Long-term effectiveness and cost-effectiveness of high versus low-to-moderate intensity resistance and endurance exercise interventions among cancer survivors

Kampshoff, Caroline S.; Dongen, Johanna M. van; Mechelen, Willem van; Schep, Goof; Vreugdenhil, Art; Twisk, Jos W. R.; Bosmans, Judith E.; Brug, Johannes; Chinapaw, Mai J. M.; Buffart, Laurien M.

doi:10.1007/s11764-018-0681-0

Cited by 48 publications

(81 citation statements)

References 38 publications

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“…Challenges to display beneficial effects of exercise training on cognitive and affective CRF has been evident in patients with breast cancer immediately following completion of chemotherapy [ 29 ]. Conversely, a trial conducted post-chemotherapy on breast cancer survivors assessing different exercise loads/intensities demonstrated that only the group performing high load resistance training combined with high-intensity continuous/interval training was able to counteract mental fatigue [ 30 ], and results from their 12-month follow-up study showed that the higher intensity group was superior to lower intensity exercise on role functioning [ 31 ]. It may be speculated that the HIIT component in the current trial may have played a role in inducing beneficial effects for cognitive CRF found for AT-HIIT, possibly through beneficial effects of HIIT on cerebral oxygenation [ 32 ] and/or improvements in information processing speed [ 33 ] as found in obese and elderly individuals, respectively.…”

Section: Discussionmentioning

confidence: 99%

High-intensity exercise during chemotherapy induces beneficial effects 12 months into breast cancer survivorship

et al. 2019

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Purpose Whether the benefits of exercise during chemotherapy continue into survivorship is not well-known. Here, the aim was to examine the effects of two exercise interventions on self-reported health-related and objectively measured physiological outcomes 12 months following commencement of chemotherapy. Methods Two hundred and forty women with breast cancer stage I–IIIa were randomized to 16 weeks of high-intensity aerobic interval training combined with either resistance training (RT-HIIT), or moderate-intensity aerobic training (AT-HIIT), or to usual care (UC). Primary outcome: cancer-related fatigue (CRF); secondary outcomes: quality of life (QoL), symptom burden, muscle strength, cardiorespiratory-fitness, body mass, and return to work. Results Compared to UC, both RT-HIIT and AT-HIIT significantly counteracted increases in total CRF (ES = − 0.34; ES = − 0.10), daily life CRF (ES=-0.76; ES=-0.50, and affective CRF (ES=-0.60; ES=-0.39). Both RT-HIIT and AT-HIIT reported significantly lower total symptoms (ES = − 0.46, ES = − 0.46), and displayed gains in lower limb (ES = 0.73; ES = 1.03) and handgrip muscle strength (surgery side ES = 0.70, ES = 0.71; non-surgery side ES = 0.57, ES = 0.59). AT-HIIT displayed significant reductions in body mass (ES = − 0.24), improved QoL: role (ES = 0.33) and emotional functioning (ES = 0.40), and a larger proportion had returned to work ( p = 0.02) vs UC. Conclusion These findings emphasize the beneficial effects of supervised high-intensity exercise during chemotherapy to improve the health and to reduce societal costs associated with prolonged sick leave for patients with breast cancer several months following chemotherapy. Implications for Cancer Survivors These findings provide important information with substantial positive consequences for breast cancer survivorship. High-intensity exercise programs during chemotherapy and support to maintain physical activity can be a powerful strategy to manage or prevent many of the short- and long-term adverse effects of treatment for the increasing cohort of cancer survivors.

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Section: Discussionmentioning

confidence: 99%

High-intensity exercise during chemotherapy induces beneficial effects 12 months into breast cancer survivorship

et al. 2019

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“…In addition, reports suggest that analyses including comprehensive costs, which capture reductions in health care utilization more consistently, favor resource‐intensive and exercise‐intensive programs. A randomized trial that compared high‐intensity and low‐intensity exercise programs found that the former were cost‐effective, mostly due to significantly lower health care costs in the high‐intensity exercise group . Several studies noted reductions in unplanned hospitalizations, lengths of stay, and emergency room visits among patients who participated in exercise programming .…”

Section: Implementation Issuesmentioning

confidence: 99%

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Schmitz

Campbell

Stuiver

et al. 2019

CA A Cancer J Clinicians

503

465

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Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

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“…Physical activity (PA) benefits people living with or beyond cancer by improving physical function and QoL during and after cancer treatment, and cancer-related outcomes like treatment completion, maintenance of, or faster return to, pretreatment health, fewer unnecessary healthcare visits and better survival rates [6,[17][18][19][20][21][22]. Improvements are greater in those engaging in PA sooner after a diagnosis [23].…”

Section: Introductionmentioning

confidence: 99%

Physical activity and nutrition interventions for older adults with cancer: a systematic review

et al. 2020

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The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC). Methods We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials. Results Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice. Conclusions Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement. Implications for Cancer Survivors More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations.

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Long-term effectiveness and cost-effectiveness of high versus low-to-moderate intensity resistance and endurance exercise interventions among cancer survivors

Cited by 48 publications

References 38 publications

High-intensity exercise during chemotherapy induces beneficial effects 12 months into breast cancer survivorship

High-intensity exercise during chemotherapy induces beneficial effects 12 months into breast cancer survivorship

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Physical activity and nutrition interventions for older adults with cancer: a systematic review

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