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Erschienen in: Journal of Cancer Survivorship 4/2013

01.12.2013

Feasibility and efficacy of a supervised exercise intervention in de-conditioned cancer survivors during the early survivorship phase: the PEACH trial

verfasst von: J. M. Broderick, E. Guinan, M. J. Kennedy, D. Hollywood, K. S. Courneya, S. N. Culos-Reed, K. Bennett, D. M. O’ Donnell, J. Hussey

Erschienen in: Journal of Cancer Survivorship | Ausgabe 4/2013

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Abstract

Purpose

This study aims to evaluate the feasibility and efficacy of an 8-week supervised exercise program in de-conditioned cancer survivors within 2–6 months of chemotherapy completion.

Methods

Participants were randomly assigned to an 8-week, twice-weekly, supervised aerobic exercise training regime (n = 23) or a usual care group (n = 20). Feasibility was assessed by recruitment rate, program adherence and participant feedback. The primary outcome was aerobic fitness assessed by the Modified Bruce fitness test at baseline (0 weeks), post-intervention (8 weeks) and at 3-month follow-up. Secondary outcomes included physical activity, waist circumference, fatigue and quality of life.

Results

The recruitment rate was 81 % and adherence to the supervised exercise was 78.3 %. Meaningful differences in aerobic fitness between the exercise and usual care groups at both the 8-week [mean 3.0 mL kg−1 min−1 (95 % CI −1.1–7.0)] and 3-month follow-up [2.1 mL kg−1 min−1 (−2.3–6.6)] were found, although these differences did not achieve statistical significance (p values >0.14). Self-reported physical activity increased in the exercise group (EG) compared to the usual care group at both 8-week (p = 0.01) and 3-month follow-up (p = 0.03) and significant differences in favour of the EG were found for physical well-being at both the 8-week (p = 0.03) and 3-month follow-up (p = 0.04). Improvements in fatigue (p = 0.01), total quality of life plus fatigue (p = 0.04), and a composite physical functioning score (p = 0.01) at the 3-month follow-up were also found.

Conclusion

The PEACH trial suggests that 8 weeks of supervised aerobic exercise training was feasible and may improve aerobic fitness, fatigue and quality of life in de-conditioned cancer survivors during the early survivorship phase.

Implications for Cancer Survivors

Exercise interventions commenced in the early survivorship phase appear safe, feasible and may lead to improvements in QOL and fatigue.
Literatur
5.
Zurück zum Zitat Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100. doi:10.1007/s11764-009-0110-5.PubMedCrossRef Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100. doi:10.​1007/​s11764-009-0110-5.PubMedCrossRef
6.
Zurück zum Zitat Duijts SF, Faber MM, Oldenburg HS, van Beurden M, Aaronson NK. Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors—a meta-analysis. Psychooncology. 2011;20(2):115–26. doi:10.1002/pon.1728.PubMedCrossRef Duijts SF, Faber MM, Oldenburg HS, van Beurden M, Aaronson NK. Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors—a meta-analysis. Psychooncology. 2011;20(2):115–26. doi:10.​1002/​pon.​1728.PubMedCrossRef
7.
Zurück zum Zitat Courneya KS, Friedenreich CM. Framework PEACE: an organizational model for examining physical exercise across the cancer experience. Ann Behav Med. 2001;23(4):263–72.PubMedCrossRef Courneya KS, Friedenreich CM. Framework PEACE: an organizational model for examining physical exercise across the cancer experience. Ann Behav Med. 2001;23(4):263–72.PubMedCrossRef
10.
Zurück zum Zitat Thorsen L, Skovlund E, Stromme SB, Hornslien K, Dahl AA, et al. Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. J Clin Oncol. 2005;23(10):2378–88. doi:10.1200/jco.2005.04.106.PubMedCrossRef Thorsen L, Skovlund E, Stromme SB, Hornslien K, Dahl AA, et al. Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. J Clin Oncol. 2005;23(10):2378–88. doi:10.​1200/​jco.​2005.​04.​106.PubMedCrossRef
12.
Zurück zum Zitat McGowan EL, Speed-Andrews AE, Blanchard CM, Rhodes RE, Friedenreich CM, et al. Physical activity preferences among a population-based sample of colorectal cancer survivors. Oncol Nurs Forum. 2013;40(1):44–52. doi:10.1188/13.onf.44-52.PubMedCrossRef McGowan EL, Speed-Andrews AE, Blanchard CM, Rhodes RE, Friedenreich CM, et al. Physical activity preferences among a population-based sample of colorectal cancer survivors. Oncol Nurs Forum. 2013;40(1):44–52. doi:10.​1188/​13.​onf.​44-52.PubMedCrossRef
15.
Zurück zum Zitat Karvinen KH, Courneya KS, Campbell KL, Pearcey RG, Dundas G, et al. Exercise preferences of endometrial cancer survivors: a population-based study. Cancer Nurs. 2006;29(4):259–65.PubMedCrossRef Karvinen KH, Courneya KS, Campbell KL, Pearcey RG, Dundas G, et al. Exercise preferences of endometrial cancer survivors: a population-based study. Cancer Nurs. 2006;29(4):259–65.PubMedCrossRef
17.
Zurück zum Zitat Irwin ML, Crumlet D, Mc Tiernan A. Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity (HEAL) study. Cancer. 2003;97(7):1746–57.PubMedCrossRef Irwin ML, Crumlet D, Mc Tiernan A. Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity (HEAL) study. Cancer. 2003;97(7):1746–57.PubMedCrossRef
18.
19.
Zurück zum Zitat Nikander R, Sievanen H, Ojala K, Oivanen T, Kellokumpu-Lehtinen PL, et al. Effect of a vigorous aerobic regimen on physical performance in breast cancer patients—a randomized controlled pilot trial. Acta Oncol. 2007;46(2):181–6. doi:10.1080/02841860600833145.PubMedCrossRef Nikander R, Sievanen H, Ojala K, Oivanen T, Kellokumpu-Lehtinen PL, et al. Effect of a vigorous aerobic regimen on physical performance in breast cancer patients—a randomized controlled pilot trial. Acta Oncol. 2007;46(2):181–6. doi:10.​1080/​0284186060083314​5.PubMedCrossRef
21.
Zurück zum Zitat Vallance JK, Courneya KS, Jones LW, Reiman T. Exercise preferences among a population-based sample of non-Hodgkin’s lymphoma survivors. Eur J Cancer Care. 2005;15:34–43.CrossRef Vallance JK, Courneya KS, Jones LW, Reiman T. Exercise preferences among a population-based sample of non-Hodgkin’s lymphoma survivors. Eur J Cancer Care. 2005;15:34–43.CrossRef
22.
Zurück zum Zitat Jones L, Courneya KS. Exercise counseling and programming preferences of cancer survivors. Cancer Pract. 2002;10:208–15.PubMedCrossRef Jones L, Courneya KS. Exercise counseling and programming preferences of cancer survivors. Cancer Pract. 2002;10:208–15.PubMedCrossRef
23.
Zurück zum Zitat Rogers LQ, Markwell SJ, Verhulst S, McAuley E, Courneya KS. Rural breast cancer survivors: exercise preferences and their determinants. Psychooncology. 2009;18(4):412–21. doi:10.1002/pon.1497.PubMedCrossRef Rogers LQ, Markwell SJ, Verhulst S, McAuley E, Courneya KS. Rural breast cancer survivors: exercise preferences and their determinants. Psychooncology. 2009;18(4):412–21. doi:10.​1002/​pon.​1497.PubMedCrossRef
24.
Zurück zum Zitat Walsh JM, Hussey J, Guinan E, O’Donnell D. 'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': a feasibility study PEACH trial: prescribed exercise after chemotherapy. BMC Cancer. 2010;10:42. doi:10.1186/1471-2407-10-42.PubMedCrossRef Walsh JM, Hussey J, Guinan E, O’Donnell D. 'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': a feasibility study PEACH trial: prescribed exercise after chemotherapy. BMC Cancer. 2010;10:42. doi:10.​1186/​1471-2407-10-42.PubMedCrossRef
25.
Zurück zum Zitat Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, et al. Exercise standards for testing and training. A statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694–740.PubMedCrossRef Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, et al. Exercise standards for testing and training. A statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694–740.PubMedCrossRef
26.
Zurück zum Zitat Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–81.PubMedCrossRef Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377–81.PubMedCrossRef
27.
Zurück zum Zitat Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef
28.
29.
Zurück zum Zitat Fielding RA, Frontera WR, Hughes VA, Fisher EC, Evans WJ. The reproducibility of the Bruce protocol exercise test for the determination of aerobic capacity in older women. Med Sci Sports Exerc. 1997;29(8):1109–13.PubMedCrossRef Fielding RA, Frontera WR, Hughes VA, Fisher EC, Evans WJ. The reproducibility of the Bruce protocol exercise test for the determination of aerobic capacity in older women. Med Sci Sports Exerc. 1997;29(8):1109–13.PubMedCrossRef
30.
Zurück zum Zitat Glass S, Dwyer G. ACSM’s metabolic calculations handbook. 1st ed. Baltimore: Lippincott Williams and Wilkins; 2006. Glass S, Dwyer G. ACSM’s metabolic calculations handbook. 1st ed. Baltimore: Lippincott Williams and Wilkins; 2006.
31.
Zurück zum Zitat McArdle WD, Katch FI, Katch FI. Essentials of exercise physiology. 4th ed: Lippincott Williams and Wilkins; 2010. McArdle WD, Katch FI, Katch FI. Essentials of exercise physiology. 4th ed: Lippincott Williams and Wilkins; 2010.
32.
Zurück zum Zitat Cella D, Tulsky DS, Gray G, Sarafin B, Linn E, et al. The Functional Assessment of Cancer Therapy Scale: development and validation of the general measure. J Clin Oncol. 1993;11(3):570–9.PubMed Cella D, Tulsky DS, Gray G, Sarafin B, Linn E, et al. The Functional Assessment of Cancer Therapy Scale: development and validation of the general measure. J Clin Oncol. 1993;11(3):570–9.PubMed
33.
Zurück zum Zitat Cella D, Eton DT, Lai JS. Combining anchor and distribution based methods to derive clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage. 2002;24:547–61.PubMedCrossRef Cella D, Eton DT, Lai JS. Combining anchor and distribution based methods to derive clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage. 2002;24:547–61.PubMedCrossRef
34.
Zurück zum Zitat Cella D. The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol. 1997;34(3 Suppl 2):13–9.PubMed Cella D. The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol. 1997;34(3 Suppl 2):13–9.PubMed
35.
Zurück zum Zitat Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey. Manual and interpretation guide. Boston: The Health institute, New England Medical Center; 1993. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey. Manual and interpretation guide. Boston: The Health institute, New England Medical Center; 1993.
36.
Zurück zum Zitat Ware JE, Kosinski M, Dewey JE. How to score Version Two of the SF-36 Health Survey. Lincoln: Quality Metric; 2000. Ware JE, Kosinski M, Dewey JE. How to score Version Two of the SF-36 Health Survey. Lincoln: Quality Metric; 2000.
39.
Zurück zum Zitat Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(11 Suppl):S531–43.PubMedCrossRef Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(11 Suppl):S531–43.PubMedCrossRef
40.
Zurück zum Zitat Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167(7):875–81. doi:10.1093/aje/kwm390.PubMedCrossRef Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol. 2008;167(7):875–81. doi:10.​1093/​aje/​kwm390.PubMedCrossRef
41.
42.
Zurück zum Zitat Godin G, Shephard RJ. A simple method to assess exercise behaviour in the community. Can J Appl Sports Sci. 1985;10:141–6. Godin G, Shephard RJ. A simple method to assess exercise behaviour in the community. Can J Appl Sports Sci. 1985;10:141–6.
43.
Zurück zum Zitat Godin G, Shephard RJ. Godin Leisure-Time Exercise Questionnaire. Med Sci Sports Exerc. 1997;29 June Supplement:S36–S8. Godin G, Shephard RJ. Godin Leisure-Time Exercise Questionnaire. Med Sci Sports Exerc. 1997;29 June Supplement:S36–S8.
45.
Zurück zum Zitat Stevinson C, Lawlor DA, Fox KR. Exercise interventions for cancer patients: systematic review of controlled trials. Cancer Causes Control. 2004;15(10):1035–56.PubMedCrossRef Stevinson C, Lawlor DA, Fox KR. Exercise interventions for cancer patients: systematic review of controlled trials. Cancer Causes Control. 2004;15(10):1035–56.PubMedCrossRef
46.
Zurück zum Zitat Milne HM, Wallman KE, Gordon S, Courneya KS. Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat. 2008;108(2):279–88. doi:10.1007/s10549-007-9602-z.PubMedCrossRef Milne HM, Wallman KE, Gordon S, Courneya KS. Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat. 2008;108(2):279–88. doi:10.​1007/​s10549-007-9602-z.PubMedCrossRef
47.
Zurück zum Zitat Courneya KS, Friedenreich CM. Physical activity and cancer control. Semin Oncol. 2007;23(4):242–52.CrossRef Courneya KS, Friedenreich CM. Physical activity and cancer control. Semin Oncol. 2007;23(4):242–52.CrossRef
48.
Zurück zum Zitat Myers J, Prakash M, Froelicher V. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793–801.PubMedCrossRef Myers J, Prakash M, Froelicher V. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793–801.PubMedCrossRef
49.
Zurück zum Zitat Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, et al. Randomized controlled trial of exercise training in post-menopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21:1660–8.PubMedCrossRef Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, et al. Randomized controlled trial of exercise training in post-menopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21:1660–8.PubMedCrossRef
50.
Zurück zum Zitat Courneya KS, Sellar CM, Stevinson C, McNeely ML, Peddle CJ, et al. Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol. 2009;27(27):4605–12. doi:10.1200/jco.2008.20.0634.PubMedCrossRef Courneya KS, Sellar CM, Stevinson C, McNeely ML, Peddle CJ, et al. Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol. 2009;27(27):4605–12. doi:10.​1200/​jco.​2008.​20.​0634.PubMedCrossRef
51.
52.
Zurück zum Zitat Dimeo FC, Stieglitz RD, Novelli-Fischer U, Fetscher S, Keul J. Effects of physical activity on the fatigue and physiologic status of cancer patients during chemotherapy. Cancer. 1999;85:2273–7.PubMedCrossRef Dimeo FC, Stieglitz RD, Novelli-Fischer U, Fetscher S, Keul J. Effects of physical activity on the fatigue and physiologic status of cancer patients during chemotherapy. Cancer. 1999;85:2273–7.PubMedCrossRef
55.
Zurück zum Zitat Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.1200/jco.2006.07.9988.PubMedCrossRef Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.​1200/​jco.​2006.​07.​9988.PubMedCrossRef
Metadaten
Titel
Feasibility and efficacy of a supervised exercise intervention in de-conditioned cancer survivors during the early survivorship phase: the PEACH trial
verfasst von
J. M. Broderick
E. Guinan
M. J. Kennedy
D. Hollywood
K. S. Courneya
S. N. Culos-Reed
K. Bennett
D. M. O’ Donnell
J. Hussey
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Journal of Cancer Survivorship / Ausgabe 4/2013
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-013-0294-6

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