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Huizinga F, Kieboom EAM, de Greef MHG, Walenkamp AME, Berendsen AJ, Berger MY, Brandenbarg D. Cancer survivors' experiences of a physical activity program in primary care: a qualitative study. J Cancer Surviv 2024:10.1007/s11764-024-01571-w. [PMID: 38517578 DOI: 10.1007/s11764-024-01571-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE This study aimed to gain insight into the experiences of, and reasons for, cancer survivors participating in a primary care PA program. METHODS We interviewed 17 patients from 11 Dutch GP practices. Patients were selected by purposive sampling based on their general practice, gender, educational level, motivation for PA, and change in PA. Interviews were audio recorded, transcribed verbatim, and pseudonymized for inductive thematic analysis. RESULTS Three domains were identified with five themes: institutional domain: GP practice; program-specific domain: content sessions and PA, and activity tracker and goal setting; individual domain: experienced benefits, and personalized care needs. Participants valued the PA program because it was offered close to home, without additional costs, and by a trusted practice nurse familiar with the patients' medical background. Activity tracker use and goal setting motivated many participants but also led to demotivation and feelings of failure in others. Reported benefits included behavior change and favorable health outcomes. Many patients expressed the need to personalize psychological support and the program's timing. CONCLUSIONS Access to a PA program in a primary care setting is valued for its accessibility and experienced health benefits, but also seems to meet an unmet need for support in picking up life during cancer recovery. IMPLICATIONS FOR CANCER SURVIVORS Primary care is important for continued care of cancer survivors. An accessible PA program in this setting may fulfil a need for not only lifestyle support but also continuing life after cancer treatment.
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Affiliation(s)
- Famke Huizinga
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands.
| | - Eleonora A M Kieboom
- Department of Human Movement Sciences, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 23, 9700 AD, Groningen, The Netherlands
| | - Mathieu H G de Greef
- Department of Human Movement Sciences, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 23, 9700 AD, Groningen, The Netherlands
| | - Annemiek M E Walenkamp
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, DA 11, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Annette J Berendsen
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands
| | - Marjolein Y Berger
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands
| | - Daan Brandenbarg
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands
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Noh H, Anota A, Mongondry R, Meyrand R, Dupuis C, Schiffler C, Marijnen P, Rinaldi S, Lachuer J, Keski-Rahkonen P, Gunter MJ, Fléchon A, Fervers B, Pérol O. Impact of a one-year supervised physical activity program on long-term cancer-related fatigue and mediating effects of the gut microbiota in metastatic testicular cancer patients: protocol of the prospective multicentre, randomized controlled phase-III STARTER trial. BMC Cancer 2024; 24:84. [PMID: 38225551 PMCID: PMC10790440 DOI: 10.1186/s12885-024-11824-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Testicular germ cell tumours (TGCTs) are the most common malignancy in men aged 15-40 years, with increasing incidence worldwide. About 33 ~ 50% of the patients present with metastatic disease at diagnosis. TGCT survivors experience short- and long-term sequelae, including cancer-related fatigue (CRF). Physical activity (PA) has established effects on reducing CRF and other sequelae and improving health-related quality of life (HRQoL). However, its impact on TGCT survivors has so far received little attention. The gut microbiota plays a crucial role in various physiological functions, including cognition and metabolism, and may mediate the effects of PA on CRF and other sequelae, but this has not been investigated in randomized controlled trials. METHODS This national, multicentre, phase-III trial will evaluate the impact of a one-year supervised PA program on CRF and other short- and long-term sequelae in metastatic TGCT patients receiving cisplatin-based chemotherapy combined with etoposide+/-bleomycin. It will also investigate potential mediating effects of the gut microbiota and its metabolites involved in the gut-brain axis on the relationship between PA and CRF and other sequelae. A total of 236 men ≥ 18 years of age with metastatic TGCT (seminoma and non-seminoma) will be enrolled before starting first-line chemotherapy in several French hospitals. The primary (CRF) and secondary (cognitive/psychological/metabolic sequelae, HRQoL, etc.) outcomes and gut microbiota and relevant metabolites will be assessed at inclusion, during and at the end of the one-year intervention, and annually until 10 years since inclusion to assess long-term sequelae, more specifically CRF, cardiovascular toxicities, and second primary cancer occurrence in this population. DISCUSSION This trial will provide comprehensive and novel insights into the effects of a long-term supervised PA program on CRF and other sequelae in metastatic TGCT patients receiving first-line chemotherapy. It will also contribute to understanding the potential role of the gut microbiota and its metabolites in mediating the effects of PA on these outcomes. The findings of this study will help the development of effective PA interventions to improve the health of TGCT survivors and may have implications for other cancer populations as well. TRIAL REGISTRATION The study was registered on ClinicalTrials.gov (NCT05588700) on 20 Oct. 2022.
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Affiliation(s)
- Hwayoung Noh
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France.
- INSERM U1296, Léon Bérard Cancer Centre, Lyon, France.
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
| | - Amélie Anota
- Direction of Clinical Research and Innovation, Léon Bérard Cancer Centre, Lyon, France
| | - Rodolf Mongondry
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Renaud Meyrand
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Carmen Dupuis
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Camille Schiffler
- Direction of Clinical Research and Innovation, Léon Bérard Cancer Centre, Lyon, France
| | - Philippe Marijnen
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Joel Lachuer
- INSERM U1052, Cancer Research Center of Lyon (CRCL), University Lyon 1, Lyon, France
- ProfileXpert, SFR santé Lyon-Est, CNRS UMR-S3453, INSERM US7, Lyon, France
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, London, UK
| | - Aude Fléchon
- Department of Medical Oncology, Léon Bérard Cancer Centre, Lyon, France
| | - Béatrice Fervers
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
- INSERM U1296, Léon Bérard Cancer Centre, Lyon, France
| | - Olivia Pérol
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
- INSERM U1296, Léon Bérard Cancer Centre, Lyon, France
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Willbanks A, Seals M, Karmali R, Roy I. Harnessing the Systemic Biology of Functional Decline and Cachexia to Inform more Holistic Therapies for Incurable Cancers. Cancers (Basel) 2024; 16:360. [PMID: 38254849 PMCID: PMC10814065 DOI: 10.3390/cancers16020360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Options for treatment of incurable cancer remain scarce and are largely focused on limited therapeutic mechanisms. A new approach specific to advanced cancers is needed to identify new and effective treatments. Morbidity in advanced cancer is driven by functional decline and a number of systemic conditions, including cachexia and fatigue. This review will focus on these clinical concepts, describe our current understanding of their underlying biology, and then propose how future therapeutic strategies, including pharmaceuticals, exercise, and rehabilitation, could target these mechanisms as an alternative route to addressing incurable cancer.
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Affiliation(s)
| | - Mina Seals
- Shirley Ryan AbilityLab, Chicago, IL 60611, USA
| | - Reem Karmali
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA
| | - Ishan Roy
- Shirley Ryan AbilityLab, Chicago, IL 60611, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, USA
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Vinolo-Gil MJ, García-Campanario I, Estebanez-Pérez MJ, Pastora-Bernal JM, Rodríguez-Huguet M, Martín-Vega FJ. Blood Flow Restriction in Oncological Patients: Advantages and Safety Considerations. Healthcare (Basel) 2023; 11:2062. [PMID: 37510502 PMCID: PMC10379018 DOI: 10.3390/healthcare11142062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Cancer, being a highly widespread disease on a global scale, has prompted researchers to explore innovative treatment approaches. In this regard, blood flow restriction has emerged as a promising procedure utilized in diverse clinical populations with favorable results including improvements in muscle strength, cardiovascular function, and postoperative recovery. The aim of this systematic review was to assess the efficacy of blood flow restriction in cancer survivors. METHODS An investigation was carried out using various databases until February 2023: PubMed, Scientific Electronic Library Online, Physiotherapy Evidence Database, Scopus, Web of Science, Cochrane Plus, SPORTDiscus, Physiotherapy and Podiatry of the Complutense University of Madrid, ScienceDirect, ProQuest, Research Library, Cumulative Index of Nursing and Allied Literature Complete Journal Storage, and the gray literature. To assess the methodological quality of the studies, the PEDro scale was utilized, and the Cochrane Collaboration tool was employed to evaluate the risk of bias. RESULTS Five articles found that blood flow restriction was beneficial in improving several factors, including quality of life, physical function, strength, and lean mass, and in reducing postoperative complications and the length of hospital stay. CONCLUSION Blood flow restriction can be a viable and effective treatment option. It is important to note that the caution with which one should interpret these results is due to the restricted quantity of articles and significant variation, and future research should concentrate on tailoring the application to individual patients, optimizing load progression, ensuring long-term follow-up, and enhancing the methodological rigor of studies, such as implementing sample blinding.
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Affiliation(s)
- Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, University of Cadiz, 11003 Cadiz, Spain; (M.R.-H.); (F.J.M.-V.)
- Institute for Biomedical Research and Innovation of Cádiz, 11009 Cadiz, Spain
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cadiz Bay-La Janda Health District, 11006 Cadiz, Spain
| | - Ismael García-Campanario
- Department of Medicine, Faculty of Medicine, University of Cadiz, Grupo PAIDI UCA CTS391, 11003 Cadiz, Spain;
| | - María-José Estebanez-Pérez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (M.-J.E.-P.); (J.-M.P.-B.)
| | - José-Manuel Pastora-Bernal
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, 29071 Malaga, Spain; (M.-J.E.-P.); (J.-M.P.-B.)
| | - Manuel Rodríguez-Huguet
- Department of Nursing and Physiotherapy, University of Cadiz, 11003 Cadiz, Spain; (M.R.-H.); (F.J.M.-V.)
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Belloni S, Arrigoni C, Baroni I, Conte G, Dellafiore F, Ghizzardi G, Magon A, Villa G, Caruso R. Non-pharmacologic interventions for improving cancer-related fatigue (CRF): A systematic review of systematic reviews and pooled meta-analysis. Semin Oncol 2023:S0093-7754(23)00035-0. [PMID: 36973125 DOI: 10.1053/j.seminoncol.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Literature encloses numerous systematic reviews (SRs) on nonpharmacologic interventions for improving cancer-related fatigue (CRF). The effect of these interventions remains controversial, and the available SRs have not been synthesized yet. We conducted a systematic synthesis of SRs and meta-analysis to determine the effect of nonpharmacologic interventions on CRF in adults. MATERIAL AND METHODS We systematically searched 4 databases. The effect sizes (standard mean difference) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity. RESULTS We selected 28 SRs, including 35 eligible meta-analyses. The pooled effect size (standard mean difference, 95% CI) was -0.67 (-1.16, -0.18). The subgroup analysis by types of interventions showed a significant effect in all the investigated approaches (complementary integrative medicine, physical exercise, self-management/e-health interventions). CONCLUSIONS There is evidence that nonpharmacologic interventions are associated with CRF reduction. Future research should focus on testing these interventions on specific population clusters and trajectories. PROSPERO REGISTRATION CRD42020194258.
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Affiliation(s)
- Silvia Belloni
- IRCCS Humanitas Research Hospital, Educational and Research Unit, Rozzano, Italy.
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Greta Ghizzardi
- Health Professions Directorate, Bachelor in Nursing Course, ASST Lodi, Lodi, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
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Zhang YB, Zhong XM, Han N, Tang H, Wang SY, Lin WX. Effectiveness of exercise interventions in the management of cancer-related fatigue: a systematic review of systematic reviews. Support Care Cancer 2023; 31:153. [PMID: 36746815 DOI: 10.1007/s00520-023-07619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/29/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cancer-related fatigue is a widely prevalent global public health concern with serious consequences. Increasing evidence suggests the effectiveness of exercise intervention in treating cancer-related fatigue, but there is a lack of a summary of relevant literature on the same to help reach a clear consensus. OBJECTIVE To summarize evidence regarding the efficacy of exercise interventions to reduce cancer fatigue, as determined in systematic reviews (SRs) and/or meta-analyses (MAs). METHOD From inception to September 2022, PubMed (1948-2022), Embase (1974-2022), Cochrane Library (1993-2022), CINAHL (1937-2022), Web of Science (1997-2022), China Knowledge Resource Integrated Database (1999-2022), Wanfang Database (1993-2022), and Chinese Biomedical Database (1994-2022) were searched for inclusion to the study. Two reviewers independently extracted the data from the included articles. AMSTAR II was to evaluate the methodological quality of the reviews. RESULTS A total of 46 systematic reviews were assessed for data on exercise intervention in reducing cancer-related fatigue among cancer patients. In addition, some studies have reported adverse events during the exercise intervention period. The quality of the included systematic review was found to be low or critically low. CONCLUSIONS The present systematic review of systematic reviews supports exercise intervention for reducing cancer-related fatigue. Further higher-quality studies are warranted to improve the level of evidence for exercise interventions for application in the treatment of cancer-related fatigue.
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Affiliation(s)
- Ya-Bin Zhang
- The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Zhengzhou, Henan, People's Republic of China
| | - Xue-Mei Zhong
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China
| | - Ni Han
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China
| | - Huang Tang
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China
| | - Shui-Yu Wang
- The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Zhengzhou, Henan, People's Republic of China.
| | - Wen-Xuan Lin
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China.
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Huizinga F, Westerink NDL, Berendsen AJ, Walenkamp AME, de Greef MHG, de Bock GH, Berger MY, Brandenbarg D. Implementation and evaluation of a physical activity counselling programme in primary care among cancer survivors: SoDA study protocol. BMJ Open 2022; 12:e060098. [PMID: 35236736 PMCID: PMC8896033 DOI: 10.1136/bmjopen-2021-060098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Physical activity (PA) favourably affects various health outcomes in cancer survivors, but little is known about how to implement a PA programme in primary care. We therefore aim to implement and evaluate such a programme for cancer survivors in general practice. METHODS AND ANALYSES The Stimulation of Daily Activity study is an implementation study with a single-arm longitudinal design in 15 Dutch general practices. Patients aged ≥18 years who finished cancer treatment more than 6 months ago will be eligible for inclusion. The intervention will comprise six coaching sessions with the practice nurse in 9 months, seeking to increase PA in daily activities and using an activity tracker for goal setting and feedback. The Reach, Effectiveness, Adoption, Implementation and Maintenance framework will be used to evaluate implementation in terms of the health outcomes, extent of implementation and barriers and facilitators to implementation, using a mixed methods approach. Descriptive analyses and linear mixed model analyses will be performed on the quantitative data, while qualitative data from focus groups and interviews will be analysed by thematic analyses. ETHICS AND DISSEMINATION The Medical Research Ethics Committee of the University Medical Centre Groningen, the Netherlands, concluded that this study was not subject to the Dutch Medical Research Involving Human Subjects Act (registration number: 201900586). The study results will be made available to patients and general practitioners via (inter)national publications and conferences, newsletters, public summaries and via (social) media.
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Affiliation(s)
- Famke Huizinga
- General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Annette J Berendsen
- General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Mathieu H G de Greef
- Human Movement Sciences, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Marjolein Y Berger
- General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Daan Brandenbarg
- General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands
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HUIZINGA FAMKE, WESTERINK NICODERKLODEWIJK, BERENDSEN ANNETTEJ, WALENKAMP ANNEMIEKME, DE GREEF MATHIEUHG, OUDE NIJEWEEME JULIËTK, DE BOCK GEERTRUIDAH, BERGER MARJOLEINY, BRANDENBARG DAAN. Home-based Physical Activity to Alleviate Fatigue in Cancer Survivors: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2021; 53:2661-2674. [PMID: 34649267 PMCID: PMC8594505 DOI: 10.1249/mss.0000000000002735] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Physical activity (PA) affects fatigue and mental health in cancer survivors favorably, but participation in PA interventions tends to be low. More participants may be reached by home-based PA owing to greater accessibility and self-monitoring. This systematic review therefore evaluated the effects of home-based PA of low to moderate intensity on symptoms of fatigue, depression, and anxiety among cancer survivors. METHODS PubMed, CINAHL, PsycINFO, and Web of Science were systematically searched for randomized controlled trials. We included investigations of home-based PA interventions in adults treated curatively for cancer and evaluating fatigue, depression, or anxiety as outcomes. We performed a random-effect meta-analysis for the effects of PA interventions on fatigue in the short and long terms. Subgroup analyses were performed for the frequency of counseling. Standardized mean differences (SMD) and 95% confidence intervals are reported. RESULTS Eleven articles comprising 1066 participants were included: 77% had a history of breast cancer; 14%, ovarian cancer; 4%, colorectal cancer; 4%, prostate cancer; and 1%, "other" cancer (not specified). Concerning the outcomes, nine articles reported on fatigue and two reported on depression or anxiety. Meta-analyses showed a significant effect of home-based PA on fatigue immediately after the intervention (SMD = 0.22 [0.06-0.37]), at 3 months' follow-up (SMD = 0.27 [0.04-0.51]), and at 6-9 months' follow-up (SMD = 0.31 [0.08-0.55]). PA interventions that used frequent counseling were associated with larger improvements in fatigue than those using no or infrequent counseling. CONCLUSIONS Home-based PA interventions can reduce fatigue among adult cancer survivors for up to 9 months, and frequent counseling may improve the benefits of these interventions.
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Affiliation(s)
- FAMKE HUIZINGA
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - NICO-DERK LODEWIJK WESTERINK
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - ANNETTE J. BERENDSEN
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - ANNEMIEK M. E. WALENKAMP
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - MATHIEU H. G. DE GREEF
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - JULIËT K. OUDE NIJEWEEME
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - GEERTRUIDA H. DE BOCK
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - MARJOLEIN Y. BERGER
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
| | - DAAN BRANDENBARG
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, THE NETHERLANDS
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Johannsen M, Stoll C, Raida M, van Oorschot B, Flörcken A. Supportive therapy and complementary medicine in renal cell carcinoma. World J Urol 2021; 40:2359-2371. [PMID: 34821959 DOI: 10.1007/s00345-021-03885-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE As part of the German interdisciplinary S3-guideline "Diagnosis, Treatment and Followup of Renal Cell Carcinoma", this article aimes to provide guidance regarding the use of supportive therapy and complementary medicine in patients with advanced or metastatic renal cell carcinoma. METHODS The German interdisciplinary S3-guidelines are national clinical practice guidelines that implement the highest methodological quality of evidence-based medicine. Recommendations and evidence-based statements are provided according to available evidence. RESULTS Supportive and palliative care are important areas of tumor treatment and require knowledge on the management of a variety of issues. This article outlines the management of tumor-related symptoms such as pain, undesired treatment-related effects, palliative care and end-of-life care in patients with renal cell carcinoma. CONCLUSION Patients with advanced or metastatic renal cell carcinoma should have access to supportive and palliative care according to their individual needs. There is very limited evidence regarding the impact of complementary medicine for the treatment of patients with renal cell carcinoma.
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Affiliation(s)
- M Johannsen
- Urology Practice Johannsen & Laux, Berlin and d-uo (Deutsche Uro-Onkologen), Berlin, Germany
| | - C Stoll
- Department of Oncology, Clinic Herzoghoehe, Bayreuth, Germany
| | - M Raida
- VAMED Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | - B van Oorschot
- Interdisciplinary Center for Palliative Medicine, Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - A Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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Yang W, Xi J, Guo L, Cao Z. Nurse-led exercise and cognitive-behavioral care against nurse-led usual care between and after chemotherapy cycles in Han Chinese women of ovarian cancer with moderate to severe levels of cancer-related fatigue: A retrospective analysis of the effectiveness. Medicine (Baltimore) 2021; 100:e27317. [PMID: 34871205 PMCID: PMC8568398 DOI: 10.1097/md.0000000000027317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/07/2021] [Indexed: 01/05/2023] Open
Abstract
Women with ovarian cancer are reported to fatigue over time. Moderate to severe levels of cancer-related fatigue is fluent in Han Chinese patients with cancer. Comprehensive Cancer Network guidelines are recommending exercise and cognitive behavioral therapy to reduce cancer-related fatigue. Exercise is an easy, cost-effective, and non-pharmacological approach. The objective of the study was to evaluate the effectiveness of nurse-led exercise and cognitive-behavioral care against nurse-led usual care in Han Chinese women of ovarian cancer regarding cancer-related fatigue, depressive symptoms, and sleep quality.Han Chinese women with moderate to severe levels of cancer-related fatigue have received 30 minutes, 5 times/week nurse-led exercise and 60 min/week cognitive-behavioral care (EC cohort, n = 118) or nurse-led usual care regarding educations and recommendations only (UC cohort, n = 126) or have not received nurse-led exercise, cognitive-behavioral care, educations, and recommendations (NC cohort, n = 145) between and after chemotherapy cycles. The Piper Fatigue Scale, the Zung Self-rating Depression Scale, and Pittsburgh Sleep Quality Index questionnaires were evaluated at the start and the end of non-pharmacological treatment.At the end of treatment as compared to the start of treatment, only women of EC cohort had decrease Piper Fatigue Scale (5.40 ± 1.49/woman vs 6.06 ± 1.49/woman, P < .0001, q = 4.973) and Zung Self-rating Depression Scale score (48.67 ± 4.24/woman vs 49.93 ± 4.29/woman, P = .001, q = 3.449). Also, at the end of treatment, as compared to the start of treatment, only women of EC cohort have increased Pittsburgh Sleep Quality Index score (14.76 ± 2.18/woman vs 13.94 ± 2.90/woman, P = .045, q = 3.523). Only exercise and cognitive-behavioral care were successful in a decrease in the numbers of women with depression (the Mandarin Chinese version of the Zung Self-rating Depression Scale score >53, 32 vs 16, P = .015).Nurse-led exercise and cognitive-behavioral care can help Han Chinese women with ovarian cancer to decrease cancer-related fatigue and depression. Also, it can improve the quality of sleep.Evidence Level: 4.Technical Efficacy: Stage 5.
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Affiliation(s)
- Wei Yang
- Department of Obstetrics and Gynecology, Shanghai Fourth People's Hospital, No. 1279 Sanmen Road, Hongkou District, Shanghai, China
| | - Jia Xi
- Department of Nursing, Shanghai Fourth People's Hospital, No. 1279 Sanmen Road, Hongkou District, Shanghai, China
| | - Lingxin Guo
- Department of Gynecology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Road, Xuhui District, Shanghai, China
| | - Zhefei Cao
- Department of Nursing, Shanghai Fourth People's Hospital, No. 1279 Sanmen Road, Hongkou District, Shanghai, China
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11
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Vincent F, Deluche E, Bonis J, Leobon S, Antonini MT, Laval C, Favard F, Dobbels E, Lavau-Denes S, Labrunie A, Thuillier F, Venat L, Tubiana-Mathieu N. Home-Based Physical Activity in Patients With Breast Cancer: During and/or After Chemotherapy? Impact on Cardiorespiratory Fitness. A 3-Arm Randomized Controlled Trial (APAC). Integr Cancer Ther 2020; 19:1534735420969818. [PMID: 33228382 PMCID: PMC7691904 DOI: 10.1177/1534735420969818] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives: Physical activity (PA) programs are recommended for breast cancer care.
However, their modalities remain to be discussed. This study determined the
best time to begin a personalized or adapted program based on
cardiopulmonary exercise test function. This randomized controlled trial
evaluated the effect of home-based adapted PA (APA) performed during or
after treatment on cardiorespiratory fitness (CRF) at 12 months. Method: The primary endpoint was the peak oxygen consumption (VO2peak) at
12 months (group A vs C and B vs C). Secondary endpoints included the
6-minute walking test, assessment of muscle strength, fatigue, quality of
life, anxiety, and depression, and a questionnaire on PA levels. All tests
were evaluated at baseline and at 6 and 12 months. A total of 94 patients
with breast cancer were randomized to 3 different groups: group A,
performing 6 months of APA during adjuvant care; group B, 6 months of APA
after adjuvant care; and group C, 12 months of APA during and after specific
care. The program combined 1 resistance session and 2 aerobic sessions per
week. Analysis of variance was used for repeated measures, Student’s
t-test or the Mann–Whitney U-test for
continuous variables, and χ2 test for binary or categorical
variables. Results: The study assessed 81 participants at 6 months and 73 at 12 months. The
majority of patients completed more than 85% of the exercise sessions. The
baseline for VO2peak and secondary outcomes did not differ among
the groups. VO2peak increased during the exercise period and
decreased during the chemotherapy period without APA, but at 12 months no
significant difference was observed. The same variation was observed in the
6-minute walking test, with significance at 6 months between A+C versus B
(P = .04), but no difference among the groups at
12 months. In the 3 groups, no decreases in other studied parameters were
noted, except at 6 months in group B without APA. Conclusion: Home-based APA in breast cancer patients has a positive effect on CRF and
physical functions, with no differences based on the timing of this program
based on specific cancer treatment. Trial Registration: ClinicalTrials.gouv.fr (NCT01795612). Registered 20 February
2013.
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Affiliation(s)
- François Vincent
- Department of Physiology, University Hospital, Limoges, France.,Faculty of Medicine, University of Limoges, Limoges, France
| | - Elise Deluche
- Faculty of Medicine, University of Limoges, Limoges, France.,Department of Medical Oncology, University Hospital, Limoges, France
| | - Joëlle Bonis
- Faculty of Medicine, University of Limoges, Limoges, France
| | - Sophie Leobon
- Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
| | | | - Caroline Laval
- Department of Physiology, University Hospital, Limoges, France.,Faculty of Medicine, University of Limoges, Limoges, France
| | - Florent Favard
- Department of Physiology, University Hospital, Limoges, France
| | - Eloïse Dobbels
- Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
| | - Sandrine Lavau-Denes
- Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
| | - Anaïs Labrunie
- Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
| | - Frédéric Thuillier
- Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
| | - Laurence Venat
- Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
| | - Nicole Tubiana-Mathieu
- Faculty of Medicine, University of Limoges, Limoges, France.,Department of Medical Oncology, University Hospital, Limoges, France.,Department of Biostatistics and Clinical Research, University Hospital, Limoges, France
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12
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Cantwell M, Walsh DMJ, Furlong B, Moyna N, McCaffrey N, Woods C. The Development of the MedEx IMPACT Intervention: A Patient-Centered, Evidenced-Based and Theoretically-Informed Physical Activity Behavior Change Intervention for Individuals Living With and Beyond Cancer. Cancer Control 2020; 27:1073274820906124. [PMID: 32715730 PMCID: PMC7658858 DOI: 10.1177/1073274820906124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Regular physical activity (PA) can address many of the negative side effects
experienced by individuals following cancer treatment and support the
optimization of physical and psychosocial well-being. However, many survivors of
cancer are not sufficiently active to achieve these health benefits. The purpose
of this study was to describe the development of a physical activity behavior
change (PABC) intervention, MedEx IMPACT (IMprove Physical Activity after Cancer
Treatment), which aims to increase cancer survivors’ PA levels. A review of the
literature and focus groups with survivors of cancer were conducted in order to
generate recommendations to inform the intervention development process. This
process was guided and informed by: (1) the Medical Research Council’s (MRC)
framework for the development, evaluation, and implementation of complex
interventions, (2) the Behaviour Change Wheel (BCW), and (3) the Theoretical
Domains Framework (TDF). Recommendations for strategies to support habitual PA
and adherence to community-based exercise programs, generated by survivors of
cancer who participated in 7 focus groups (n = 41), were synthesized with 13
statements of findings that were generated from 10 studies included within the
review of the literature. Detailed mapping exercises are presented which outline
the link between these sources, the MRC framework, the BCW and TDF, and the
intervention content. MedEx IMPACT is the first PABC intervention for survivors
of cancer to be developed through the application of the MRC framework, BCW, and
TDF. The next phase in this research is to test the acceptability and
effectiveness of MedEx IMPACT.
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Affiliation(s)
- Mairéad Cantwell
- The Irish Cancer Society, Dublin, Ireland.,School of Health and Human Performance, Dublin City University, Dublin, Ireland.,Department of Sport and Health Sciences, Athlone Institute of Technology, Westmeath, Ireland
| | - Deirdre M J Walsh
- Department of Social Science and Design, Athlone Institute of Technology, Westmeath, Ireland
| | - Bróna Furlong
- Department of Sport and Exercise Science, Waterford Institute of Technology
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | | | - Catherine Woods
- Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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13
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Gebreyesus T, Belay A, Berhe G, Haile G. Burden of fatigue among adults living with HIV/AIDS attending antiretroviral therapy in Ethiopia. BMC Infect Dis 2020; 20:280. [PMID: 32295546 PMCID: PMC7161178 DOI: 10.1186/s12879-020-05008-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fatigue is one of the most common and devastating Human Immuno-deficiency Virus (HIV) - related symptoms, with a varying prevalence in different study areas. In Ethiopia, there is a paucity of information on the magnitude and factors associated with fatigue among HIV/Acquired Immune Deficiency Syndrome (AIDS) patients. This may lead to under-diagnosis and eventually under-management of the symptom. METHODS Institution based cross-sectional study design was conducted among 609 HIV/AIDS patients who were selected by using a systematic random sampling method. Data were collected by using interviewer administered structured questionnaire. Level of fatigue was measured by Fatigue Severity Scale. RESULTS The prevalence of fatigue was found to be 51.7%. The factors associated with fatigue were: Parity [AOR = 2.01; 95% CI: 1.09-3.71], CD4 count 200-499 cells/mm3 [AOR = 2.81; 95% CI: 1.58-4.99], anemia [AOR = 4.90 95% CI: 2.40-9.97], co-morbidities [AOR = 3.65; 95% CI: 1.71-7.78], depression [AOR = 3.68 95% CI: 1.99-6.79], not being physically active [AOR = 3.20 95% CI: 1.50-6.81], clinical stage II or IV HIV [AOR = 3.11; 95% CI: 1.51-6.40] and [AOR = 4.08; 95% CI: 1.37-12.14], respectively. CONCLUSION The finding of this study revealed that fatigue is a common health problem among adult People Living with HIV (PLHIV). Factors associated with fatigue included: Parity, CD4 count 200-499 cells/mm3, Clinical Stage II or IV HIV, anemia, co-morbidities, depression, and not being physically active. The health care service needs to address the predisposing factors by provision integrated care including timely detection and treatment of comorbidities, mental health problems, and promote physical activity to slow down disease progression and then reduce exposure to fatigue.
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Affiliation(s)
- Tsiwaye Gebreyesus
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia
| | - Addisalem Belay
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia
| | - Gebretsadik Berhe
- Department of Epidemiology, School of Public Health, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Gebremedhin Haile
- Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, P.O.Box: 1871, Mekelle, Ethiopia
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14
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Salehifar E, Azimi S, Janbabai G, Zaboli E, Hendouei N, Saghafi F, Borhani S. Efficacy and safety of bupropion in cancer-related fatigue, a randomized double blind placebo controlled clinical trial. BMC Cancer 2020; 20:158. [PMID: 32106832 PMCID: PMC7045731 DOI: 10.1186/s12885-020-6618-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/11/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cancer-related fatigue (CRF) is one of the most prevalent complications experienced by cancer patients during and after the process of treatment. Despite conducting a lot of studies, there is no approved therapy to help manage CRF. This study aims to investigate the efficacy of bupropion on CRF. MATERIALS AND METHODS In this double-blind randomized placebo-controlled clinical trial, a total of 30 eligible cancer patients suffering from fatigue were randomly divided into two groups (15 patients in each group). Bupropion was administered 75 mg/day for the first three days and 150 mg/day (divided in two doses) till the end of the study at week 6. Fatigue as the primary outcome was measured by BFI (Brief Fatigue Inventory) and FACIT-Fatigue (Functional Assessment of Chronic Illness Therapy) scales. Secondary outcomes included HADS (Hospital Anxiety and Depression Scale) and performance status (PS) measured by Karnofsky and ECOG (Eastern Cooperative Oncology Group) scales. Assessments were done at baseline, end of the second and sixth week. RESULTS There was no significant difference between placebo and bupropion at baseline and the end of second week. Significant difference was seen between two groups at the end of week six (P = 0.006 based on BFI) in favor of bupropion. In-group assessment showed improvement in fatigue levels in both groups during study time (P = 0.000 based on BFI for both bupropion and placebo). Secondary outcomes (e.g., HADS and PS) were not different at baseline and the end of second week. However, at the end of week six, the difference was significant in favor of bupropion. CONCLUSION A six-week trial of bupropion reduces the CRF and improves the PS of cancer patients. TRIAL REGISTRATION Current Controlled Trials IRCT20090613002027N12, registration date: 2018-06-01.
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Affiliation(s)
- Ebrahim Salehifar
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Saeid Azimi
- Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Janbabai
- Gastrointestinal Cancer Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ehsan Zaboli
- Gastrointestinal Cancer Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Narjes Hendouei
- Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Saghafi
- Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Samaneh Borhani
- Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
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15
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Lion A, Backes A, Duhem C, Ries F, Delagardelle C, Urhausen A, Vögele C, Theisen D, Malisoux L. Motivational Interviewing to Increase Physical Activity Behavior in Cancer Patients: A Pilot Randomized Controlled Trials. Integr Cancer Ther 2020; 19:1534735420914973. [PMID: 32202163 PMCID: PMC7092651 DOI: 10.1177/1534735420914973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/17/2020] [Accepted: 03/03/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This pilot randomized controlled trial (RCT) aimed at evaluating the feasibility and potential efficacy of a motivational interviewing (MI) intervention to increase physical activity (PA) behavior in cancer patients. METHODS Participants were randomly assigned to an experimental group with standard care plus 12 MI sessions within 12 weeks or a control group with standard care only. The number of recruited participants and the modality of recruitment were recorded to describe the reach of the study. The acceptability of the study was estimated using the attrition rate during the intervention phase. The potential efficacy of the intervention was evaluated by analyzing the PA behavior. RESULTS Twenty-five participants were recruited within the 16-month recruitment period (1.6 participants per month). Five participants (38.5%) from the experimental group (n = 13) and one participant (8.3%) from the control group (n = 12) dropped out of the study before the end of the intervention phase. No group by time interaction effect for PA behavior was observed at the end of the intervention. CONCLUSION Due to the low recruitment rate and compliance, no conclusion can be drawn regarding the efficacy of MI to increase PA behavior in cancer patients. Moreover, the current literature cannot provide any evidence on the effectiveness of MI to increase PA in cancer survivors. Future RCTs should consider that the percentage of uninterested patients to join the study may be as high as 60%. Overrecruitment (30% to 40%) is also recommended to accommodate the elevated attrition rate.
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Affiliation(s)
- Alexis Lion
- Fédération Luxembourgeoise des Associations de Sport de Santé, Strassen, Luxembourg
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg, Luxembourg
- Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anne Backes
- Luxembourg Institute of Health, Strassen, Luxembourg
| | - Caroline Duhem
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Fernand Ries
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Charles Delagardelle
- Fédération Luxembourgeoise des Associations de Sport de Santé, Strassen, Luxembourg
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg, Luxembourg
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Axel Urhausen
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg, Luxembourg
- Luxembourg Institute of Health, Strassen, Luxembourg
- Centre Hospitalier Luxembourg—Clinique d’Eich, Luxembourg, Luxembourg
| | - Claus Vögele
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Daniel Theisen
- Luxembourg Institute of Health, Strassen, Luxembourg
- ALAN Maladies Rares Luxembourg, Bascharage, Luxembourg
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16
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Kim S, Han J, Lee MY, Jang MK. The experience of cancer-related fatigue, exercise and exercise adherence among women breast cancer survivors: Insights from focus group interviews. J Clin Nurs 2019; 29:758-769. [PMID: 31769562 DOI: 10.1111/jocn.15114] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/21/2019] [Accepted: 11/19/2019] [Indexed: 12/11/2022]
Abstract
AIMS AND OBJECTIVES To identify the experience of breast cancer survivors regarding cancer-related fatigue, exercise and exercise adherence. BACKGROUND Cancer-related fatigue is a common symptom among cancer survivors that limits quality of life. Despite exercise being recommended as a viable solution to manage cancer-related fatigue, relatively few research studies on the experience of cancer-related fatigue and exercise adherence have been conducted. DESIGN This was a qualitative study to identify breast cancer survivors' experience of cancer-related fatigue, exercise and exercise adherence. This paper adhered to the COREQ checklist in reporting. METHODS Four focus group interviews were conducted with 16 breast cancer survivors who had fatigue score of 4 out of 10 (moderate fatigue) or greater. Ethical approval was obtained and participants met for focus group interview discussion. The interview guide included questions on cancer-related fatigue, barriers and facilitators of exercising, strategies for exercise adherence and suggestions for a supportive programme. RESULTS Four themes were identified through thematic analysis: (a) The insidious and overpowering nature of cancer-related fatigue; (b) exercising when experiencing fatigue surrounded by prevailing myths; (c) multiple barriers to exercise; and (d) facilitative factors to continue exercising despite fatigue. CONCLUSIONS Participants' experience of moderate or greater cancer-related fatigue prevented them from exercising, despite knowing its importance, and limited them to passive activities. Misconceptions that exercise is associated with lymphedema and risk of recurrence, poor psychosocial self-image and lack of clear knowledge and exercise programmes for cancer survivors further limited adherence to exercise. In contrast, finding comfort and strength through exercising and interacting with other breast cancer survivors were facilitative factors. RELEVANCE TO CLINICAL PRACTICE The insights shared by breast cancer survivors experiencing cancer-related fatigue can contribute to developing an exercise adherence programme as a way to manage and alleviate fatigue and establish healthy survivorship care.
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Affiliation(s)
- Sue Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Jeehee Han
- Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Min Young Lee
- Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Min Kyeong Jang
- University of Illinois Cancer Center, Chicago, IL, USA.,College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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17
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Campbell KL, Winters-Stone K, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker D, Matthews C, Ligibel J, Gerber L, Morris S, Patel A, Hue T, Perna F, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc 2019; 51:2375-2390. [PMID: 31626055 PMCID: PMC8576825 DOI: 10.1249/mss.0000000000002116] [Citation(s) in RCA: 1358] [Impact Index Per Article: 271.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue. METHODS A second Roundtable was convened in 2018 to advance exercise recommendations beyond public health guidelines and toward prescriptive programs specific to cancer type, treatments, and/or outcomes. RESULTS Overall findings retained the conclusions that exercise training and testing were generally safe for cancer survivors and that every survivor should "avoid inactivity." Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. Implications for other outcomes, such as peripheral neuropathy and cognitive functioning, remain uncertain. CONCLUSIONS The proposed recommendations should serve as a guide for the fitness and health care professional working with cancer survivors. More research is needed to fill remaining gaps in knowledge to better serve cancer survivors, as well as fitness and health care professionals, to improve clinical practice.
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Affiliation(s)
- Kristin L. Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kerri Winters-Stone
- School of Nursing, Oregon Health Sciences University and Knight Cancer Institute, Portland USA
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Clinic, Heidelberg, Germany
| | - Anne M. May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anna L. Schwartz
- School of Nursing, Northern Arizona University, Flagstaff, Arizona
| | - Kerry S. Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - David Zucker
- Medical Director & Program Leader, Cancer Rehabilitation Medicine Services, Swedish Cancer Institute, Swedish Health Services, Seattle, WA
| | - Charles Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | | | - Lynn Gerber
- Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA
| | | | - Alpa Patel
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, USA
| | - Trisha Hue
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Frank Perna
- Division of Cancer Control and Population Sciences, Behavioral Research Program, Health Behaviors Research Branch, National Cancer Institute, Rockville, MD
| | - Kathryn H. Schmitz
- Public Health Science, Penn State Cancer Institute, Penn State College of Medicine, Hershey, PA
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18
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Ouyang N, Cai R, Zhou X, Huang H, Qiu X, Liu K. Effects of a group-based physical activity program for pediatric patients with cancer on physical activity and symptom experience: A quasi-experimental study. Pediatr Blood Cancer 2019; 66:e27965. [PMID: 31407493 DOI: 10.1002/pbc.27965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 01/11/2023]
Abstract
AIMS To examine the effects of a group-based physical activity intervention on improvement in physical activity and mitigation of symptom distress among pediatric patients with cancer. METHODS Based on convenience sampling, 57 pediatric patients with cancer admitted to the cancer center were included in the intervention group. The control group included 57 pediatric patients with cancer from two other hospitals matched to the patients in the intervention group by age, sex, and diagnosis. A group-based physical activity program was implemented among the children in the intervention group, whereas the children in the control group received standard care. Physical activity and symptoms were measured using the Children's Leisure Time Activities Study Survey-Chinese and using the Memorial Symptom Assessment Scale 10-18 at baseline and after the 12th exercise session in both the intervention and control groups. RESULTS The repeated-measures analysis of variance showed that the main intervention effects on the decrease in light-intensity physical activity and increase in moderate-to-vigorous physical activity were significant between the two groups (P < .001). The group-based physical activity intervention could decrease the scores of psychological symptoms (P < .001), Global Distress Index (P < .001), and physical symptoms (P = .01) when comparing the difference between the two groups before and after the intervention. There was no significant difference in the number of symptoms or the total symptom experience score between the two groups. CONCLUSION These findings suggest that a group-based physical activity intervention can promote physical activity and relieve psychological and physical symptom distress among pediatric patients with cancer.
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Affiliation(s)
- Na Ouyang
- Division of Pediatric Nursing, School of Nursing, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ruiqing Cai
- Pediatric Oncology Department, Sun Yat-sen Cancer Center, Guangzhou, People's Republic of China
| | - Xuezhen Zhou
- Nursing Department, Sun Yat-sen Memorial Hospital, Guangzhou, People's Republic of China
| | - Haiying Huang
- Hematology Oncology Department, Guangzhou Women and Children's Medical Center, Guangzhou, People's Republic of China
| | - Xing Qiu
- Division of Pediatric Nursing, School of Nursing, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ke Liu
- Division of Pediatric Nursing, School of Nursing, Sun Yat-sen University, Guangzhou, People's Republic of China
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19
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Hooke MC, Hoelscher A, Tanner LR, Langevin M, Bronas UG, Maciej A, Mathiason MA. Kids Are Moving: A Physical Activity Program for Children With Cancer. J Pediatr Oncol Nurs 2019; 36:379-389. [DOI: 10.1177/1043454219858607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Children undergoing cancer treatment are less active than healthy peers. Inactivity persists into survivorship, negatively influencing health and quality of life. Fatigue is one of the most prevalent symptoms during treatment yet children with increased physical activity (PA) have less fatigue. This pilot study evaluated the impact of coaching on PA and fatigue in children undergoing cancer treatment delivered by pediatric oncology nurse practitioners (NPs) during routine clinic visits. NPs used motivational interviewing during clinic visits to coach children and their families on strategies to increase PA at home. Self-report measures of PA and fatigue were completed at treatment months 2, 4, and 6. PA was also measured using actigraphy. Among 30 children ages 6 to 18 years, 7 had acute lymphoblastic leukemia (ALL), 11 had lymphoma, and 12 had solid tumors. Patterns of fatigue were different by disease group with trends to fatigue decreasing during treatment in the patients with ALL ( p = .09) and lymphoma ( p = .13) but increasing in those with solid tumors ( p = .06). Self-report PA was unchanged. Actigraph measurements remained stable for the group. NPs reported time challenges in implementing coaching during the clinic visit and in providing coaching continuity. The intensive, repeating chemotherapy cycles in solid tumor treatment may contribute to increasing fatigue. Treatment intensity decreases during ALL and lymphoma treatment, which may allow for improvement in fatigue. Inactivity persisted during treatment but did not progress. Future research is needed to evaluate more “dose-intensive” PA interventions in larger samples of specific disease groups.
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Affiliation(s)
- Mary C. Hooke
- University of Minnesota, Minneapolis, MN, USA
- Children’s Minnesota, Minneapolis, MN, USA
| | | | | | | | | | - Alexis Maciej
- University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA
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Webel AR, Willig AL, Liu W, Sattar A, Boswell S, Crane HM, Hunt P, Kitahata M, Matthews WC, Saag MS, Lederman MM, Rodriguez B. Physical Activity Intensity is Associated with Symptom Distress in the CNICS Cohort. AIDS Behav 2019; 23:627-635. [PMID: 30368620 PMCID: PMC6408232 DOI: 10.1007/s10461-018-2319-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Symptom distress remains a challenging aspect of living with HIV. Physical activity is a promising symptom management strategy, but its effect on symptom distress has not been examined in a large, longitudinal HIV-infected cohort. We hypothesized that higher physical activity intensity would be associated with reduced symptom distress. We included 5370 people living with HIV (PLHIV) who completed patient-reported assessments of symptom distress, physical activity, alcohol and substance use, and HIV medication adherence between 2005 and 2016. The most frequent and burdensome symptoms were fatigue (reported by 56%), insomnia (50%), pain (46%), sadness (45%), and anxiety (45%), with women experiencing more symptoms and more burdensome symptoms than men. After adjusting for age, sex, race, time, HIV medication adherence, alcohol and substance use, site, and HIV RNA, greater physical activity intensity was associated with lower symptom intensity. Although individual symptoms may be a barrier to physical activity (e.g. pain), the consistent association between symptoms with physical activity suggests that more intense physical activity could mitigate symptoms experienced by PLHIV.
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Affiliation(s)
- Allison R Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44122, USA.
| | - Amanda L Willig
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wei Liu
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44122, USA
| | - Abdus Sattar
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44122, USA
| | | | - Heidi M Crane
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Peter Hunt
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Mari Kitahata
- School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Michael S Saag
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Benigno Rodriguez
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Fuller JT, Hartland MC, Maloney LT, Davison K. Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials. Br J Sports Med 2018; 52:1311. [PMID: 29549149 DOI: 10.1136/bjsports-2017-098285] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To systematically appraise and summarise meta-analyses investigating the effect of exercise compared with a control condition on health outcomes in cancer survivors. DESIGN Umbrella review of intervention systematic reviews. DATA SOURCES Web of Science, Scopus, Cochrane Library, CINAHL and MEDLINE databases were searched using a predefined search strategy. ELIGIBILITY CRITERIA Eligible meta-analyses compared health outcomes between cancer survivors participating in an exercise intervention and a control condition. Health outcomes were cardiovascular fitness, muscle strength, health-related quality of life, cancer-related fatigue and depression. Pooled effect estimates from each meta-analysis were quantified using standardised mean differences and considered trivial (<0.20), small (0.20-0.49), moderate (0.50-0.79) and large (≥0.80). Findings were summarised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS There were 65 eligible articles that reported a total of 140 independent meta-analyses. 139/140 meta-analyses suggested a beneficial effect of exercise. The beneficial effect was statistically significant in 104 (75%) meta-analyses. Most effect sizes were moderate for cardiovascular fitness and muscle strength and small for cancer-related fatigue, health-related quality of life and depression. The quality of evidence was variable according to the GRADE scale, with most studies rated low or moderate quality. Median incidence of exercise-related adverse events was 3.5%. CONCLUSION Exercise likely has an important role in helping to manage physical function, mental health, general well-being and quality of life in people undergoing and recovering from cancer and side effects of treatment. PROSPERO REGISTRATION NUMBER CRD42015020194.
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Affiliation(s)
- Joel T Fuller
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Michael C Hartland
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Luke T Maloney
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
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Physical Therapist Coaching to Improve Physical Activity in Children With Brain Tumors: A Pilot Study. Pediatr Phys Ther 2018; 30:310-317. [PMID: 30199514 DOI: 10.1097/pep.0000000000000531] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Children with brain tumors (BTs) experience fatigue and decreased quality of life (QOL). Physical activity (PA) is recommended during and after cancer treatment. We explored whether a fitness tracker intervention combined with tailored coaching by a physical therapist (PT) increased PA and QOL and decreased fatigue in children with BTs. METHODS Participants were 7 to 18 years' old, within 2 years of diagnosis, and received a 12-week PA intervention using a fitness tracker combined with 5 PT coaching sessions. Steps/day measured by Fitbit and self-reports of QOL, fatigue, and PA were evaluated at baseline, 12 weeks, and 24 weeks. RESULTS Participants had nonsignificant increase in steps/day. Total fatigue, general, and sleep/rest subscales improved while cognitive fatigue and QOL remained unchanged. Higher steps/day were associated with lower fatigue. CONCLUSION This is a feasible intervention that may contribute to an increase in PA and improve fatigue in children with BTs.
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Cormie P, Zopf EM, Zhang X, Schmitz KH. The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiol Rev 2018; 39:71-92. [PMID: 28453622 DOI: 10.1093/epirev/mxx007] [Citation(s) in RCA: 362] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 02/16/2017] [Indexed: 12/15/2022] Open
Abstract
The combination of an increasing number of new cancer cases and improving survival rates has led to a large and rapidly growing population with unique health-care requirements. Exercise has been proposed as a strategy to help address the issues faced by cancer patients. Supported by a growing body of research, major health organizations commonly identify the importance of incorporating exercise in cancer care and advise patients to be physically active. This systematic review comprehensively summarizes the available epidemiologic and randomized controlled trial evidence investigating the role of exercise in the management of cancer. Literature searches focused on determining the potential impact of exercise on 1) cancer mortality and recurrence and 2) adverse effects of cancer and its treatment. A total of 100 studies were reviewed involving thousands of individual patients whose exercise behavior was assessed following the diagnosis of any type of cancer. Compared with patients who performed no/less exercise, patients who exercised following a diagnosis of cancer were observed to have a lower relative risk of cancer mortality and recurrence and experienced fewer/less severe adverse effects. The findings of this review support the view that exercise is an important adjunct therapy in the management of cancer. Implications on cancer care policy and practice are discussed.
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Tzelepis F, Paul CL, Sanson-Fisher RW, Campbell HS, Bradstock K, Carey ML, Williamson A. Unmet supportive care needs of haematological cancer survivors: rural versus urban residents. Ann Hematol 2018. [DOI: 10.1007/s00277-018-3285-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bertani A, Ferrari P, Terzo D, Russo E, Burgio G, De Monte L, Raffaele F, Droghetti A, Crisci R. A comprehensive protocol for physiokinesis therapy and enhanced recovery after surgery in patients undergoing video-assisted thoracoscopic surgery lobectomy. J Thorac Dis 2018; 10:S499-S511. [PMID: 29629196 DOI: 10.21037/jtd.2018.02.55] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Video-assisted thoracoscopic surgery (VATS) lobectomy has recently been adopted as the gold standard surgical option for the treatment of early stage non-small cell lung cancer. Enhanced recovery after surgery (ERAS) is being progressively adopted in thoracic surgery to improve the postoperative outcomes. Even if the benefits of ERAS are universally accepted, to date a standardized and uniform approach has not been described in the medical literature. The Italian VATS group has recently proposed to include in the VATS lobectomy database a structured protocol for ERAS. Methods The ERAS section of the Italian VATS group is proposing a comprehensive ERAS protocol within the VATS lobectomy database, allowing the prospective collection of a dedicated set of data. Separate sections of the protocol are dedicated to different topics of ERAS. This study is specifically dedicated to the section of physiokinesis therapy. The medical literature will be extensively reviewed and a physiotherapy (PT) protocol of ERAS will be presented and discussed. A seta of structured clinical pathways will also be suggested for adoption in the VATS Group database. Discussion Pre- and post-operative adoption of an ERAS protocol in patients undergoing VATS lobectomy may promote an improved post-operative course, a shorter hospital stay and an overall more comfortable patients' experience. The mainstays of a physiokinesis therapy ERAS protocol are patients' education, constant physical and respiratory therapy sessions, and adoption of adequate devices. Although many studies have investigated the usefulness of physical and respiratory physiokinesis therapy, a comprehensive ERAS protocol for VATS lobectomy patients has not yet been described. The proposed ERAS platform, adopted by the VATS Group database, will contribute to a prospective data collection and allow a scientific analysis of the results.
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Affiliation(s)
- Alessandro Bertani
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT - UPMC, Palermo, Italy
| | - Paolo Ferrari
- Division of Thoracic Surgery, A. Businco Cancer Center, Ospedale Brotzu, Cagliari, Italy
| | - Danilo Terzo
- Rehabilitation Services, IRCCS ISMETT - UPMC, Palermo, Italy
| | - Emanuele Russo
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT - UPMC, Palermo, Italy
| | - Gaetano Burgio
- Department of Anesthesia and CCM, IRCCS ISMETT - UPMC, Palermo, Italy
| | - Lavinia De Monte
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT - UPMC, Palermo, Italy
| | - Francesco Raffaele
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT - UPMC, Palermo, Italy
| | | | - Roberto Crisci
- Division of Thoracic Surgery, University of L'Aquila, L'Aquila, Italy
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Abstract
Falls are a particular health issue for hospice patients with cancer. Studies have found that 50% of patients diagnosed with advanced cancer fall during the subsequent 6-month time frame. The impact of falls on hospice and cancer patients is costly both in terms of reduced functional quality of life, increased anxiety and resulting pain and suffering. Physical therapy (PT) and exercise have been shown to be effective in reducing falls among older adult populations in the community. The purpose of this article is to review studies that examined PT and exercise for hospice and terminally ill cancer patients. Although none of the five studies evaluated the effect of PT and exercise specifically on falls, outcomes included factors such as balance, strength, pain, sleep and fatigue, all of which can contribute to falls. All the studies reviewed found benefits such as improved health status, functional mobility, or muscle strength.
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Rueegg CS, Kriemler S, Zuercher SJ, Schindera C, Renner A, Hebestreit H, Meier C, Eser P, von der Weid NX. A partially supervised physical activity program for adult and adolescent survivors of childhood cancer (SURfit): study design of a randomized controlled trial [NCT02730767]. BMC Cancer 2017; 17:822. [PMID: 29207962 PMCID: PMC5717834 DOI: 10.1186/s12885-017-3801-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Beyond survival of nowadays >80%, modern childhood cancer treatment strives to preserve long-term health and quality of life. However, the majority of today's survivors suffer from short- and long-term adverse effects such as cardiovascular and pulmonary diseases, obesity, osteoporosis, fatigue, depression, and reduced physical fitness and quality of life. Regular exercise can play a major role to mitigate or prevent such late-effects. Despite this, there are no data on the effects of regular exercise in childhood cancer survivors from randomized controlled trials (RCTs). Primary outcome of the current RCT is therefore the effect of a 12-months exercise program on a composite cardiovascular disease risk score in childhood cancer survivors. Secondary outcomes are single cardiovascular disease risk factors, glycaemic control, bone health, body composition, physical fitness, physical activity, quality of life, mental health, fatigue and adverse events (safety). METHODS A total of 150 childhood cancer survivors aged ≥16 years and diagnosed ≥5 years prior to the study are recruited from Swiss paediatric oncology clinics. Following the baseline assessments patients are randomized 1:1 into an intervention and control group. Thereafter, they are seen at month 3, 6 and 12 for follow-up assessments. The intervention group is asked to add ≥2.5 h of intense physical activity/week, including 30 min of strength building and 2 h of aerobic exercises. In addition, they are told to reduce screen time by 25%. Regular consulting by physiotherapists, individual web-based activity diaries, and pedometer devices are used as motivational tools for the intervention group. The control group is asked to keep their physical activity levels constant. DISCUSSION The results of this study will show whether a partially supervised exercise intervention can improve cardiovascular disease risk factors, bone health, body composition, physical activity and fitness, fatigue, mental health and quality of life in childhood cancer survivors. If the program will be effective, all relevant information of the SURfit physical activity intervention will be made available to interested clinics that treat and follow-up childhood cancer patients to promote exercise in their patients. TRIAL REGISTRATION Prospectively registered in clinicaltrials.gov [ NCT02730767 ], registration date: 10.12.2015.
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Affiliation(s)
- Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Simeon J. Zuercher
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Christina Schindera
- Department of Pediatric Oncology and Hematology, University Children’s Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - Andrea Renner
- Paediatric Endocrinology, Pediatric Endocrinology Centre Zurich AG (PEZZ), Möhrlistrasse 69, 8006 Zürich, Switzerland
| | - Helge Hebestreit
- Children’s Hospital, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
| | - Christian Meier
- Division of Endocrinology, Diabetes, Metabolism and Bone Research, University Hospital Basel, Missionsstrasse 24, 4055 Basel, Switzerland
| | - Prisca Eser
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital Bern, 3010 Bern, Switzerland
| | - Nicolas X. von der Weid
- Department of Pediatric Oncology and Hematology, University Children’s Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
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Abbott L, Hooke MC. Energy Through Motion©: An Activity Intervention for Cancer-Related Fatigue in an Ambulatory Infusion Center. Clin J Oncol Nurs 2017; 21:618-626. [DOI: 10.1188/17.cjon.618-626] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Segal R, Zwaal C, Green E, Tomasone JR, Loblaw A, Petrella T. Exercise for people with cancer: a systematic review. ACTA ACUST UNITED AC 2017; 24:e290-e315. [PMID: 28874900 DOI: 10.3747/co.24.3619] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND This systematic review was completed by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario's Program in Evidence-Based Care (pebc). It provides background and guidance for clinicians with respect to exercise for people living with cancer in active and post treatment. It focuses on the benefits of specific types of exercise, pre-screening requirements for new referrals, safety concerns, and delivery models. METHODS Using the pebc's standardized approach, medline and embase were systematically searched for existing guidelines, systematic reviews, and primary literature. RESULTS The search identified two guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present review provides conclusions about the duration, frequency, and intensity of exercise appropriate for people living with cancer. CONCLUSIONS The evidence shows that exercise is safe and provides benefit in quality of life and in muscular and aerobic fitness for people with cancer both during and after treatment. The evidence is sufficient to support the promotion of exercise for adults with cancer, and some evidence supports the promotion of exercise in group or supervised settings and for a long period of time to improve quality of life and muscular and aerobic fitness. Exercise at moderate intensities could also be sustainable for longer periods and could encourage exercise to be continued over an individual's lifetime. It is important that a pre-screening assessment be conducted to evaluate the effects of disease, treatments, and comorbidities.
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Affiliation(s)
- R Segal
- Medical Oncology, The Ottawa Hospital, Ottawa
| | - C Zwaal
- McMaster University, Hamilton
| | - E Green
- Canadian Partnership Against Cancer, Toronto
| | | | - A Loblaw
- Odette Cancer Research Program, Sunnybrook Hospital, Toronto; and
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Zhang Q, Li F, Zhang H, Yu X, Cong Y. Effects of nurse-led home-based exercise & cognitive behavioral therapy on reducing cancer-related fatigue in patients with ovarian cancer during and after chemotherapy: A randomized controlled trial. Int J Nurs Stud 2017; 78:52-60. [PMID: 28939343 DOI: 10.1016/j.ijnurstu.2017.08.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 08/13/2017] [Accepted: 08/18/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND High levels of fatigue have been documented in ovarian cancer patients. However, increased levels of fatigue are positively associated with a high risk of sleep disturbance and depression. OBJECTIVE To investigate the feasibility of a nurse-led home-based exercise and cognitive behavioral therapy (E&CBT) for ovarian cancer adults with cancer-related fatigue on outcomes of fatigue, plus other secondary outcomes (sleep disturbance and depression), either during or after completion of primary cancer treatment. DESIGN Randomized, single-blind control trial. SETTINGS Gynaecologic oncology department of the First Hospital of Jilin University in China. PARTICIPANTS 72 eligible women who recently had surgery and completed their first cycle of adjuvant chemotherapy were randomly assigned to two groups. INTERVENTION The experimental group received exercise and cognitive behavioral therapy. Five nurses with nursing master degree were trained to deliver this intervention. Patients received online interventions each week in the patient's place of residence or in the nurse-led clinic, as requested. Home visits, coupled with telephone-based motivational interviews twice a week were available with the permission of the participants. comparison group participants received services as usual. MEASUREMENTS The primary outcome was measured by the Chinese version of the Piper Fatigue Scale that has 4 subscales (Behavior, Affect, Sensory, and Cognition). Secondary outcomes were measured using the Self-Rating Depression Scale and the Pittsburgh Sleep Quality Index questionnaire. Repeated-measure ANOVA was used to examine the effectiveness of this intervention in reducing fatigue, depression, and improving sleep quality. RESULTS For baseline comparisons, no significant differences were found between the two groups. After the interventions, total fatigue scores were significantly reduced from T1 to T2, to T3 in the experimental group (4.37, 4.24, 3.90), respectively. The comparison group showed almost no change in total fatigue score over time. In the repeated measures ANOVA, the differences of behavioral fatigue score (F=11.647, p=0.001) and cognitive fatigue score (F=5.741, p=0.019) were statistically significant for the group by time interaction. After the interventions, the experimental group participants demonstrated significantly lower symptoms of depression compared with the comparison group (T2: p=0.001 and T3: p<0.001). Sleep duration, sleep dysfunction, daytime dysfunction as well as total sleep quality significantly improved. CONCLUSION Nurse-delivered home-based E&CBT have measurable benefits in helping women with ovarian cancer to decrease cancer-related fatigue, depressive symptoms, and improving their quality of sleep.
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Affiliation(s)
- Qi Zhang
- School of Nursing, Jilin University, Changchun, Jilin Province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin Province, China
| | - Han Zhang
- School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xiuli Yu
- Department of Obstetrics and Gynecology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yunfeng Cong
- Department of Obstetrics and Gynecology, First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
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Hunter EG, Gibson RW, Arbesman M, D'Amico M. Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 1. Impact of Physical Activity and Symptom Management Interventions. Am J Occup Ther 2017; 71:7102100030p1-7102100030p11. [PMID: 28218585 DOI: 10.5014/ajot.2017.023564] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue.
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Affiliation(s)
- Elizabeth G Hunter
- Elizabeth G. Hunter, PhD, OTR/L, is Assistant Professor, Graduate Center for Gerontology, University of Kentucky, Lexington;
| | - Robert W Gibson
- Robert W. Gibson, PhD, MS, OTR/L, FAOTA, is Professor and Director of Research, Department of Emergency Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Marian Arbesman
- Marian Arbesman, PhD, OTR/L, FAOTA, is Consultant, Evidence-Based Practice Project, American Occupational Therapy Association, Bethesda, MD; President, ArbesIdeas, Inc., Williamsville, NY; and Adjunct Associate Professor, Department of Clinical Research and Leadership, School of Medicine and Health Sciences, George Washington University, Washington, DC
| | - Mariana D'Amico
- Mariana D'Amico, EdD, OTR/L, BCP, FAOTA, is Associate Professor, Department of Occupational Therapy, Nova Southeastern University, Fort Lauderdale, FL
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Kendall F, Abreu P, Pinho P, Oliveira J, Bastos P. The role of physiotherapy in patients undergoing pulmonary surgery for lung cancer. A literature review. REVISTA PORTUGUESA DE PNEUMOLOGIA 2017. [PMID: 28623106 DOI: 10.1016/j.rppnen.2017.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This review aims to appraise the role of physiotherapy care in patients submitted to pulmonary surgery, in preoperative, perioperative, and postoperative phases. Pulmonary surgery is the gold standard treatment for patients with lung cancer if it is completely resectable. However, the major impairments and complications induced by surgery are well known. Physiotherapy has been regularly used both in the preparation of the surgical candidates; in their functional recovery in the immediate postoperative period, and in the medium/long term but there is a lack of concise evidence-based recommendations. Therefore, the aim of this review is to appraise the literature about the role of physiotherapy interventions in patients undergoing lung surgery for lung cancer, in preoperative, perioperative, postoperative and maintenance stages, to the recovery and well-being, regardless of the extent of surgical approach. In conclusion, physiotherapy programs should be individually designed, and the goals established according to surgery timings, and according to each subject's needs. It can also be concluded that in the preoperative phase, the main goals are to avoid postoperative pulmonary complications and reduce the length of hospital stay, and the therapeutic targets are respiratory muscle training, bronchial hygiene and exercise training. For the perioperative period, breathing exercises for pulmonary expansion and bronchial hygiene, as well as early mobilization and deambulation, postural correction and shoulder range of motion activities, should be added. Finally, it can be concluded that in the postoperative phase exercise training should be maintained, and adoption of healthy life-style behaviours must be encouraged.
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Affiliation(s)
- F Kendall
- Department of Cardio-Thoracic Surgery, Centro Hospitalar de São João, Porto, Portugal; CESPU, Polytechnic Health Institute of the North, Gandra, Portugal; CIAFEL, Faculty of Sports, University of Porto, Porto, Portugal.
| | - P Abreu
- Department of Physiotherapy, Escola Superior Saúde Dr. Lopes Dias, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - P Pinho
- Department of Cardio-Thoracic Surgery, Centro Hospitalar de São João, Porto, Portugal
| | - J Oliveira
- CIAFEL, Faculty of Sports, University of Porto, Porto, Portugal
| | - P Bastos
- Department of Cardio-Thoracic Surgery, Centro Hospitalar de São João, Porto, Portugal
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Wu ML, Yu KH, Tsai JC. The Effectiveness of Exercise in Adults With Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis to Guide Evidence-Based Practice. Worldviews Evid Based Nurs 2017; 14:306-315. [PMID: 28432856 DOI: 10.1111/wvn.12221] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fatigue is the most common and unpleasant symptom of patients with systemic lupus erythematosus (SLE). However, there is limited information regarding how exercise affects fatigue. AIMS The purpose of this study is to review and synthesize the current knowledge concerning the effectiveness of exercise training for treating fatigue among adults with SLE. The characteristics of beneficial exercise training are further evaluated. METHODS We conducted a systematic review and meta-analysis. The databases searched were MEDLINE, CINAHL, PEDro, Cochrane Library, Scopus, and PQDT from their inception to February 3, 2016. The quality of each selected study was assessed using the PEDro scale. A between-group analysis was performed to evaluate the effectiveness of the exercise training. Data were analyzed using the Cochrane Collaboration's RevMan 5.3 (Copenhagen, Denmark). RESULTS Two randomized controlled trials and one quasiexperimental study were included in this systematic review and meta-analysis. Aerobic exercise, three times a week and of moderate intensity, was a common component of the three studies. Two studies were conducted in a supervised setting and one study was based at home. One study lasted 8 weeks and two studies lasted 12 weeks. The meta-analysis showed that aerobic exercise could decrease fatigue (MD = -.52, 95% confidence interval [CI] [-.91, -.13], p = .009) and increase vitality (MD = 14.98, 95% CI [7.45, 22.52], p < .001). The subgroup analysis indicated that 12 weeks of exercise training and exercise under a supervised setting significantly benefited fatigue. LINKING EVIDENCE TO ACTION The pooled data indicate that 12 weeks of an aerobic exercise program that is supervised by health professionals could reduce fatigue and increase vitality for patients with SLE. SLE patients with mild disease should begin with moderate intensity for at least 20 minutes, 3 days a week.
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Affiliation(s)
- Mei-Ling Wu
- Instructor, Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan and Doctoral Candidate, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Kuang-Hui Yu
- Medical Doctor and Associate Professor, Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Jen-Chen Tsai
- Professor, School of Nursing, National Yang-Ming University, Taipei, Taiwan
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Berntsen S, Aaronson NK, Buffart L, Börjeson S, Demmelmaier I, Hellbom M, Hojman P, Igelström H, Johansson B, Pingel R, Raastad T, Velikova G, Åsenlöf P, Nordin K. Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome. BMC Cancer 2017; 17:218. [PMID: 28347291 PMCID: PMC5368942 DOI: 10.1186/s12885-017-3197-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 03/14/2017] [Indexed: 12/16/2022] Open
Abstract
Background Cancer-related fatigue is a common problem in persons with cancer, influencing health-related quality of life and causing a considerable challenge to society. Current evidence supports the beneficial effects of physical exercise in reducing fatigue, but the results across studies are not consistent, especially in terms of exercise intensity. It is also unclear whether use of behaviour change techniques can further increase exercise adherence and maintain physical activity behaviour. This study will investigate whether exercise intensity affects fatigue and health related quality of life in persons undergoing adjuvant cancer treatment. In addition, to examine effects of exercise intensity on mood disturbance, adherence to oncological treatment, adverse effects from treatment, activities of daily living after treatment completion and return to work, and behaviour change techniques effect on exercise adherence. We will also investigate whether exercise intensity influences inflammatory markers and cytokines, and whether gene expressions following training serve as mediators for the effects of exercise on fatigue and health related quality of life. Methods/design Six hundred newly diagnosed persons with breast, colorectal or prostate cancer undergoing adjuvant therapy will be randomized in a 2 × 2 factorial design to following conditions; A) individually tailored low-to-moderate intensity exercise with or without behaviour change techniques or B) individually tailored high intensity exercise with or without behaviour change techniques. The training consists of both resistance and endurance exercise sessions under the guidance of trained coaches. The primary outcomes, fatigue and health related quality of life, are measured by self-reports. Secondary outcomes include fitness, mood disturbance, adherence to the cancer treatment, adverse effects, return to activities of daily living after completed treatment, return to work as well as inflammatory markers, cytokines and gene expression. Discussion The study will contribute to our understanding of the value of exercise and exercise intensity in reducing fatigue and improving health related quality of life and, potentially, clinical outcomes. The value of behaviour change techniques in terms of adherence to and maintenance of physical exercise behaviour in persons with cancer will be evaluated. Trial registration NCT02473003, October, 2014.
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Affiliation(s)
- Sveinung Berntsen
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden.,Dept. of Public Health, Sport and Nutrition, University of Agder, Gimlemoen 25, 4604, Kristiansand, Norway
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Laurien Buffart
- Departments of Epidemiology & Biostatistics and Medical Oncology, VU University Medical Center, PO Box 7057, 7007 MB, Amsterdam, the Netherlands
| | - Sussanne Börjeson
- Dept. of Medical and Health Sciences, Division of Nursing Science, Linköping University Campus Valla, 581 83, Linköping, Sweden
| | - Ingrid Demmelmaier
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Maria Hellbom
- Division of Oncology and Pathology, Dept. of Clinical Sciences, Lund University, Box 117, 221 00, Lund, Sweden
| | - Pernille Hojman
- Centre of Inflammation and Metabolism, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Igelström
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Birgitta Johansson
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden.,Experimental and Clinical Oncology, Dept. of Immunology, Genetics and Pathology, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Ronnie Pingel
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Truls Raastad
- Dept. of Physical Performance, Norwegian School of Sport Science, Sognsveien 220, 0863, Oslo, Norway
| | - Galina Velikova
- Leeds Institute of Cancer and Pathology, St James's University Hospital LEEDS LS9 7TF University of Leeds, Leeds, UK
| | - Pernilla Åsenlöf
- Dept. of Neuro Science, Physiotherapy, Uppsala University, Box 564, 75122, Uppsala, Sweden
| | - Karin Nordin
- Dept. of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness, Uppsala University, Box 564, 75122, Uppsala, Sweden. .,Dept. of Public Health, Sport and Nutrition, University of Agder, Gimlemoen 25, 4604, Kristiansand, Norway.
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35
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Segal R, Zwaal C, Green E, Tomasone JR, Loblaw A, Petrella T. Exercise for people with cancer: a clinical practice guideline. ACTA ACUST UNITED AC 2017; 24:40-46. [PMID: 28270724 DOI: 10.3747/co.24.3376] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario's Program in Evidence-Based Care (pebc). The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer, focusing on the benefits of specific types of exercise, recommendations about screening requirements for new referrals, and safety concerns. METHODS Consistent with the pebc's standardized approach, a systematic search was conducted for existing guidelines, and systematic literature searches were performed in medline and embase for both systematic reviews and primary literature. Content and methodology experts performed an internal review, which was followed by an external review by targeted experts and intended users. RESULTS The search identified three guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present guideline provides recommendations for the duration, frequency, and intensity of exercise appropriate for people living with cancer. It also provides recommendations for pre-exercise assessment, safety concerns, and delivery models. CONCLUSIONS There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment, and that it does not cause harm. The present guideline is intended to support the Canadian Society for Exercise Physiology's Canadian physical activity guidelines. The recommendations are intended for clinicians and institutions treating cancer patients in Ontario, and for policymakers and program planners involved in the delivery of exercise programs for cancer patients.
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Affiliation(s)
- R Segal
- Medical Oncology, The Ottawa Hospital, Ottawa
| | - C Zwaal
- McMaster University, Hamilton
| | - E Green
- Canadian Partnership Against Cancer, Toronto
| | | | - A Loblaw
- Evaluative Clinical Sciences, Odette Cancer Research Program, Sunnybrook Hospital, Toronto; and
| | - T Petrella
- ncic Melanoma Clinical Trials Group, Sunnybrook Hospital, Toronto, ON
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Polo KM, Smith C. Taking Our Seat at the Table: Community Cancer Survivorship. Am J Occup Ther 2017; 71:7102100010p1-7102100010p5. [DOI: 10.5014/ajot.2017.020693] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Cancer survivors are at risk for occupational performance issues related to activities of daily living, instrumental activities of daily living, work, and social and community participation. Occupational therapy practitioners can address these performance issues by offering services within existing community cancer survivorship programs that focus on adaptive and compensatory strategies to facilitate meaningful lifestyles and optimize health and well-being. Occupational therapy services do not currently exist at these community sites, nor are occupational therapy practitioners recognized as providers in existing community cancer survivorship programs. Recognition of practitioners’ distinct value in cancer survivorship, advocacy for occupational therapy services in the community, development of supporting documentation for occupational therapy’s role in community survivorship, and research on the efficacy of interventions in community cancer survivorship are needed to expand occupational therapy’s role with this growing population.
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Affiliation(s)
- Katie M. Polo
- Katie M. Polo, DHS, OTR/L, CLT-LANA, is Assistant Professor, College of Health Sciences, School of Occupational Therapy, University of Indianapolis, Indianapolis, IN. At the time of writing, she was Assistant Professor, Occupational Therapy Program, Midwestern University, Downers Grove, IL;
| | - Caitlin Smith
- Caitlin Smith, OTD, OTR/L, is Occupational Therapist, PhysioPartners, Chicago, IL
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Igelström H, Berntsen S, Demmelmaier I, Johansson B, Nordin K. Exercise during and after curative oncological treatment – a mapping review. PHYSICAL THERAPY REVIEWS 2016. [DOI: 10.1080/10833196.2016.1262109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Helena Igelström
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
| | - Sveinung Berntsen
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
- Department of Public Health, Sport and Nutrition, University of Agder , Kristiansand, Norway
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
| | - Birgitta Johansson
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University , Uppsala, Sweden
| | - Karin Nordin
- Department of Public Health and Caring Sciences, Uppsala University , Uppsala, Sweden
- Department of Public Health, Sport and Nutrition, University of Agder , Kristiansand, Norway
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38
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Lin KY, Frawley H, Denehy L, Feil D, Granger C. Exercise interventions for patients with gynaecological cancer: a systematic review and meta-analysis. Physiotherapy 2016; 102:309-319. [DOI: 10.1016/j.physio.2016.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 02/16/2016] [Indexed: 02/09/2023]
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Webel AR, Perazzo J, Decker M, Horvat-Davey C, Sattar A, Voss J. Physical activity is associated with reduced fatigue in adults living with HIV/AIDS. J Adv Nurs 2016; 72:3104-3112. [PMID: 27485463 PMCID: PMC5118117 DOI: 10.1111/jan.13084] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 01/09/2023]
Abstract
AIMS The aim of this study was to describe the relationships among home-based physical activity, fatigue, sleep, gender and quality of life in people living with HIV/AIDS BACKGROUND: Fatigue is a common and distressing symptom among people living with HIV/AIDS. Few interventions exist that effectively reduce fatigue in this population. Physical activity has shown promise to reduce fatigue in other populations, but its impact on fatigue in HIV/AIDS has not yet been explored. DESIGN This study was conducted using a prospective, descriptive cohort design. METHODS Overall, 90 adults living with HIV/AIDS completed cross-sectional measures. Home-based physical activity was measured using a 7-day self-report diary. Fatigue was measured using the self-reported HIV-Related Fatigue Scale. Sleep was assessed using wrist actigraphy and quality of life was assessed using the HIV-Associated Quality of Life Scale. Data were collected from December 2012-April 2013 and analysed using correlations and multiple linear regression. RESULTS The number of minutes of home-based physical activity was significantly associated with reduced fatigue among people living with HIV/AIDS. In addition, increased fatigue was associated with decreased quality of life. No associations were found among fatigue, sleep or gender. CONCLUSIONS Our study demonstrates that physical activity in the home setting is an effective strategy to reduce fatigue among people living with HIV/AIDS. Future work developing and testing interventions to improve home-based physical activity in this population is needed.
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Affiliation(s)
- Allison R. Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106-4904, USA, 012163683939, , Twitter: @allisonwebelPhD
| | - Joe Perazzo
- Frances Payne Bolton School of Nursing, Case Western Reserve University
| | - Michael Decker
- Frances Payne Bolton School of Nursing, Case Western Reserve University
| | | | - Abdus Sattar
- School of Medicine, Case Western Reserve University
| | - Joachim Voss
- Sarah Cole Hirsh Center for Evidence-Based Practice, Frances Payne Bolton School of Nursing, Case Western Reserve University
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40
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Spathis A, Booth S, Grove S, Hatcher H, Kuhn I, Barclay S. Teenage and Young Adult Cancer-Related Fatigue Is Prevalent, Distressing, and Neglected: It Is Time to Intervene. A Systematic Literature Review and Narrative Synthesis. J Adolesc Young Adult Oncol 2016; 4:3-17. [PMID: 25852970 DOI: 10.1089/jayao.2014.0023] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Cancer-related fatigue in adults has been the subject of considerable recent research, confirming its importance as a common and debilitating symptom, and establishing a number of evidence-based interventions. There has, however, been limited focus on the fatigue suffered by teenagers and young adults with cancer, a group recognized as having unique experiences and developmental needs. We have undertaken a systematic review of the literature to provide a comprehensive overview of studies evaluating fatigue in this younger patient group in order to guide clinical practice and future research. METHOD We searched MEDLINE, EMBASE, PsycINFO, and CINAHL databases for literature containing data relating to any aspect of fatigue in patients aged 13-24 at cancer diagnosis or treatment. RESULTS Sixty articles were identified, of which five described interventional clinical trials. Cancer-related fatigue was consistently one of the most prevalent, severe, and distressing symptoms, and it persisted long-term in survivors. It was associated with a number of factors, including poor sleep, depression, and chemotherapy. There was little evidence for the effectiveness of any intervention, although exercise appears to be the most promising. Importantly, fatigue was itself a significant barrier to physical and social activities. CONCLUSION Cancer-related fatigue is a major and disabling problem in young cancer patients. Effective management strategies are needed to avoid compounding the dependence and social isolation of this vulnerable patient group. Future research should focus on providing evidence for the effectiveness of interventions, of which activity promotion and management of concurrent symptoms are the most promising.
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Affiliation(s)
- Anna Spathis
- Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom . ; Department of Public Health and Primary Care, University of Cambridge , Cambridge, United Kingdom
| | - Sara Booth
- Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom . ; University of Cambridge , Cambridge, United Kingdom
| | - Sarah Grove
- Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom
| | - Helen Hatcher
- TYA Cancer Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom
| | - Isla Kuhn
- University of Cambridge Medical Library , Cambridge, United Kingdom
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge , Cambridge, United Kingdom
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Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2016; 25 Suppl 3:1-72. [PMID: 26606383 DOI: 10.1111/sms.12581] [Citation(s) in RCA: 1699] [Impact Index Per Article: 212.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
Abstract
This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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Affiliation(s)
- B K Pedersen
- The Centre of Inflammation and Metabolism and The Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B Saltin
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Effects of aerobic exercise on cancer-related fatigue: a meta-analysis of randomized controlled trials. Support Care Cancer 2016; 24:969-983. [PMID: 26482381 DOI: 10.1007/s00520-015-2953-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/14/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is the most commonly reported and most distressing symptom in cancer patients. Currently, there are no effective strategies for managing this condition. OBJECTIVE The purpose of this study is to compare the effects of aerobic exercise on CRF with the standard of care. METHODS A systematic search for randomized controlled trials (RCTs) was performed using the Cochrane Library, JBI Library, Embase, MEDLINE, Web of Science, China Biology Medicine (CBM), and China National Knowledge Infrastructure (CNKI). The risk of bias was critically evaluated, and data were independently extracted by two reviewers. All of the analyses were performed using Review Manager 5. RESULTS A total of 26 qualified studies that included 2830 participants (aerobic exercise, 1426; control, 1404) were included in the meta-analysis. Cancer patients who completed adjuvant therapy in the aerobic exercise group reported reduced CRF levels relative to patients undergoing the standard of care. Aerobic exercise had a moderate effect on CRF for patients not currently undergoing anticancer treatment. Supervised aerobic exercise, exercise for 20–30 min/session, or exercise three times/week had a small effect on CRF. Exercise for 50 min/session or exercise two sessions/week had a significant effect on patient CRF, whereas 8 weeks of exercise had a moderate effect. CONCLUSIONS Aerobic exercise is effective for the management of CRF, especially for patients who have completed adjuvant therapy. IMPLICATIONS FOR PRACTICE Cancer patients can make more informed choices regarding their cancer-related fatigue management based on the best available evidence.
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Macera CA, Cavanaugh A, Bellettiere J. State of the Art Review: Physical Activity and Older Adults. Am J Lifestyle Med 2016; 11:42-57. [PMID: 30202313 DOI: 10.1177/1559827615571897] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 12/31/2022] Open
Abstract
Physical activity is an important component of a healthy lifestyle for all adults and especially for older adults. Using information from the updated 2008 Physical Activity Guidelines, 3 dimensions of physical activity are identified for older adults. These include increasing aerobic activity, increasing muscle-strengthening activity, and reducing sedentary or sitting behavior. Although the overall goal of the physical activity recommendations is to prevent chronic diseases and conditions from developing, many older adults are already affected. Therefore, suggested types of physical activity are described for specific diseases and conditions that are designed to mediate the condition or prevent additional disability. Finally, barriers to participation in physical activity specific to older adults are described, and possible solutions offered. Encouraging older adults to continue or even start a physical activity program can result in major health benefits for these individuals.
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Affiliation(s)
- Caroline A Macera
- Graduate School of Public Health (CAM) San Diego State University, San Diego, California.,Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health (JB) San Diego State University, San Diego, California.,Joint Doctoral Program in Public Health Epidemiology, San Diego State University and University of California at San Diego, San Diego, California (AC)
| | - Alyson Cavanaugh
- Graduate School of Public Health (CAM) San Diego State University, San Diego, California.,Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health (JB) San Diego State University, San Diego, California.,Joint Doctoral Program in Public Health Epidemiology, San Diego State University and University of California at San Diego, San Diego, California (AC)
| | - John Bellettiere
- Graduate School of Public Health (CAM) San Diego State University, San Diego, California.,Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health (JB) San Diego State University, San Diego, California.,Joint Doctoral Program in Public Health Epidemiology, San Diego State University and University of California at San Diego, San Diego, California (AC)
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Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C. Cancer-Related Fatigue, Version 2.2015. J Natl Compr Canc Netw 2016; 13:1012-39. [PMID: 26285247 DOI: 10.6004/jnccn.2015.0122] [Citation(s) in RCA: 512] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.
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Vogelaar L, van den Berg-Emons R, Bussmann H, Rozenberg R, Timman R, van der Woude CJ. Physical fitness and physical activity in fatigued and non-fatigued inflammatory bowel disease patients. Scand J Gastroenterol 2016; 50:1357-67. [PMID: 25966749 DOI: 10.3109/00365521.2015.1046135] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess physical fitness and physical activity in inflammatory bowel disease (IBD) patients and whether fatigue is associated with impaired physical fitness and impaired physical activity. MATERIALS AND METHODS Ten patients with quiescent IBD and fatigue (fatigue group [FG]) based on the Checklist Individual Strength-Fatigue score of ≥35 were matched for age (±5 years) and sex with a non-fatigue group (NFG) with IBD. Physical fitness was measured with a cyclo-ergometric-based maximal exercise test, a submaximal 6-min walk test, and a dynamometer test to quantify the isokinetic muscle strength of the knee extensors and flexors. Level of physical activity was measured with an accelerometer-based activity monitor. RESULTS The patients in both groups did not differ in regard to medication use, clinical characteristics, and body composition. However, medium-to-large effect sizes for impaired physical fitness (both cardiorespiratory fitness and muscle strength) and physical activity were seen between the patients in the FG and the NFG. Especially, intensity of physical activity was significantly lower in the FG patients compared with the NFG patients (effect size: 1.02; p = 0.037). Similar results were seen when outcomes of the FG and NFG were compared with reference values of the normal population. CONCLUSION Fatigued IBD patients show an impaired physical fitness and physical activity compared with non-fatigued IBD patients. This gives directions for a physical component in fatigue in IBD patients. Therefore, these new insights into fatigue indicate that these patients might benefit from an exercise program to improve physical fitness and physical activity.
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Affiliation(s)
- Lauran Vogelaar
- Department of Gastroenterology and Hepatology, Erasmus MC , Rotterdam , The Netherlands
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Hooke MC, Gilchrist L, Tanner L, Hart N, Withycombe JS. Use of a Fitness Tracker to Promote Physical Activity in Children With Acute Lymphoblastic Leukemia. Pediatr Blood Cancer 2016; 63:684-9. [PMID: 26756736 DOI: 10.1002/pbc.25860] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/27/2015] [Accepted: 11/06/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Children with cancer identify fatigue as a pervasive symptom, which increases during the corticosteroid pulse in acute lymphoblastic leukemia (ALL) maintenance. The FitBit is a fitness tracker that downloads activity measurements to the Internet in real time. In this feasibility study, we explored if children who received daily FitBit coaching for 2 weeks before a maintenance steroid pulse had an increase in steps per day and determined the relationship between steps per day prepulse and fatigue postpulse. PROCEDURE Seventeen children in ALL maintenance, aged 6-15, wore the FitBit for 3 days to establish a baseline. A tailored weekly step goal was then set with the child and parent. Daily emails with feedback and FitBit screenshots were sent over the 2-week intervention. Self-report of fatigue was measured at baseline, after 2 weeks (i.e. before the steroid pulse), and after 5 days of steroids. RESULTS There was a trend toward increased steps per day from weeks 1-2 (P = 0.079); fatigue was low and did not increase during the corticosteroid pulse. A significant correlation (r = -0.66, P = 0.005) was found between the steps per day during week 2 and fatigue after the steroid pulse with higher steps associated with lower fatigue. CONCLUSIONS The intervention was feasible in this small sample. The average steps each time period (week 1, week 2, and during steroids) was over 10,000, demonstrating that children with ALL can be active during treatment. Physical activity may be protective of fatigue during a corticosteroid pulse.
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Affiliation(s)
- Mary C Hooke
- School of Nursing, University of Minnesota, Minneapolis, Minnesota.,Children's Minnesota, Minneapolis, Minnesota
| | | | - Lynn Tanner
- Children's Minnesota, Minneapolis, Minnesota
| | - Nicole Hart
- Children's Minnesota, Minneapolis, Minnesota
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Lowe SS, Tan M, Faily J, Watanabe SM, Courneya KS. Physical activity in advanced cancer patients: a systematic review protocol. Syst Rev 2016; 5:43. [PMID: 26968701 PMCID: PMC4788843 DOI: 10.1186/s13643-016-0220-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 03/07/2016] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Progressive, incurable cancer is associated with increased fatigue, increased muscle weakness, and reduced physical functioning, all of which negatively impact quality of life. Physical activity has demonstrated benefits on cancer-related fatigue and physical functioning in early-stage cancer patients; however, its impact on these outcomes in end-stage cancer has not been established. The aim of this systematic review is to determine the potential benefits, harms, and effects of physical activity interventions on quality of life outcomes in advanced cancer patients. METHODS/DESIGN A systematic review of peer-reviewed literature on physical activity in advanced cancer patients will be undertaken. Empirical quantitative studies will be considered for inclusion if they present interventional or observational data on physical activity in advanced cancer patients. Searches will be conducted in the following electronic databases: CINAHL; CIRRIE Database of International Rehabilitation Research; Cochrane Database of Systematic Reviews (CDSR); Database of Abstracts of Reviews of Effects (DARE); Cochrane Central Register of Controlled Trials (CENTRAL); EMBASE; MEDLINE; PEDro: the Physiotherapy Evidence Database; PQDT; PsycInfo; PubMed; REHABDATA; Scopus; SPORTDiscus; and Web of Science, to identify relevant studies of interest. Additional strategies to identify relevant studies will include citation searches and evaluation of reference lists of included articles. Titles, abstracts, and keywords of identified studies from the search strategies will be screened for inclusion criteria. Two independent reviewers will conduct quality appraisal using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP) and the Cochrane risk of bias tool. A descriptive summary of included studies will describe the study designs, participant and activity characteristics, and objective and patient-reported outcomes. DISCUSSION This systematic review will summarize the current evidence base on physical activity interventions in advanced cancer patients. The findings from this systematic review will identify gaps to be explored by future research studies and inform future practice guideline development of physical activity interventions in advanced cancer patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015026281.
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Affiliation(s)
- Sonya S Lowe
- Department of Symptom Control and Palliative Care, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada.
| | - Maria Tan
- Knowledge Resource Service, Knowledge Management Department, Research Innovation and Analytics, Abdul Khaliq Library, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Joan Faily
- Edmonton Zone Palliative Care Program-Palliative Community Consult Team (EZPCP-PCCT), #335, 1090 Youville Drive West, Edmonton, AB, T6L 0A3, Canada
| | - Sharon M Watanabe
- Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada
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Zhang LL, Wang SZ, Chen HL, Yuan AZ. Tai Chi Exercise for Cancer-Related Fatigue in Patients With Lung Cancer Undergoing Chemotherapy: A Randomized Controlled Trial. J Pain Symptom Manage 2016; 51:504-11. [PMID: 26721747 DOI: 10.1016/j.jpainsymman.2015.11.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 10/31/2015] [Accepted: 11/09/2015] [Indexed: 11/20/2022]
Abstract
CONTEXT Tai Chi is a traditional Chinese health-promoting exercise. It has been shown to enhance mental health and improve psychological condition. OBJECTIVES We aimed to assess the effectiveness of Tai Chi exercise for cancer-related fatigue in patients with lung cancer undergoing chemotherapy. METHODS We conducted a randomized trial of Tai Chi exercise as compared with low-impact exercise as a control intervention. Exercises were practiced every other day, a one-hour session for 12 weeks for each of the study groups. The primary end point was a change in total score of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary end points were changes in five subscale scores of the MFSI-SF. All assessments were repeated at three time points, T0: before first course of chemotherapy; T1: before third course of chemotherapy; and T2: at the end of the fourth course of chemotherapy. RESULTS Between January 2012 and December 2014, 96 patients were enrolled in this trial. At six and 12 weeks, the Tai Chi group had a lower MFSI-SF total score compared with the control group (59.5 ± 11.3 vs. 66.8 ± 11.9, P < 0.05; 53.3 ± 11.8 vs. 59.3 ± 12.2, P < 0.05). At six weeks, the Tai Chi group had lower MFSI-SF general subscale scores (18.1 ± 4.6 vs. 20.4 ± 4.5, P < 0.05) and physical subscale scores (17.5 ± 4.4 vs. 19.1 ± 4.5, P < 0.05), and higher MFSI-SF vigor subscale scores (14.5 ± 3.3 vs. 11.6 ± 3.4, P < 0.05), compared with the control group. But no significant differences were found in emotional subscale (20.2 ± 3.6 vs. 20.0 ± 3.5, P > 0.05) and mental subscale (18.2 ± 4.0 vs. 18.9 ± 3.9, P > 0.05) scores between the Tai Chi group and the control group. At 12 weeks, the MFSI-SF subscale scores showed the same trends as at six weeks. CONCLUSION Tai Chi is an effective intervention for managing cancer-related fatigue in patients with lung cancer undergoing chemotherapy, especially for decreasing general fatigue and physical fatigue, and increasing vigor.
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Affiliation(s)
- Li-Li Zhang
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou, Jiangsu, China
| | - Su-Zhen Wang
- Department of Nursing, Taizhou People's Hospital, Taizhou, Jiangsu, China
| | | | - A-Zhen Yuan
- Department of Nursing, Taizhou People's Hospital, Taizhou, Jiangsu, China.
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Abd El-Kader SM, Al-Jiffri OH, Al-Shreef FM. Aerobic exercises alleviate symptoms of fatigue related to inflammatory cytokines in obese patients with type 2 diabetes. Afr Health Sci 2015; 15:1142-8. [PMID: 26958015 DOI: 10.4314/ahs.v15i4.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Non-insulin dependent diabetic patients frequently suffer from fatigue symptoms that result from chronic systemic inflammation. Aerobic exercise was proved to modulate systemic inflammation. OBJECTIVE This study was an attempt to measure the impact of aerobic exercises on fatigue symptoms related to systemic inflammation in obese patients with type 2 diabetes. METHODS Eighty obese patients with type 2 diabetes participated in the present study, their age ranged from 40-58 years and their BMI ranged from 31-36 kg/m2 and were assigned to two subgroups; group (A) received aerobic exercise training for 12 weeks and group (B) received no exercise training for 3 months. Measurements of fatigue symptoms and markers of systemic inflammation were assessed before and at the end of the study for all participants in both groups. RESULTS The mean values of inflammatory markers (IL-6 and TNF-α) and Multidimensional Fatigue Inventory (MFI) was significantly decreased in group (A), while changes were not significant in group (B). Moreover, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. CONCLUSION Treadmill walking exercise training is an effective treatment policy to improve symptoms of fatigue related to inflammatory cytokines in obese patients with type 2 diabetes.
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50
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Husson O, Mols F, van de Poll-Franse LV, Thong MSY. The course of fatigue and its correlates in colorectal cancer survivors: a prospective cohort study of the PROFILES registry. Support Care Cancer 2015; 23:3361-71. [PMID: 26123601 PMCID: PMC4584107 DOI: 10.1007/s00520-015-2802-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022]
Abstract
PURPOSE Colorectal cancer (CRC) survivors who remain fatigued during long-term follow-up are at risk for worse health outcomes and need relevant interventions most. The aim of this study is to prospectively assess cancer-related fatigue (CRF) and four categories of CRF correlates (clinical characteristics, demographic characteristics, behavior/well-being, functional status). METHODS CRC survivors diagnosed between 2000 and 2009, as registered in the population-based Eindhoven Cancer Registry, completed the Fatigue Assessment Scale at three annual time points. Linear mixed models were used to assess the course of CRF and identify its correlates. RESULTS CRF levels were relatively stable over time. Being female, young (≤65 years of age), and single; having a low educational level; treatment with chemotherapy; and having one or more comorbid conditions were associated with higher CRF scores. Years since diagnosis, radiotherapy, and disease stage were not related to CRF over time. Significant between- and within-subject effects were found for all well-being factors (social, emotional, and cognitive functioning, and global quality of life), symptoms (anxiety, depression, pain, and insomnia), and functional status (physical and role functioning, physical activity levels) in relation to CRF. The differences in CRF levels could, for a large part, be attributed to differences in behavior/well-being (59 %), functional status (37 %), and, to a lesser extent, to sociodemographic (4 %) and clinical characteristics (8 %). CONCLUSION This study showed that sociodemographic and clinical factors were associated with CRF levels over time among CRC survivors; however, behavior/well-being and functional status explained a larger part of the variance in levels of CRF.
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Affiliation(s)
- Olga Husson
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands.
| | - Floortje Mols
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Lonneke V van de Poll-Franse
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Melissa S Y Thong
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands
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