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Charles C, Bardet A, Ibrahimi N, Aromatario O, Cambon L, Imbert A, Pons M, Raynard B, Sauveplane D, Pouchepadass C, Baudinet C, Lambotte O, Marabelle A, Dauchy S. Delivering adapted physical activity by videoconference to patients with fatigue under immune checkpoint inhibitors: Lessons learned from the PACTIMe-FEAS feasibility study. J Telemed Telecare 2023; 29:716-724. [PMID: 34137641 DOI: 10.1177/1357633x211021743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Fatigue is one of the most frequent symptoms in anti-cancer immune therapy. Physical activity has been proven effective in reducing fatigue, but unmet needs remain regarding the provision and access to adapted programmes, which efficiently addresses the main barriers to PA. METHODS The PACTIMe-FEAS study primarily aimed at primarily to evaluate the feasibility and the acceptability of a videoconference-based 6-month programme promoting physical activity, and secondarily to assess its potential post-immediate and short-term effectiveness in reducing fatigue in cancer patients under immune therapy. Numeric self-reported questionnaires (Visual Analogue Scale-fatigue, Multidimensional Fatigue Inventory, International Physical Activity Questionnaire, Échelle de Motivation envers l'Activité Physique en contexte de Santé, Medical Outcomes Study 36-Item Short Form Health Survey, Hospital Anxiety and Depression Scale and Insomnia Severity Index) were completed by participants through an online secure platform at three time points: just before (T1), and after (T2) the programme, and 3 months later (T3). RESULTS Sixteen participants (50% male, 50% female, mean age 54 years, 69% melanoma, 31% overweight), with moderate-to-severe fatigue, entered the internet-delivered intervention; 14 completed it, with an average completion rate of physical activity supervised sessions of 75%. Satisfaction was high, confirming a demand for group format, personalised approach, professional guidance and home-based device, to support the practice of regular physical activity. A decrease in fatigue was observed at the end of the programme. DISCUSSION The recruitment process did prove to be challenging, with a relatively small eligible population, and will need to be reconsidered to envision a larger scale trial. But here and now, this feasibility study provides the first promising foundations to develop further research on the effectiveness of an original remote programme.
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Affiliation(s)
- Cécile Charles
- Gustave Roussy, Université Paris-Saclay, France
- Bordeaux Population Health Research Center (BPH- INSERM U1219), Methods for Intervention Research in Population Health (MéRISP), Bordeaux University, France
| | | | | | - Olivier Aromatario
- Bordeaux Population Health Research Center (BPH- INSERM U1219), Methods for Intervention Research in Population Health (MéRISP), Bordeaux University, France
| | - Linda Cambon
- Bordeaux Population Health Research Center (BPH- INSERM U1219), Methods for Intervention Research in Population Health (MéRISP), Bordeaux University, France
| | | | - Magali Pons
- Gustave Roussy, Université Paris-Saclay, France
| | | | | | | | - Cédric Baudinet
- Mooven SAS, Research and Development Unit, Montpellier University, France
| | - Olivier Lambotte
- Clinical Immunology Department, AP-HP, Université Paris-Saclay, Hôpital Bicêtre, France
- Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, INSERM, CEA, France
| | - Aurélien Marabelle
- Drug Development Department, Gustave Roussy, Université Paris-Saclay, France
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Heitkamp M, Spanier B, von Korn P, Knapp S, Groß C, Haller B, Halle M. Feasibility of a 12-Month Exercise Intervention in Postsurgical Colorectal Cancer Patients. Transl Sports Med 2023; 2023:4488334. [PMID: 38654917 PMCID: PMC11022773 DOI: 10.1155/2023/4488334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/19/2022] [Accepted: 12/25/2022] [Indexed: 04/26/2024]
Abstract
Background Extensive physical activity (PA; ≥18 MET∗h/week, MET metabolic equivalent of tasks hours) postcancer diagnosis has shown favorable effects on colorectal cancer disease-free survival. However, the feasibility of introducing this high volume of PA in this patient group is unclear. Therefore, the aim of the F-PROTECT study was to evaluate the feasibility of extensive and prolonged PA (≥18 MET∗h/week over 12 months) in colorectal cancer patients with the primary objectives to (1) recruit 50 patients within 12 months and (2) reach an attendance rate of ≥70%. Methods Single-armed, bicentric, prospective intervention study in colorectal cancer patients (≤80 years; UICC II/III Union for International Cancer Control) after histopathological confirmed R0-resection who were consecutively recruited from visceral surgery units of 10 clinics in Germany. Recruitment rates were calculated using screening logs. Intervention was a 12-month endurance-focused exercise program with supervised and home-based training. Attendance rates defined as ≥70% participation in training sessions were calculated by training diaries. Results Out of 521 patients who were screened for eligibility, 50 (23 female; 59 ± 10 years, UICC 44% II, 56% III; adjuvant chemotherapy 60%) were recruited within 15 months. Mean duration between surgery and first training was 103 ± 57 days. Training attendance rate was 64% (including 9 dropouts). Six (12%) participants reached ≥18 MET∗h/week in ≥70% of training sessions between 4-12 months. 28 adverse events (n = 9 serious) occurred, however, were not assessed as training related. Conclusions The present intervention involving a combination of supervised and home-based exercise training in postsurgical colorectal cancer patients was not feasible. Strategies specifically designed for this patient group must be developed and investigated to motivate long-term PA. Registration. The study was prospectively registered at clinicaltrials.gov (NCT01991847).
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Affiliation(s)
- Melanie Heitkamp
- Department of Prevention and Sports Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich (TUM), Munich, Germany
| | - Bianca Spanier
- Department of Prevention and Sports Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich (TUM), Munich, Germany
| | - Pia von Korn
- Department of Prevention and Sports Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich (TUM), Munich, Germany
| | - Sebastian Knapp
- Department of Prevention and Sports Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich (TUM), Munich, Germany
| | - Claudia Groß
- Department of Prevention and Sports Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich (TUM), Munich, Germany
| | - Bernhard Haller
- Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich (TUM), Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich (TUM), Munich, Germany
- German Center for Cardiovascular Research (Deutsches Zentrum für Herzkreislaufforschung, DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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Thomsen SN, Sundberg A, Osterkamp J, Thorsen-Streit S, Østerlind K, Krarup PM, Vistisen K, Pedersen BK, Christensen JF. Interindividual changes in peak oxygen consumption in patients with colorectal cancer following endurance training: a secondary analysis of the I-WALK-CRC study. Acta Oncol 2020; 59:1098-1102. [PMID: 32459127 DOI: 10.1080/0284186x.2020.1765414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Simon Nørskov Thomsen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna Sundberg
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Osterkamp
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
| | - Sarah Thorsen-Streit
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kell Østerlind
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Peter-Martin Krarup
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Surgical Science, Zealand University Hospital, Roskilde, Denmark
| | - Kirsten Vistisen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University, Copenhagen, Denmark
| | - Bente Klarlund Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Frank Christensen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
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Lopez C, McGarragle K, Pritlove C, Jones JM, Alibhai SMH, Lenton E, Santa Mina D. Variability and limitations in home-based exercise program descriptions in oncology: a scoping review. Support Care Cancer 2020; 28:4005-4017. [PMID: 32296982 DOI: 10.1007/s00520-020-05453-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The literature reflects considerable heterogeneity in what constitutes home-based exercise interventions. The variability for where and what "home-based" exercise can represent challenges interpretation of findings and appropriate advocacy, referral, or development of these models of care. Therefore, the objective of this review was to provide a comprehensive summary of how home-based exercise is defined and reported in the literature and summarize the range of supportive elements utilized in home-based exercise trials. METHODS We followed methodology for scoping reviews. Relevant research databases were searched from inception to March 2019. Two reviewers independently screened articles to determine eligibility and extracted terminology used to describe home-based exercise and intervention details for intervention delivery. RESULTS Of the 9432 records identified, 229 articles met inclusion criteria. Across the literature, exercise interventions were described as home-based if they were completed at-home, outdoors in the neighbourhood, and in community facilities; or in self-selected environments; or if they were unsupervised. Supportive elements for home-based models ranged with respect to the amount of supervision and resources utilized, including the provision of print materials, exercise equipment, telephone support, home visits, and technology. CONCLUSIONS This review provides a comprehensive summary of strategies previously utilized to deliver home-based exercise interventions in oncology, along with the various definitions of the home-based environment for exercise reported by researchers. Specific recommendations to improve the prescription and reporting of home-based exercise interventions are provided in order to facilitate the delivery, evaluation, and translation of findings into clinical practice.
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Affiliation(s)
- Christian Lopez
- Faculty of Kinesiology and Physical Education, The University of Toronto, 55 Harbord St., Toronto, Ontario, M5S 2W6, Canada
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Kaitlin McGarragle
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Cheryl Pritlove
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Jennifer M Jones
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shabbir M H Alibhai
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Erica Lenton
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, The University of Toronto, 55 Harbord St., Toronto, Ontario, M5S 2W6, Canada.
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Christensen JF, Sundberg A, Osterkamp J, Thorsen-Streit S, Nielsen AB, Olsen CK, Djurhuus SS, Simonsen C, Schauer T, Ellingsgaard H, Østerlind K, Krarup PM, Mosgaard C, Vistisen K, Tolver A, Pedersen BK, Hojman P. Interval Walking Improves Glycemic Control and Body Composition After Cancer Treatment: A Randomized Controlled Trial. J Clin Endocrinol Metab 2019; 104:3701-3712. [PMID: 31220283 DOI: 10.1210/jc.2019-00590] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/05/2019] [Indexed: 12/14/2022]
Abstract
CONTEXT Patients with colorectal cancer have increased risk of metabolic diseases including diabetes. Exercise training may counteract metabolic dysregulation, but the impact of exercise training on glycemic control, including postprandial glycemia, has never been explored in patients with colorectal cancer. OBJECTIVE To examine the effects of home-based interval walking on aerobic and metabolic fitness and quality of life in patients with colorectal cancer. DESIGN Randomized controlled trial. SETTING Clinical research center. PARTICIPANTS Thirty-nine sedentary (<150 minutes moderate-intensity exercise per week) patients with stage I to III colorectal cancer who had completed primary treatment. INTERVENTION Home-based interval walking 150 min/wk or usual care for 12 weeks. MAIN OUTCOME MEASURES Changes from baseline to week 12 in maximum oxygen uptake (VO2peak) by cardiopulmonary exercise test, glycemic control by oral glucose tolerance test (OGTT), body composition by dual-energy x-ray absorptiometry scan, blood biochemistry, and quality of life. RESULTS Compared with control, interval walking had no effect on VO2peak [mean between-group difference: -0.32 mL O2 · kg-1 · min-1 (-2.09 to 1.45); P = 0.721] but significantly improved postprandial glycemic control with lower glucose OGTT area under the curve [-126 mM · min (-219 to -33); P = 0.009], 2-hour glucose concentration [-1.1 mM (-2.2 to 0.0); P = 0.056], and improved Matsuda index [1.94 (0.34; 3.54); P = 0.01]. Also, interval walking counteracted an increase in fat mass in the control group [-1.47 kg (-2.74 to -0.19); P = 0.025]. CONCLUSION A home-based interval-walking program led to substantial improvements in postprandial glycemic control and counteracted fat gain in posttreatment patients with colorectal cancer, possibly providing an effective strategy for prevention of secondary metabolic diseases.
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Affiliation(s)
- Jesper F Christensen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
| | - Anna Sundberg
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Jens Osterkamp
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
| | | | - Anette B Nielsen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Cecilie K Olsen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Sissal S Djurhuus
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Casper Simonsen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Tim Schauer
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Helga Ellingsgaard
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Kell Østerlind
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Peter-Martin Krarup
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Surgical Science, Zealand University Hospital, Roskilde, Denmark
| | - Camilla Mosgaard
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Kirsten Vistisen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Anders Tolver
- Data Science Laboratory, Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bente K Pedersen
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism/, Rigshospitalet, Copenhagen, Denmark
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Brown M, Murphy M, McDermott L, McAneney H, O’Sullivan JM, Jain S, Prue G. Exercise for advanced prostate cancer: a multicomponent, feasibility, trial protocol for men with metastatic castrate-resistant prostate cancer (EXACT). Pilot Feasibility Stud 2019; 5:102. [PMID: 31428443 PMCID: PMC6696674 DOI: 10.1186/s40814-019-0486-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Men with metastatic castrate-resistant prostate cancer can experience an array of treatment-related side effects. Accumulating evidence suggests exercise may alleviate some of these adversities and assist in disease management. However, empirical evidence in advanced prostate cancer patients remains limited. The purpose of this study is to determine whether men with metastatic prostate cancer, who are ineligible for high-intensity exercise, can partake in a home-based, moderate-intensity exercise program and the impact of doing so on quality of life and physical fitness parameters. METHODS Thirty men with adenocarcinoma of the prostate and progressive systemic, metastatic disease will be recruited. Clinicians will screen patients against inclusion criteria to determine eligibility. All men enrolled will be prescribed a tailored, home-based, moderate-intensity exercise intervention consisting of aerobic and strengthening components for 12 weeks. Patients will receive supplementary education materials and weekly behavioural change consultations throughout the intervention. The primary outcome will be the feasibility of delivering such an intervention in men with metastatic disease. Secondary endpoints including skeletal events will be monitored for safety, as will the feasibility of patient-reported outcome measures and the sampling time points, generating data pertaining to completion rates and potential effect in future trials. General physical fitness will be assessed during these visits, using timed sit-to-stand testing and a 6-min walking test. Prior to each visit, objective physical activity levels will be captured for 7 days using an accelerometer, to determine the feasibility of this technology and the quality of data obtained. In parallel with the feasibility aspects of the trial, changes compared to baseline will be reported. Direct regular contact will also serve as a feedback loop, should any issues arise. This study has received ethical approval from the Office for Research Ethics Committees Northern Ireland. CONCLUSIONS This study aims to determine the potential utility of a home-based exercise intervention in managing side effects associated with advanced prostate cancer and its treatment. This feasibility trial will inform the design and implementation of a larger randomised control trial to determine the efficacy of moderate aerobic and strengthening exercise as an adjuvant therapy in men with metastatic prostate cancer. Collecting such evidence provides further support for exercise in this paradigm and potential for its inclusion as a low-toxicity therapy in standard cancer care, in the longer term. TRIAL REGISTRATION ClinicalTrials.gov, NCT03658486Trial sponsor: Queen's University Belfast (Reference: B18/15). Contact: Dr. Paula Tighe, Research and Enterprise, Queen's University Belfast. Telephone: 02890 973,296. Email: p.tighe@qub.ac.uk. The sponsor reviewed the protocol and ethical application prior to submission.Protocol issue: Version 1 (18th May 2018). Authors: MB, MM, SJ and GP.
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Affiliation(s)
- Malcolm Brown
- School of Nursing & Midwifery, Medical Biology Centre, Queen’s University Belfast, Lisburn Road, Belfast, Northern Ireland BT9 7BL
| | - Marie Murphy
- Sport & Exercise Sciences Research Institute, Ulster University, Jordanstown, Northern Ireland BT37 0QB
| | - Lauri McDermott
- Insight Centre for Data Analytics, Dublin City University, Glasnevin, Dublin 9 Ireland
| | - Helen McAneney
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland BT12 6BA
| | - Joe M. O’Sullivan
- Centre for Cancer Research & Cell Biology, Queen’s University Belfast, Belfast, Northern Ireland BT9 7AE
| | - Suneil Jain
- Centre for Cancer Research & Cell Biology, Queen’s University Belfast, Belfast, Northern Ireland BT9 7AE
| | - Gillian Prue
- School of Nursing & Midwifery, Medical Biology Centre, Queen’s University Belfast, Lisburn Road, Belfast, Northern Ireland BT9 7BL
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