Introduction: Physical exercise intervention programs show beneficial effects in early stage cancer patients during and after treatment. There is also growing evidence that physical exercise is safe ...and feasible for advanced cancer patients but knowledge is limited.
Areas covered: This review provides an overview of randomized controlled exercise trials implemented in palliative care settings with advanced cancer patients. A comprehensive literature search was carried out in PubMed (MEDLINE), CINAHL, and the Cochrane Library. Six articles providing data of 590 patients met the predefined inclusion criteria. Mainly resistance exercise was applied and duration of interventions was between 8 and 16 weeks.
Expert commentary: Beneficial effects for exercise patients were reported for both physical and psychological outcomes. However, general exercise recommendation for patients undergoing palliative treatment cannot be derived from the six analyzed studies. This is due to large heterogeneity of the applied exercise programs, included patient groups and performed assessment methods.
To determine the individual training response of allo-HSCT patients depending on their baseline fitness level. In a multicenter RCT105 patients were equally randomized to an exercise (EX) and a ...social contact group (Control). Exercisers trained in a home-based setting prior to hospital admission, during inpatient treatment and 6-8 weeks period after discharge (partly self-administered with an intervention manual and DVD). Regarding maximal voluntary isometric strength in knee extensor muscles patients in the "unfit" group declined about 6,4% over the whole study period whereas the "fit" group looses 30,8% in average (p<0.05). Comparable results could be reported for all other measured muscle groups. Also the 6MWT distance showed a significant better development for the "unfit" vs. the "fit" group (+13,4% vs. -3,7%, p<0.05). Furthermore, a better development in physical performance was significantly associated with less treatment-related side effects (e.g. cancerrelated fatigue, p<0.05).
Abstract Background and rationale Cancer-related fatigue is a common severe symptom in breast cancer patients, especially during chemotherapy. Exercise appears to be promising in prevention or ...treatment of fatigue. Resistance training as an accompanying treatment to chemotherapy has been minimally investigated, yet might counteract muscle degradation and inflammation caused by many chemotherapeutics, and thus forestall or reduce fatigue. Previous exercise trials mostly compared the intervention with ‘usual care’. Therefore, it is unclear to what extent the observed effects on fatigue are based on physical adaptations by exercise itself, or rather on psycho-social factors linked to the group support or attention by the trainer. Methods and design The BEATE study is a randomized, controlled intervention trial comparing a 12-week supervised progressive resistance training program with a supervised group-based progressive muscle relaxation training in 100 patients with breast cancer under adjuvant chemotherapy. The primary endpoint is cancer-related fatigue; secondary endpoints include quality of life, depression, and cognitive capacity. In addition, isokinetic and isometric muscle strength, cardiorespiratory fitness, and body composition are measured, and biomarkers, such as inflammatory parameters, cortisol, and oxidative stress are analyzed in blood, saliva and urine. Safety of the resistance training during chemotherapy is monitored. Discussion Strengths of the BEATE study include the investigation of progressive resistance training parallel with chemotherapy, the choice of a control group that enables an evaluation of the physiological effects of exercise beyond potential psycho-social effects, and the comprehensive and high-quality assessment of physiological factors and biomarkers potentially related to fatigue.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
