Changes in exercise capacity, quality of life and fatigue in cancer patients during an intervention.

The study explored the interdependence of changes in oxygen uptake, quality of life and cancer-related side-effect fatigue during a 4-month exercise intervention. Participants were during adjuvant (curative) or palliative therapy and post-adjuvant therapy (finished within the previous 12 months). Aerobic exercise capacity (VO2 peak), quality of life and fatigue symptom (EORTC QLQ-C30) were obtained in 101 cancer patients (30-77 years). After initial examination, patients participated in supervised and/or home-based training interventions. Patients were re-examined after 16-20 weeks and stratified into 3 subgroups (terciles) with respect to the absolute change in VO2 peak. The ANCOVA, with significant covariate effect for pretest fatigue score (F(5,101) = 8.150, P < 0.001), indicated significant differences between groups in outcome measures (P < 0.001). Based on the absolute change of VO2 peak (1.9 ± 1.7; 1.8 ± 0.8; 5.7 ± 2.8 ml/kg/min) there were significant differences in the quality of life improvement (17.2 ± 15.1 vs. 4.8 ± 22.0 points, P < 0.05) and cancer-related fatigue reduction (-6.1 ± 30.7; -11.5 ± 20.9; -21.2 ± 21.4 points) between upper and lower tercile. The findings point towards a relationship of exercise capacity enhancement, quality of life improvement and fatigue symptom reduction during and shortly after cancer treatment.

Exercise effects on HRV in cancer patients.

The present study evaluated the effects of physical exercise on heart rate variability (HRV) in cancer patients. 3 matched groups of each 15 tumour patients (60.4±8.9 years, 27 male, 18 female) were recruited: Physical exercise group 1 (acute treatment), Physical exercise group 2 (post treatment) and non-intervention group (acute treatment, no exercise). Exercise group patients received counselling for exercise and participated in a Nordic-Walking program. Short-term HRV-recordings, assessments of fatigue and quality of life (QoL) were performed prior to and 16 weeks after the exercise program initiation. MANCOVA revealed group × time differences in total power frequency domain of HRV and QoL (p<0.05). TP follow-up scores [logms(2)] differed significantly between non-intervention and intervention post treatment (2.0±0.5 vs. 2.6±0.5), but not between non-intervention and intervention during acute treatment. QoL follow-up scores differed significantly between non-intervention and intervention during acute treatment (47±15 vs. 64±18) and post treatment (47±15 vs. 69±19). Exercise enhances cardiac autonomic regulation of tumour patients during and after acute treatment. Because of the association of higher HRV-parameters and prolonged survival in cancer patients, improvement in autonomic control may be an important goal of exercise.

Recurrent childhood wheezing and exercise induced asthma in later life.

AIM: Exercise induced asthma (EIA) common in endurance and other athletes limits physical activity. Although a correlation between recurrent childhood bronchitis and the development of asthma has been reported, its relation to EIA in adult athletes has not been assessed. The study evaluates the EIA risk after recurrent childhood wheezing (RCW) and its aggravating influence on the known risk factors outdoor and professional sports. METHODS: To evaluate the effect of RCW on EIA, 570 multiple choice questionnaires were evaluated, assessing the history of RCW and the EIA occurrence. The latter was defined either according to physician-derived diagnosis, by typical symptoms or by decrease of the 1-second forced expiratory volume after a 6-minute running test. Contingency tables and a logistic regression model were worked out to describe referring parameters of EIA incidence. RESULTS: Almost one quarter of the athletes with RCW were attributed positive for EIA. Contingency calculations revealed a 2.6 times higher chance of symptoms of EIA after RCW which further increased in outdoor sports on a professional level. The duration of sports participation, cold environment and self-limiting of symptoms are predicting factors of a higher risk of EIA, being responsible for 53% of the prevalence variance. CONCLUSION: The results point towards a facilitating effect of recurrent affections of the respiratory tract in young age in addition to generally accepted factors of EIA in adults. For safe sports participation, the athlete, as well as involved caregivers (parents, coach) should have an adequate knowledge of EIA and prevention/intervention strategies like warming up or the use of inhalers.

Implementation of structured physical activity in the pediatric stem cell transplantation.

The peripheral blood stem cell transplantation (PBSCT) represents a specific, but stressful therapy for hemato-oncological diseases. While for adults, data suggest positive eff ects for a supportive sport therapy, this question is not evaluated sufficiently for children. The objective of this study was to examine the integration of sports activity into pediatric PBSCT and to indicate attainable results. This 2-step case-control-study included 23 children and adolescents from the PBSCT: During the isolation phase 13 patients trained 3 times per week on a cycle ergometer and passed a course with different sports equipment. Apart from recording physiologic adaptations, quality of live was inquired in a pre-post design using questionnaires. Guided interviews according to necessity and requirements for sports activity at the PBSCT unit completed the evaluation and were used for the intervention as well as for the control group (n = 10) without sports therapy. On the ergometer, patients trained average 25 min with 0.6 watt / kg. In the majority, a loss of muscular power could be avoided. Quality of life and fatigue symptoms improved by trend. Interview analysis showed general acceptance of physical activity during PBSCT. After initial skepticism due to the additional burden, our implementation study showed the feasibility of supportive sports therapy in PBSCT. Quality and flexibility of the equipment should be higher than normal and different physical and psychological conditions of the patients should be anticipated and integrated into the training program.