Original articleDifferential Effects of Cardiovascular and Resistance Exercise on Functional Mobility in Individuals With Advanced Cancer: A Randomized Trial
Section snippets
Participants
Participants were patients aged ≥18 years with advanced cancer who were recruited to attend an oncology-specific exercise program at a hospital-based fitness facility between February 2010 and March 2012. We operationally defined advanced cancers as those determined by an oncologist to be in the terminal (ie, tertiary, incurable) stage of diagnosis. Participants were recruited through the cancer center, palliative care service, rehabilitation department, and a local hospice. Study candidates
Results
Sixty-six participants (30 men; 36 women; mean age ± SD, 62.35±12.49y) were randomly assigned to either the resistance (n=34) or cardiovascular (n=32) group. Most were white, with a diagnosis of breast, lung, or colorectal cancer. Many participants reported receiving chemotherapy or combination treatment during the study. There were no significant differences in age or sex between groups. Baseline participant demographic characteristics appear in table 1. The trial was discontinued once the
Discussion
The findings revealed that both resistance and cardiovascular training appeared to contribute to improved functional mobility in a sample of individuals with advanced cancer who were interested in exercise. The results generally confirmed the outcome of preliminary studies.21, 22 In contrast with the initial hypothesis, however, there did not appear to be a substantial differential effect of 1 mode of exercise compared with the other. Indeed, the modest differential effect identified in the
Conclusions
Individuals with advanced cancer struggle with disease and treatment-related symptoms that limit their functional mobility. The findings of this pilot study suggested that for individuals with advanced cancer who are willing and interested in exercise, the benefits of exercise for reducing fatigue and improving functional mobility do not appear to depend on exercise mode. Future research that supports the ongoing development of exercise guidelines for this population is strongly encouraged.
Suppliers
- a.
SPSS Inc, 233 S Wacker Dr, 11th Fl, Chicago, IL 60606.
- b.
NuStep TRS 4000; NuStep Inc, 5111 Venture Dr, Ste 1, Ann Arbor, MI 48108.
- c.
LifeGlider 3000; Rehabco, LLC, 424 Commerce Rd, Staunton, VA 24401.
Acknowledgments
This study would not have been possible without the dedication of our inspirational cancer survivors. We wish to thank the staff of Exeter Hospital Center for Cancer Care and the Cancer Well-fit Program for its help conducting the study. We also wish to thank the Northern New England Clinical Oncology Society for its generous support.
References (53)
- et al.
Identifying factors associated with falls in postmenopausal breast cancer survivors: a multidisciplinary approach
Arch Phys Med Rehabil
(2011) - et al.
Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients?
Eur J Cancer
(2004) - et al.
The effect of a physical exercise program in palliative care: a phase II study
J Pain Symptom Manage
(2006) - et al.
Symptom prevalence in patients with incurable cancer: a systematic review
J Pain Symptom Manage
(2007) - et al.
Falls and physical performance deficits in older patients with prostate cancer undergoing androgen deprivation therapy
Urology
(2008) - et al.
Prognostic significance of symptoms of hospitalized advanced cancer patients
Eur J Cancer
(2006) The reliability and validity of pain measures in adults with cancer
J Pain
(2003)- et al.
A study to assess the existence of the symptom cluster of breathlessness, fatigue and anxiety in patients with advanced lung cancer
Eur J Oncol Nurs
(2005) - et al.
Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients
J Pain Symptom Manage
(2000) - et al.
Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients
J Pain Symptom Manage
(2001)
The problems experienced by patients with cancer and their needs for palliative care
Support Care Cancer
Symptom patterns of advanced cancer in patients in a palliative care unit
Palliat Med
Quality of life of cancer patients receiving inpatient and home-based palliative care
J Adv Nurs
The role of physical and psychological symptoms in desire for death: a study of terminally ill cancer patients
Psychooncology
An examination of the causes for the underutilization of rehabilitation services among people with advanced cancer
Am J Phys Med Rehabil
Pressure ulcers in palliative care: development of a hospice pressure ulcer risk assessment scale
Int J Palliat Nurs
Fall risk factors and the nature of falls in inpatient oncology and palliative care settings
Contemp Nurse
Physical performance and subsequent disability and survival in older adults with malignancy: results from the health, aging, and body composition study
J Am Geriatr Soc
Quantitative assessment of cardiorespiratory fitness, skeletal muscle function, and body composition in adults with primary malignant glioma
Cancer
Physical activity for cancer survivors: meta-analysis of randomized controlled trials
BMJ
Utilization of services among elderly cancer patients—relationship to age, symptoms, physical functioning, comorbidity, and survival status
Ethn Dis
Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer
J Clin Oncol
The detection and treatment of cancer-related functional problems in an outpatient setting
Support Care Cancer
Exercise intervention research for patients with cancer on treatment
Semin Oncol Nurs
Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review
J Natl Cancer Inst
Exercise is an effective treatment modality for reducing cancer-related fatigue and improving physical capacity in cancer patients and survivors: a meta-analysis
Appl Physiol Nutr Metab
Cited by (51)
Nurse-Supervised Exercise for People with Stage IV Cancer: The EFICANCER Randomized Clinical Trial
2023, Seminars in Oncology NursingExercise for individuals with bone metastases: A systematic review
2021, Critical Reviews in Oncology/HematologyCitation Excerpt :Overall, unsupervised exercise was included with 892 (60% of total) participants. Exercise supervision was predominantly provided by qualified exercise professionals (n = 13, 76%) including physical therapists/physiotherapists (n = 6, 35%) (Cheville et al., 2019; Litterini et al., 2013; Rief et al., 2014a, b, c, d, 2016; Sprave et al., 2019; Uster et al., 2018; Villumsen et al., 2019), clinical exercise physiologists (n = 6, 35%) (Bourke et al., 2011, 2014; Cormie et al., 2013; Galvão et al., 2018; Scott et al., 2018; Sprave et al., 2019) or other university trained exercise professionals (e.g., kinesiologists or sports therapists) (n = 3, 18%) (Litterini et al., 2013; Yee et al., 2019; Rosenberger et al., 2017). All but one trial reported on adverse events (AEs) (Bourke et al., 2011), with nine (53%) trials measuring AEs in both intervention and comparator groups and seven (41%) trials measuring AEs in the intervention group only (Table 2).
Physical Activity for Individuals Living with Advanced Cancer: Evidence and Recommendations
2021, Seminars in Oncology NursingCancer-Related Fatigue in Breast and Gynecologic Cancers
2020, Breast Cancer and Gynecologic Cancer RehabilitationExercise interventions for patients with advanced cancer: A systematic review of recruitment, attrition, and exercise adherence rates
2019, Palliative and Supportive CarePhysical activity and pain in people with cancer: a systematic review and meta-analysis
2024, Supportive Care in Cancer
Current affiliations for Litterini, Department of Physical Therapy, University of New England, Portland, ME; and Fieler, Department of Nursing, St. Joseph Hospital, Nashua, NH.
Supported by the Northern New England Clinical Oncology Society and Exeter Hospital.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.