High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis

Palma, Stefano; Hasenoehrl, Timothy; Jordakieva, Galateja; Ramazanova, Dariga; Crevenna, Richard

doi:10.1007/s00520-020-05834-x

Cited by 52 publications

(67 citation statements)

References 52 publications

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“…From observational studies, there is some evidence to support associations between higher activity levels and reduced risk of all-cause and cancer-specific mortality among patients with breast, colorectal and prostate cancer [49]. However, results from RCTs are lacking [50][51][52]. Recently, a systematic review investigating effects of exercise on mortality and recurrence in patients with cancer and cancer survivors was published [53].…”

Section: Discussionmentioning

confidence: 99%

Effects of a 12-Week Multimodal Exercise Intervention Among Older Patients with Advanced Cancer: Results from a Randomized Controlled Trial

et al. 2022

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Background. Older patients with cancer are at risk of physical decline and impaired quality of life during oncological treatment. Exercise training has the potential to reduce these challenges. The study aim was to investigate the feasibility and effect of a multimodal exercise intervention in older patients with advanced cancer (stages III/IV). Patients and Methods. Eighty-four older adults (≥65 years) with advanced pancreatic, biliary tract, or non-small cell lung cancer who received systemic oncological treatment were randomized 1:1 to an intervention group or a control group. The intervention was a 12-week multimodal exercise-based program including supervised exercise twice weekly followed by a protein supplement, a home-based walking program, and nurse-led support and counseling. The primary endpoint was change in physical function (30-second chair stand test) at 13 weeks.Results. Median age of the participants was 72 years (interquartile range [IQR] 68-75). Median adherence to the exercise sessions was 69% (IQR 21-88) and 75% (IQR 33-100) for the walking program. At 13 weeks, there was a significant difference in change scores of 2.4 repetitions in the chair stand test, favoring the intervention group (p < .0001). Furthermore, significant beneficial effects were seen for physical endurance (6-minute walk test), hand grip strength, physical activity, symptom burden, symptoms of depression and anxiety, global health status (quality of life), and lean body mass. No effects were seen for dose intensity, hospitalizations, or survival. Conclusion.A 12-week multimodal exercise intervention with targeted support proved effective in improving physical function in older patients with advanced cancer during oncological treatment. The Oncologist 2021;26:1-12 Implications for Practice: Exercise is generally recommended during anticancer treatment to maintain physical function and to increase psychological well-being. Although current evidence is mainly based on younger and middle-aged patients, this study showed that a multimodal exercise and support intervention increased physical function in older patients (≥65 years) with advanced cancer during oncological treatment. Hence, these new findings strengthen the basis for existing recommendations and highlight the importance of focusing on and supporting older patients with cancer in a physically active lifestyle and engagement in exercise training.

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Section: Discussionmentioning

confidence: 99%

Effects of a 12-Week Multimodal Exercise Intervention Among Older Patients with Advanced Cancer: Results from a Randomized Controlled Trial

et al. 2022

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“…Commonly proposed strategies include combination of high-protein nutritional support, exercise, and pharmacological interventions. Use of an intervention program, which includes nutrition support and high-intensity exercise, is probably an ideal option for patients with low SMM [31,32].…”

Section: Discussionmentioning

confidence: 99%

Patterns, Predictors, and Prognostic Value of Skeletal Muscle Mass Loss in Patients with Locally Advanced Head and Neck Cancer Undergoing Cisplatin-Based Chemoradiotherapy

Chargi

Wegner

Markazi

et al. 2021

JCM

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Low skeletal muscle mass (SMM) is associated with toxicities and decreased survival in head and neck cancer (HNC). Chemoradiotherapy (CRT) may exaggerate loss of SMM. We investigated the changes in SMM, their predictors, and prognostic impact of SMM in patients treated with CRT between 2012 and 2018. Skeletal muscle area (SMA) segmentation was performed on pre- and post-CRT imaging. Observed changes in SMM were categorized into: (I) Stable, (II) moderate gain (III), moderate loss, (IV) large gain, and (V) large loss. In total, 235 HNC patients were included, of which 39% had stable SMM, 55% moderate loss, 13% moderate gain, 0.4% large loss, and 0.4% large gain of SMM. After CRT, SMA decreased compared to pre-CRT (31.6 cm2 versus 33.3 cm2, p < 0.01). The key predictor was a body mass index (BMI) of ≥30 kg/m2 (OR 3.6, 95% CI 1.4–9.3, p < 0.01). Low SMM at diagnosis (HR 2.1; 95% CI 1.1–4.1, p = 0.03) and an HPV-positive oropharyngeal tumor (HR 0.1; 95% CI 0.01–0.9, p = 0.04) were prognostic for overall survival. Changes in SMM were not prognostic for survival. Loss of SMM is highly prevalent after CRT and a high BMI before treatment may aid in identifying patients at risk.

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“…The advantages of this type of training are that patients are able to sustain high intensity workloads over short time periods in the initial stages of prehabilitation, and a similar volume of exercise can be achieved in a much shorter duration of time when compared to continuous exercise at a moderate intensity. HIIT has also been shown to achieve similar or greater improvement in aerobic fitness when compared to moderate intensity continuous training [23].…”

Section: Prehabilitation Program Parametersmentioning

confidence: 99%

Remote Monitoring Model for the Preoperative Prehabilitation Program of Patients Requiring Abdominal Surgery

2021

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Physical fitness and level of activity are considered important factors for patients with cancer undergoing major abdominal surgery. Cancer patients with low fitness capacity are at greater risk of postoperative complications, longer hospital stays, and mortality. One of the main challenges facing both healthcare providers and patients is to improve the patient’s physical fitness within the available short period (four to six weeks) prior to surgery. Supervised and unsupervised physical prehabilitation programs are the most common recommended methods for enhancing postoperative outcomes in patients undergoing abdominal surgery. Due to obstacles such as geographical isolation, many patients have limited access to medical centers and facilities that provide onsite prehabilitation programs. This article presents a review of the literature and the development of a model that can remotely monitor physical activities during the prehabilitation period. The mixed prehabilitation model includes the identification of fundamental parameters of physical activities (type, intensity, frequency, and duration) over time. A mathematical model has been developed to offer a solution for both the healthcare provider and patients. This offers the opportunity for physicians or physiotherapists to monitor patients performing their prescribed physical exercises in real time. The model that has been developed is embedded within the internet of things (IoT) system, which calculates the daily and weekly efforts made by the patients and automatically stores this in a comma-separated values (CSV) file that medical staff can access. In addition, this model allows the patient to compensate for missed prescribed activity by adding additional efforts to meet the prehabilitation requirements. As a result, healthcare staff are provided with feedback on patient engagement in prescribed exercise during the period of the prehabilitation program.

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High-intensity interval training in the prehabilitation of cancer patients—a systematic review and meta-analysis

Cited by 52 publications

References 52 publications

Effects of a 12-Week Multimodal Exercise Intervention Among Older Patients with Advanced Cancer: Results from a Randomized Controlled Trial

Effects of a 12-Week Multimodal Exercise Intervention Among Older Patients with Advanced Cancer: Results from a Randomized Controlled Trial

Patterns, Predictors, and Prognostic Value of Skeletal Muscle Mass Loss in Patients with Locally Advanced Head and Neck Cancer Undergoing Cisplatin-Based Chemoradiotherapy

Remote Monitoring Model for the Preoperative Prehabilitation Program of Patients Requiring Abdominal Surgery

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