Skip to main content
SpringerLink
Log in

A randomised controlled trial comparing the effects of a 12-week supervised exercise versus usual care on outcomes in haematological cancer patients

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Following treatment, haematological cancer (HEM) patients exhibit significant physical deconditioning and psychological distress. Exercise has been shown as a clinically effective and safe intervention for cancer patients, with the potential to reverse the deleterious effects following treatment. Our aim was to investigate the efficacy of a 12-week exercise rehabilitation on cancer-related fatigue (CRF) and associated outcomes in HEM patients post-treatment.

Methods

Patients with a HEM were recruited to participate in a 12-week exercise rehabilitation intervention post-treatment. Pre-, post- and follow-up assessments were conducted on outcome measures including CRF, quality of life (QoL), psychological distress, cardiovascular fitness, muscle strength (MS) and body composition. Patients were given tailored exercise programmes comprising aerobic and resistance exercises, carried out three times per week for 12 weeks in local gyms and clinics. Usual-care participants were offered a delayed, tailored 12-week exercise intervention after the initial study period.

Results

Thirty-seven patients (49 % recruitment rate) were randomly assigned to the 12-week exercise rehabilitation (n = 18) or usual care (n = 19) with a 91 % adherence to the exercise intervention. Following the exercise programme, significant improvements were seen in CRF (p = 0.01), cardiovascular fitness (p ≤ 0.001), QoL (p ≤ 0.001), MS (p ≤ 0.001) and body composition (p = 0.001), with moderate to large effects for all primary outcomes. Patient follow-up at 24 weeks demonstrated outcome maintenance in the exercise rehabilitation group and significant improvements in outcomes in usual-care patients following participation in a delayed exercise programme. There were no adverse reactions or study withdrawals.

Conclusions

A 12-week exercise rehabilitation programme resulted in significant statistical (p ≤ 0.05) and clinical improvements in CRF and additional outcomes in HEM patients following treatment. Additionally, a 12-week delayed exercise programme showed similar significant improvements in patient outcomes.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12609000450213.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. 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 12:428–434

    Article  PubMed  Google Scholar 

  2. Courneya KS, Rogers LQ, Campbell KL et al (2015) Top 10 research questions related to physical activity and cancer survivorship. Res Q Exerc Sport 86:107–116. doi:10.1080/02701367.2015.991265

    Article  PubMed  Google Scholar 

  3. American Cancer Society (2012) Cancer facts & figures 2012. American Cancer Society, Atlanta

    Google Scholar 

  4. Pratt M, Norris J, Lobelo F et al (2014) The cost of physical inactivity: moving into the 21st century. Br J Sports Med 48:171–173. doi:10.1136/bjsports-2012-091810

    Article  PubMed  Google Scholar 

  5. American Cancer Society (2011) Global cancer facts & figures, 2nd edn. American Cancer Society, Atlanta

    Google Scholar 

  6. Dimeo FC, Stieglitz RD, Novelli-Fischer U et al (1999) Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer 85:2273–2277

    Article  CAS  PubMed  Google Scholar 

  7. Schmitz KH, Courneya KS, Matthews C et al (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426. doi:10.1249/MSS.0b013e3181e0c112

    Article  PubMed  Google Scholar 

  8. Lakoski SG, Willis BL, Barlow CE, Leonard D et al (2015) Midlife cardiorespiratory fitness, incident cancer and survival after cancer in men: the Cooper Center Longitudinal Study. JAMA Oncol 1:231–237. doi:10.1001/jamaoncol.2015.0226

    Article  PubMed  Google Scholar 

  9. Christensen JF, Spry NA, Galvão DA (2014) Resistance training and cancer survival. Mayo Clin Proc 89:1465. doi:10.1016/j.mayocp.2014.08.001

    Article  PubMed  Google Scholar 

  10. Friendenreich CM, Courneya KS (1996) Exercise as rehabilitation for cancer patients. Clin J Sport Med 6:237–244

    Article  CAS  PubMed  Google Scholar 

  11. Mishra SI, Scherer RW, Geigle PM et al (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 8:CD007566. doi:10.1002/14651858.CD007566.pub2

    PubMed  Google Scholar 

  12. Liu RD, Chinapaw MJM, Huijgens PC, van Mechelen W (2009) Physical exercise interventions in haematological cancer patients, feasible to conduct but effectiveness to be established: a systematic literature review. Cancer Treat Rev 35:185–192. doi:10.1016/j.ctrv.2008.09.008

    Article  PubMed  Google Scholar 

  13. Courneya KS, Sellar CM, Stevinson C et al (2009) Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. J Clin Oncol 27:4605–4612. doi:10.1200/JCO.2008.20.0634

    Article  PubMed  Google Scholar 

  14. Cramp F, Byron-Daniel J (2012) Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 11:CD006145. doi:10.1002/14651858.CD006145.pub3

    PubMed  Google Scholar 

  15. Thomas S, Reading J, Shephard RJ (1992) Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci 17:338–345

    CAS  PubMed  Google Scholar 

  16. Schwartz AL (1998) The Schwartz Cancer Fatigue Scale: testing reliability and validity. Oncol Nurs Forum 25:711–717

    CAS  PubMed  Google Scholar 

  17. Sanson-Fisher RW, Perkins JJ (1998) Adaptation and validation of the SF-36 Health Survey for use in Australia. J Clin Epidemiol 51:961–967

    Article  CAS  PubMed  Google Scholar 

  18. Telford RD, Minikin B, Hahn AG (1989) A simple method for the assessment of general fitness: the tri-level profile. Aust J Sci Med Sport 21:6–9

    Google Scholar 

  19. Furzer BJ, Wallman KE, Ackland TR, Joske DJL (2012) Test-retest reliability of the aerobic power index submaximal exercise test in cancer patients. J Sports Sci Med 11:690–694

    PubMed Central  PubMed  Google Scholar 

  20. Cella D, Tulsky D, Gray G (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    CAS  PubMed  Google Scholar 

  21. Carroll BT, Kathol RG, Noyes R et al (1993) Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale. Gen Hosp Psychiatry 15:69–74

    Article  CAS  PubMed  Google Scholar 

  22. Reynolds JM, Gordon T, Robergs RA (2006) Prediction of one repetition maximum strength from multiple repetition maximum testing and anthropometry. J Strength Cond Res 20:584–592

    PubMed  Google Scholar 

  23. Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10:141–146

    CAS  PubMed  Google Scholar 

  24. Craig CL, Marshall AL, Sjostrom M et al (2003) International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exer 35:1381–1395

    Article  Google Scholar 

  25. Aoun SM, Monterosso L, Kristjanson LJ, McConigley R (2011) Measuring symptom distress in palliative care: psychometric properties of the Symptom Assessment Scale (SAS). J Palliat Med 14:315–321. doi:10.1089/jpm.2010.0412

    Article  PubMed  Google Scholar 

  26. Borg G (1982) Psychophysical basis of perceived exertion. Med Sci Sports Exer 14:377–381

    CAS  Google Scholar 

  27. Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd ed. xxi–567

  28. Galvão DA, Taaffe DR, Spry N et al (2010) Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 28:340–347. doi:10.1200/JCO.2009.23.2488

    Article  PubMed  Google Scholar 

  29. Adamsen L, Quist M, Andersen C et al (2009) Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ 339:3410. doi:10.1136/bmj.b3410

    Article  Google Scholar 

  30. Puccio M, Nathanson L (1997) The cancer cachexia syndrome. Semin Oncol 24:277–287

    CAS  PubMed  Google Scholar 

  31. Ackland TR, Lohman TG, Sundgot-Borgen J et al (2012) Current status of body composition assessment in sport: review and position statement on behalf of the ad hoc research working group on body composition health and performance, under the auspices of the I.O.C. Medical Commission. Sports Med 42:227–249. doi:10.2165/11597140-000000000-00000

    Article  PubMed  Google Scholar 

  32. Courneya KS, Stevinson C, McNeely ML et al (2012) Predictors of follow-up exercise behavior 6 months after a randomized trial of supervised exercise training in lymphoma patients. Psychooncology 21:1124–1131. doi:10.1002/pon.2010

    Article  PubMed  Google Scholar 

  33. Grove JR, Jackson B, Longbottom J-L, Medic N (2011) Distinguishing between positive and negative exercise habits. Handbook of applied topics in health psychology

  34. Curt GA, Breitbart W, Cella D et al (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 5:353–360

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported, in part, by a research grant from the SolarisCare Foundation.

Compliance with ethical standards

ᅟ

Conflict of interest

The authors declare that they have no competing interests.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were 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.

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. University of Western Australia, M408, 35 Stirling Hwy, Crawley, WA, 6009, Australia

    Bonnie J. Furzer, Timothy R. Ackland, Karen E. Wallman, Sandy M. Gordon, Kemi E. Wright & David J. L. Joske

  2. SolarisCare Foundation Collaborative Research Team, PO Box 7144, Shenton Park, WA, 6008, Australia

    Bonnie J. Furzer, Anna S. Petterson & David J. L. Joske

  3. Haematology Care Centre, Sir Charles Gairdner Hospital, E Block, Hospital Ave, Nedlands, WA, 6009, Australia

    David J. L. Joske

  4. Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia

    Anna S. Petterson

Authors
  1. Bonnie J. Furzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Timothy R. Ackland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen E. Wallman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna S. Petterson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sandy M. Gordon
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kemi E. Wright
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David J. L. Joske
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bonnie J. Furzer.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

Participants cardiovascular fitness ranking based on Aerobic Power Index normative values (JPEG 43 kb)

ESM 2

(DOCX 21 kb)

ESM 3

(DOC 43 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Furzer, B.J., Ackland, T.R., Wallman, K.E. et al. A randomised controlled trial comparing the effects of a 12-week supervised exercise versus usual care on outcomes in haematological cancer patients. Support Care Cancer 24, 1697–1707 (2016). https://doi.org/10.1007/s00520-015-2955-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-015-2955-7

Keywords

Search

Navigation