Exercise Effects on HRV in Cancer Patients

 

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Abstract

The present study evaluated the effects of physical exercise on heart rate variability (HRV) in cancer patients. 3 matched groups of each 15 tumour patients (60.4±8.9 years, 27 male, 18 female) were recruited: Physical exercise group 1 (acute treatment), Physical exercise group 2 (post treatment) and non-intervention group (acute treatment, no exercise). Exercise group patients received counselling for exercise and participated in a Nordic-Walking program. Short-term HRV-recordings, assessments of fatigue and quality of life (QoL) were performed prior to and 16 weeks after the exercise program initiation. MANCOVA revealed group × time differences in total power frequency domain of HRV and QoL (p<0.05). TP follow-up scores [logms²] differed significantly between non-intervention and intervention post treatment (2.0±0.5 vs. 2.6±0.5), but not between non-intervention and intervention during acute treatment. QoL follow-up scores differed significantly between non-intervention and intervention during acute treatment (47±15 vs. 64±18) and post treatment (47±15 vs. 69±19). Exercise enhances cardiac autonomic regulation of tumour patients during and after acute treatment. Because of the association of higher HRV-parameters and prolonged survival in cancer patients, improvement in autonomic control may be an important goal of exercise.

• References

• 1 Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, Haes JC. 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 I 1993; 85: 365-376
  CrossrefPubMedGoogle Scholar
• 2 Adamsen L, Quist M, Midtgaard J, Andersen C, Møller T, Knutsen L, Tveterås A, Rorth M. The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Support Care Cancer 2006; 14: 116-127
  CrossrefPubMedGoogle Scholar
• 3 Amano M, Kanda T, Ue H, Moritani T. Exercise training and autonomic nervous system activity in obese individuals. Med Sci Sport Exerc 2001; 33: 1287-1291
  CrossrefPubMedGoogle Scholar
• 4 Boullosa DA, Leicht AS, Tuimil JL.. Impact of fire-fighters training on a female with smoldering multiple myeloma. J Sport Med Phys Fitness 2010; 50: 326-329
  PubMedGoogle Scholar
• 5 Buch AN, Coote JH, Townend JN. Mortality, cardiac vagal control and physical training – what’s the link?. Exp Physiol 2002; 87: 423-435
  PubMedGoogle Scholar
• 6 Camillo CA, Laburu VM, de Gonçalves NS, Cavalheri V, Tomasi FP, Hernandes NA, Ra-mos D, Marquez Vanderlei LC, Cipulo Ramos EM, Probst VS, Pitta F. Improvement of heart rate variability after exercise training and its predictors in COPD. Resp Med 2011; 105: 1054-1062
  CrossrefPubMedGoogle Scholar
• 7 Chiang J, Koo M, Kuo TBJ, Fu C. Association between cardiovascular autonomic functions and time to death in patients with terminal hepatocellular carcinoma. J Pain Symptom Manag 2010; 39: 673-679
  CrossrefPubMedGoogle Scholar
• 8 Courneya KS, Mackey JR, Jones LW. Coping with cancer: can exercise help?. Physician Sportsmed 2000; 28: 49-73
  PubMedGoogle Scholar
• 9 Curt GA. Impact of fatigue on quality of life in oncology patients. Semin Hematol 2000; 37: 14-17
  CrossrefPubMedGoogle Scholar
• 10 Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A.. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol 2007; 25: 1713-1721
  CrossrefPubMedGoogle Scholar
• 11 Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J. Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood 1997; 90: 3390-3394
  PubMedGoogle Scholar
• 12 Dimeo F, Stieglitz RD, Novelli-Fischer U, Fetscher S, Mertelsmann R, Keul J. Correlation between physical performance and fatigue in cancer patients. Ann Oncol 1997; 8: 1251-1255
  CrossrefPubMedGoogle Scholar
• 13 Fadul N, Strasser F, Palmer JL, Yusuf SW, Guo Y, Li Z, Allo J, Bruera E. The association between autonomic dysfunction and survival in male patients with advanced cancer: a preliminary report. J Pain Symptom Manag 2010; 39: 283-290
  CrossrefPubMedGoogle Scholar
• 14 Fenzl M, Schlegel C. Herzratenvariabilität – Diagnosemittel für die Gesundheit: altersbezogene Effektgrößen. Schw Z Sportmed Sporttraum 2010; 58: 134-140
  PubMedGoogle Scholar
• 15 Galvão DA, Newton RU. Review of exercise intervention studies in cancer patients. J Clin Oncol 2005; 23: 899-909
  CrossrefPubMedGoogle Scholar
• 16 Greiser K, Kluttig A, Schumann B, Swenne C, Kors J, Kuss O, Haerting J, Schmidt H, Thiery J, Werdan K. Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002–2006. Eur J Epidemiol 2009; 24: 123-142
  CrossrefPubMedGoogle Scholar
• 17 Gulli G, Cevese A, Cappelletto P, Gasparini G, Schena F. Moderate aerobic training improves autonomic cardiovascular control in older women. Clin Auton Res 2003; 13: 196-202
  PubMedGoogle Scholar
• 18 Harriss D, Atkinson G. Update – ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
  Article in Thieme ConnectPubMedGoogle Scholar
• 19 Irvine D, Vincent L, Graydon JE, Bubela N, Thompson L. 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 1994; 17: 367-378
  PubMedGoogle Scholar
• 20 Kim DH, Kim JA, Choi YS, Kim SH, Lee JY, Kim YE. Heart rate variability and length of survival in hospice cancer patients. J Korean Med Sci 2010; 25: 1140-1145
  CrossrefPubMedGoogle Scholar
• 21 Kingwell BA. Nitric oxide as a metabolic regulator during exercise: effects of training in health and disease. Clin Exp Pharmacol Physiol 2000; 27: 239-250
  CrossrefPubMedGoogle Scholar
• 22 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
• 23 Lai F, Tu S, Huang C, Jeng C. A home-based exercise program improves heart rate variability and functional capacity among postmenopausal women with coronary artery disease. J Cardiovasc Nurs 2011; 26: 137-144
  PubMedGoogle Scholar
• 24 Lauer M. Autonomic function and prognosis. Clev Clin J Med 2009; 76 (Suppl. 02) S18-S22
  CrossrefPubMedGoogle Scholar
• 25 McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. Can Med Assoc J 2006; 175: 34-41
  CrossrefPubMedGoogle Scholar
• 26 Melanson EL, Freedson PS. The effect of endurance training on resting heart rate variability in sedentary adult males. Eur J Appl Physiol 2001; 85: 442-449
  CrossrefPubMedGoogle Scholar
• 27 Mock V, Atkinson A, Barsevick AM, Berger AM, Cimprich B, Eisenberger MA, Hinds P, Kaldor P, Otis-Green SA, Piper BF. Cancer-related fatigue. Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2007; 5: 1054-1078
  PubMedGoogle Scholar
• 28 Nevruz O, Yokusoglu M, Uzun M, Demirkol S, Avcu F, Baysan O, Koz C, Cetin T, Sag C, Ural AU, Isik E.. Cardiac autonomic functions are altered in patients with acute leukemia, assessed by heart rate variability. Tohoku J Exp Med 2007; 211: 121-126
  CrossrefPubMedGoogle Scholar
• 29 Pietila M, Malminiemi K, Vesalainen R, Jartti T, Teras M, Nagren K, Lehikoinen P, Voipio-Pulkki L. Exercise training in chronic heart failure: beneficial effects on cardiac (11)C-hydroxyephedrine PET, autonomic nervous control, and ventricular repolarization. J Nucl Med 2002; 43: 773-779
  PubMedGoogle Scholar
• 30 Piotrowicz E, Baranowski R, Piotrowska M, Zieliński T, Piotrowicz R. Variable effects of physical training of heart rate variability, heart rate recovery, and heart rate turbulence in chronic heart failure. Pacing Clin Electrophysiol 2009; 32 (Suppl. 01) 113-115
  CrossrefPubMedGoogle Scholar
• 31 Postma A, Elzenga NJ, Haaksma J, Schasfoort-Van Leeuwen MJM, Kamps WA, Bink-Boelkens MTE. Cardiac status in bone tumor survivors up to nearly 19 years after treatment with doxorubicin: a longitudinal study. Med Ped Oncol 2002; 39: 86-92
  CrossrefPubMedGoogle Scholar
• 32 Quilliot D, Bohme P, Zannad F, Ziegler O. Sympathetic-leptin relationship in obesity: effect of weight loss. Metabolism: clinical and experimental 2008; 57: 555-562
  PubMedGoogle Scholar
• 33 Routledge FS, Campbell TS, McFetridge-Durdle JA, Bacon SL.. Improvements in heart rate variability with exercise therapy. Can J Cardiol 2010; 26: 303-312
  CrossrefPubMedGoogle Scholar
• 34 Schmitz K, Courneya K, Matthews C, Demark-Wahnefried W, Galvao D, Pinto B, Irwin M, Wolin K, Segal R, Lucia A, Schneider C, von G, Schwartz A. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sport Exerc 2010; 42: 1409-1426
  CrossrefPubMedGoogle Scholar
• 35 Scott NW, Fayers PM, Aaronson NK, Bottomley A, Graeff A, Groenvold M, Gundy C, Koller M, Petersen MA, Sprangers MA, Mirjam AG. EORTC QLQ-C30 Reference Values. Brussels: EORTC Quality of Life Group; 2008
  Google Scholar
• 36 Shan K, Lincoff AM, Young JB. Anthracycline-induced cardiotoxicity. Ann Intern Med 1996; 125: 47-58
  CrossrefPubMedGoogle Scholar
• 37 Task Force of the European Society of Cardiology, the North American Society of Pacing, Electrophysiology . Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 1996; 17: 354-381
  CrossrefPubMedGoogle Scholar
• 38 Townend JN, al-Ani M, West JN, Littler WA, Coote JH. Modulation of cardiac autonomic control in humans by angiotensin II. Hypertension 1995; 25: 1270-1275
  CrossrefPubMedGoogle Scholar
• 39 Tsuji H, Larson MG, Venditti F, Manders ES, Evans JC, Feldman CL, Levy D. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 1996; 94: 2850-2855
  CrossrefPubMedGoogle Scholar
• 40 Ueno LM, Moritani T. Effects of long-term exercise training on cardiac autonomic nervous activities and baroreflex sensitivity. Eur J Appl Physiol 2003; 89: 109-114
  CrossrefPubMedGoogle Scholar
• 41 Vinik AI, Maser RE, Ziegler D. Autonomic imbalance: prophet of doom or scope for hope?. Diabetic Med 2011; 28: 643-351
  CrossrefPubMedGoogle Scholar
• 42 Walsh D, Nelson KA. Autonomic nervous system dysfunction in advanced cancer. Support Care Cancer 2002; 10: 523-528
  CrossrefPubMedGoogle Scholar
• 43 Watson T, Mock V. Exercise as an intervention for cancer-related fatigue. Phys Ther 2004; 84: 736-743
  PubMedGoogle Scholar
• 44 Wiggins MS, Simonavice EM. Quality of life benefits in cancer survivorship with supervised exercise. Psychol Rep 2009; 104: 421-424
  CrossrefPubMedGoogle Scholar