Exercise Improves Physical Function and Mental Health of Brain Cancer Survivors

Abstract

Background Malignant brain tumors are unpredictable and incurable, with 5-year survival rates less than 30%. The poor prognosis combined with intensive treatment necessitates the inclusion of complementary and supportive therapies that optimize quality of life and reduce treatment-related declines in health. Exercise therapy has been shown to be beneficial in other cancer populations, but no evidence is available for brain cancer survivors. Therefore, we report results from 2 preliminary cases. Methods Two female patients diagnosed with glioblastoma multiforme and oligodendroglioma participated in a structured and supervised 12-week exercise program. The program consisted of two 1-hour resistance and aerobic exercise sessions per week and additional self-managed aerobic sessions. Outcome measures of strength, cardiovascular fitness, and several psychological indicators (depression, anxiety, and quality of life) were recorded at baseline, after 6 weeks and at the conclusion of the intervention. Results Exercise was well tolerated; both participants completed all 24 sessions and the home-based component with no adverse effects. Objective outcome measures displayed positive responses relating to reduced morbidity. Similar positive responses were found for psychological outcomes. Scores on the Hospital Anxiety and Depression Scale showed clinically meaningful improvements in depression and total distress. Conclusion These findings provide initial evidence that, despite the difficulties associated with brain cancer treatment and survivorship, exercise may be safe and beneficial and should be considered in the overall management of patients with brain cancer.

Development of an exercise intervention as part of rehabilitation in a glioblastoma multiforme survivor during irradiation treatment: a case report

“…At follow-up, our case improved aerobe power (24%), muscle strength (0-38%), walking ability (9%), and standing balance (71%). This indicates that exercise rehabilitation can improve functional performance as previously reported [24,40,41,43,44]. He also improved 'Global Health Status/QOL' by 8.4 points and 'Physical functioning' by 6.7 points.…”

“…He also improved 'Global Health Status/QOL' by 8.4 points and 'Physical functioning' by 6.7 points. Though it does not reach a delta score of ten points or more, which is considered to being clinically relevant [47], it does indicate a potential difference from baseline, which is compelling to other studies [40,41,42,43]. He also reported a decrease in 'Social functioning'.…”

“…However, performance status and age are among the best described prognostic factors in GBM, and most likely there is a strong relation between highperformance status and lower age [37]. Mean age in studies of patients with gliomas attending outpatient rehabilitation or physical capacity assessments ranges between 34 and 61 [7,26,28,38,39,40,41,42,43,44]. This implies that exercise rehabilitation intervention mainly addresses the younger population or patients with high Karnofsky performance status, which makes our case highly representative of this glioma population.…”

Feasibility, Safety and Effects of a One-Week, Ski-Based Exercise Intervention in Brain Tumor Patients and Their Relatives: A Pilot Study

“…A six-week program was attended by a single case, who subsequently improved in balance, walking, and QOL, again with no adverse events [14]. Another 12-week program in two cases was again well-tolerated and improved QOL [13]. In a case reported by our group, a two-year exercise program, including two marathon runs, did not produce any adverse effects [15].…”

“…The German GBM guidelines explicitly discourage exercise in this patient cohort [11]. Only recently, some case series and case reports indicated that exercise is tolerable in brain tumor patients [12][13][14]. Our group reported a case of a GBM patient who participated in a twoyear training program and completed two marathon runs under multimodal therapy with no adverse events [15].…”