TY - JOUR
T1 - Optimal Timing of a Physical Exercise Intervention to Improve Cardiorespiratory Fitness
T2 - During or After Chemotherapy
AU - van der Schoot, Gabriela G F
AU - Ormel, Harm L
AU - Westerink, Nico-Derk L
AU - May, Anne M
AU - Elias, Sjoerd G
AU - Hummel, Yoran M
AU - Lefrandt, Joop D
AU - van der Meer, Peter
AU - van Melle, Joost P
AU - Poppema, Boelo J
AU - Stel, Joyce M A
AU - van der Velden, Annette W G
AU - Vrieling, Aline H
AU - Wempe, Johan B
AU - Ten Wolde, Marcel G
AU - Nijland, Marcel
AU - de Vries, Elisabeth G E
AU - Gietema, Jourik A
AU - Walenkamp, Annemiek M E
N1 - Funding Information:
The authors thank all participating patients, oncologists, research staff members, and physical therapists. Also, the authors thank the Dutch Cancer Society, Alpe d'HuZes (grant DCS 2011-5265) and the MD-PhD program provided by the Junior Scientific Master class at UMCG for making this clinical trial possible.
Funding Information:
The authors thank all participating patients, oncologists, research staff members, and physical therapists. Also, the authors thank the Dutch Cancer Society, Alpe d’HuZes (grant DCS 2011-5265) and the MD-PhD program provided by the Junior Scientific Master class at UMCG for making this clinical trial possible.
Publisher Copyright:
© 2022 The Authors
PY - 2022/11
Y1 - 2022/11
N2 - BACKGROUND: Despite the widely acknowledged benefit of exercise for patients with cancer, little evidence on the optimal timing of exercise on adverse effects of cancer treatment is available.OBJECTIVES: The aim of this study was to determine whether an exercise intervention initiated during chemotherapy is superior to an intervention initiated after chemotherapy for improving long-term cardiorespiratory fitness (peak oxygen uptake [VO
2peak]).
METHODS: In this prospective, randomized clinical trial, patients scheduled to receive curative chemotherapy were randomized to a 24-week exercise intervention, initiated either during chemotherapy (group A) or afterward (group B). The primary endpoint was VO
2peak 1 year postintervention. Secondary endpoints were VO
2peak postintervention, muscle strength, health-related quality of life (HRQoL), fatigue, physical activity, and self-efficacy. Between-group differences were calculated using intention-to-treat linear mixed-models analyses.
RESULTS: A total of 266 patients with breast (n = 139), testicular (n = 95), and colon cancer (n = 30) as well as lymphoma (n = 2) were included. VO
2peak immediately postintervention and 1 year postintervention did not differ between the 2 groups. Immediately postchemotherapy, patients in group A exhibited significantly lower decreases in VO
2peak (3.1 mL/kg/min; 95% CI: 2.2-4.0 mL/kg/min), HRQoL, and muscle strength and reported less fatigue and more physical activity than those in group B.
CONCLUSIONS: Exercise can be safely performed during chemotherapy and prevents fatigue and decreases in VO
2peak, muscle strength, and HRQoL, in addition to hastening the return of function after chemotherapy. Also, if exercise cannot be performed during chemotherapy, a program afterward can enable patients to regain the same level of function, measured 1 year after completion of the intervention. (Optimal Timing of Physical Activity in Cancer Treatment [ACT]; NCT01642680).
AB - BACKGROUND: Despite the widely acknowledged benefit of exercise for patients with cancer, little evidence on the optimal timing of exercise on adverse effects of cancer treatment is available.OBJECTIVES: The aim of this study was to determine whether an exercise intervention initiated during chemotherapy is superior to an intervention initiated after chemotherapy for improving long-term cardiorespiratory fitness (peak oxygen uptake [VO
2peak]).
METHODS: In this prospective, randomized clinical trial, patients scheduled to receive curative chemotherapy were randomized to a 24-week exercise intervention, initiated either during chemotherapy (group A) or afterward (group B). The primary endpoint was VO
2peak 1 year postintervention. Secondary endpoints were VO
2peak postintervention, muscle strength, health-related quality of life (HRQoL), fatigue, physical activity, and self-efficacy. Between-group differences were calculated using intention-to-treat linear mixed-models analyses.
RESULTS: A total of 266 patients with breast (n = 139), testicular (n = 95), and colon cancer (n = 30) as well as lymphoma (n = 2) were included. VO
2peak immediately postintervention and 1 year postintervention did not differ between the 2 groups. Immediately postchemotherapy, patients in group A exhibited significantly lower decreases in VO
2peak (3.1 mL/kg/min; 95% CI: 2.2-4.0 mL/kg/min), HRQoL, and muscle strength and reported less fatigue and more physical activity than those in group B.
CONCLUSIONS: Exercise can be safely performed during chemotherapy and prevents fatigue and decreases in VO
2peak, muscle strength, and HRQoL, in addition to hastening the return of function after chemotherapy. Also, if exercise cannot be performed during chemotherapy, a program afterward can enable patients to regain the same level of function, measured 1 year after completion of the intervention. (Optimal Timing of Physical Activity in Cancer Treatment [ACT]; NCT01642680).
KW - cardiorespiratory fitness
KW - chemotherapy
KW - fatigue
KW - muscle strength
KW - physical exercise
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85141263784&partnerID=8YFLogxK
U2 - 10.1016/j.jaccao.2022.07.006
DO - 10.1016/j.jaccao.2022.07.006
M3 - Article
C2 - 36444224
SN - 2666-0873
VL - 4
SP - 491
EP - 503
JO - J AM Coll Cardiol CardioOnc
JF - J AM Coll Cardiol CardioOnc
IS - 4
ER -