Resistance training in advanced cancer: a phase II safety and feasibility trial—home versus hospital

Abstract

BackgroundResistance training (RT) is an effective way to increase muscle mass but little is known about its role to prevent sarcopenia in advanced cancer. Furthermore, the preferred setting for this training is not known. Considering home is frequently the place of care and death preferred by cancer patients, it is important to find out whether this would also be the best training setting as opposed to the most common one, hospital.ObjectivesWe aimed to test if RT at home and in hospital is feasible (primary outcome) and safe in advanced cancer, with a view to inform a phase III trial.MethodsPhase II randomised controlled trial including adults (≥18 years) with incurable solid tumours, randomised into one of three arms: (1) supervised RT at home; (2) supervised RT in hospital; (3) standard care with information leaflet. Both training programmes were similar, ran one-to-one with therapists and planned to last 12 weeks (three sessions/week). Feasibility included adherence (proportion of completed sessions) and acceptability (proportion of completed exercises), compared using Fisher’s test.ResultsWe included 15 patients (53% men, median age 68), 5 per arm. The home intervention had higher adherence (49% vs 9% in hospital; p<0.001). Acceptability was similar (93% in home and 95% in hospital; p=0.179). No adverse events were recorded.ConclusionsRT is a safe intervention, more feasible at home than in hospital in advanced cancer. Ways to increase adherence to the home intervention could further improve its potential benefit.Trial registration numberNCT02930876.

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“…However, these data are fundamental to fostering individual compliance with the recommended dose of exercise 12. In fact, despite the well-known benefits of physical exercise for cancer survivors,12 16 this population is frequently unactive17 and reports several common barriers to exercise, such as the location or distance to facilities 18–20. Furthermore, hospital-based supervised physical exercise interventions can be challenging to implement because they requires the use of complex hospital resources 18 21 22.…”

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