ovid MEDLINE®, Embase, APA PsycInfo, the Cochrane Central Register of Controlled Trials, CINAHL, and SPORTDiscus. We included experimental and quasi-experimental designs where pain was measured as an outcome. Data synthesis included narrative and tabular summary. A meta-analysis was performed on studies powered to detect the effect of exercise on pain. Study quality was evaluated using the Cochrane risk of bias tool and certainty of evidence was evaluated using the GRADE tool. RESULTS Seventy-six studies were included. Studies were predominantly conducted in breast cancer and exercise usually included a combination of aerobic and strength training. Ten studies were included in the meta-analysis demonstrating a significant effect for exercise in decreasing pain (estimated average standard mean difference (SMD) was g = - 0.73 (95% CI: - 1.16 to - 0.30)); however, the overall effect prediction interval was large. Overall risk of bias for most studies was rated as some concerns and the grading of evidence certainty was low. CONCLUSION There are limitations in the evidence for exercise to manage cancer-related pain. Further research is needed to understand the role of exercise in a multimodal pain management strategy.
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Affiliation(s)
- Colleen Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Rosie Twomey
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Benny Rana
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Tana Dhruva
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | | | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - S Nicole Culos-Reed
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada
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Shirazipour CH, Raines C, Diniz MA, Salvy SJ, Haile RW, Freedland SJ, Asher A, Tomasone JR, Gresham G. The 24-Hour Movement Paradigm: An integrated approach to the measurement and promotion of daily activity in cancer clinical trials. Contemp Clin Trials Commun 2023; 32:101081. [PMID: 36875555 PMCID: PMC9974421 DOI: 10.1016/j.conctc.2023.101081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/11/2023] [Accepted: 01/28/2023] [Indexed: 02/02/2023] Open
Abstract
Increased physical activity (PA), improved sleep, and decreased sedentary behavior (SB) are essential components of supportive care for cancer survivors. However, researchers and health care professionals have achieved limited success in improving these behaviors among cancer survivors. One potential reasoning is that, over the past two decades, guidelines for promoting and measuring PA, sleep, and SB have been largely siloed. With greater understanding of these three behaviors, health behavior researchers have recently developed a new paradigm: the 24-Hour movement approach. This approach considers PA, SB, and sleep as movement behaviors along a continuum that represent low through vigorous intensity activity. Together these three behaviors form the sum of an individual's movement across a 24-hour day. While this paradigm has been studied in the general population, its usage is still limited in cancer populations. Here, we seek to highlight (a) the potential benefits of this new paradigm for clinical trial design in oncology; (b) how this approach can allow for greater integration of wearable technology as a means of assessing and monitoring patient health outside the clinical setting, improving patient autonomy through self-monitoring of movement behavior. Ultimately, implementation of the 24-Hour movement paradigm will allow health behavior research in oncology to better promote and assess critical health behaviors to support the long-term well-being for cancer patients and survivors.
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Affiliation(s)
- Celina H. Shirazipour
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
- University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Sarah-Jeanne Salvy
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Arash Asher
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Li S, Gao Y, Lin Y, Wu W, Fang Q, Ni X, Zhou Y, Hong M, Zhang R, Lou Y. Development and preliminary testing of the cancer-related fatigue comprehensive assessment scale in cancer survivors. J Clin Nurs 2023; 32:1186-1217. [PMID: 35285109 DOI: 10.1111/jocn.16272] [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: 09/07/2021] [Revised: 01/19/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tailored management of cancer-related fatigue (CRF) is important for effective coping; however, it has been hindered by the lack of a comprehensive tool that assesses both symptoms and treatable influencing factors. AIMS AND OBJECTIVES The aim was to develop a cancer-related fatigue comprehensive assessment scale (CRF-CAS) and assess its psychometric properties. DESIGN This was a mixed-method study. METHODS The study included two phases which were conducted in Zhejiang Province, China. In phase one, a literature search, brainstorming sessions, Delphi studies, cognitive interviews and a pilot study were conducted to construct and revise CRF-CAS indicators. In phase two, a questionnaire-based survey was conducted among cancer survivors. Item analysis was used to select and optimize indicators. Cronbach's α was calculated for reliability analysis. Validity analysis included concurrent validity and structural validity. RESULTS A 93-item tool was initially constructed. Phase one ended with revision and optimization. The preliminary scale included five dimensions (CRF symptoms, physical activity, cognitive-emotional status, sleep status, nutritional status) and 30 items. The mean item-content validity index (I-CVI) and scale-level CVI universal agreement (S-CVI/UA) were .98, and the adjusted mean values of Kappa for indicators ranged from .91-1, as evaluated by the expert group. The Pearson correlation coefficient between the CRF-CAS and criterion scales ranged from .337-.862. Cronbach's α coefficient ranged from .624-.728. Respondents agreed that the scale was acceptable for administration and that it contributed to decision-making in fatigue management. Confirmatory factor analysis (CFA) indicated that the CRF-CAS fit well. CONCLUSIONS The construction process of the CRF-CAS, involving panel discussion and expert and participant evaluations, was shown to be scientific and feasible. The CRF-CAS had relatively good validity and reliability in version 5 of its preliminary scale, which requires further improvement in future studies.
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Affiliation(s)
- Shuaini Li
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,The Children's Hospital Zhejiang University School of Medicine (National Clinical Research Center for Child Health), Hangzhou, Zhejiang Province, China
| | - Yating Gao
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Ying Lin
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Wanying Wu
- Zhejiang Cancer Hospital (Cancer Hospital of the University of Chinese Academy of Sciences), Hangzhou, Zhejiang Province, China
| | - Qunying Fang
- Zhejiang Cancer Hospital (Cancer Hospital of the University of Chinese Academy of Sciences), Hangzhou, Zhejiang Province, China
| | - Xiaosha Ni
- Hangzhou Ninth People's Hospital, Hangzhou, Zheijiang province, China
| | - Yao Zhou
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Meirong Hong
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Ruolin Zhang
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Yan Lou
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
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30
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Morishita S, Suzuki K, Okayama T, Inoue J, Tanaka T, Nakano J, Fukushima T. Recent Findings in Physical Exercise for Cancer Survivors. Phys Ther Res 2023; 26:10-16. [PMID: 37181484 PMCID: PMC10169310 DOI: 10.1298/ptr.r0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/10/2023] [Indexed: 05/16/2023]
Abstract
In recent years, the number of cancer survivors has been increasing each year due to advances in the early diagnosis and treatment of cancer. Cancer survivors present a variety of physical and psychological complications due to cancer and its treatment. Physical exercise is an effective nonpharmacological treatment for complications in cancer survivors. Furthermore, recent evidence has shown that physical exercise improves the prognosis of cancer survivors. The benefits of physical exercise have been widely reported, and guidelines for physical exercise for cancer survivors have been published. These guidelines recommend that cancer survivors engage in moderate- or vigorous-intensity aerobic exercises and/or resistance training. However, many cancer survivors have a poor commitment to physical exercise. In the future, it is necessary to promote physical exercise among cancer survivors through outpatient rehabilitation and community support.
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Affiliation(s)
- Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, Japan
| | | | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Japan
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31
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Belloni S, Arrigoni C, Baroni I, Conte G, Dellafiore F, Ghizzardi G, Magon A, Villa G, Caruso R. Non-pharmacologic interventions for improving cancer-related fatigue (CRF): A systematic review of systematic reviews and pooled meta-analysis. Semin Oncol 2023:S0093-7754(23)00035-0. [PMID: 36973125 DOI: 10.1053/j.seminoncol.2023.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Literature encloses numerous systematic reviews (SRs) on nonpharmacologic interventions for improving cancer-related fatigue (CRF). The effect of these interventions remains controversial, and the available SRs have not been synthesized yet. We conducted a systematic synthesis of SRs and meta-analysis to determine the effect of nonpharmacologic interventions on CRF in adults. MATERIAL AND METHODS We systematically searched 4 databases. The effect sizes (standard mean difference) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity. RESULTS We selected 28 SRs, including 35 eligible meta-analyses. The pooled effect size (standard mean difference, 95% CI) was -0.67 (-1.16, -0.18). The subgroup analysis by types of interventions showed a significant effect in all the investigated approaches (complementary integrative medicine, physical exercise, self-management/e-health interventions). CONCLUSIONS There is evidence that nonpharmacologic interventions are associated with CRF reduction. Future research should focus on testing these interventions on specific population clusters and trajectories. PROSPERO REGISTRATION CRD42020194258.
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Affiliation(s)
- Silvia Belloni
- IRCCS Humanitas Research Hospital, Educational and Research Unit, Rozzano, Italy.
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Greta Ghizzardi
- Health Professions Directorate, Bachelor in Nursing Course, ASST Lodi, Lodi, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
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32
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Purcell SA, Melanson EL, Afghahi A, Borges VF, Sinelli I, Cornier MA. The effects of resistance exercise on appetite sensations, appetite related hormones and energy intake in hormone receptor-positive breast cancer survivors. Appetite 2023; 182:106426. [PMID: 36539160 DOI: 10.1016/j.appet.2022.106426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Appetite is a determinant of dietary intake and is impacted by sex hormones, exercise, and body composition among individuals without chronic conditions. Whether appetite is altered by exercise in the context of estrogen suppression and cancer survivorship is unknown. This randomized cross-over study compared appetite and ad libitum energy intake (EI) after acute resistance exercise (REx) versus sedentary (SED) conditions and in relation to body composition and resting metabolic rate (RMR) in breast cancer survivors (BCS). Physically inactive premenopausal females with previous stage I-III estrogen receptor-positive breast cancer completed a single bout of REx or SED 35 minutes after a standardized breakfast meal. Appetite visual analog scales and hormones (total ghrelin and peptide-YY [PYY]) were measured before and 30, 90, 120, 150, and 180 minutes post-meal and expressed as area under the curve (AUC). Participants were offered a buffet-type meal 180 minutes after breakfast to assess ad libitum EI. Body composition (dual X-ray absorptiometry) and RMR (indirect calorimetry) were measured during a separate visit. Sixteen BCS were included (age: 46 ± 2 y, BMI: 24.9 ± 1.0 kg/m2). There were no differences in appetite ratings or EI between conditions. There were no differences in appetite hormone AUC, but REx resulted in lower ghrelin 120 (-85 ± 39 pg/mL, p = 0.031) and 180 (-114 ± 43 pg/mL, p = 0.018) minutes post-breakfast and higher PYY 90 (21 ± 10 pg/mL, p = 0.028) and 120 (14 ± 7 pg/mL, p = 0.041) minutes post-breakfast. Fat-free mass and RMR negatively correlated with hunger and prospective food consumption AUC after SED, but not REx. In sum, a single REx bout temporarily reduces orexigenic and increases anorexic appetite hormones, but not acute subjective appetite sensations or EI.
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Affiliation(s)
- Sarah A Purcell
- School of Medicine, Division of Endocrinology Metabolism and Diabetes, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA; Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada; Department of Biology, University of British Columbia - Okanagan, Kelowna, BC, V1V 1V7, Canada.
| | - Edward L Melanson
- School of Medicine, Division of Endocrinology Metabolism and Diabetes, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA; Rocky Mountain Regional VA Medical Center, Aurora, CO, 80045, USA; Department of Medicine, Division of Geriatric Medicine, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Anosheh Afghahi
- School of Medicine, Division of Medical Oncology, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA; Young Women's Breast Cancer Translational Program, University of Colorado Cancer Center, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Virginia F Borges
- School of Medicine, Division of Medical Oncology, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA; Young Women's Breast Cancer Translational Program, University of Colorado Cancer Center, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Isabella Sinelli
- School of Medicine, Division of Endocrinology Metabolism and Diabetes, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Marc-Andre Cornier
- School of Medicine, Division of Endocrinology Metabolism and Diabetes, University of Colorado - Anschutz Medical Campus, Aurora, CO, 80045, USA; Department of Medicine, Division of Endocrinology, Diabetes, and Metabolic Diseases, Medical University of South Carolina, Charleston, SC, 29425, USA
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Tackling the adverse health effects of excess body fat in breast cancer: where does physical activity fit in? Proc Nutr Soc 2023; 82:63-68. [PMID: 36524561 DOI: 10.1017/s0029665122002889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Weight gain is commonly observed during and after breast cancer treatment due to chemotherapy and endocrine therapies, induced menopause, changes in metabolism and food intake and decreased physical activity. Systematic reviews show that women who are overweight or obese at diagnosis, and those who gain weight, have poorer breast cancer survival outcomes than women of a healthy weight, irrespective of menopausal status. Excess body weight after breast cancer also increases the risk of type 2 diabetes mellitus and CVD. The adverse impact of excess body weight on survival outcomes is clearly shown for women with oestrogen receptor-positive (ER+) breast cancer, which accounts for 70 % of all breast cancer cases. Higher body fat is thought to increase the risk of ER+ recurrence because of increased aromatase activity. However, this could be compounded by other risk factors, including abnormal insulin and adipokine metabolism, impaired anti-tumour immunity and chronic low-grade systemic inflammation. Observational evidence linking poorer survival outcomes with excess body fat and low physical activity in women recovering from early-stage curative-intent breast cancer treatment is reviewed, before reflecting on the proposed biological mechanisms. The issues and sensitivities surrounding exercise participation amongst overweight breast cancer patients is also discussed, before providing an overview of the co-design process involved in development of an intervention (support programme) with appropriate content, structure and delivery model to address the weight management challenges faced by overweight ER+ breast cancer patients.
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Systematic review of aquatic therapeutic exercise efficacy in breast cancer survivors. Support Care Cancer 2023; 31:44. [DOI: 10.1007/s00520-022-07460-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
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35
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Wochatz M, Schraplau A, Engel T, Zecher MM, Sharon H, Alt Y, Mayer F, Kalron A. Application of eccentric training in various clinical populations: Protocol for a multi-centered pilot and feasibility study in people with low back pain and people with multiple sclerosis. PLoS One 2022; 17:e0270875. [PMID: 36548298 PMCID: PMC9779041 DOI: 10.1371/journal.pone.0270875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 05/25/2022] [Indexed: 12/24/2022] Open
Abstract
Physical activity and exercise are effective approaches in prevention and therapy of multiple diseases. Although the specific characteristics of lengthening contractions have the potential to be beneficial in many clinical conditions, eccentric training is not commonly used in clinical populations with metabolic, orthopaedic, or neurologic conditions. The purpose of this pilot study is to investigate the feasibility, functional benefits, and systemic responses of an eccentric exercise program focused on the trunk and lower extremities in people with low back pain (LBP) and multiple sclerosis (MS). A six-week eccentric training program with three weekly sessions is performed by people with LBP and MS. The program consists of ten exercises addressing strength of the trunk and lower extremities. The study follows a four-group design (N = 12 per group) in two study centers (Israel and Germany): three groups perform the eccentric training program: A) control group (healthy, asymptomatic); B) people with LBP; C) people with MS; group D (people with MS) receives standard care physiotherapy. Baseline measurements are conducted before first training, post-measurement takes place after the last session both comprise blood sampling, self-reported questionnaires, mobility, balance, and strength testing. The feasibility of the eccentric training program will be evaluated using quantitative and qualitative measures related to the study process, compliance and adherence, safety, and overall program assessment. For preliminary assessment of potential intervention effects, surrogate parameters related to mobility, postural control, muscle strength and systemic effects are assessed. The presented study will add knowledge regarding safety, feasibility, and initial effects of eccentric training in people with orthopaedic and neurological conditions. The simple exercises, that are easily modifiable in complexity and intensity, are likely beneficial to other populations. Thus, multiple applications and implementation pathways for the herein presented training program are conceivable. Trial registration: DRKS00020483 (DRKS, German Clinical Trials Register; 24th January 2020 -retrospectively registered; https://www.drks.de/DRKS00020483).
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Affiliation(s)
- Monique Wochatz
- University of Potsdam, University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Potsdam, Germany
| | - Anne Schraplau
- University of Potsdam, University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Potsdam, Germany
- Faculty of Health Sciences, Joint Faculty of the University of Potsdam, The Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology, Cottbus, Senftenberg, Germany
| | - Tilman Engel
- University of Potsdam, University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Potsdam, Germany
| | - Mahli M. Zecher
- University of Potsdam, University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Potsdam, Germany
| | - Hadar Sharon
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Yasmin Alt
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Frank Mayer
- University of Potsdam, University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, Potsdam, Germany
| | - Alon Kalron
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Yang X, Allen JC, Aslim EJ, Tay KJ, Yuen SPJ, Kanesvaran R, Chua MLK, Chong TW, Ho SSH, Lee LS. Patient-reported outcomes of a phase II neoadjuvant apalutamide (ARN-509) and radical prostatectomy in treatment of intermediate- to high-risk prostate cancer (NEAR) trial. Int J Urol 2022; 29:1322-1330. [PMID: 36000794 DOI: 10.1111/iju.14994] [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: 05/02/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The NEAR trial is a single-arm phase II trial investigating the efficacy of neoadjuvant apalutamide and radical prostatectomy in the treatment of D'Amico intermediate- to high-risk prostate cancer. This publication focuses on health-related quality of life (HRQoL) during 12 weeks of neoadjuvant apalutamide treatment. METHODS From 2017 to 2019, 30 suitable patients received neoadjuvant apalutamide 240 mg once daily for 12 weeks followed by radical prostatectomy (ClinicalTrials.gov Identifier: NCT03124433). Patient-reported quality of life outcomes was analyzed using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core Module (EORTC QLQ-C30), EORTC Quality of Life Questionnaire Prostate Module (QLQ-PR25), and Sexual Health Inventory for Men questionnaire (SHIM) at weeks 0,4,12, and 20 of the study. RESULTS Thirty patients completed 12 weeks of apalutamide therapy and data analyzed for 29 with complete datasets. Neoadjuvant apalutamide therapy was associated with no clinically significant negative impact on patients' global health and QoL scores. Deteriorations in mean scores of functional and symptom scales of QLQ-C30 questionnaire were statistically significant (p = 0.011 and p = 0.008, respectively) but were not clinically meaningful. Patients were also affected by fatigue (p = 0.012), cognitive function (p = 0.038), reduced role functioning (p = 0.025), and lower SHIM scores (p < 0.001). Median daily step count reduced from 8228/day to 6001/day per day (p = 0.063), while BMI and body weight reduction were observed (statistically but not clinically significant). CONCLUSION During 12 weeks of neoadjuvant apalutamide in organ-confined prostate cancer, the overall patient-reported HRQoL outcomes were maintained, but fatigue and sexual dysfunction were observed in those patients.
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Affiliation(s)
- Xinyan Yang
- Department of Urology, Singapore General Hospital, Singapore
| | - John Carson Allen
- Centre for Quantitative Medicine/Office of Research, Duke-NUS Medical School, Singapore
| | - Edwin Jonathan Aslim
- Department of Urology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Kae Jack Tay
- Department of Urology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Shyi Peng John Yuen
- Department of Urology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Ravindran Kanesvaran
- Duke-NUS Medical School, Singapore.,Division of Medical Oncology, National Cancer Centre, Singapore
| | - Melvin Lee Kiang Chua
- Duke-NUS Medical School, Singapore.,Divisions of Radiation Oncology and Medical Sciences, National Cancer Centre, Singapore
| | - Tsung Wen Chong
- Department of Urology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Sun Sien Henry Ho
- Department of Urology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Lui Shiong Lee
- Duke-NUS Medical School, Singapore.,Department of Urology, Sengkang General Hospital, Singapore
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Ertin B, Kurt S. Evaluation of symptom control and functional quality of life in Turkish patients with cancer. Eur J Oncol Nurs 2022; 61:102239. [DOI: 10.1016/j.ejon.2022.102239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022]
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38
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Risk factors for cancer-related fatigue in patients with colorectal cancer: a systematic review and meta-analysis. Support Care Cancer 2022; 30:10311-10322. [DOI: 10.1007/s00520-022-07432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/26/2022] [Indexed: 11/07/2022]
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39
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Doré I, Plante A, Bedrossian N, Montminy S, St-Onge K, St-Cyr J, Pomey MP, Charpentier D, Pettigrew L, Brisson I, Saad F, Tournoux F, Raynault MF, Mes-Masson AM, Gauvin L. Developing practice guidelines to integrate physical activity promotion as part of routine cancer care: A knowledge-to-action protocol. PLoS One 2022; 17:e0273145. [PMID: 35969619 PMCID: PMC9377590 DOI: 10.1371/journal.pone.0273145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background Cancer is a leading cause of disease burden worldwide and the first cause of mortality in Canada with 30.2% of deaths attributable to cancer. Given aging of the population and the improvement of prevention and treatment protocols, the number of cancer survivors is steadily increasing. These individuals have unique physical and mental health needs some of which can be addressed by integrating physical activity promotion into ongoing and long-term care. Despite the benefits of being active, delivery of PA programs for cancer patients in both clinical and community settings remains challenging. This knowledge-to-action protocol–called Kiné-Onco–aims to develop a practice guideline for the delivery, implementation, and scaling-up of cancer-specific physical activity promotion programs and services in clinical and community settings located in Québec, Canada. Method The Kiné-Onco project involves knowledge synthesis of scientific and grey literature to establish the benefits and added value of physical activity for cancer patients and survivors, describes current practices in delivering physical activity programs, analyses quantitative data from electronic health records (EHR) of patients participating in a novel hospital-based physical activity program, collects and analyses qualitative data from patients and healthcare providers interviews about lived experience, facilitators, and barriers to physical activity promotion, outlines deliberative workshops among multidisciplinary team members to develop implementation guidelines for physical activity promotion, and summarizes a variety of knowledge transfer and exchange activities to disseminate the practice guidelines. Discussion This paper describes the protocol for a knowledge-to-action project aimed at producing and sharing actionable evidence. Our aim is that physical activity promotion programs and services be scaled up in such a way as to successfully integrate physical activity promotion throughout cancer treatment and survivorship in order to improve the physical and mental health of the growing population of individuals having received a cancer diagnosis.
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Affiliation(s)
- Isabelle Doré
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
- * E-mail:
| | - Audrey Plante
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Nathalie Bedrossian
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Sarah Montminy
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Kadia St-Onge
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Jany St-Cyr
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Marie-Pascale Pomey
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
| | | | - Lise Pettigrew
- Fondation Virage, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Isabelle Brisson
- Fondation Virage, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Fred Saad
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - François Tournoux
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Marie-France Raynault
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Centre de recherche Léa-Roback, Montréal, Canada
| | - Anne-Marie Mes-Masson
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Lise Gauvin
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
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Gil Herrero L, McNeely ML, Courneya KS, Castellanos Montealegre M, González Marquez AI, Pollan Santamaría M, Casla Barrio S. Safety, feasibility, and effectiveness of implementing supervised exercise into the clinical care of individuals with advanced cancer. Clin Rehabil 2022; 36:1666-1678. [PMID: 35850600 DOI: 10.1177/02692155221114556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. DESIGN Single group implementation feasibility study using a pre-posttest design. SETTING Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). PARTICIPANTS Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. INTERVENTION A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. MAIN MEASURE Paired t-tests were used to assess pre-post changes and analyses of covariance were used to compare effects based on selected participant characteristics. RESULTS Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001). CONCLUSIONS Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. IMPLICATIONS FOR CANCER SURVIVORS With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.
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Affiliation(s)
| | - Margaret L McNeely
- Department of Physical Therapy/Department of Oncology, 3158University of Alberta, Edmonton, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, 3158University of Alberta, Edmonton, Canada
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Depenbusch J, Haussmann A, Wiskemann J, Tsiouris A, Schmidt L, Sieverding M, Ungar N, Steindorf K. The Relationship between Exercise Self-Efficacy, Intention, and Structural Barriers for Physical Activity after a Cancer Diagnosis. Cancers (Basel) 2022; 14:cancers14102480. [PMID: 35626083 PMCID: PMC9139255 DOI: 10.3390/cancers14102480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Despite numerous benefits of physical activity for cancer patients, the majority is insufficiently active. Previous research has shown that structural barriers negatively affect patients’ physical activity behavior. Identifying underlying mechanisms could help to develop effective strategies that alleviate those barriers and increase physical activity levels. In the current survey study, we investigated whether cancer patients’ self-efficacy, i.e., their confidence in their ability, and their intention to exercise mediated the relationship between structural barriers and physical activity. The results revealed a negative relation between structural barriers and patients’ self-efficacy. Lower self-efficacy, in turn, decreased patients’ intention and their likelihood to engage in physical activity. This mediating effect especially applied to those individuals who were sufficiently active before the diagnosis. Thus, the findings suggest that interventions directly addressing the perception of structural barriers or patients’ self-efficacy in dealing with these barriers might be effective in improving the physical activity levels of cancer patients. Abstract Previous research has shown that structural barriers negatively influence the physical activity (PA) behavior of cancer patients, but underlying mechanisms are unclear. The aim of the current study was to explore the potential mediating role of social-cognitive factors, namely PA self-efficacy and PA intention in this context. A total of 856 cancer patients completed a questionnaire on sociodemographic and medical characteristics, pre- and post-diagnosis PA, PA self-efficacy, PA intention, and PA impediment by structural barriers. A serial mediation model was used to test whether the association between structural barriers and post-diagnosis PA was mediated by PA self-efficacy and/or PA intention, in the overall sample and in subsamples defined by individuals’ pre-diagnosis PA. The results confirmed that structural barriers were not directly (95%CI [−0.45; 0.10]) but indirectly associated with post-diagnosis PA. Higher impediment by structural barriers decreased the likelihood of sufficient post-diagnosis PA via lower PA self-efficacy (95%CI [−0.25; −0.06]) and via the serial pathway of lower PA self-efficacy and lower PA intention (95%CI [−0.19; −0.05]). Investigating differences in these mediations by pre-diagnosis PA yielded significance only among previously active cancer patients. Both structural barriers and PA self-efficacy might hence be relevant target points for interventions aiming to improve PA behavior, especially among pre-diagnosis active cancer patients.
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Affiliation(s)
- Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (J.D.); (A.H.)
- Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Alexander Haussmann
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (J.D.); (A.H.)
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; (J.W.); (A.T.)
| | - Angeliki Tsiouris
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; (J.W.); (A.T.)
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - Laura Schmidt
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany; (L.S.); (M.S.); (N.U.)
| | - Monika Sieverding
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany; (L.S.); (M.S.); (N.U.)
| | - Nadine Ungar
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany; (L.S.); (M.S.); (N.U.)
- Faculty of Healthcare and Nursing, Catholic University of Applied Sciences Mainz, Saarstraße 3, 55122 Mainz, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (J.D.); (A.H.)
- Correspondence: ; Tel.: +49-6221-422351
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Immediate increase in perceived energy after exercise during the course of chemotherapy treatment for breast cancer. Eur J Oncol Nurs 2022; 58:102149. [DOI: 10.1016/j.ejon.2022.102149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 04/10/2022] [Accepted: 05/08/2022] [Indexed: 11/23/2022]
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Yang YP, Pan SJ, Qiu SL, Tung TH. Effects of physical exercise on the quality-of-life of patients with haematological malignancies and thrombocytopenia: A systematic review and meta-analysis. World J Clin Cases 2022; 10:3143-3155. [PMID: 35647113 PMCID: PMC9082692 DOI: 10.12998/wjcc.v10.i10.3143] [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: 08/13/2021] [Revised: 11/02/2021] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Annually, there are an estimated 1187000 new patients worldwide diagnosed with haematological malignancies. Effective strategies are needed to alleviate side effects and prevent the physical and psychosocial degeneration of patients in active treatment for haematological malignancies. AIM To explore the effects of physical exercise on quality of life (QoL) of patients with haematological malignancies and thrombocytopenia. METHODS Cochrane Library, PubMed and Embase were searched for all relevant articles reporting randomized controlled trials (RCTs) that were published up to 31 July 2021. Two authors independently selected articles in accordance with the inclusion criteria, evaluated their quality, and collected information. Any controversy was resolved through discussion with a third senior author. The PRISMA 2009 checklist was followed. RESULTS Seven RCTs were selected in the systematic review and three were included in the final meta-analysis. There were significant differences in QoL between physical exercise groups [mean score difference = 8.81; 95% confidence interval (CI): 1.81-15.81, P = 0.01], especially in emotional functioning (mean score difference = 12.34; 95%CI: 4.64-20.04, P = 0.002) and pain (mean score difference = -12.77; 95%CI: -3.91 to -21.63, P = 0.005). CONCLUSION Physical exercise has clinical effects on QoL and improves emotional function and pain indices of patients with haematological malignancies and thrombocytopenia.
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Affiliation(s)
- Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Shuang-Jun Pan
- Department of Neurosurgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
| | - Shu-Lin Qiu
- Institute for Hospital Management, Tsing Hua University, Shenzhen 518055, Guangdong Province, China
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
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Obaisi O, Fontillas RC, Patel K, Ngo-Huang A. Rehabilitation Needs for Patients Undergoing CAR T-Cell Therapy. Curr Oncol Rep 2022; 24:741-749. [PMID: 35267151 PMCID: PMC8907385 DOI: 10.1007/s11912-022-01240-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Chimeric antigen receptor (CAR) T-cell therapy is a relatively new, innovative treatment strategy to manage refractory hematological cancers, including some types of leukemia, lymphoma, and multiple myeloma. This article outlines the CAR T-cell therapy process, toxicity, and complications, along with an overview of the currently known short- and long-term physical and functional sequelae that will be helpful for general or oncology rehabilitation specialists caring for these patients. RECENT FINDINGS There is a dearth of literature on the topic of rehabilitation of patients receiving CAR T-cell therapy. Rehabilitation practices can be extrapolated from the limited functional information on patients who have completed treatment for lymphoma and multiple myeloma. Patients present with cognitive impairment, muscle weakness, reduced exercise capacity, neuropathy, and cancer-related fatigue. Physical activity and rehabilitation programs may be beneficial to address fatigue, psychological symptoms, and quality of life. There is limited rehabilitation research in patients receiving CAR T-cell therapy. These patients may present with general deconditioning and neurological complications which translate to neuromuscular and cognitive impairment that benefit from multidisciplinary rehabilitation intervention prior to, during, and after treatment. Studies measuring the impairments at baseline and evaluation of the impact of rehabilitation practices are much needed to support this.
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Affiliation(s)
- Obada Obaisi
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Rhodora C Fontillas
- Department of Rehabilitation Services, The University of Texas MD Anderson Cancer Center, Unit 0322, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Krina Patel
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Unit 0429, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - An Ngo-Huang
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
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45
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Mikkelsen MK, Lund CM, Vinther A, Tolver A, Johansen JS, Chen I, Ragle AM, Zerahn B, Engell-Noerregaard L, Larsen FO, Theile S, Nielsen DL, Jarden M. Effects of a 12-Week Multimodal Exercise Intervention Among Older Patients with Advanced Cancer: Results from a Randomized Controlled Trial. Oncologist 2022; 27:67-78. [PMID: 34498352 PMCID: PMC8842365 DOI: 10.1002/onco.13970] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/25/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Older patients with cancer are at risk of physical decline and impaired quality of life during oncological treatment. Exercise training has the potential to reduce these challenges. The study aim was to investigate the feasibility and effect of a multimodal exercise intervention in older patients with advanced cancer (stages III/IV). PATIENTS AND METHODS Eighty-four older adults (≥65 years) with advanced pancreatic, biliary tract, or non-small cell lung cancer who received systemic oncological treatment were randomized 1:1 to an intervention group or a control group. The intervention was a 12-week multimodal exercise-based program including supervised exercise twice weekly followed by a protein supplement, a home-based walking program, and nurse-led support and counseling. The primary endpoint was change in physical function (30-second chair stand test) at 13 weeks. RESULTS Median age of the participants was 72 years (interquartile range [IQR] 68-75). Median adherence to the exercise sessions was 69% (IQR 21-88) and 75% (IQR 33-100) for the walking program. At 13 weeks, there was a significant difference in change scores of 2.4 repetitions in the chair stand test, favoring the intervention group (p < .0001). Furthermore, significant beneficial effects were seen for physical endurance (6-minute walk test), hand grip strength, physical activity, symptom burden, symptoms of depression and anxiety, global health status (quality of life), and lean body mass. No effects were seen for dose intensity, hospitalizations, or survival. CONCLUSION A 12-week multimodal exercise intervention with targeted support proved effective in improving physical function in older patients with advanced cancer during oncological treatment.
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Affiliation(s)
- Marta K Mikkelsen
- Department of Oncology, Center for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark,Correspondence: Marta K. Mikkelsen, M.H.Sc., Department of Oncology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark. Tel: +45 3 868 9579; e-mail:
| | - Cecilia M Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark,CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Herlev, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark,Hospital Secretariat and Communications, Research, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Anders Tolver
- Data Science Laboratory, Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julia S Johansen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark,Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Inna Chen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Anne-Mette Ragle
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Lotte Engell-Noerregaard
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Finn O Larsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Susann Theile
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Dorte L Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark,Department of Hematology, Center for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Fukushima T, Tsuji T, Watanabe N, Sakurai T, Matsuoka A, Kojima K, Yahiro S, Oki M, Okita Y, Yokota S, Nakano J, Sugihara S, Sato H, Kawakami J, Kagaya H, Tanuma A, Sekine R, Mori K, Zenda S, Kawai A. Cancer Rehabilitation Provided by Designated Cancer Hospitals in Japan: The Current State of Outpatient Setting and Coordination after Discharge. Prog Rehabil Med 2022; 7:20220006. [PMID: 35274061 PMCID: PMC8850184 DOI: 10.2490/prm.20220006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 01/17/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives: The aim of the present study was to clarify the current state of outpatient cancer
rehabilitation and coordination systems provided by designated cancer hospitals in
Japan. Methods: A questionnaire was sent to 427 designated cancer hospitals in Japan to investigate the
status of outpatient cancer rehabilitation and whether it was sufficiently conducted.
The status of regional coordination with post-discharge rehabilitation facilities was
surveyed. Results: Responses were received from 235/427 facilities (55.0%). Outpatient cancer
rehabilitation was implemented in 92 (39.1% of responding facilities), and of these
facilities, 83.7% answered that the provision of rehabilitation was insufficient. The
reasons were ineligibility for reimbursement of medical fees, a lack of human resources,
a lack of awareness of the need, and a lack of education. Regional coordination was
conducted by 39.1% of responding facilities, yet a regional alliance path had been
established in only 9.8% of centers. The absence of coordination was associated with
large facility size, the absence of physiatrists, and few rehabilitation professionals
who had completed the training program; an insufficient framework for regional
coordination was also given as a reason. Conclusions: To provide adequate outpatient cancer rehabilitation, sufficient human resources, the
reimbursement of medical fees in the outpatient setting, and education and a framework
to promote regional coordination are necessary.
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Affiliation(s)
- Takuya Fukushima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Noriko Watanabe
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Takuro Sakurai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Aiko Matsuoka
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Kojima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Sachiko Yahiro
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Oki
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Okita
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Shota Yokota
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Jiro Nakano
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Shinsuke Sugihara
- Department of Orthopedic Oncology and Rehabilitation, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Hiroshi Sato
- Department of Gastroenterological Surgery, Saitama International Medical Center, Saitama Medical University, Saitama, Japan
| | - Juichi Kawakami
- Department of Rehabilitation Medicine, Shiga Prefectural Rehabilitation Center, Shiga, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Akira Tanuma
- Department of Rehabilitation Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Ryuichi Sekine
- Department of Pain and Palliative Care, Kameda Medical Center, Chiba, Japan
| | - Keita Mori
- Department of Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
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Belloni S, Arrigoni C, Caruso R. Effects from physical exercise on reduced cancer-related fatigue: a systematic review of systematic reviews and meta-analysis. Acta Oncol 2021; 60:1678-1687. [PMID: 34396915 DOI: 10.1080/0284186x.2021.1962543] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cancer-related fatigue is one of the most prevalent and distressing symptoms among cancer patients, resulting in a great cancer research challenge. Numerous systematic reviews of physical training interventions have been conducted to find the most effective approach. However, evidence remains fragmented, and in which cancer population physical training is more effective than other populations is still unclear. Thus, this study critically appraised systematic reviews and meta-analyses on physical training to reduce adults' cancer-related fatigue. METHODS A systematic review of systematic reviews and meta-analysis (PROSPERO: CRD42020189049), assessing the efficacy of exercise training for reducing cancer-related fatigue in adults, was conducted in PubMed, CINAHL, Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects, and Pedro. The selected studies (standardized mean difference, SMD; 95%CI), was quantitatively pooled using a random-effects model. Heterogeneity was tested using chi-squared (Q) and I-square statistics (I2). RESULTS Of 1438 identified articles, 11 met the inclusion criteria, and ten were meta-analyzed. The results yielded a positive effect of physical training on fatigue in all cancer populations, SMD = -0.33 (-0.43, -0.23). Subgroup analysis based on tumor localization showed a slightly higher physical training effect on fatigue in adults with breast cancer, SMD = -0.36 (-0.57, -0.15), and prostate cancer SMD = -0.34 (-0.45, -.0.22). CONCLUSIONS Our analysis demonstrated some potential improvement in cancer-related fatigue in adult patients undergoing physical training during and after cancer treatments, particularly in patients with breast or prostate cancer.
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Affiliation(s)
- Silvia Belloni
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
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48
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Nielsen AWM, Lundorff M, Nielsen HM, Alsner J, Vrou Offersen B, Kristensen MH, Zachariae R. Symptom trajectories in breast cancer survivors: growth mixture analysis of patient-reported pain, fatigue, insomnia, breast and arm symptoms. Acta Oncol 2021; 60:1659-1667. [PMID: 34582319 DOI: 10.1080/0284186x.2021.1981550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Variations in symptom development among breast cancer (BC) survivors are understudied. We examined: (Q1) Symptom trajectories of pain, fatigue, insomnia, breast, and arm symptoms in BC survivors, (Q2) possible patterns or cluster-like associations between trajectory classification of different symptoms, and (Q3) characteristics of survivors assigned to high-burden symptom trajectories. MATERIAL AND METHODS Participants were 968 women (mean age = 59.6 years) treated for early-stage BC and followed across a three-year postoperative period. As part of routine follow-up procedures, patients reported symptom burden and functioning levels at each hospital visit using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and the BC-specific module (QLQ-BR-23). Growth mixture modeling (GMM) analysis was used to differentiate potential subgroups of individuals with similar longitudinal symptom patterns, i.e., symptom trajectories (Q1). With this approach, groups experiencing persistent, highly distressing cancer- and treatment-related late effects (LEs) may be identified. Latent class analysis (LCA) was used for Q2 and logistic regression analysis for Q3. RESULTS GMM identified two relatively parallel trajectories across the tested symptoms: The majority of the sample exhibited a low-burden symptom trajectory (74.4-89.2%) and a minority by a high-burden symptom trajectory (10.8-25.6%). LCA revealed that approximately one in five women (18.8%) were likely to be members of the high-burden symptom trajectory across all tested symptoms. In addition to a high probability of being burdened over time across multiple symptoms, these women were also characterized by poorer self-reported physical and social functioning. CONCLUSION A substantial minority followed a high-burden symptom trajectory for several years following BC treatment. Associations were found in trajectory classification across symptoms, indicating that cancer-related LEs appear in clusters of multiple concurrent symptoms.
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Affiliation(s)
| | - Marie Lundorff
- Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - Jan Alsner
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Robert Zachariae
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
- Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Morielli AR, Boulé NG, Usmani N, Tankel K, Joseph K, Severin D, Fairchild A, Nijjar T, Courneya KS. Effects of exercise during and after neoadjuvant chemoradiation on symptom burden and quality of life in rectal cancer patients: a phase II randomized controlled trial. J Cancer Surviv 2021:10.1007/s11764-021-01149-w. [PMID: 34841461 DOI: 10.1007/s11764-021-01149-w] [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: 08/20/2021] [Accepted: 11/21/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE We previously demonstrated that exercise during and after neoadjuvant chemoradiation (NACRT) for rectal cancer may improve the rate of pathologic complete/near complete response. Here, we report the effects of exercise on symptom management and quality of life (QoL). METHODS Rectal cancer patients (N = 36) were randomized to a supervised high-intensity interval training program during NACRT followed by unsupervised continuous exercise after NACRT or usual care. Patient-reported outcomes were assessed at baseline, post-NACRT, and presurgery including symptom burden (M.D. Anderson Symptom Inventory) and QoL (European Organisation for Research and Treatment of Cancer QLQ- C30 and -CR29). RESULTS During NACRT, exercise significantly worsened stool frequency (adjusted between-group difference, 25.8; 95% CI, 4.0 to 47.6; p = 0.022), role functioning (adjusted between-group difference, -21.3; 95% CI, -41.5 to -1.1; p = 0.039), emotional functioning (adjusted between-group difference, -11.7; 95% CI, -22.0 to -1.4; p = 0.028), and cognitive functioning (adjusted between-group difference, -11.6; 95% CI, -19.2 to -4.0; p = 0.004) compared to usual care. After NACRT, exercise significantly worsened diarrhea (adjusted between-group difference, 1.2; 95% CI, 0.1 to 2.3; p = 0.030) and embarrassment (adjusted between-group difference, 19.7; 95% CI, 7.4 to 32.1; p = 0.003) compared to usual care. CONCLUSIONS Exercise exacerbated some symptoms and worsened QoL during NACRT; however, most negative effects dissipated after NACRT. Larger trials are necessary to confirm these findings. IMPLICATIONS FOR CANCER SURVIVORS If the clinical benefit of exercise is confirmed, then the modest symptom exacerbation during NACRT may be considered tolerable. However, in the absence of any clinical benefit, exercise may be contraindicated in this clinical setting.
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Affiliation(s)
- Andria R Morielli
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Normand G Boulé
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Nawaid Usmani
- Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Keith Tankel
- Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Kurian Joseph
- Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Diane Severin
- Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Alysa Fairchild
- Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Tirath Nijjar
- Department of Oncology, University of Alberta and Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.
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Zhang S. Chemotherapy-induced peripheral neuropathy and rehabilitation: A review. Semin Oncol 2021; 48:193-207. [PMID: 34607709 DOI: 10.1053/j.seminoncol.2021.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 12/29/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication after chemotherapy that can damage the sensory, motor, autonomic, or cranial nerves in approximately 30%-60% of patients with cancer. CIPN can lead to detrimental dose modifications and/or premature chemotherapy discontinuation due to patient intolerance. The long-term impact of CIPN is particularly challenging and can have a profound impact on the quality of life (QoL) and survivorship. However, this condition is often underdiagnosed. No agents have been established to prevent CIPN. Pre-chemotherapy testing is recommended for high-risk patients. Duloxetine is considered a first-line treatment, whereas gabapentin, pregabalin, tricyclic antidepressants, and topical compounding creams may be used for neuropathic pain control. Home-based, low-to-moderate walking, and resistance exercise during chemotherapy can reduce the severity and prevalence of CIPN symptoms, especially in older patients. Pre-habilitation and rehabilitation should be recommended for all patients receiving cytotoxic chemotherapies. The purpose of this article is to review common chemotherapeutic drugs causing CIPN, risk factors, diagnosis and treatment of CIPN, and evidence of the benefits of rehabilitation.
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Affiliation(s)
- Shangming Zhang
- Department of Physical Medicine and Rehabilitation, Penn State Health Milton S. Hershey medical Center, Hershey, PA.
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