CoChat
Sign Up
Cited by 492Cancer survivorship and careCardiovascular and exercise physiologyCancer-related cognitive impairment studies

Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial

Open access
Adamsen, L., Quist, M., Andersen, C., Moller, T., Herrstedt, J., Kronborg, D., Baadsgaard, M. T, Vistisen, K. +5 more·2009·BMJ
DOI 10.1136/bmj.b3410PMC PMC2762035
Open this paper in CoChat — free accountOpen PDF

Abstract

OBJECTIVE: To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease. DESIGN: Randomised controlled trial. SETTING: Two university hospitals in Copenhagen, Denmark. PARTICIPANTS: 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow-up. INTERVENTION: Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. MAIN OUTCOME MEASURES: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Medical Outcomes Study Short Form (MOS SF-36), Leisure Time Physical Activity Questionnaire, muscular strength (one repetition maximum), maximum oxygen consumption (Vo(2)max). Statistical methods The general linear model was used for continuous outcome while analysis of associates between categorical outcomes was performed as analysis of marginal homogeneity in contingency tables. RESULTS: Adjusted for baseline score, disease, and demographic covariates, the intervention group showed an estimated improvement at six weeks for the primary outcome, fatigue, of -6.6 points (95% confidence interval -12.3 to -0.9, P=0.02; effect size=0.33, 0.04 to 0.61). Significant effects were seen on vitality (effect size 0.55, 95% CI 0.27 to 0.82), physical functioning (0.37, 0.09 to 0.65), role physical (0.37, 0.10 to 0.64), role emotional (0.32, 0.05 to 0.59), and mental health (0.28, 0.02 to 0.56) scores. Improvement was noted in physical capacity: estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min (95% CI 0.1 to 0.2, P<0.0001) and for muscular strength (leg press) was 29.7 kg (23.4 to 34.9, P<0.0001). No significant effect was seen on global health status/quality of life. CONCLUSION: A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced disease. The intervention reduced fatigue and improved vitality, aerobic capacity, muscular strength, and physical and functional activity, and emotional wellbeing, but not quality of life. TRIAL REGISTRATION: Current Controlled trials ISRCTN05322922.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmj.b3410

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Walking exercise, HIIT and weight lifting are considered safe and do not cause undesirable events such as lymphedema in patients undergoing treatment.

    “Walking exercise [64, 65], HIIT and weight lifting [66, 67] is considered safe and does not cause undesirable events, such as lymphedema in patients who are undergoing treatment.”

    From Empowerment in the treatment of fatigue in breast cancer patients (2021) · cites this paper as [66]

    The Principal findings report no worsening of pre-existing lymphoedema during the six-week intervention, and describe safety measures for supervised high-intensity training. But a participant had a grade 3 seizure after cardiovascular training, and the authors advise patients with brain tumours or brain metastases against high-intensity exercise. The claim overstates the evidence by saying the exercise causes no undesirable events. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Risk of bias and methodological quality were assessed using the PEDro scale, with a minimum score of 5/10 for inclusion in the meta-analysis.

    “The methodological quality and risk of bias of the studies were assessed using the Physiotherapy Evidence Database (PEDro) scale [23].”

    From Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials (2015) · cites this paper as [23]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

5 of the 61 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Anderson BD, Spector AH. Introduction to pilates-based rehabilitation. Orthop Phys Ther Clin N Am 2000;9:395-400.
  2. Lucía A, Earnest C, Pérez M. Cancer-related fatigue: can exercise physiology assist oncologists? Lancet Oncol 2003;4:616-25.

Cited by

Sorted by citations

Related

Authors
Adamsen, L., Quist, M., Andersen, C., Moller, T., Herrstedt, J., Kronborg, D., Baadsgaard, M. T., Vistisen, K., Midtgaard, J., Christiansen, B., Stage, M., Kronborg, M. T., & Rorth, M.
Affiliations
  • University of Copenhagen (DK)
  • Copenhagen University Hospital (DK)
  • Odense University Hospital (DK)
  • Copenhagen Business School (DK)
  • Herlev Hospital (DK)
Corresponding author
Adamsen, L.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2009-10-13
Volume
339
Issue
oct13 1
Pages
b3410-b3410
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.b3410
PMC
PMC2762035
OpenAlex
W2041918383
Cited by
492
References
61
Citations by year
2026: 17 · 2025: 21 · 2024: 13 · 2023: 26 · 2022: 30 · 2021: 33 · 2020: 32 · 2019: 30 · 2018: 36 · 2017: 42 · 2016: 29 · 2015: 34 · 2014: 26 · 2013: 31 · 2012: 34
FWCI
15.00
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • CBS Research Portal (Copenhagen Business School) (submittedVersion, other-oa)
Funders
  • Kræftens Bekæmpelse
  • Aase og Ejnar Danielsens Fond
  • Lundbeckfonden
  • Novo Nordisk Fonden
  • Egmont Fonden
  • H. Lundbeck A/S
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
high-intensity training, cancer patients, chemotherapy, cancer-related fatigue, quality of life, physical capacity, aerobic exercise, resistance training, relaxation training, massage, physical activity, muscle strength, oxygen consumption, well-being, advanced cancer, adjuvant chemotherapy, mental health, physical function, vitality, role physical, emotional role
MeSH terms
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Exercise Therapy, Feasibility Studies, Female, Health Status, Humans, Leisure Activities, Male, Middle Aged, Neoplasms, Quality of Life, Exercise, Treatment Outcome, Muscle Strength, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review