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Cardiopulmonary Exercise Testing in Cancer Rehabilitation

A Systematic Review

  • Review Article
  • Cardiopulmonary Exercise Testing in Cancer Rehabilitation
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Abstract

This systematic review aims to get insight into the feasibility of cardiopulmonary exercise testing (CPET) in patients with cancer prior to a physical exercise programme. We will focus on quality (defined as the adherence to international guidelines for methods of CPET) and safety of CPET. Furthermore, we compare the peak oxygen uptake (V̇O2peak) values of patients with cancer with reference values for healthy persons to put these values into a clinical perspective. A computer aided search with ‘cardiopulmonary exercise testing’ and ‘cancer’ using MEDLINE, EMBASE, Pedro, CINAHL® and SPORTDiscus™ was carried out. We included studies in which CPET with continuous gas exchange analysis has been performed prior to a physical exercise programme in adults with cancer. Twenty studies describing 1158 patients were eligible. Reported adherence to international recommendations for CPET varied per item. In most studies, the methods of CPET were not reported in detail. Adverse events occurred in 1% of patients. The percentage V̇O2peak of reference values for healthy persons varied between 65% and 89% for tests before treatment, between 74% and 96% for tests during treatment and between 52% and 117% for tests after treatment. Our results suggest that CPET is feasible and seems to be safe for patients with cancer prior to a physical exercise programme. We recommend that standard reporting and quality guidelines should be followed for CPET methods. The decreased V̇O2peak values of patients with cancer indicate that physical exercise should be implemented in their standard care.

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Acknowledgements

The authors thank all investigators who kindly provided additional information from their studies.Research support was provided by the Dutch Cancer Society (UU 2009-4473). This study has not been published elsewhere and the authors have no conflicts of interest to declare that are directly relevant to the content of this review. Both Charlotte Steins Bisschop and Miranda Velthuis contributed equally to the design and analyses of this work and the writing of the paper.

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Authors and Affiliations

  1. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Str. 6.131, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands

    Charlotte N. Steins Bisschop MD, Miranda J. Velthuis, Petra H. M. Peeters & Anne M. May

  2. Comprehensive Cancer Center the Netherlands, Utrecht, the Netherlands

    Miranda J. Velthuis

  3. Research Group Lifestyle and Health, University of Applied Sciences, Utrecht, the Netherlands

    Harriët Wittink & Kees Kuiper

  4. Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, the Netherlands

    Tim Takken

  5. Department of Rehabilitation, Nursing Sciences and Sport, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, the Netherlands

    Wout J. T. M. van der Meulen & Eline Lindeman

  6. Center of Excellence for Rehabilitation Medicine, Rehabilitation Center De Hoogstraat, Utrecht, the Netherlands

    Eline Lindeman

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  1. Charlotte N. Steins Bisschop MD
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  2. Miranda J. Velthuis
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  9. Anne M. May
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Correspondence to Charlotte N. Steins Bisschop MD.

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Steins Bisschop, C.N., Velthuis, M.J., Wittink, H. et al. Cardiopulmonary Exercise Testing in Cancer Rehabilitation. Sports Med 42, 367–379 (2012). https://doi.org/10.2165/11598480-000000000-00000

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