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The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project

Published online by Cambridge University Press:  29 June 2006

JULIE MIDTGAARD ,
ANDERS TVETERÅS ,
MIKAEL RØRTH ,
REINHARD STELTER  and
LIS ADAMSEN
JULIE MIDTGAARD
Affiliation:
The University Hospitals Centre for Nursing and Care Research (UCSF), Copenhagen University Hospital, Department 7331, Copenhagen, Denmark
ANDERS TVETERÅS
Affiliation:
The University Hospitals Centre for Nursing and Care Research (UCSF), Copenhagen University Hospital, Department 7331, Copenhagen, Denmark
MIKAEL RØRTH
Affiliation:
Department of Oncology, Copenhagen University Hospital, Department 5073, Copenhagen, Denmark
REINHARD STELTER
Affiliation:
University of Copenhagen, Institute of Exercise and Sport Sciences, Copenhagen, Denmark
LIS ADAMSEN
Affiliation:
The University Hospitals Centre for Nursing and Care Research (UCSF), Copenhagen University Hospital, Department 7331, Copenhagen, Denmark
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Abstract

Background: Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship.

Objective: This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years, 82% oncological and 18% haematological) from the Body & Cancer Project.

Methods: Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program. The study furthermore included 3-month follow-up assessment of psychological distress (Hospital Anxiety and Depression Scale—HADS). Patient statements were selected that best illustrated trends found in the statistical material.

Results: There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks. However, the patients (half of whom were still undergoing treatment at the time of follow-up) reported a higher physical activity level postprogram compared to their baseline levels. The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level, treatment, and postprogram changes in depression.

Significance of research: Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population. However, randomized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients.

Keywords

Exercise adherenceCancerChemotherapyFollow-up studySupervised exercise intervention
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 1 , March 2006 , pp. 25 - 35
Copyright
© 2006 Cambridge University Press

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References

REFERENCES

Aadahl, M. & Jørgensen, T. (2003). Validation of a new self-report instrument for measuring physical activity. Medicine and Science in Sports and Exercise, 35, 1196–1202.Google Scholar
Adamsen, L., Midtgaard, J., Rorth, M., et al. (2003). Feasibility, physical capacity, and health benefits of a multidimensional exercise programme for cancer patients undergoing chemotherapy. Supportive Care in Cancer, 11, 707–716.Google Scholar
Adamsen, L., Midtgaard, J., Roerth, M., et al. (2004). Transforming the nature of fatigue through exercise: Qualitative findings from a multidimensional exercise programme in cancer patients undergoing chemotherapy. European Journal of Cancer Care, 13, 362–370.Google Scholar
Adamsen, L., Quist, M., Midtgaard, J., et al. (2005). The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Supportive Care in Cancer (Epub ahead of print).Google Scholar
Agresti, A. (2002). Categorical Data Analysis, 2nd ed. New York: John Wiley & Sons.
Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In Action Control: From Cognition to Behaviour, Kuhl, J. & Beckman, J. (eds.), pp. 11–39. Berlin: Springer-Verlag.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.Google Scholar
Andersen, L.B., Schnohr, P., Schroll, M., et al. (2000). All cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Archives of Internal Medicine, 160, 1621–1628.Google Scholar
Bandura, A. (1997). Self-Efficacy: The Exercise of Control. New York: Freeman.
Berman, H., Ford-Gilboe, M., & Campbell, J.C. (1998). Combining stories and numbers: A methodological approach for a critical nursing science. Advances in Nursing Science, 21, 1–15.Google Scholar
Blair, S.N., Haskell, W.L., Ho, P., et al. (1985). Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. American Journal of Epidemiology, 122, 794–804.Google Scholar
Blanchard, C.M., Courneya, K.S., Rodgers, W.M., et al. (2002). Determinants of exercise intention and behavior in survivors of breast and prostate cancer: An application of the theory of planned behavior. Cancer Nursing, 25, 88–95.Google Scholar
Coleman, E.A., Coon, S., Hall-Barrow, J., et al. (2003). Feasibility of exercise during treatment for multiple myeloma. Cancer Nursing, 26, 410–419.Google Scholar
Courneya, K.S. & Friedenreich, C.M. (1997a). Determinants of exercise during colorectal cancer treatment: An application of the theory of planned behavior. Oncology Nursing Forum, 24, 1715–1723.Google Scholar
Courneya, K.S. & Friedenreich, C.M. (1997b). Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. Journal of Alternative and Complementary Medicine, 3, 215–226.Google Scholar
Courneya, K.S. & Friedenreich, C.M. (1999a). Physical exercise and quality of life following cancer diagnosis: A literature review. Annals of Behavioral Medicine, 21, 171–179.Google Scholar
Courneya, K.S. & Friedenreich, C.M. (1999b). Utility of the theory of planned behavior for understanding exercise during breast cancer treatment. Psycho-Oncology, 8, 12–22.Google Scholar
Courneya, K.S., Friedenreich, C.M., Quinney, H.A., et al. (2004a). Predictors of adherence and contamination in a randomized trial of exercise in colorectal cancer survivors. Psycho-Oncology, 13, 857–866.Google Scholar
Courneya, K.S., Friedenreich, C.M., Sela, R.A., et al. (2004b). Exercise motivation and adherence in cancer survivors after participation in a randomized controlled trial: An attribution theory perspective. International Journal of Behavioral Medicine, 11, 8–17.Google Scholar
Denzin, N.K. (1989). The Research Act: A Theoretical Introduction to Sociological Methods, 3rd ed. New York: McGraw-Hill.
Dimeo, F.C. (2001). Effects of exercise on cancer-related fatigue. Cancer, 92(6 Suppl), 1689–1693.Google Scholar
Dimeo, F., Schwartz, S., Fietz, T., et al. (2003). Effects of endurance training on the physical performance of patients with hematological malignancies during chemotherapy. Supportive Care in Cancer, 11, 623–628.Google Scholar
Dimeo, F.C., Stieglitz, R.-D., Novelli-Fischer, U., et al. (1999). Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer, 85, 2273–2277.Google Scholar
Dishman, R.K. (1990). Determinants of participation in physical activity. In Exercise, Fitness, and Health, Bouchard, C., Shepard, R.J., Stephens & T., et al. (eds.), pp. 75–101. Champaign, IL: Human Kinetics Books.
Drake, D., Falzer, P., Xistris, D., et al. (2004). Physical fitness training: Outcomes for adult oncology patients. Clinical Nursing Research, 13, 245–264.Google Scholar
Durak, E.P. & Lilly, P.C. (1998). The application of an exercise and wellness programme for cancer patients: A preliminary outcomes report. Journal of Strength and Conditioning Research, 12, 3–6.Google Scholar
Galvão, D.A. & Newton, R.U. (2005). Review of exercise intervention studies in cancer patients. Journal of Clinical Oncology, 23, 899–909.Google Scholar
Godin, G. & Shephard, R.J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Sciences, 10, 141–146.Google Scholar
Jones, L.W., Courneya, K.S., Vallance, J.K., et al. (2004). Association between exercise and quality of life in multiple myeloma cancer survivors. Supportive Care in Cancer, 12, 780–788.Google Scholar
Jørgensen, M.E. & Rosenlund, M. (2005). National Monitorering af den Officielle Anbefaling om fysisk aktivitet: Et Metodestudie [National Survey of the Official Physical Activity Guidelines: A Methodological Study]. Copenhagen: National Institute of Public Health.
Lucia, A., Earnest, C., & Perez, M. (2003). Cancer-related fatigue: Can exercise physiology assist oncologists? Lancet Oncology, 4, 616–625.Google Scholar
MacVicar, M.G., Winningham, M.L., & Nickel, J.L. (1989). Effects of aerobic interval training on cancer patients' functional capacity. Nursing Research, 38, 348–351.Google Scholar
Malterud, K. (2001). Qualitative research: Standards, challenges, and guidelines. Lancet, 358, 483–488.Google Scholar
Midtgaard, J., Rørth, M., Stelter, R., et al. (2005). The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A Phase II study. Palliative & Supportive Care, 3, 197–208.Google Scholar
Midtgaard, J., Rorth, M., Stelter, R., et al. (2006). The group matters: An explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment. European Journal of Cancer Care, 15, 25–33.Google Scholar
Pinto, B.M., Frierson, G.M., Rabin, C., et al. (2005). Home-based physical activity intervention for breast cancer patients. Journal of Clinical Oncology, 23, 3577–3587.Google Scholar
Pinto, B.M., Trunzo, J.J., Reiss, P., et al. (2002). Exercise participation after diagnosis of breast cancer: Trends and effects on mood and quality of life. Psycho-Oncology, 11, 389–400.Google Scholar
Polit, D.F. & Beck, C.T. (2004). Nursing Research: Principles and Methods. 7th ed. Philadelphia: Lippinicott Williams & Wilkins.
Prochaska, J.O. & DiClemente, C.C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–395.Google Scholar
Saltin, B. & Grimby, G. (1968). Physiological analysis of middle-aged and old former athletes: Comparison with still active athletes of the same ages. Circulation, 38, 1104–1115.Google Scholar
Schwartz, A.L. (2000). Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Practice, 8, 16–24.Google Scholar
Schwartz, A.L. (2004). Physical activity after a cancer diagnosis: Psychosocial outcomes. Cancer Investigation, 22, 82–92.Google Scholar
Schwartz, A.L., Mori, M., Gao, R., et al. (2001). Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Medicine and Science in Sports and Exercise, 33, 718–723.Google Scholar
Segal, R., Evans, W., Johnson, D., et al. (2001). Structured exercise improves physical functioning in women with stages I and II breast cancer: Results of a randomized controlled trial. Journal of Clinical Oncology, 19, 657–665.Google Scholar
Winningham, M.L. & MacVicar, M.G. (1988). The effect of aerobic exercise on patient reports of nausea. Oncology Nursing Forum, 15, 447–450.Google Scholar
Young-McCaughan, S. & Sexton, D.L. (1991). A retrospective investigation of the relationship between aerobic exercise and quality of life in women with breast cancer. Oncology Nursing Forum, 18, 751–757.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar