Advertisement

Supportive Care in Cancer

, Volume 24, Issue 9, pp 3705–3713 | Cite as

A multicenter study on the relative effectiveness of a 12-week physical training program for adults with an oncologic diagnosis

  • Hoang Tran
  • Cheng Lin
  • Fang Yu
  • Angie Frederick
  • Molly Mieras
  • Lorena Baccaglini
Original Article

Abstract

Purpose

The purpose of this study was to examine the association between cancer survivors’ socio-demographic and clinical characteristics and aerobic fitness changes following a physical training program.

Methods

We assessed the association between participant’s characteristics and aerobic fitness in the six-min walk test (6MWT) after a 12-week LIVESTRONG® at Young Men’s Christian Association (YMCA) exercise program for adults with an oncologic diagnosis using linear mixed effects models.

Results

Fifty-one percent of participants had a breast cancer diagnosis and 22 % had received treatment within 1 year of enrollment. At baseline, participants who reported good/excellent health status performed better in the 6MWT than those who reported poor/fair health status (384.2 vs. 345.0 m, p = 0.035). After 12 weeks, all participants increased their average 6MWT performance by 54.2 m. After adjustment for age, gender, physical activity level, and smoking status, participants who were 60 years old or younger had a greater increase in the 6MWT score than participants older than 60 years (63.2 vs. 43.9 m, p = 0.041) while those who had never been YMCA members had a greater increase in the 6MWT compared to those who had ever been a YMCA member (62.2 vs. 40.3 m, p = 0.041).

Conclusion

Overall, aerobic fitness among adults with an oncologic diagnosis increased after a 12-week exercise program, particularly among participants who were 60 years old or younger or were not YMCA members at enrollment. Participants with poorer health had lower aerobic fitness at baseline, though they had a similar positive response to the program as healthier participants. Future study designs may include randomization and an additional untreated arm.

Keywords

Cancer rehabilitation Physical exercise Functional ability Aerobic exercise Cancer survivorship 

Notes

Acknowledgments

The authors thank the staff of the eight YMCA of Greater Omaha locations who conducted the training program and collected the data. The authors also acknowledge Zijian Qin, Ann-Hilary Heston, MPA, and Katherine H. Holman, MPH for their critical review of the manuscript. HT was supported by a fellowship from the Vietnam Education Foundation at the time he analyzed this study. The fellowship was not based on this research. Two of the authors, AF and MM, are currently employed by the YMCA of Greater Omaha. AF and MM were mainly involved in designing the study and ensuring data quality. The data analysis and interpretation were conducted independently at the University of Nebraska Medical Center.

Compliance with ethical standards

This study was approved by the University of Nebraska Medical Center (UNMC) Institutional Review Board. Written informed consent was obtained from all participants before starting the program. The intervention performed in present study was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    American Cancer Society (2014) Cancer facts & figures 2014. American Cancer Society, Atlanta, GAGoogle Scholar
  2. 2.
    Edwards BK (2014) Annual report to the nation on the status of cancer, 1975–2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer 120(9):1290–1314. doi: 10.1002/cncr.28509 CrossRefPubMedGoogle Scholar
  3. 3.
    US Cancer Statistics (2013) 5-year relative survival by selected primary site, race, sex, and age group. Centers for Disease Control and Prevention. http://apps.nccd.cdc.gov/uscs/SurvivalData.aspx. Accessed April 6 2015
  4. 4.
    Hewitt M, Rowland JH, Yancik R (2003) Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci 58(1):M82–M91CrossRefGoogle Scholar
  5. 5.
    Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE (1998) Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol 16(2):501–514PubMedGoogle Scholar
  6. 6.
    Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M (2010) It’s not over when it’s over: long-term symptoms in cancer survivors—a systematic review. Int J Psychiatry Med 40(2):163–181CrossRefPubMedGoogle Scholar
  7. 7.
    Ganz PA, Kwan L, Stanton AL, Bower JE, Belin TR (2011) Physical and psychosocial recovery in the year after primary treatment of breast cancer. J Clin Oncol 29(9):1101–1109. doi: 10.1200/JCO.2010.28.8043 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Clough-Gorr KM, Ganz PA, Silliman RA (2007) Older breast cancer survivors: factors associated with change in emotional well-being. J Clin Oncol 25(11):1334–1340CrossRefPubMedGoogle Scholar
  9. 9.
    Mehnert A, Koch U (2008) Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psychosom Res 64(4):383–391. doi: 10.1016/j.jpsychores.2007.12.005 CrossRefPubMedGoogle Scholar
  10. 10.
    Hayes SC, Spence RR, Galvão DA, Newton RU (2009) Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. J Sci Med Sport 12(4):428–434CrossRefPubMedGoogle Scholar
  11. 11.
    Courneya KS, Friedenreich CM (1999) Physical exercise and quality of life following cancer diagnosis: a literature review. Ann Behav Med 21(2):171–179CrossRefPubMedGoogle Scholar
  12. 12.
    Musanti R (2012) A study of exercise modality and physical self-esteem in breast cancer survivors. Med Sci Sports Exerc 44(2):352–361. doi: 10.1249/MSS.0b013e31822cb5f2 CrossRefPubMedGoogle Scholar
  13. 13.
    Buffart L, Ros W, Chinapaw M, Brug J, Knol D, Korstjens I, Weert E, Mesters I, Borne B, Hoekstra-Weebers J (2014) Mediators of physical exercise for improvement in cancer survivors’ quality of life. Psycho-Oncology 23(3):330–338CrossRefPubMedGoogle Scholar
  14. 14.
    Pinto BM, Trunzo JJ (2004) Body esteem and mood among sedentary and active breast cancer survivors. Mayo Clin Proc 79(2):181–186CrossRefPubMedGoogle Scholar
  15. 15.
    McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175(1):34–41CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Mishra SI, Scherer RW, Snyder C, Geigle P, Gotay C Are exercise programs effective for improving health-related quality of life among cancer survivors? A systematic review and meta-analysis. In: Oncol Nurs Forum, 2014. NIH Public Access, p E326Google Scholar
  17. 17.
    Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–2486CrossRefPubMedGoogle Scholar
  18. 18.
    Ibrahim EM, Al-Homaidh A (2011) Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol 28(3):753–765CrossRefPubMedGoogle Scholar
  19. 19.
    Irwin ML, McTiernan A, Manson JE, Thomson CA, Sternfeld B, Stefanick ML, Wactawski-Wende J, Craft L, Lane D, Martin LW, Chlebowski R (2011) Physical activity and survival in postmenopausal women with breast cancer: results from the women’s health initiative. Cancer Prev Res (Phila) 4(4):522–529. doi: 10.1158/1940-6207.CAPR-10-0295 CrossRefGoogle Scholar
  20. 20.
    Livestrong Foundation (2014) LIVESTRONG at the YMCA: what we do. http://www.livestrong.org/what-we-do/our-actions/programs-partnerships/livestrong-at-the-ymca/. Accessed December 24 2014
  21. 21.
    Heston A-H (2015) Addressing physical activity needs of survivors by developing a community-based exercise program: LIVESTRONG® at the YMCA. Clin J Oncol Nurs 19(2):213–217CrossRefPubMedGoogle Scholar
  22. 22.
    Rajotte EJ, Jean CY, Baker KS, Gregerson L, Leiserowitz A, Syrjala KL (2012) Community-based exercise program effectiveness and safety for cancer survivors. J Cancer Surviv 6(2):219–228CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Irwin ML, Cartmel B, Harrigan M, Sanft TB, Wong C, Hughes M, Hootsmans N, Winterhalter B, Shockro L, O’Connor K, Tolaney SM, Mayer EL, Yung RL, Freedman RA, Ligibel JA (2015) Impact of the LIVESTRONG at the YMCA Program on physical activity, fitness, and quality of life in cancer survivors. Paper presented at the 2015 ASCO Annual MeetingGoogle Scholar
  24. 24.
    Burr JF, Bredin SS, Faktor MD, Warburton DE (2011) The 6-minute walk test as a predictor of objectively measured aerobic fitness in healthy working-aged adults. Phys Sportsmed 39(2):133–139. doi: 10.3810/psm.2011.05.1904 CrossRefPubMedGoogle Scholar
  25. 25.
    Cahalin L, Pappagianopoulos P, Prevost S, Wain J, Ginns L (1995) The relationship of the 6-min walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease. Chest 108(2):452–459CrossRefPubMedGoogle Scholar
  26. 26.
    Schmidt K, Vogt L, Thiel C, Jager E, Banzer W (2013) Validity of the six-minute walk test in cancer patients. Int J Sports Med 34(7):631–636. doi: 10.1055/s-0032-1323746 CrossRefPubMedGoogle Scholar
  27. 27.
    Rasekaba T, Lee AL, Naughton MT, Williams TJ, Holland AE (2009) The six-minute walk test: a useful metric for the cardiopulmonary patient. Intern Med J 39(8):495–501. doi: 10.1111/j.1445-5994.2008.01880.x CrossRefPubMedGoogle Scholar
  28. 28.
    Vrieze SI (2012) Model selection and psychological theory: a discussion of the differences between the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). Psychol Methods 17(2):228CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Vallance JK, Courneya KS, Jones LW, Reiman T (2005) Differences in quality of life between non-Hodgkin’s lymphoma survivors meeting and not meeting public health exercise guidelines. Psycho-Oncology 14(11):979–991CrossRefPubMedGoogle Scholar
  30. 30.
    Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26(13):2198–2204CrossRefPubMedGoogle Scholar
  31. 31.
    Huy C, Schmidt ME, Vrieling A, Chang-Claude J, Steindorf K (2012) Physical activity in a German breast cancer patient cohort: one-year trends and characteristics associated with change in activity level. Eur J Cancer 48(3):297–304CrossRefPubMedGoogle Scholar
  32. 32.
    Ventura EE, Ganz PA, Bower JE, Abascal L, Petersen L, Stanton AL, Crespi CM (2013) Barriers to physical activity and healthy eating in young breast cancer survivors: modifiable risk factors and associations with body mass index. Breast Cancer Res Treat 142(2):423–433CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Blaney J, Lowe-Strong A, Rankin J, Campbell A, Allen J, Gracey J (2010) The cancer rehabilitation journey: barriers to and facilitators of exercise among patients with cancer-related fatigue. Phys Ther 90(8):1135–1147CrossRefPubMedGoogle Scholar
  34. 34.
    Bellizzi KM, Rowland JH, Arora NK, Hamilton AS, Miller MF, Aziz NM (2009) Physical activity and quality of life in adult survivors of non-Hodgkin’s lymphoma. J Clin Oncol 27(6):960–966CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Sander AP, Wilson J, Izzo N, Mountford SA, Hayes KW (2012) Factors that affect decisions about physical activity and exercise in survivors of breast cancer: a qualitative study. Phys Ther 92(4):525–536CrossRefPubMedGoogle Scholar
  36. 36.
    Leach CR, Weaver KE, Aziz NM, Alfano CM, Bellizzi KM, Kent EE, Forsythe LP, Rowland JH (2014) The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions. J Cancer Surviv (Journal Article). doi: 10.1007/s11764-014-0403-1 Google Scholar
  37. 37.
    Hall WH, Jani AB, Ryu JK, Narayan S, Vijayakumar S (2005) The impact of age and comorbidity on survival outcomes and treatment patterns in prostate cancer. Prostate Cancer Prostatic Dis 8(1):22–30. doi: 10.1038/sj.pcan.4500772 CrossRefPubMedGoogle Scholar
  38. 38.
    Sabin SL, Rosenfeld RM, Sundaram K, Har-el G, Lucente FE (1999) The impact of comorbidity and age on survival with laryngeal cancer. Ear Nose Throat J 78(8):578 581–574PubMedGoogle Scholar
  39. 39.
    Mao JJ, Armstrong K, Bowman MA, Xie SX, Kadakia R, Farrar JT (2007) Symptom burden among cancer survivors: impact of age and comorbidity. J Am Board Fam Med 20(5):434–443. doi: 10.3122/jabfm.2007.05.060225 CrossRefPubMedGoogle Scholar
  40. 40.
    Hefferon K, Murphy H, McLeod J, Mutrie N, Campbell A (2013) Understanding barriers to exercise implementation 5-year post-breast cancer diagnosis: a large-scale qualitative study. Health Educ Res:cyt083Google Scholar
  41. 41.
    Evans WJ, Campbell WW (1993) Sarcopenia and age-related changes in body composition and functional capacity. J Nutr 123(2 Suppl):465–468PubMedGoogle Scholar
  42. 42.
    Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, Roberts SB, Kehayias JJ, Lipsitz LA, Evans WJ (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330(25):1769–1775CrossRefPubMedGoogle Scholar
  43. 43.
    Perera S, Mody SH, Woodman RC, Studenski SA (2006) Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 54(5):743–749. doi: 10.1111/j.1532-5415.2006.00701.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Hoang Tran
    • 1
  • Cheng Lin
    • 1
  • Fang Yu
    • 2
  • Angie Frederick
    • 3
  • Molly Mieras
    • 3
  • Lorena Baccaglini
    • 1
  1. 1.Department of Epidemiology, College of Public HealthUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Department of Biostatistics, College of Public HealthUniversity of Nebraska Medical CenterOmahaUSA
  3. 3.YMCA at Greater OmahaOmahaUSA

Personalised recommendations