Physical Exercise for Cancer Patients with Advanced Disease: A Randomized Controlled Trial

Author:

Oldervoll Line M.12,Loge Jon H.3,Lydersen Stian4,Paltiel Hanne5,Asp May B.5,Nygaard Unni V.6,Oredalen Elisabeth7,Frantzen Tone L.89,Lesteberg Ingvild10,Amundsen Lise11,Hjermstad Marianne J.112,Haugen Dagny F.19,Paulsen Ørnulf13,Kaasa Stein114

Affiliation:

1. a European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

2. b Research Centre for Health Promotion and Resources, Norwegian University of Science and Technology, Trondheim, Norway

3. d National Resource Centre for Late Effects, Department of Oncology, Oslo University Hospital-Ullevaal, Oslo, Norway

4. c Unit for Applied Clinical Research, Norwegian University of Science and Technology, Trondheim, Norway;

5. g Physiotherapy Department, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

6. i Hospice Lovisenberg, Lovisenberg Deaconal Hospital, Oslo, Norway;

7. j Department of Physiotherapy, Telemark Hospital, Skien, Norway

8. l Sunniva Clinic for Palliative Care, Haraldsplass Deaconal Hospital, Bergen Norway;

9. m Regional Centre of Excellence for Palliative Care, Western Norway, Multidisciplinary Pain Clinic, Haukeland, University Hospital, Bergen, Norway

10. e Physiotherapy Department, Oslo University Hospital-Ullevaal, Oslo, Norway

11. n Palliative Care Team, Multidisciplinary Pain Clinic, Haukeland, University Hospital, Bergen, Norway

12. f Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital-Ullevaal, Oslo, Norway;

13. k Palliative Care Unit, Department of Medicine, Telemark Hospital, Skien, Norway;

14. h Palliative Medicine Unit, Department of Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Describe the impact of physical exercise on fatigue and physical performance outcomes in cancer patients with advanced and incurable disease.Identify potential clinical benefits of inclusion of physical exercise in treatment regimens for cancer patients with advanced disease. CME This article is available for continuing medical education credit at CME.TheOncologist.com Background. Physical exercise can improve cancer patients' functioning and reduce their symptom levels. A randomized, controlled trial was launched to test the hypothesis that physical exercise reduces fatigue and improves physical performance in cancer patients with advanced and incurable disease. Methods. Cancer patients (n = 231) with a life expectancy ≤2 years were randomized to a physical exercise group (PEG, n = 121) or a control usual care group (UCG, n = 110). The PEG exercised under supervision 60 minutes twice a week for 8 weeks. Assessments were performed before and after the intervention. The primary outcome was physical fatigue (PF) measured by the Fatigue Questionnaire. Physical performance was a secondary outcome measured by the Shuttle Walk Test (SWT) and hand grip strength (HGS) test. Analyses were performed after multiple imputations for missing data. The trial is registered with ClinicalTrials.gov (identifier, NCT00397774). Findings. Thirty-six percent of the PEG were lost to follow-up compared with 23% of the UCG, primarily as a result of disease progression. Seventy-eight PEG and 85 UCG patients completed the intervention. Analyses showed no significant between-group effects in PF. However, clinically and statistically significant between-group effects were found for the SWT and HGS test. Interpretation. Fatigue was not reduced but physical performance (SWT and HGS test) was significantly improved after 8 weeks of physical exercise. Physical exercise might therefore be a suitable approach for maintaining physical capacity in cancer patients with incurable and advanced disease.

Funder

Norwegian Foundation for Health and Rehabilitation

Norwegian Cancer Society

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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