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Modality of exercise influences rate of decrease in depression for cancer survivors with elevated depressive symptomatology

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Abstract

Purpose

This three-arm feasibility controlled trial examined whether different exercise modalities provide reductions in depression symptoms to cancer survivors with elevated depression.

Methods

Thirty-two participants (58.9 ± 9.4 years) were allocated to a 12-week supervised exercise group (EX; n = 10), a self-managed home-based exercise group (SMHB; n = 8), or a usual care control group (CONT; n = 14). EX performed two supervised resistance and aerobic sessions per week. SMHB were provided with printed material about benefits of exercise and encouraged to complete 150 min of exercise weekly. CONT received no exercise or printed material and were encouraged to maintain usual activity.

Results

A group × time interaction was found for the primary outcome of depression scores, measured using the Hospital Anxiety and Depression Scale (HADS-D; p = .008). SMHB (6.4 ± 5.3 to 2.2 ± 2.9, p = .006) and EX (6.9 ± 4.2 to 4.0 ± 2.4, p = .021) interventions both effectively reduced HADS-D scores compared to CONT (7.2 ± 2.5 to 7.7 ± 3.6). SMHB decreased depression to a greater extent, and this occurred more rapidly with greatest changes noted at 6 weeks (d = 0.50). Further favourable outcomes for exercise were also noted for several secondary outcome measures.

Conclusion

The rate of exercise-related reduction in depression is influenced by the modality of exercise. However, increasing the duration of the programme appears to diminish the favourable short-term response to self-managed exercise with subsequent secondary outcomes of mental health favouring supervised exercise.

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References

  1. Clark EJ, Stovall EL, Leigh S, Siu AL, Austin DK, Rowland JH (1996) Imperatives for quality cancer care: access, advocacy, action, and accountability. National Coalation for Cancer Survivorship. Silver Spring, MD

    Google Scholar 

  2. Li M, Fitzgerald P, Rodin G (2012) Evidence-based treatment of depression in patients with cancer. J Clin Oncol 30(11):1187–1196. https://doi.org/10.1200/JCO.2011.39.7372

    Article  PubMed  Google Scholar 

  3. Satin JR, Linden W, Phillips MJ (2009) Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer 115(22):5349–5361. https://doi.org/10.1002/cncr.24561

    Article  PubMed  Google Scholar 

  4. Pinquart M, Duberstein PR (2010) Depression and cancer mortality: a meta-analysis. Psychol Med 40(11):1797–1810. https://doi.org/10.1017/S0033291709992285

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Pasquini M, Biondi M (2007) Depression in cancer patients: a critical review. Clin Pract Epidemiol Ment Health 3(1):2. https://doi.org/10.1186/1745-0179-3-2

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hopwood P, Stephens RJ (2000) Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol 18(4):893–903. https://doi.org/10.1200/JCO.2000.18.4.893

    Article  CAS  PubMed  Google Scholar 

  7. Craft LL, Vaniterson EH, Helenowski IB, Rademaker AW, Courneya KS (2012) Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev 21(1):3–19. https://doi.org/10.1158/1055-9965.EPI-11-0634

    Article  Google Scholar 

  8. Daley A (2008) Exercise and depression: a review of reviews. J Clin Psychol Med Settings 15(2):140–147. https://doi.org/10.1007/s10880-008-9105-z

    Article  PubMed  Google Scholar 

  9. Lopresti AL, Hood SD, Drummond PD (2013) A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord 148(1):12–27. https://doi.org/10.1016/j.jad.2013.01.014

    Article  PubMed  Google Scholar 

  10. Dimeo FC (2001) Effects of exercise on cancer-related fatigue. Cancer 92(6 Suppl):1689–1693. https://doi.org/10.1002/1097-0142(20010915)92:6+<1689::AID-CNCR1498>3.0.CO;2-H

    Article  CAS  PubMed  Google Scholar 

  11. McTiernan A (2004) Physical activity after cancer: physiologic outcomes. Cancer Investig 22(1):68–81. https://doi.org/10.1081/CNV-120027581

    Article  Google Scholar 

  12. Rimer J, Dwan K, Lawlor DA, Greig CA, McMurdo M, Morley W, Mead GE (2012) Exercise for depression. Cochrane Db Syst Rev (7). https://doi.org/10.1002/14651858.Cd004366.Pub5

  13. Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, Herman S, Craighead WE, Brosse AL, Waugh R, Hinderliter A, Sherwood A (2007) Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosom Med 69(7):587–596. https://doi.org/10.1097/PSY.0b013e318148c19a

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426. https://doi.org/10.1249/MSS.0b013e3181e0c112

    Article  PubMed  Google Scholar 

  15. Sellick SM, Crooks DL (1999) Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psychooncology 8(4):315–333. https://doi.org/10.1002/(SICI)1099-1611(199907/08)8:4<315::AID-PON391>3.0.CO;2-G

    Article  CAS  PubMed  Google Scholar 

  16. Bultz BD, Carlson LE (2006) Emotional distress: the sixth vital sign—future directions in cancer care. Psychooncology 15(2):93–95. https://doi.org/10.1002/pon.1022

    Article  PubMed  Google Scholar 

  17. Chaze F, Thomson MS, George U, Guruge S (2015) Role of cultural beliefs, religion, and spirituality in mental health and/or service utilization among immigrants in Canada: a scoping review. Can J Commun Ment Health 34(3):87–101. https://doi.org/10.7870/cjcmh-2015-015

    Article  Google Scholar 

  18. Singh NA, Stavrinos TM, Scarbek Y, Galambos G, Liber C, Fiatarone Singh MA (2005) A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci 60(6):768–776

    Article  PubMed  Google Scholar 

  19. Carek PJ, Laibstain SE, Carek SM (2011) Exercise for the treatment of depression and anxiety. Int J Psychiatry Med 41(1):15–28. https://doi.org/10.2190/PM.41.1.c

    Article  PubMed  Google Scholar 

  20. Levin GT, Greenwood KM, Singh F, Tsoi D, Newton RU (2015) Exercise improves physical function and mental health of brain cancer survivors: two exploratory case studies. Integr Cancer Ther 15(2):190–196. https://doi.org/10.1177/1534735415600068

    Article  PubMed  PubMed Central  Google Scholar 

  21. Stathopoulou G, Powers MB, Berry AC, Smits JAJ, Otto MW (2006) Exercise interventions for mental health: a quantitative and qualitative review. Clin Psychol Sci Pract 13(2):179–193. https://doi.org/10.1111/j.1468-2850.2006.00021.x

    Article  Google Scholar 

  22. Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU (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(2):340–347. https://doi.org/10.1200/JCO.2009.23.2488

    Article  CAS  PubMed  Google Scholar 

  23. Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J, Woodard S, Wells G, Reid R (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19(3):657–665. https://doi.org/10.1200/JCO.2001.19.3.657

    Article  CAS  PubMed  Google Scholar 

  24. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

    Article  CAS  PubMed  Google Scholar 

  25. Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77

    Article  PubMed  Google Scholar 

  26. Ware JE, Kosinski M, Dewey JE (2002) How to score version 2 of the SF-36 Health Survey. QualityMetric Inc, Lincoln (RI)

    Google Scholar 

  27. Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10(3):141–146

    CAS  PubMed  Google Scholar 

  28. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43(7):1334–1359. https://doi.org/10.1249/MSS.0b013e318213fefb

    Article  PubMed  Google Scholar 

  29. Simonsick EM, Fan E, Fleg JL (2006) Estimating cardiorespiratory fitness in well-functioning older adults: treadmill validation of the long distance corridor walk. J Am Geriatr Soc 54(1):127–132. https://doi.org/10.1111/j.1532-5415.2005.00530.x

    Article  PubMed  Google Scholar 

  30. Newman AB, Simonsick EM, Naydeck BL, Boudreau RM, Kritchevsky SB, Nevitt MC, Pahor M, Satterfield S, Brach JS, Studenski SA, Harris TB (2006) Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA 295(17):2018–2026. https://doi.org/10.1001/jama.295.17.2018

    Article  CAS  PubMed  Google Scholar 

  31. Knubben K, Reischies FM, Adli M, Schlattmann P, Bauer M, Dimeo F (2007) A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. Br J Sports Med 41(1):29–33. https://doi.org/10.1136/bjsm.2006.030130

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Brown JC, Huedo-Medina TB, Pescatello LS, Ryan SM, Pescatello SM, Moker E, LaCroix JM, Ferrer RA, Johnson BT (2012) The efficacy of exercise in reducing depressive symptoms among cancer survivors: a meta-analysis. PLoS One 7(1):e30955. https://doi.org/10.1371/journal.pone.0030955

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Hayes SC, Rye S, Disipio T, Yates P, Bashford J, Pyke C, Saunders C, Battistutta D, Eakin E (2013) Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer. Breast Cancer Res Treat 137(1):175–186. https://doi.org/10.1007/s10549-012-2331-y

    Article  PubMed  Google Scholar 

  34. Campbell HS, Phaneuf MR, Deane K (2004) Cancer peer support programs—do they work? Patient Educ Couns 55(1):3–15. https://doi.org/10.1016/j.pec.2003.10.001

    Article  PubMed  Google Scholar 

  35. Jayakody K, Gunadasa S, Hosker C (2014) Exercise for anxiety disorders: systematic review. Br J Sports Med 48(3):187–196. https://doi.org/10.1136/bjsports-2012-091287

    Article  PubMed  Google Scholar 

  36. Korstjens I, Mesters I, May AM, van Weert E, van den Hout JH, Ros W, Hoekstra-Weebers JE, van der Schans CP, van den Borne B (2010) Effects of cancer rehabilitation on problem-solving, anxiety and depression: a RCT comparing physical and cognitive-behavioural training versus physical training. Psychol Health 26(sup1):1–20. https://doi.org/10.1080/08870441003611569

    Google Scholar 

  37. Reidy J, Keogh E (1997) Testing the discriminant and convergent validity of the mood and anxiety symptoms questionnaire using a British sample. Personal Individ Differ 23(2):337–344. https://doi.org/10.1016/s0191-8869(97)00048-2

    Article  Google Scholar 

  38. Mather AS, Rodriguez C, Guthrie MF, McHarg AM, Reid IC, McMurdo ME (2002) Effects of exercise on depressive symptoms in older adults with poorly responsive depressive disorder: randomised controlled trial. Br J Psychiatry 180(5):411–415. https://doi.org/10.1192/bjp.180.5.411

    Article  PubMed  Google Scholar 

  39. Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO (2005) Exercise treatment for depression: efficacy and dose response. Am J Prev Med 28(1):1–8. https://doi.org/10.1016/j.amepre.2004.09.003

    Article  PubMed  Google Scholar 

  40. Bloom JR, Petersen DM, Kang SH (2007) Multi-dimensional quality of life among long-term (5+ years) adult cancer survivors. Psychooncology 16(8):691–706. https://doi.org/10.1002/pon.1208

    Article  PubMed  Google Scholar 

  41. Roesch SC, Adams L, Hines A, Palmores A, Vyas P, Tran C, Pekin S, Vaughn AA (2005) Coping with prostate cancer: a meta-analytic review. J Behav Med 28(3):281–293. https://doi.org/10.1007/s10865-005-4664-z

    Article  PubMed  Google Scholar 

  42. Smith DJ (2003) A framework for understanding the training process leading to elite performance. Sports Med 33(15):1103–1126. https://doi.org/10.2165/00007256-200333150-00003

    Article  PubMed  Google Scholar 

  43. Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, Ladha AB, Proulx C, Vallance JK, Lane K, Yasui Y, McKenzie DC (2007) Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 25(28):4396–4404. https://doi.org/10.1200/JCO.2006.08.2024

    Article  PubMed  Google Scholar 

  44. Keppel G (1991) Design and analysis: a researcher’s handbook. Prentice-Hall, Inc, Englewood Cliffs

    Google Scholar 

  45. Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy M, Moore K, Craighead WE, Baldewicz TT, Krishnan KR (2000) Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosom Med 62(5):633–638. https://doi.org/10.1097/00006842-200009000-00006

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Parts of this research have previously been presented at the MASCC 2016 conference held in Adelaide, Australia, and at the World Congress of Psycho-Oncology 2015 conference held in Washington, DC, USA. Gregory Levin received a Cancer Council PhD Top-up Scholarship to support this research.

Funding

Dr. Levin received a Cancer Council PhD Top-up Scholarship to support this research.

Author information

Authors and Affiliations

  1. School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia

    Gregory T. Levin, Favil Singh & Robert U. Newton

  2. School of Social Sciences, University of the Sunshine Coast, Queensland, Australia

    Kenneth M. Greenwood

  3. Exercise Medicine Research Institute, Edith Cowan University, Western Australia, Australia

    Favil Singh & Robert U. Newton

  4. University Centre for Clinical Research, University of Queensland, Queensland, Australia

    Robert U. Newton

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  1. Gregory T. Levin
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Correspondence to Gregory T. Levin.

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The authors declare that they have no conflict of interest. Dr. Levin has full control of all primary data and agrees to allow the journal to review their data if requested.

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Levin, G.T., Greenwood, K.M., Singh, F. et al. Modality of exercise influences rate of decrease in depression for cancer survivors with elevated depressive symptomatology. Support Care Cancer 26, 1597–1606 (2018). https://doi.org/10.1007/s00520-017-3996-x

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