Onkologische Trainings- und Bewegungstherapie (OTT)

 

 Buy Article Permissions and Reprints

Zusammenfassung

Eine medizinisch-onkologische Therapie, aber auch die Krebserkrankung selbst verursacht zahlreiche akute wie auch chronische Nebenwirkungen. Vermehrt bestätigen Studien die validen Effekte von Bewegungstherapie zur bio-psycho-sozialen Regeneration. Doch fehlen in der onkologischen Versorgung bislang patientenorientierte Bewegungskonzepte, die die Translation wissenschaftlicher Erkenntnisse in die Therapie und Praxis ermöglichen. Reviews und RCT-Studien zu den Effekten von körperlicher Aktivität auf krebsspezifische Defizite zeigen, dass spezifische Bewegungsprogramme einen positiven Einfluss auf Fatigue-Syndrom, Harninkontinenz, Lymphödem, Polyneuropathie, Arthralgie und den Nebenwirkungen einer Hormontherapie haben. Mit der zunehmend aussagekräftigeren Evidenz zur körperlichen Aktivität in der Onkologie können im nächsten Schritt die aus den Studien resultierenden Empfehlungen in Praxis und Therapie übertragen werden. Dazu wurde das personalisierte Behandlungskonzept „Onkologische Trainings- und Bewegungstherapie“ (OTT) entwickelt.

Abstract

Oncological treatments can lead to acute and chronic cancer related toxicities. In recent years, a large number of clinical studies have reported positive effects of exercise to the bio-psycho-social regeneration of cancer patients. However, very few evidence-based programs have been implemented into practice with little opportunity for cancer patients to engage in such programs. Reviews and RCT studies on exercise and cancer are showing that specific exercise programs have a positive impact on fatigue syndrome, urinary incontinence, lymphedema, polyneuropathy, arthralgia, and androgen deprivation related toxicities. With the increasing evidence for exercise oncology interventions, recommendations arising from clinical trials should be translated into clinical practice and this should be viewed as an important next step in this fast moving field of exercise oncology. For that the personalized treatment concept „Oncologic clinical exercise“ (OTT) was developed.

• Literatur

• 1 Ahmed R, Thomas W, Yee D, Schmitz K. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol 2006; 24: 2765-2772
  CrossrefPubMedGoogle Scholar
• 2 American College of Sports Medicine. Position Stand: Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults. Med Sci Sports Exerc 2011; 1334-1359
  PubMedGoogle Scholar
• 3 Andersen C, Rørth M, Ejlertsen B et al. The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue. Eur J Oncol Nurs 2013; 17: 331-339
  CrossrefPubMedGoogle Scholar
• 4 Baumann FT, Bernhörster M, Dimeo FC et al. Kommission „Krebs und Sport“ der Deutschen Krebsgesellschaft. Teil 1: Richtlinien für die Anwendung von Sport und körperlicher Aktivität in der Prävention, supportiven Therapie und Rehabilitation neoplastischer Erkrankungen. Forum – Das offizielle Magazin der Deutschen Krebsgesellschaft e. V. 2009; 4: 14-17
  PubMedGoogle Scholar
• 5 Baumann FT, Bernhörster M, Dimeo FC et al. Kommission „Krebs und Sport“ der Deutschen Krebsgesellschaft. Teil 2: Richtlinien für die Anwendung von Sport und körperlicher Aktivität in der Prävention, supportiven Therapie und Rehabilitation neoplastischer Erkrankungen. Forum – Das offizielle Magazin der Deutschen Krebsgesellschaft e. V. 2009; 5: 9-12
  PubMedGoogle Scholar
• 6 Baumann FT, Zopf EM, Bloch W. Clinical exercise interventions in prostate cancer patients – a systematic review of randomized controlled trials. Support Care Cancer 2012; 20: 212-233
  PubMedGoogle Scholar
• 7 Baumann FT, Bloch W, Weissen A et al. Physical activity in breast cancer patients during medical treatment and in the aftercare. Breast Care 2013; 8: 330-334
  CrossrefPubMedGoogle Scholar
• 8 Ballard-Barbash R, Friedenreich CM, Courneya KS et al. Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 2012; 104: 815-840
  CrossrefPubMedGoogle Scholar
• 9 Cantarero-Villanueva I, Fernández-Lao C, Cuesta-Vargas AI et al. The effectiveness of a deep water aquatic exercise program in cancer-related fatigue in breast cancer survivors: a randomized controlled trial. Arch Phys Med Rehabil 2013; 94: 221-230
  CrossrefPubMedGoogle Scholar
• 10 Carayol M, Bernard P, Boiché J et al. Psychological effect of exercise in women with breast cancer receiving adjuvant therapy: what is the optimal dose needed?. Ann Oncol 2013; 24: 291-300
  CrossrefPubMedGoogle Scholar
• 11 Centemero A, Rigatti L, Giraudo D et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomised controlled study. Eur Urol 2010; 57: 1039-104
  CrossrefPubMedGoogle Scholar
• 12 Cormie P, Galvão DA, Spry N et al. Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int 2014; 115: 256-266
  PubMedGoogle Scholar
• 13 Cormie P, Newton RU, Spry N et al. Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 2013; 16: 328-335
  CrossrefPubMedGoogle Scholar
• 14 Cormie P, Pumpa K, Galvão DA et al. Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: a randomised controlled trial. J Cancer Surviv 2013; 7: 413-424
  CrossrefPubMedGoogle Scholar
• 15 Cormie P, Spry N, Jasas K et al. Exercise as medicine in the management of pancreatic cancer: a case study. Med Sci Sports Exerc 2014; 46: 664-670
  PubMedGoogle Scholar
• 16 Courneya KS, Friedenreich CM. Physical Activity and Cancer. Berlin: Springer; 2011
  CrossrefGoogle Scholar
• 17 Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012; 11 CD006145
  PubMedGoogle Scholar
• 18 Dimeo F, Stieglitz RD, Novelli-Fischer U et al. Correlation between physical performance and fatigue in cancer patients. Ann Oncol 1997; 8: 1251-1255
  CrossrefPubMedGoogle Scholar
• 19 Fernandez-Lao CC, Cantarero-Villanueva I, Ariza-Garcia A et al. Water versus land-based multimodal exercise program effects on body composition in breast cancer survivors: a controlled clinical trial. Support Care Cancer 2013; 21: 521-530
  CrossrefPubMedGoogle Scholar
• 20 Serdà BC, Marcos-Gragera R. Urinary incontinence and prostate cancer: A progressive rehabilitation program design. Rehabil Nurs 2014; 39: 271-280
  CrossrefPubMedGoogle Scholar
• 21 Galvão DA, Spry N, Denham J et al. A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TROG 03. 04 RADAR. Eur Urol 2014; 65: 856-864
  CrossrefPubMedGoogle Scholar
• 22 Galvão DA, Taaffe DR, Spry N et al. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 2010; 28: 340-347
  CrossrefPubMedGoogle Scholar
• 23 Galvão DA, Taaffe DR, Spry N, Newton RU. Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. Prostate Cancer Prostatic Dis 2007; 10: 340-346
  CrossrefPubMedGoogle Scholar
• 24 Hayes S, Spence R, Galvao D et al. Australian Association for Exercise and Sport Science Position Stand: Optimising cancer outcomes through exercise. J Sci Med Sport  2009; 12: 428-434
  PubMedGoogle Scholar
• 25 Husebø AM, Dyrstad SM, Mjaaland IA et al. Effects of scheduled exercise on cancer-related fatigue in women with early breast cancer. Sci World J 2014; DOI: 10.1155/2014/271828.
  PubMedGoogle Scholar
• 26 Irwin ML, Cartmel B, Gross CP et al. Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors. J Clin Oncol 2015; 1; 33: 1104-1111
  PubMedGoogle Scholar
• 27 Jeffs E, Wiseman T. Randomised controlled trial to determine the benefit of daily home-based exercise in addition to self-care in the management of breast cancer-related lymphoedema: a feasibility study. Support Care Cancer 2013; 21: 1013-1023
  CrossrefPubMedGoogle Scholar
• 28 Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 2005; 23: 3830-3842
  CrossrefPubMedGoogle Scholar
• 29 Letellier ME, Towers A, Shimony A, Tidhar D. Breast cancer-related lymphedema. A randomized controlled pilot and feasibility study. Am J Phys Med Rehabil 2014; 93: 751-759
  CrossrefPubMedGoogle Scholar
• 30 McNeely ML, Courneya KS. Exercise programs for cancer-related fatigue: evidence and clinical guidelines. J Natl Compr Canc Netw 2010; 8: 945-953
  PubMedGoogle Scholar
• 31 Mishra SI, Scherer RW, Geigle PM et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 2012; 15; 8 CD007566
  PubMedGoogle Scholar
• 32 Mishra SI, Scherer RW, Snyder C et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 2012; 15; 8 CD008465
  PubMedGoogle Scholar
• 33 Nikander R, Sievänen H, Ojala K et al. Effect of exercise on bone structural traits, physical performance and body composition in breast cancer patients – a 12-month RCT. J Musculoskelet Neuronal Interact 2012; 12: 127-135
  PubMedGoogle Scholar
• 34 Overgard M, Angelsen A, Lydersen S, Morkved S. Does physiotherapist-guided pelvic floor muscle training reduce urinary incontinence after radical prostatectomy? A randomised controlled trial. Europ Urol 2008; 54: 438-448
  CrossrefPubMedGoogle Scholar
• 35 Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 2003; 21: 1653-1659
  CrossrefPubMedGoogle Scholar
• 36 Segal RJ, Reid RD, Courneya RJ et al. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation for prostate cancer. J Clin Oncol 2009; 27: 344-351
  CrossrefPubMedGoogle Scholar
• 37 Schmitz KH, Courneya KS, Matthews C et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010; 42: 1409-1426
  CrossrefPubMedGoogle Scholar
• 38 Schmitz K, Ahmed RL, Troxel A et al. Weight lifting in women with breast cancer-related lymphedema. New Engl J Med 2009; 361: 664-673
  CrossrefPubMedGoogle Scholar
• 39 Schüle K. Thirty years of physical activity in oncology in Germany – from the birth of the first rehabilitative cancer sports group until today. Europ Rev Aging Phys Activity 2013; 10: 61-64
  PubMedGoogle Scholar
• 40 Singh F, Newton RU, Galvão DA et al. A systematic review of pre-surgical exercise intervention studies with cancer patients. Surg Oncol 2013; 22: 92-104
  CrossrefPubMedGoogle Scholar
• 41 Steindorf K, Schmidt ME, Klassen O et al. Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 2014; 25: 2237-2243
  CrossrefPubMedGoogle Scholar
• 42 Streckmann F, Zopf EM, Lehmann HC et al. Exercise intervention studies in patients with peripheral neuropathy: A systematic review. Sports Medicine 2014; 44: 1289-1304
  CrossrefPubMedGoogle Scholar
• 43 Streckmann F, Kneis S, Leifert JA et al. Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Ann Oncol 2014; 25: 493-499
  CrossrefPubMedGoogle Scholar
• 44 Streckmann F, Rittweger J, Bloch W et al. Bewegungsempfehlungen bei Chemotherapieinduzierter peripherer Polyneuropathie. B&G Bewegungstherapie und Gesundheitssport 2014; 30: 179-182
  Article in Thieme ConnectPubMedGoogle Scholar
• 45 Tidhar D, Katz-Leurer M. Aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study. Support Care Cancer 2009; 18: 383-392
  PubMedGoogle Scholar
• 46 Uth J, Hornstrup T, Schmidt JF et al. Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy. Scand J Med Sci Sports 2014; 105-112
  PubMedGoogle Scholar
• 47 Winters-Stone KM, Dobek JC, Bennett JA et al. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: Evidence from a randomized controlled trial. Arch Phys Med Rehabil 2015; 96: 7-14
  CrossrefPubMedGoogle Scholar
• 48 WHO. International Classification of Functioning, Disability and Health (ICF). http://www.who.int/classifications/icf/en/ (letzter Zugriff 3.9.2015)
  Google Scholar