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Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial

Department of Hematology, Oncology and Transfusion Medicine, Charité Campus Benjamin Franklin, 12200 Berlin, Germany.
Supportive Care Cancer (Impact Factor: 2.5). 12/2004; 12(11):774-9. DOI: 10.1007/s00520-004-0676-4
Source: PubMed

ABSTRACT Fatigue is a frequent problem after surgical treatment of solid tumours. Aerobic exercise and psychosocial interventions have been shown to reduce the severity of this symptom in cancer patients. Therefore, we compared the effect of the two therapies on fatigue in a randomised controlled study. Seventy-two patients who underwent surgery for lung (n=27) or gastrointestinal tumours (n=42) were assigned to an aerobic exercise group (stationary biking 30 min five times weekly) or a progressive relaxation training group (45 min three times per week). Both interventions were carried out for 3 weeks. At the beginning and the end of the study, we evaluated physical, cognitive and emotional status and somatic complaints with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core Module (EORTC-QLQ-30) questionnaire, and maximal physical performance with an ergometric stress test. Physical performance of the training group improved significantly during the programme (9.4+/-20 watts, p=0.01) but remained unchanged in the relaxation group (1.5+/-14.8 watts, p=0.37). Fatigue and global health scores improved in both groups during the intervention (fatigue: training group 21%, relaxation group 19%; global health of both groups 19%, p for all < or =0.01); however, there was no significant difference between changes in the scores of both groups (p=0.67). We conclude that a structured aerobic training programme improves the physical performance of patients recovering from surgery for solid tumours. However, exercise is not better than progressive relaxation training for the treatment of fatigue in this setting.

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    • "We found that our patients believed that exercise does not increase energy but requires more energy. This belief is not supported by the current evidence that physical activity, including exercise, is an effective strategy for managing fatigue (Barsevick et al., 2008; de Nijs et al., 2008; Dimeo et al., 2004; Iop et al., 2004; Jacobsen et al., 2007). Future studies need to address this important misconception. "
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    ABSTRACT: Pain and fatigue are recognized as critical symptoms that impact QOL for patients with colon cancer. Barriers to optimum pain and fatigue relief include patient-related beliefs and attitudes about the treatment of cancer-related symptoms. The overall objective of this paper was to describe quality of life (QOL) and barriers to pain and fatigue management in patients with colon cancer. This longitudinal, descriptive study included was conducted in the ambulatory clinic of one NCI-designated comprehensive cancer center. A cohort of 56 patients with colon cancer and a pain and/or fatigue of ≥4 (moderate to severe) was recruited. Subjects completed questionnaires to assess subjective ratings of overall QOL, fatigue, barriers to pain and fatigue, and pain and fatigue knowledge. The majority of subjects (58%) reported having moderate to severe (4-6) fatigue at the time of accrual. Overall QOL score was moderate (M = 5.20, SD = 1.43), and the social well-being subscale had the lowest score (M = 4.57, SD = 1.82). Patient barriers to pain and fatigue existed in attitudes and beliefs regarding addiction, tolerance, and that fatigue is an inevitable part of cancer and its treatments. Patient knowledge of pain and fatigue was high (77%-88% correct), but lack of knowledge persisted in areas such as addiction to pain medications and utilizing physical activity to manage fatigue. Several patient-related attitudes and beliefs may hinder optimum relief of symptoms such as pain and fatigue. Social well-being may be a major determinant of overall QOL for patients with colon cancer.
    European journal of oncology nursing: the official journal of European Oncology Nursing Society 07/2011; 16(3):276-80. DOI:10.1016/j.ejon.2011.06.011 · 1.79 Impact Factor
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    • "Ses causes sont multiples : e ´tat nutritionnel, troubles du sommeil, anémie, traitements, facteurs psychologiques mais aussi déconditionnement physique [9] [10] [13] [20]. Cette fatigue est a ` prendre en compte dans les programmes de rééducation et de réadaptation qui sont proposés. "
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    ABSTRACT: Cancer patients are living longer with deficiencies and functional impairments requiring often typically a care in physical medicine and rehabilitation (PMR). To examine the care of cancer patients in PMR. Investigation made with a questionnaire diffused from the e-mail listing of the Société Française de Médecine Physique et de Réadaptation. Sixty-seven answers received. Fifty-seven centers take care of cancer patients. On average, 4% of cancer patients are hospitalised in PMR. Spinal cord injuries and hemiplegias are the most common impairments. Forty-two percent of the PMR units take the patients in all the stages of cancer treatment. Working relationships between PMR and oncology units are formalized only eight times out of 52. In case of health degradation, relationships with a palliative care unit are frequent but not generalized. Eighty-five percent of the centers think that PMR is not enough developed in oncology. In spite of its limited character, this investigation shows that the PMR units take these patients. Situations where PMR has an important role in the follow-up of cancer patients are multiple and publications have showed its interest, especially on the limitations of activities. It is important to make better known the interest of PMR in oncology units but also to develop specific care within PMR units.
    Annals of physical and rehabilitation medicine 09/2009; 52(7-8):568-78. DOI:10.1016/j.rehab.2009.05.004
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    • "Evidence is accumulating that exercise interventions have the potential to assist the individual in adapting to the physical and psychological stress of cancer and related treatments (Dimeo et al. 2004, Stricker et al. 2004, Galvao & Newton 2005, Knols et al. 2005, Schmitz et al. 2005). Exercise can help to maintain or increase capacity for physical activity and activity tolerance, resulting in performance of daily activities with less fatigue (Lucia et al. 2003, ASCM 2005). "
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    ABSTRACT: This paper is a discussion of the use of the Levine Conservation Model to guide the investigation of an exercise intervention to mitigate cancer-related fatigue. Researchers use conceptual models or theoretical frameworks to provide an organizing structure for their studies, to guide the development and testing of hypotheses, and to place research finding within the context of science. Selection of an appropriate and useful framework is an essential step in the development of a research project. A descriptive approach is used to present the components of the conceptual model and details of the articulation of the study intervention and outcomes with the model. The Levine Conservation Model provided a useful framework for this investigation, conducted in 2002-2006, of the effects of exercise on fatigue and physical functioning in cancer patients. The four conservation principles of the model guided the development of the exercise intervention, the identification of salient outcomes for patients, and the selection of appropriate instruments to measure study variables. The model is also proving useful in the analysis and interpretation of data in relation to the conservation principles. Use of an appropriate conceptual model facilitates the design and testing of theory-based interventions and the development of science to support nursing practice.
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