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The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy

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Abstract

The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity; one-repetition maximum (1RM) and maximum oxygen uptake (VO2Max), activity level, general well-being and quality of life in cancer patients undergoing chemotherapy. The intervention comprised resistance and fitness training, massage, relaxation and body-awareness training. Eighty-two cancer patients, with or without evidence of residual disease, were included: 66 patients with 13 different types of solid tumours and 16 patients with 6 types of haematological malignancies. The patients trained in mixed groups for 9 h weekly for 6 weeks. Physical capacity, physical activity level and psychosocial well-being as measured by the Medical Outcomes Study 36-item Short-Form Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 were assessed pre- and post-intervention. Highly significant increases were achieved in muscular strength (p<0.001), physical fitness (p<0.001) and physical activity levels (p<0.001). The patients reported significant reduction in treatment-related symptoms, i.e., fatigue (p=0.006) and pain (p=0.03). Highly significant improvements were observed in physical functioning (p<0.001) and role functioning (p<0.001). Even patients with advanced disease were able to improve their results after 6 weeks. It is concluded that a multidimensional exercise intervention, including resistance training, may be beneficial for cancer patients undergoing chemotherapy. This study indicates significant clinical meaningful improvements. The exact role of the intervention has to be defined in a randomized controlled design. A clinically controlled trial including 250 patients is currently being carried out.

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References

  1. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    PubMed  Google Scholar 

  2. Adamsen L, Rasmussen JM, Pedersen LS (2001) ‘Brothers in arms’: how men with cancer experience a sense of comradeship through group intervention which combines physical activity with information relay. J Clin Nurs 10:528–537

    PubMed  Google Scholar 

  3. Adamsen L, Rasmussen JM (2001) Sociological perspectives on self-help groups: reflections on conceptualization and social processes. J Adv Nurs 35:909–917

    PubMed  Google Scholar 

  4. Adamsen L (2002) ‘From victim to agent’: the clinical and social significance of self-help group participation for people with life-threatening diseases. Scand J Caring Sci 16:224–231

    PubMed  Google Scholar 

  5. Adamsen L, Midtgaard J, Rorth M, Borregaard N, Andersen C, Quist M, Moller T, Zacho M, Madsen JK, Knutsen L (2003) Feasibility, physical capacity, and health benefits of a multidimensional exercise programme for cancer patients undergoing chemotherapy. Support Care Cancer 11:707–716

    PubMed  Google Scholar 

  6. Adamsen L, Midtgaard J, Andersen C, Quist M, Moeller T, Roerth M (2004) Transforming the nature of fatigue through exercise: qualitative findings from a multidimensional exercise program in cancer patients undergoing chemotherapy. Eur J Cancer Care 13:362–370

    Article  Google Scholar 

  7. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498–S504

    Article  PubMed  Google Scholar 

  8. Andersen LB (1995) A maximal cycle exercise protocol to predict maximal oxygen uptake. Scand J Med Sci Sports 5:143–146

    PubMed  Google Scholar 

  9. Arakawa S (1997) Relaxation to reduce nausea, vomiting, and anxiety induced by chemotherapy in Japanese patients. Cancer Nurs 20:342–349

    PubMed  Google Scholar 

  10. Ballard-Barbash R, Blair A, Blair SN, Byers T, Hoffman-Goetz L, Lee I-M, Troiano R, Westerlind K (2002) Physical activity across the cancer continuum: report of a workshop: review of existing knowledge and innovative designs for future research. Cancer 95:1134–1143

    Article  PubMed  Google Scholar 

  11. Bindemann S, Soukop M, Kaye SB (1991) Randomised controlled study of relaxation training. Eur J Cancer 27:170–174

    PubMed  Google Scholar 

  12. Bjorner JB, Damsgaard MT, Watt T, Groenvold M (1998) Tests of data quality, scaling assumptions, and reliability of the Danish SF-36. J Clin Epidemiol 51:1001–1011

    Article  PubMed  Google Scholar 

  13. Bredin M, Corner J, Krishnasamy M, Plant H, Bailey C, A’Hern R (1999) Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. BMJ 318:901–904

    PubMed  Google Scholar 

  14. Bridge LR, Benson P, Pietroni PC, Priest RG (1988) Relaxation and imagery in the treatment of breast cancer. BMJ 297:1169–1172

    PubMed  Google Scholar 

  15. Brzycki M (1993) Strength testing: predicting a one-rep max from reps to fatigue. J Phys Educ Recreat Dance 64:88–90

    Google Scholar 

  16. Bunkan BH, Schultz CM (1998) Medisinsk massasje (Medical massage), 2nd edn. Universitetsforlaget, Oslo, Norway

    Google Scholar 

  17. Burish TG, Lyles JN (1981) Effectiveness of relaxation training in reducing adverse reactions to cancer chemotherapy. J Behav Med 4:65–78

    Article  PubMed  Google Scholar 

  18. Coleman EA, Coon S, Hall-Barrow J, Richards K, Gaylor D, Stewart B (2003) Feasibility of exercise during treatment for multiple myeloma. Cancer Nurs 26:410–419

    PubMed  Google Scholar 

  19. Courneya KS, Friedenreich CM (1999) Physical exercise and quality of life following cancer diagnosis: a literature review. Ann Behav Med 21:171–179

    PubMed  Google Scholar 

  20. Courneya KS, Keats MR, Turner AR (2000) Physical exercise and quality of life in cancer patients following high dose chemotherapy and autologous bone marrow transplantation. Psychooncology 9:127–136

    PubMed  Google Scholar 

  21. Courneya KS (2003) Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 35:1846–852

    PubMed  Google Scholar 

  22. Curt GA (2000) Impact of fatigue on quality of life in oncology patients. Semin Hematol 37(Suppl 6):14–17

    Article  PubMed  Google Scholar 

  23. Dimeo FC, Stieglitz R-D, Novelli-Fischer U, Fetscher S, Keul J (1999) Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer 85:2273–2277

    Article  PubMed  Google Scholar 

  24. Dimeo F, Schwartz S, Fietz T, Wanjura T, Boning D, Thiel E (2003) Effects of endurance training on the physical performance of patients with hematological malignancies during chemotherapy. Support Care Cancer 11:623–628

    Article  PubMed  Google Scholar 

  25. Dimeo FC (2001) Effects of exercise on cancer-related fatigue. Cancer 92(6 Suppl):1689–1693

    Article  PubMed  Google Scholar 

  26. Durak EP, Lilly PC (1998) The application of an exercise and wellness program for cancer patients: a preliminary outcomes report. J Strength Cond Res 12:3–6

    Article  Google Scholar 

  27. Fentem PH (1994) ABC of sports medicine: benefits of exercise in health and disease. BMJ 308:1291–1295

    PubMed  Google Scholar 

  28. Galvão DA, Newton RU (2005) Review of exercise intervention studies in cancer patients. J Clin Oncol 23:899–909

    Article  PubMed  Google Scholar 

  29. Green S (1994) A definition and systems view of anaerobic capacity. Eur J Appl Physiol Occup Physiol 69:168–173

    Article  PubMed  Google Scholar 

  30. Greene D, Nai LM, Fieler VK, Dudgeon D, Jones LS (1994) A comparison of patient-reported side effects among three chemotherapy regimens for breast cancer. Cancer Pract 2:57–62

    PubMed  Google Scholar 

  31. Griffin AM, Butow PN, Coates AS, Childs AM, Ellis PM, Dunn SM, Tattersall MH (1996) On the receiving end. V. Patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7:189–195

    PubMed  Google Scholar 

  32. Groenvold M, Klee MC, Sprangers MA, Aaronson NK (1997) Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient–observer agreement. J Clin Epidemiol 50:441–450

    Article  PubMed  Google Scholar 

  33. Irvine D, Vincent L, Graydon JE, Bubela N, Thompson L (1994) The prevalence and correlates of fatigue in patients receiving treatment with chemotherapy and radiotherapy. A comparison with the fatigue experienced by healthy individuals. Cancer Nurs 17:367–378

    PubMed  Google Scholar 

  34. Klee M, Groenvold M, Machin D (1997) Quality of life of Danish women: population-based norms of the EORTC QLQ-C30. Qual Life Res 6:27–34

    Article  PubMed  Google Scholar 

  35. Kolden GG, Strauman TJ, Ward A, Kuta J, Woods TE, Schneider KL, Heerey E, Sanborn L, Burt C, Millbrandt L, Kalin NH, Stewart JA, Mullen B (2002) A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psychooncology 11:447–456

    PubMed  Google Scholar 

  36. Lucia A, Earnest C, Perez M (2003) Cancer-related fatigue: can exercise physiology assist oncologists? Lancet Oncol 4:616–625

    Article  PubMed  Google Scholar 

  37. Luebbert K, Dahme B, Hasenbring M (2001) The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non-surgical cancer treatment: a meta-analytical review. Psychooncology 10:490–502

    PubMed  Google Scholar 

  38. Lyles JN, Burish TG, Krozely MG, Oldham RK (1982) Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy. J Consult Clin Psychol 50:509–524

    Article  PubMed  Google Scholar 

  39. MacVicar MG, Winningham ML, Nickel JL (1989) Effects of aerobic interval training on cancer patients’ functional capacity. Nurs Res 38:348–351

    PubMed  Google Scholar 

  40. Malterud K (2001) The art and science of clinical knowledge: evidence beyond measures and numbers. Lancet 358:397–400

    Article  PubMed  Google Scholar 

  41. Michelson H, Bolund C, Nilsson B, Brandberg Y (2000) Health-related quality of life measured by the EORTC QLQ-C30-reference values from a large sample of Swedish population. Acta Oncol 39:477–484

    Article  PubMed  Google Scholar 

  42. Mock V, Pickett M, Ropka ME, Muscari E, Stewart KJ, Rhodes VA, McDaniel R, Grimm PM, Krumm S, McCorkle R (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 9:119–127

    Article  PubMed  Google Scholar 

  43. Mock V, Frangakis C, Davidson NE, Ropka ME, Pickett M, Poniatowski B, Stewart KJ, Cameron L, Zawacki K, Podewils LJ, Cohen G, McCorkle R (2005) Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology 14:464–477

    PubMed  Google Scholar 

  44. Molassiotis A, Yung HP, Yam BMC, Chan FYS, Mok TSK (2002) The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial. Support Care Cancer 10:237–246

    Article  PubMed  Google Scholar 

  45. Nail LM, Jones LS (1995) Fatigue as a side effect of cancer treatment: impact on quality of life. Qual Life—A Nursing Challenge 4:8–13

    Google Scholar 

  46. Pensgaard AM, Ursin H (1998) Stress, control, and coping in elite athletes. Scand J Med Sci Sports 8:183–189

    PubMed  Google Scholar 

  47. Pinto BM, Eakin E, Maruyama NC (2000) Health behavior changes after a cancer diagnosis: what do we know and where do we go from here? Ann Behav Med 22:38–52

    PubMed  Google Scholar 

  48. Polit DF, Beck CT (2003) Nursing research: principles and methods, 7th edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  49. Saltin B, Gollnick PD (1983) Skeletal muscle adaptability: significance for metabolism and performance. In: Peachey LD, Adrian PH, Geiger SR (eds) Handbook of physiology—skeletal muscle, American Physiological Society, Washington, DC, pp 555–631

    Google Scholar 

  50. Schwartz AL (1999) Fatigue mediates the effects of exercise on quality of life. Qual Life Res 8:529–538

    Article  PubMed  Google Scholar 

  51. Schwartz AL, Mori M, Gao R, Nail LM, King ME (2001) Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med Sci Sports Exerc 33:718–723

    Article  PubMed  Google Scholar 

  52. Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J, Woodard S, Wells G, Reid R (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19:657–665

    PubMed  Google Scholar 

  53. Sloman R, Brown P, Aldana E, Chee E (1994) The use of relaxation for the promotion of comfort and pain relief in persons with advanced cancer. Contemp Nurse 3:6–12

    PubMed  Google Scholar 

  54. Sloman R (1995) Relaxation and the relief of cancer pain. Nurs Clin North Am 30:697–709

    PubMed  Google Scholar 

  55. Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC (1993) Fatigue in cancer patients. Br J Cancer 68:220–224

    PubMed  Google Scholar 

  56. Stricker CT, Drake D, Hoyer K-A, Mock V (2004) Evidence-based practice for fatigue management in adults with cancer: exercise as an intervention. Oncol Nurs Forum 31:963–976

    PubMed  Google Scholar 

  57. Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE (1995) Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain 63:189–198

    Article  PubMed  Google Scholar 

  58. Troesch LM, Rodehaver CB, Delaney EA, Yanes B (1993) The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncol Nurs Forum 20:1179–1185

    PubMed  Google Scholar 

  59. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I: conceptual framework and item selection. Med Care 30:473–483

    PubMed  Google Scholar 

  60. Weinrich SP, Weinrich MC (1990) The effect of massage on pain in cancer patients. Appl Nurs Res 3:140–145

    PubMed  Google Scholar 

  61. Winningham ML, MacVicar MG, Burke CA (1986) Exercise for cancer patients: guidelines and precautions. Phys Sportsmed 14:125–134

    Google Scholar 

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Acknowledgements

This research was supported by grants from The Egmont Foundation, The Lundbeck Foundation, The Novo Nordic Foundation, The Svend Andersen Foundation, The Danish Cancer Society, The Becket Foundation, The Åse & Ejnar Foundation, and The Copenhagen Hospital Cooperation.

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Authors and Affiliations

  1. The University Hospitals Centre for Nursing and Care Research, Department 7331, The University Hospital of Copenhagen, Blegdamvej 9, 2100, Copenhagen, Denmark

    Lis Adamsen, Morten Quist, Julie Midtgaard, Lasse Knutsen & Anders Tveterås

  2. Department of Oncology, Department 5073, The University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Christina Andersen & Mikael Rorth

  3. Department of Hematology, Department 4042, The University Hospital of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Tom Møller

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  1. Lis Adamsen
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Correspondence to Lis Adamsen.

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Adamsen, L., Quist, M., Midtgaard, J. et al. The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Support Care Cancer 14, 116–127 (2006). https://doi.org/10.1007/s00520-005-0864-x

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  • DOI: https://doi.org/10.1007/s00520-005-0864-x

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