Feasibility and Impact of a Physical Exercise Program in Patients with Advanced Cancer: A Pilot Study

To cite this article:
DungenIlse A. van den, VerhagenConstans A., van der GraafWinette T., van den BergJan-Paul, VissersKris C., and EngelsYvonne. Journal of Palliative Medicine.  July 8, 2014

Author information

Ilse A. van den Dungen, MSc,¹ Constans A. Verhagen, MD, PhD,^1,2 Winette T. van der Graaf, MD, PhD,² Jan-Paul van den Berg, MD, PhD,³ Kris C. Vissers, MD, PhD, FIPP,¹ and Yvonne Engels, PhD¹

¹Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

²Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.

³Department of Rehabilitation Medicine, Anthony van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Address correspondence to:

Kris C. Vissers, MD

Department of Anesthesiology, Pain,

and Palliative Medicine

Radboudumc

Geert Grooteplein 10

6500 HB, Nijmegen

The Netherlands
E-mail: Kris.Vissers@radboudumc.nl

Accepted May 7, 2014

ABSTRACT

Objective: Our aim was to investigate the feasibility of completing an exercise program in patients with advanced cancer and to obtain preliminary data of its impact on physical and quality of life (QoL) outcomes.

Methods: We conducted a nonrandomized pilot study. Participants were 26 palliative care patients with advanced cancer (mean age=54.5 years; standard deviation [SD] 8.9 years) of the outpatient clinic of the medical oncology and the urology departments of a medical center in The Netherlands. Participants followed an individually graded group exercise program, consisting of resistance training and aerobic exercise, twice a week during 6 weeks. Feasibility of the training program, muscle strength, aerobic fitness, body composition, QoL, fatigue, and physical role, social, and activities of daily living (ADL) functioning were assessed at baseline and immediately after the intervention.

Results: Dropout rate during the training period was 35% due to disease progression.

After the training period, based on intention to treat analysis, muscle strength and aerobic functional fitness had increased significantly (p≤0.01). A significant decrease in fat percentage (p≤0.02) was observed.

QoL had increased significantly (p≤0.02), as well as social (p≤0.04), physical role (p≤0.01), and ADL functioning (p≤0.05).

Fatigue decreased significantly on the Checklist Individual Strength (CIS) and RAND-36 questionnaires (p≤0.02), however not on the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (p=0.48). No change in physical functioning was observed with the EORTC QLQ-C30 and RAND-36 (respectively, p=0.33 and p=0.09).

Conclusions: These preliminary results show that physical exercise in patients with advanced cancer is feasible. A significant impact was observed on physical and QoL outcomes. These findings need to be confirmed with a larger-scale, randomized controlled trial.