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Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial

Demmelmaier, Ingrid ; Brooke, Hannah L. ; Henriksson, Anna ; Mazzoni, Anne Sophie ; Bjørke, Ann Christin Helgesen ; Igelström, Helena ; Ax, Anna Karin ; Sjövall, Katarina LU ; Hellbom, Maria LU and Pingel, Ronnie , et al. (2021) In Scandinavian Journal of Medicine and Science in Sports 31(5). p.1144-1159
Abstract

Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The... (More)

Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie <2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
behavior change, cancer-related fatigue, endurance training, oncology, resistance training
in
Scandinavian Journal of Medicine and Science in Sports
volume
31
issue
5
pages
16 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:33527488
  • scopus:85101912223
ISSN
0905-7188
DOI
10.1111/sms.13930
language
English
LU publication?
yes
id
3bcd1701-268b-424b-973a-980b0fadd800
date added to LUP
2022-04-12 17:56:49
date last changed
2024-06-17 01:56:08
@article{3bcd1701-268b-424b-973a-980b0fadd800,
  abstract     = {{<p>Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie &lt;2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.</p>}},
  author       = {{Demmelmaier, Ingrid and Brooke, Hannah L. and Henriksson, Anna and Mazzoni, Anne Sophie and Bjørke, Ann Christin Helgesen and Igelström, Helena and Ax, Anna Karin and Sjövall, Katarina and Hellbom, Maria and Pingel, Ronnie and Lindman, Henrik and Johansson, Silvia and Velikova, Galina and Raastad, Truls and Buffart, Laurien M. and Åsenlöf, Pernilla and Aaronson, Neil K. and Glimelius, Bengt and Nygren, Peter and Johansson, Birgitta and Börjeson, Sussanne and Berntsen, Sveinung and Nordin, Karin}},
  issn         = {{0905-7188}},
  keywords     = {{behavior change; cancer-related fatigue; endurance training; oncology; resistance training}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  pages        = {{1144--1159}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Scandinavian Journal of Medicine and Science in Sports}},
  title        = {{Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial}},
  url          = {{http://dx.doi.org/10.1111/sms.13930}},
  doi          = {{10.1111/sms.13930}},
  volume       = {{31}},
  year         = {{2021}},
}