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Endurance and resistance training in patients with acute leukemia undergoing induction chemotherapy—a randomized pilot study

Abstract

Purpose

Acute leukemia (AL) and its initial treatment can impair physical functioning and capacity significantly. Exercise as a countermeasure has been investigated in few studies confirming its feasibility and safety during intensive induction chemotherapy, but the relative effects of diverse exercise programs have not been analyzed. Therefore, we aimed to investigate independent effects of endurance and resistance training on physical capacity and quality of life (QOL).

Methods

Twenty-nine adult AL patients were randomly allocated to an endurance (EG), resistance (RG), or control (CG) group. The intervention took place during induction chemotherapy with three exercise sessions per week for 30–45 min each. Endurance capacity at individual anaerobic threshold, maximum knee extension and flexion strength, standardized phase angle (SPA), and QOL were measured at baseline prior to induction chemotherapy and before discharge.

Results

Endurance capacity changed in neither the EG, RG, or CG (P = 0.104); descriptively, the EG (− 0.05 W/kg) and RG (− 0.04 W/kg) exhibited a smaller decrease than CG (− 0.22 W/kg). We noted a significant difference in knee extension strength (P = 0.002); RG improved their maximum strength (+ 0.14 Nm/kg), while the EG’s (− 0.13 Nm/kg) and CG’s (− 0.19 Nm/kg) was significantly reduced. QOL and SPA revealed no change after the intervention.

Conclusions

We conclude that resistance training is a key component when exercising during induction chemotherapy: it improved maximum strength, but also influenced endurance capacity even during intensive treatment. Considering the prognostic value of physical function, we strongly propose integrating exercise, especially resistance-based training, already during induction chemotherapy to preserve AL patients’ physical capacity and functional status.

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Acknowledgements

We thank all patients who participated in this study. We are grateful to Carole Cürten (English Copy Editor) for proofreading our manuscript and we thank Manfred Baumstark for statistical assistance.

Funding

This trial was supported by Baden-Württemberg foundation.

Author information

Correspondence to Anja Wehrle.

Ethics declarations

All patients gave written informed consent for the study protocol and data collection; this pilot study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Commission of the University of Freiburg, Germany.

Conflict of interest

The authors declare that they have no conflict of interest.

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Wehrle, A., Kneis, S., Dickhuth, H. et al. Endurance and resistance training in patients with acute leukemia undergoing induction chemotherapy—a randomized pilot study. Support Care Cancer 27, 1071–1079 (2019) doi:10.1007/s00520-018-4396-6

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Keywords

  • Hematologic neoplasms
  • Hospitalization
  • Exercise therapy
  • Muscle strength
  • Physical endurance
  • Quality of life