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Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial
Open accessAbstract
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.
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“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]
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“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]
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Metadata
- 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.
- 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
- 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
- hybrid
- doi.org
- 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 › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Oncology › 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
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