Effects of supervised exercise intervention in colorectal cancer patients undergoing chemotherapy
Date Issued
2011
Date
2011
Author(s)
Lin, Kuan-Yin
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer mortality in Taiwan. Majority of CRC patients received surgery (80.2%) and chemotherapy (53.8%) as their primary treatment. Although improved surgical techniques and chemotherapeutics result in higher cure rates, cancer and its treatment sequelae are associated with significant morbidity that may impair function and cause disability. Exercise has been introduced as a safe, feasible, and promising therapy to help alleviate many of the common side effects from cancer and its treatments. However, to date, no study on the benefits of an exercise program for CRC patients during chemotherapy period was identified. The purpose of this study was to investigate the effects of supervised exercise intervention on physical fitness, fatigue, emotional distress, sleep quality, and quality of life (QoL) in patients with CRC undergoing chemotherapy.
Patients with CRC (stage II to III) aged 18 years or older were recruited after operation from Department of Surgery of National Taiwan University Hospital if they had an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0–2 and were admitted for adjuvant chemotherapy. Subjects who consented to participate in this study were allocated to either a supervised exercise group that received a 12-week combined aerobic and resistance exercise program or a control group that received home-based exercise after baseline assessment. The participants were assessed at baseline and post-intervention. Assessments included cardiorespiratory fitness (6-minute walk test), muscle strength (hand-held dynamometer), QoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, EORTC QLQ-C30), emotional distress (Hospital Anxiety and Depression Scale), physical activity (Index of Physical Activity Questionnaire-Short Form), fatigue (Fatigue Symptom Inventory), and sleep quality (Medical Outcomes Study Sleep Scale). All analyses were performed using the SPSS version 13.0. The baseline data of the two groups were compared using independent t-test/ Mann-Whitney U test. A 2x2 two way repeated measures analysis of variance (ANOVA)/Friedman test was used to compare between supervised exercise and home-based exercise group in changes in the outcome variables between baseline and the 12-week assessments.
In total, 45 patients with CRC aged 32-76 years were recruited. No significant difference was found between both groups at baseline and post-intervention. A time main effect was found for hand-grip strength and physical functioning subscale of EORTC QLQ-C30. The Friedman test showed statistically significant differences between pre- and post-intervention values within both groups in cardiorespiratory fitness. Moreover, significant differences in physical activity level (χ2 (1) = 7.200, p=0.007), fatigue interference (χ2 (1) = 4.263, p=0.039), and four subscales of EORTC QLQ-C30, role functioning (χ2 (1) = 7.143, p=0.008), social functioning (χ2 (1) = 10.286, p=0.001), fatigue (χ2 (1) = 9.308, p=0.002), and pain (χ2 (1) = 9.308, p=0.002) over time were seen in supervised exercise group.
The results of this study with a limited number of subjects indicate that, for patients with CRC who were receiving adjuvant chemotherapy, supervised exercise program may improve physical fitness, physical activity, fatigue, and QoL more than home-based exercise. Larger randomized controlled trials are needed to confirm these findings.
Patients with CRC (stage II to III) aged 18 years or older were recruited after operation from Department of Surgery of National Taiwan University Hospital if they had an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0–2 and were admitted for adjuvant chemotherapy. Subjects who consented to participate in this study were allocated to either a supervised exercise group that received a 12-week combined aerobic and resistance exercise program or a control group that received home-based exercise after baseline assessment. The participants were assessed at baseline and post-intervention. Assessments included cardiorespiratory fitness (6-minute walk test), muscle strength (hand-held dynamometer), QoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, EORTC QLQ-C30), emotional distress (Hospital Anxiety and Depression Scale), physical activity (Index of Physical Activity Questionnaire-Short Form), fatigue (Fatigue Symptom Inventory), and sleep quality (Medical Outcomes Study Sleep Scale). All analyses were performed using the SPSS version 13.0. The baseline data of the two groups were compared using independent t-test/ Mann-Whitney U test. A 2x2 two way repeated measures analysis of variance (ANOVA)/Friedman test was used to compare between supervised exercise and home-based exercise group in changes in the outcome variables between baseline and the 12-week assessments.
In total, 45 patients with CRC aged 32-76 years were recruited. No significant difference was found between both groups at baseline and post-intervention. A time main effect was found for hand-grip strength and physical functioning subscale of EORTC QLQ-C30. The Friedman test showed statistically significant differences between pre- and post-intervention values within both groups in cardiorespiratory fitness. Moreover, significant differences in physical activity level (χ2 (1) = 7.200, p=0.007), fatigue interference (χ2 (1) = 4.263, p=0.039), and four subscales of EORTC QLQ-C30, role functioning (χ2 (1) = 7.143, p=0.008), social functioning (χ2 (1) = 10.286, p=0.001), fatigue (χ2 (1) = 9.308, p=0.002), and pain (χ2 (1) = 9.308, p=0.002) over time were seen in supervised exercise group.
The results of this study with a limited number of subjects indicate that, for patients with CRC who were receiving adjuvant chemotherapy, supervised exercise program may improve physical fitness, physical activity, fatigue, and QoL more than home-based exercise. Larger randomized controlled trials are needed to confirm these findings.
Subjects
Colorectal cancer
Chemotherapy
Exercise
Fatigue
Quality of life
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-100-R98428003-1.pdf
Size
23.32 KB
Format
Adobe PDF
Checksum
(MD5):c042a38ad4ad675559568670a810a656