1
|
Wolff J, Wuelfing P, Koenig A, Ehrl B, Damsch J, Smollich M, Baumann FT, Harbeck N, Wuerstlein R. App-Based Lifestyle Coaching (PINK!) Accompanying Breast Cancer Patients and Survivors to Reduce Psychological Distress and Fatigue and Improve Physical Activity: A Feasibility Pilot Study. Breast Care (Basel) 2023; 18:354-365. [PMID: 37901047 PMCID: PMC10601684 DOI: 10.1159/000531495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/09/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction This pilot study aimed to investigate the effects of using an app-based certified medical product named PINK! on breast cancer patients and survivors. The objectives were to measure psychological distress, physical activity, and therapy-related fatigue of patients using PINK! to identify trends and develop a study design for a subsequent multicentric proof of efficacy RCT. Materials and Methods PINK! offers individualized, evidence-based therapy and side-effect management, mindfulness-based stress reduction, nutritional and psychological education, physical activity tracking, and motivational exercises to implement lifestyle changes sustainably in daily routine. A prospective, intraindividual RCT was performed with n = 60 patients in 2021 at Comprehensive Cancer Center Munich. Patients with BC were included independent of the stage of diseases. The intervention group got access to PINK! over 12 weeks. Control group served as a waiting-list comparison to "standard of care." Results Primary efficacy variable analysis revealed a relative average decrease of 32.9% in psychological distress, which corresponds to a statistically significant reduction (p < 0.001) within 12 weeks compared to the control group. Linear regressions within usage groups showed a correlation of high app usage and a reduction of psychological distress. Fatigue data presented a statistically significant antifatigue efficacy (p < 0.001) and physical activity increased by 63.9%. Conclusion App-based supportive care offers a promising, low-threshold, and cost-efficient opportunity to improve psychological well-being, quality of life, fatigue, and physical activity. More research is needed to implement eHealth solutions in clinical cancer care.
Collapse
Affiliation(s)
- Josefine Wolff
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University, University Hospital, Munich, Germany
| | - Pia Wuelfing
- PINK! gegen Brustkrebs GmbH, Department Clinical Research, Hamburg, Germany
| | - Alexander Koenig
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University, University Hospital, Munich, Germany
| | - Brigitte Ehrl
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University, University Hospital, Munich, Germany
| | - Jana Damsch
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University, University Hospital, Munich, Germany
| | - Martin Smollich
- Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | | | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University, University Hospital, Munich, Germany
| | - Rachel Wuerstlein
- Breast Center, Department of Gynecology and Obstetrics, and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University, University Hospital, Munich, Germany
| |
Collapse
|
2
|
Zoth N, Tomanek A, Seuthe K, Pfister R, Baumann FT. Exercise as medicine could be a chance for early detection and prevention of Cardiotoxicity in cancer treatments - a narrative review. Oncol Res Treat 2023; 46:131-139. [PMID: 36652921 DOI: 10.1159/000529205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND For cancer patients, cardiovascular complications as a consequence of certain oncological therapies are the leading cause of death, apart from the cancer itself. Currently, there are no uniform guidelines for detecting subclinical cardiotoxicity. Hence, the identification of cardiotoxicity arises late in the course of myocardial dysfunction after cardiac damage has occurred already. Early detection, prevention and treatment of these cardiotoxic effects remains a challenge, therefore supportive strategies such as physical activity gain in importance. SUMMARY Exercise therapy, during and after cancer therapy, is considered to be safe, feasible and effective. While animal models show protective effects, the evidence for the benefits of physical activity on future cardiovascular outcomes in human patients caused by certain cancer treatments is still limited. Consequently, targeted exercise recommendations such as frequency, intensity, time or type are yet unclear and certain guidelines, specifically preventing cardiotoxicity, are non-existent. Low cardiorespiratory fitness is strongly associated with all-cause mortality as well as cardiac dysfunction. In this context, the role of cardiorespiratory fitness as an early predictor in the detection of cardiovascular dysfunction will be discussed. KEY MESSAGE Exercise therapy during cancer treatment could have the potential to aid in both the diagnosis and treatment of cardiovascular complications. This narrative review considers the current evidence on the impact of physical activity on cardiovascular outcomes in cancer patients and proposes, according to the present knowledge, a framework for cardioprotective exercise therapies.
Collapse
Affiliation(s)
- Nora Zoth
- Department of Internal Medicine, Centre of Integrated Oncology Aachen, Bonn, Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - Annika Tomanek
- Department of Internal Medicine, Centre of Integrated Oncology Aachen, Bonn, Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - Katharina Seuthe
- Department of Cardiology, Heart Centre, University Hospital of Cologne, Cologne, Germany
| | - Roman Pfister
- Department of Cardiology, Heart Centre, University Hospital of Cologne, Cologne, Germany
| | - Freerk Theeagnus Baumann
- Department of Internal Medicine, Centre of Integrated Oncology Aachen, Bonn, Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| |
Collapse
|
3
|
Siebert S, Kollikowski A, Minto CA, Byrtus F, Lesnik J, Weis J, Horneber M, Bloch W, Baumann FT, Salchow J. A randomized, controlled pilot study to evaluate the immediate effect of targeted exercise therapy on cancer-related fatigue in cancer survivors - the FatiGO study. Oncol Res Treat 2022; 45:639-649. [PMID: 35850110 DOI: 10.1159/000525705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Cancer-related fatigue (CRF) is a clinically relevant side-effect that impairs cancer survivors after treatment cessation. Exercise interventions have proven effective, however specific exercise modalities remain untested. The purpose of this study was to evaluate the feasibility of daily fatigue screenings and to show the impact of various exercise interventions on CRF. METHODS The randomised controlled pilot study ran for 4 weeks with 3 training sessions per week, in 5 groups: endurance versus strength (moderate- and vigorous-intensity levels for each) compared to a non-active control group. The primary outcome was feasibility, more specifically it was evaluated whether the documentation with the Numerical Rating Scale (NRS) on a daily basis, and the Multidimensional Fatigue Inventory (MFI,) on a weekly basis are usable assessments to generate information about CRF. RESULTS Over the course of the four-week intervention 8.3% of the participants (n=3) dropped out. 33 of the initial 36 participants completed the exercise sessions with an adherence of 95%. Measurements of daily fatigue were collected three times per day, 85% of which were completely filled out. In regard to weekly fatigue, all but one of the questionnaires were submitted (99.5%). Neither during the intervention, nor during the tests, did any serious adverse events occur within the FatiGO study, hence the exercise intervention is considered to be feasible for participants. CONCLUSIONS This pilot study showed the feasibility of close-meshed daily fatigue screening. Preliminary data indicates that Cancer survivors are able to train in high intensity ranges with tendencies towards decreased fatigue. Therefore, practicability of the study design is shown. Further results are expected within the prospective multicentre trial.
Collapse
Affiliation(s)
- Stefanie Siebert
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - Anne Kollikowski
- Department for Complementary and Integrative Medicine, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Carrie-Ann Minto
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Byrtus
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - Jennifer Lesnik
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - Joachim Weis
- Department of Self-Help Research, Medical Faculty, Comprehensive Cancer Center, University Freiburg, Freiburg im Breisgau, Germany
| | - Markus Horneber
- Division of Oncology and Hematology, Department of Internal Medicine, Paracelsus Medical University, Klinikum Nuremberg, Nuremberg, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - Freerk Theeagnus Baumann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| | - Jannike Salchow
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
4
|
Reimer N, Zopf EM, Böwe R, Baumann FT. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review. J Sex Med 2021; 18:1899-1914. [PMID: 37057481 DOI: 10.1016/j.jsxm.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 08/27/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Emerging evidence suggests that exercise interventions may improve sexual dysfunction, one of the most common and distressing long-term adverse effects of cancer treatment. AIM The aim of this systematic review is to provide an overview of the effects of exercise on sexual dysfunction in prostate cancer patients. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The systematic literature search was performed on 13th July 2021 using CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing sexual function in prostate cancer patients conducting an exercise intervention alone or in combination with other supportive interventions. The methodological quality was assessed using the Physiotherapy Education Database Score and Jadad scale. Outcomes were reported as between-group differences. Intragroup differences were also reported if significant. OUTCOMES Positive intervention effects on sexual function were primarily observed in patients following prostatectomy and undergoing anti-hormone treatment and for pelvic floor muscle exercises as well as aerobic and resistance exercise. RESULTS 22 RCTs (n = 1.752 patients) met the eligibility criteria, conducting either an exercise-only intervention (n = 10), a multimodal (exercise plus other supportive therapy) intervention (n = 4), or pelvic floor muscle exercises (n = 8). 6 RCTs assessed sexual dysfunction as a primary endpoint and 8 RCTs used dedicated assessment methods. 9 of the 22 RCTs found significant between-group differences in favor of the intervention group. CLINICAL IMPLICATIONS The multifaceted etiology of sexual dysfunction provides a strong rationale to further investigate the effects of exercise on sexual dysfunction in prostate cancer patients and also to consider a multidisciplinary approach. STRENGTHS AND LIMITATIONS A strength is the comprehensive literature search to identify RCTs involving different exercise interventions and a wide range of sexual function assessments. Further, this is the first systematic review on this topic. The main limitations include the difficulty to compare studies due to the heterogeneity of exercise interventions and low questionnaire completion rates in some studies. CONCLUSION Preliminary data from a small number of studies suggest that certain exercise interventions may improve sexual dysfunction in prostate cancer patients, however further trials involving sexual dyfunction as a primary outcome and more comprehensive assessment tools are needed to confirm the rehabilitative and preventive effects of exercise on sexual dysfunction in prostate cancer patients. Nadine Reimer, Eva Maria Zopf, Rebecca Böwe, et al. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review. J Sex Med 2021;18:1899-1914.
Collapse
Affiliation(s)
- Nadine Reimer
- University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany.
| | - Eva Maria Zopf
- Australian Catholic University, Mary MacKillop Institute for Health Research, Melbourne, Australia
| | - Rebecca Böwe
- Hochschule Fresenius, University of Applied Sciences, Faculty of Health & Social Work, Cologne, Duesseldorf, Germany
| | - Freerk Theeagnus Baumann
- University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
| |
Collapse
|
5
|
Streckmann F, Lehmann HC, Balke M, Schenk A, Oberste M, Heller A, Schürhörster A, Elter T, Bloch W, Baumann FT. Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy-a randomized controlled pilot trial. Support Care Cancer 2018; 27:2471-2478. [PMID: 30382392 DOI: 10.1007/s00520-018-4531-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/23/2018] [Indexed: 01/08/2023]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and clinically relevant side effect of chemotherapy. The symptoms diminish patients' quality of life and represent a decisive limiting factor for medical therapy. To date, effective treatment options are lacking. Specific exercise interventions have proven promising to target relevant symptoms. We conducted a prospective, four-armed, randomized, controlled trial, to evaluate the effects of sensorimotor training (SMT) and whole-body vibration training (WBV) on patients with CIPN. Participants (N = 40) were randomized to either one of two intervention groups (SMT N = 10 or WBV N = 10) or oncological control group (N = 10) and matched by gender and age with a healthy control (N = 10). The intervention groups exercised twice a week for 6 weeks. Primary endpoint was the reduction of CIPN-related symptoms (improve peripheral deep sensitivity, Achilles tendon reflex (ASR) and patellar tendon reflex (PSR), light-touch perception, sense of position, and lower leg strength). Secondary endpoints were nerve conduction velocity and amplitude, balance control, quality of life, and CIPN-related pain. Patients exercising improved sensory and associated motor symptoms. Significant intergroup differences were found for the tendon reflexes (ASR P = .017 and PSR P = .020), peripheral deep sensitivity (P = .010), and pain (P = .043). Furthermore, tendencies were found regarding the subjective improvement of symptoms (P = .075) and two subscales of the EORTC-QLQ-C30 questionnaire: pain (P = .054) and dyspnea (P = .054). The results for the SMT group were superior regarding the tendon reflexes, and a tendency regarding the subjective report of symptoms, while WBV was superior regarding pain. SMT and WBV behold a large potential to reduce CIPN-related symptoms and can be considered feasible and safe for patients with CIPN (compliance 97.5%, no adverse events).Registration: DRKS00013027.
Collapse
Affiliation(s)
- Fiona Streckmann
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany. .,Department of Sport, Exercise and Health, University of Basel, Birsstr. 320B, 4052, Basel, Switzerland. .,Department of Oncology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - H C Lehmann
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - M Balke
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - A Schenk
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany
| | - M Oberste
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany
| | - A Heller
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany
| | - A Schürhörster
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany
| | - T Elter
- Department of Oncology, Center for Integrated Oncology, University Hospital Cologne, Cologne, Germany
| | - W Bloch
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany
| | - F T Baumann
- Department of Oncology, Center for Integrated Oncology, University Hospital Cologne, Cologne, Germany
| |
Collapse
|
6
|
Baumann FT, Reike A, Reimer V, Schumann M, Hallek M, Taaffe DR, Newton RU, Galvao DA. Effects of physical exercise on breast cancer-related secondary lymphedema: a systematic review. Breast Cancer Res Treat 2018; 170:1-13. [PMID: 29470804 DOI: 10.1007/s10549-018-4725-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this systematic review is to assess the effect of different types of exercise on breast cancer-related lymphedema (BCRL) in order to elucidate the role of exercise in this patient group. METHODS A systematic data search was performed using PubMed (December 2016). The review is focused on the rehabilitative aspect of BCRL and undertaken according to the PRISMA statement with Levels of Evidence (LoE) assessed. RESULTS 11 randomized controlled trials (9 with LoE 1a and 2 with LoE 1b) that included 458 women with breast cancer in aftercare were included. The different types of exercise consisted of aqua lymph training, swimming, resistance exercise, yoga, aerobic, and gravity-resistive exercise. Four of the studies measured a significant reduction in BCRL status based on arm volume and seven studies reported significant subjective improvements. No study showed adverse effects of exercise on BCRL. CONCLUSION The evidence indicates that exercise can improve subjective and objective parameters in BCRL patients, with dynamic, moderate, and high-frequency exercise appearing to provide the most positive effects.
Collapse
Affiliation(s)
- F T Baumann
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany.
| | - A Reike
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - V Reimer
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - M Schumann
- Department of Molecular and Cellular Sport, Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - M Hallek
- Department I of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
| | - D R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Institute of Human Performance, The University of Hong Kong, Hong Kong, Hong Kong.,University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
| | - D A Galvao
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
7
|
Däggelmann J, Krauth KA, Mailand P, Nopper S, Renniger M, Bündgen L, Rustler V, Bloch W, Baumann FT. [Effects of a Four-Week Rehabilitation Program on Motor Performance, Quality of Life and Fatigue in Childhood Cancer Patients and Healthy Siblings]. REHABILITATION 2017; 56:119-126. [PMID: 28395375 DOI: 10.1055/s-0043-103064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aim In Germany all childhood cancer patients and their families are offered the opportunity to participate in a four-week, family-oriented, inpatient rehabilitation program in order to facilitate (re-)integration into everyday life. The aim of this study is to evaluate the effect of this rehabilitation program on motor performance, quality of life (QoL) and fatigue. Methods Motor performance, QoL and fatigue were assessed in 22 childhood cancer patients and 20 healthy siblings at the beginning (t1) and the end (t2) of the four-week rehabilitation program, as well as 6 months later (t3). Results At t1 significant differences between groups were found in motor performance and physical well-being. Improvements in motor performance, QoL and fatigue were found in both groups. Conclusion Different preconditions must be considered. Childhood cancer patients as well as healthy siblings benefit from a family-oriented rehabilitation program.
Collapse
Affiliation(s)
- J Däggelmann
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - K A Krauth
- Kinder- und Jugendmedizin, Klinik Bad Oexen
| | - P Mailand
- Kinder- und Jugendmedizin, Klinik Bad Oexen
| | - S Nopper
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - M Renniger
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - L Bündgen
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - V Rustler
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - W Bloch
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - F T Baumann
- Institut für Kreislaufforschung und Sportmedizin, Abt. Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| |
Collapse
|
8
|
Zopf EM, Newton RU, Taaffe DR, Spry N, Cormie P, Joseph D, Chambers SK, Baumann FT, Bloch W, Galvão DA. Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: a cross-sectional investigation. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27647712 DOI: 10.1111/ecc.12575] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2016] [Indexed: 11/30/2022]
Abstract
Cancer patients with bone metastases have previously been excluded from participation in physical activity programmes due to concerns of skeletal fractures. Our aim was to provide initial information on the association between physical activity levels and physical and mental health outcomes in prostate cancer patients with bone metastases. Between 2012 and 2015, 55 prostate cancer patients (mean age 69.7 ± 8.3; BMI 28.6 ± 4.0) with bone metastases (58.2% >2 regions affected) undertook assessments for self-reported physical activity, physical and mental health outcomes (SF-36), objective physical performance measures and body composition by DXA. Sixteen men (29%) met the current aerobic exercise guidelines for cancer survivors, while 39 (71%) reported lower aerobic exercise levels. Men not meeting aerobic exercise guidelines had lower physical functioning (p = .004), role functioning (physical and emotional) (p < .05), general health scores (p = .014) as well all lower measures of physical performance (p < .05). Lower levels of aerobic exercise are associated with reduced physical and mental health outcomes in prostate cancer patients with bone metastases. While previous research has focused primarily in those with non-metastatic disease, our initial results suggest that higher levels of aerobic exercise may preserve physical and mental health outcomes in prostate cancer patients with bone metastases. Clinical Trial Registry: Trial Registration: ACTRN12611001158954.
Collapse
Affiliation(s)
- E M Zopf
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, St Lucia, Australia
| | - D R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,School of Medicine, University of Wollongong, Wollongong, Australia
| | - N Spry
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia.,Faculty of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - P Cormie
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Vic., Australia
| | - D Joseph
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia.,Faculty of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - S K Chambers
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, St Lucia, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Qld, Australia.,Prostate Cancer Foundation of Australia, Sydney, Australia
| | - F T Baumann
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - W Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
| | - D A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
9
|
Baumann FT, Hallek M, Meyer J, Galvão DA, Bloch W, Elter T. [Evidence and recommendations for oncologic clinical exercise - a personalized treatment concept for cancer patients]. Dtsch Med Wochenschr 2015; 140:1457-61. [PMID: 26402184 DOI: 10.1055/s-0041-104465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Oncological treatments can lead to acute and chronic cancer related toxicities. In recent years, a large number of clinical studies have reported positive effects of exercise to the bio-psycho-social regeneration of cancer patients. However, very few evidence-based programs have been implemented into practice with little opportunity for cancer patients to engage in such programs. Reviews and RCT studies on exercise and cancer are showing that specific exercise programs have a positive impact on fatigue syndrome, urinary incontinence, lymphedema, polyneuropathy, arthralgia, and androgen deprivation related toxicities. With the increasing evidence for exercise oncology interventions, recommendations arising from clinical trials should be translated into clinical practice and this should be viewed as an important next step in this fast moving field of exercise oncology. For that the personalized treatment concept "Oncologic clinical exercise" (OTT) was developed.
Collapse
Affiliation(s)
- Freerk Theeagnus Baumann
- Abteilung Molekulare und Zelluläre Sportmedizin, Institut für Kreislaufforschung und Sportmedizin, Deutsche Sporthochschule Köln
| | - Michael Hallek
- Klinik I für Innere Medizin der Universitätsklinik zu Köln
| | - Janika Meyer
- Abteilung Molekulare und Zelluläre Sportmedizin, Institut für Kreislaufforschung und Sportmedizin, Deutsche Sporthochschule Köln
| | - Daniel Abido Galvão
- Edith Cowan University Health and Wellness Institute, Joondalup, WA, Australia
| | - Wilhelm Bloch
- Abteilung Molekulare und Zelluläre Sportmedizin, Institut für Kreislaufforschung und Sportmedizin, Deutsche Sporthochschule Köln
| | - Thomas Elter
- Klinik I für Innere Medizin der Universitätsklinik zu Köln
| |
Collapse
|
10
|
Abstract
AIM OF THE WORK Cancer and its commonly required continuous and intensive medical treatment have a profound and lasting effect on patients' physical, functional, emotional and social wellbeing. In this context the positive comprehensive effects of physical exercise interventions increasingly prove to be promising. The aim of this review is to derive physical exercise recommendations for patients with cancer, especially concerning aerobic and resistance training during rehabilitation, based on the current literature. In a second step the 3 main cancer types breast cancer, prostate cancer and colon cancer and their distinctive features will be addressed briefly. METHODS A hierarchic literature research was conducted using the medical information portal Medpilot. The evaluation system of the "European Society of Cardiology" was applied in order to evaluate the evidence and compile evidence-based exercise recommendations for patients with cancer. RESULTS When summing up the current data, physical exercise proves to be efficient, safe and feasible for patients with cancer. Both aerobic and resistance training have a positive influence on a patient's physical, psychological and social level and should therefore be included in every exercise program. CONCLUSION While the evidence for breast cancer and increasingly also for prostate cancer is strong, research in colon cancer, for example, is still sparse. In order to create precise recommendations regarding the ideal exercise type and dose for the different cancer types during various treatment phases further high quality studies are necessary.
Collapse
Affiliation(s)
- E M Zopf
- Institut für Kreislaufforschung und Sportmedizin, Abteilung Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - F T Baumann
- Institut für Kreislaufforschung und Sportmedizin, Abteilung Molekulare und Zelluläre Sportmedizin, Deutsche Sporthochschule Köln
| | - K Pfeifer
- Institut für Sportwissenschaft und Sport, Abteilung Bewegung und Gesundheit, Friedrich-Alexander-Universität Erlangen-Nürnberg
| |
Collapse
|
11
|
Schmidt T, Weisser B, Jonat W, Baumann FT, Mundhenke C. Gentle strength training in rehabilitation of breast cancer patients compared to conventional therapy. Anticancer Res 2012; 32:3229-3233. [PMID: 22843897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Movement therapy during the rehabilitation of breast cancer has become more important over the last years. PATIENTS AND METHODS In a randomized controlled study the feasibility of gentle strenght training was compared to conventional gymnastic exercises during rehabilitation of breast cancer patients. The aim oft this study was to identify alternative sports intervention in the treatment of breast cancer patients. The intervention group (IG) was lifting standardized weights weekly (50 % of h1RM), while the control group (CG) received conventional gymnastic exercises. A bicycle ergometry adjusted to the WHO system was performed with all participants at study entry (T0), after three (T1) and six months (T2). The quality of life was measured by standardized report forms (EORTC QLQ C30 Version 3 and BR23). RESULTS Both methods showed a slight improvement in submaximal endurance performance, a significant improvement in the subjective feeling of effort (IG: 75 W: <0.01, CG: 75 W <0.01), in psychosocial and psychological parameters like quality of life (IG: <0.01, CG <0.01) and in fatigue (IG: <0,01, CG: <0.01). CONCLUSION This study shows positive effects for gentle strength lifting in the rehabilitation of breast cancer patients and turned out to be a probate alternative to gymnastic exercises.
Collapse
Affiliation(s)
- Thorsten Schmidt
- Comprehensive Cancer Center North, Breast Oncology Unit at Kiel University Hospital for Women, Michaelisstrasse 16, 24105 Kiel, Germany.
| | | | | | | | | |
Collapse
|
12
|
Baumann FT, Leskaroski A, Knicker A, Krakowski-Roosen H, Bloch W, Harbeck N. Abstract P2-13-01: Effects of 12-Week Resistance Training on Strength, Fatigue Syndrome and Quality of Life with Breast Cancer Patients during Chemotherapy. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p2-13-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Up to 100% of all breast cancer patients are suffering from fatigue during chemotherapy [Mock 2001, Jacobsson 1998, Irvine 1994]. Causality as well as the treatment of this non-uniform symptom complex is yet unclear. Exercising studies show a positive effect of endurance training on the development of fatigue [Dimeo 2003]. The study situation regarding feasibility and efficiency of pure resistance training with breast cancer patients with fatigue is still unsatisfactory [De Backer 2009, Courneya 2007].
Methods: In this prospective, controlled, randomized study 32 female patients were recruited 6 weeks after operation. 20 probands (IG) accomplished a 12-week resistance training (2 x per week, 60 min each with 75% of the maximum voluntary capacity) during adjuvant chemotherapy. The control group (CG, n=12) did not train. The measurements took place before and after the intervention and maximally isometric and isocinetic strength was tested with the Isomed 2000. Quality of life was evaluated with the EORTC QLQ-C30 inclusive module BR23 and fatigue symptoms by the MFI questionnaires.
Results: No exacerbations could be observed during the study. Strength (p=0.029), fatigue (p=0.048) and different ranges of the quality of life significantly improved in IG, while in CG fatigue and quality of life worsened. 4 out of 5 ranges of the fatigue diagnostic (f.e. General Fatigue, p=0.01) as well as nearly all ranges of the quality of life evaluation were significantly different between IG and KG. In addition, muscle strength (of the arm concerned) showed significant differences between the groups (p=0.032).
Discussion: It could be shown for the first time, that maximum strength testing as well as resistance training with breast cancer patients were feasible already 6 weeks post-OP. Positively, the increase in muscle power, the reduction of fatigue symptoms and the improvement of the quality of life occurred despite concurrent cytotoxic treatment. We rate the high acceptance of the training program as a success. Based on the positive results and the past studies [De Backer 2009, Courneya 2007] we recommend the integration of strength training into the early rehabilitation of breast cancer patients. We note that this study will be completed by December 2010 yet further studies have to be conducted, in order to better understand the effects of different training intensities. Literature:
Courneya et al.: JCO 2007; 25: 4396-4404
Dimeo et al.: Sup Care in Canc 2003; 11:S623-628
Irvine et al. Cancer Nurs 1994; 17: 367-378
Jacobsson et al. J Pain Symptom Manage 1999;18 (4): 233-242
Mock V. Cancer Suppl 2001; 92 (6): 1699-1707
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-13-01.
Collapse
Affiliation(s)
- FT Baumann
- German Sport University, Cologne, NRW, Germany; Interdisziplinary Breast Center, Cologne, NRW, Germany; German Cancer Research Center, Germany
| | - A Leskaroski
- German Sport University, Cologne, NRW, Germany; Interdisziplinary Breast Center, Cologne, NRW, Germany; German Cancer Research Center, Germany
| | - A Knicker
- German Sport University, Cologne, NRW, Germany; Interdisziplinary Breast Center, Cologne, NRW, Germany; German Cancer Research Center, Germany
| | - H Krakowski-Roosen
- German Sport University, Cologne, NRW, Germany; Interdisziplinary Breast Center, Cologne, NRW, Germany; German Cancer Research Center, Germany
| | - W Bloch
- German Sport University, Cologne, NRW, Germany; Interdisziplinary Breast Center, Cologne, NRW, Germany; German Cancer Research Center, Germany
| | - N. Harbeck
- German Sport University, Cologne, NRW, Germany; Interdisziplinary Breast Center, Cologne, NRW, Germany; German Cancer Research Center, Germany
| |
Collapse
|
13
|
Baumann FT, Kraut L, Schüle K, Bloch W, Fauser AA. A controlled randomized study examining the effects of exercise therapy on patients undergoing haematopoietic stem cell transplantation. Bone Marrow Transplant 2009; 45:355-62. [PMID: 19597418 DOI: 10.1038/bmt.2009.163] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A haematopoietic SCT (HSCT) can cause severe side effects, which may have a profound impact on a patient's life both physically and psychologically. Some studies have shown that physical activity has positive effects for inpatients after an HSCT. Therefore, the question arises whether a controlled exercise programme right from the beginning of the conditioning phase could help contribute to a patient's physical and psychological recovery. To evaluate the different effects of specific, moderate physical activities on the physical and psychological condition of HSCT patients we performed a controlled randomized study with 64 inpatients undergoing an allogeneic or autologous HSCT. The patients were randomly assigned to two groups. Although the training group took part in a specific programme of exercise therapy twice a day throughout the entire hospitalization phase, patients in the control group were offered the hospital's standard mobilization programme. The results of this study showed significant differences in favour of the training group regarding strength, endurance, lung function and quality of life. However, further studies are needed to confirm these results.
Collapse
Affiliation(s)
- F T Baumann
- Institute for Rehabilitation and Sport for the Disabled, German Sport University, Cologne, Germany
| | | | | | | | | |
Collapse
|
14
|
Schneider J, Baumann FT, Müller S, Knicker AJ, Krakowski-Roosen H, Mallmann P, Warm M. Krafttraining während der chemotherapeutischen Behandlung von Patientinnen mit Mammakarzinom. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|