Re: The effect of a physical exercise program in palliative care: a phase II study.

Hayward House Macmillan, Specialist Palliative Cancer Care, Unit Nottingham University Hospitals, NHS Trust, Nottingham, UK
Journal of Pain and Symptom Management (Impact Factor: 2.74). 01/2007; 32(6):513-5; author reply 515-6. DOI: 10.1016/j.jpainsymman.2006.07.001
Source: PubMed
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    ABSTRACT: Zusammenfassung Zahlreiche klinische Studien zeigen, dass gezielte Trainingsprogramme bei Patienten unter onkologischer Therapie trotz der krankheits- und therapiebedingten Einschränkungen möglich sind und zur verbesserten Lebensqualität und Leistungsfähigkeit dieser Patienten führen. Während die meisten Studien den Einsatz bewegungstherapeutischer Programme bei kurativ behandelten Patienten untersuchten, liegen zum Stellenwert solcher Trainingsprogramme bei unheilheilbar kranken Patienten unter palliativer Chemo- oder Strahlentherapie bisher kaum Ergebnisse vor. In einem Pilotprojekt wurden im Rahmen einer Fragebogenanalyse Patienten unter laufender palliativer Chemotherapie hinsichtlich Lebensqualität, körperlicher Aktivität und Akzeptanz einer Bewegungstherapie während der Therapie untersucht. Hierbei zeigte sich ein positiver Zusammenhang zwischen körperlicher Aktivität und Lebensqualität. Viele der Patienten führten eigenständig sportliche Aktivitäten unter der Palliativtherapie fort und bekundeten großes Interesse an individuell angepassten Trainingsprogrammen. Im Universitären Cancer Center Hamburg (UCCH) konnte im vergangenen Jahr ein breites Trainingsangebot für onkologische Patienten unter ambulanter Chemotherapie etabliert werden, das den objektiven und subjektiven Benefit von sportlicher Aktivität auch bei unheilbar kranken onkologischen Patienten deutlich macht.
    05/2011; 26(3). DOI:10.1007/s12312-011-0611-9
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    ABSTRACT: 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.
    Journal of Palliative Medicine 07/2014; 17(10). DOI:10.1089/jpm.2013.0638 · 2.06 Impact Factor
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    ABSTRACT: Cancer and its treatments produce a myriad of burdensome side effects and significantly impair quality of life (QOL). Exercise reduces side effects and improves QOL for cancer patients during treatment and recovery. Exercise prior to, during, and after completion of cancer treatments provides numerous beneficial outcomes. Exercise represents an effective therapeutic intervention for preparing patients to successfully complete treatments, for reducing acute, chronic and late side effects, and for improving QOL during and after treatments. This overview of exercise oncology and side-effect management summarizes existing evidence-based exercise guidelines for cancer patients and survivors.