Abstract

Research has demonstrated that a physically active lifestyle can counter some of the cardio-respiratory and musculoskeletal losses associated with cancer. Still, exercise guidelines for advanced cancer patients are unspecific, and exercise prescription can be complicated, due to a multitude of factors that may influence the degree of physiological and functional decline from patient to patient. In the present study, twenty-one supportive care patients with stage III or IV cancers were prescribed a 4-week exercise intervention, in conjunction to standard care. The program included 12 unsupervised resistance training and walking sessions, and participants were assessed pre and post exercise intervention. The primary aim of this study is to examine pre-post exercise program changes in function, strength, body composition, energy expenditure, and health-related quality of life (HRQOL). Functional tests, including the 6-minute-walk-test (6MWT) were used to assess performance. Body composition was assessed using dual-energy x-ray absorptiometry (DXA) and accelerometers were used to assess energy expenditure and step-count before and after exercise intervention. The Edmonton Symptom Assessment System (ESAS) and the abridged Patient-Generated Subjective Global Assessment (aPG-SGA) questionnaires were used to examine symptom profile and health related quality of life (HRQOL). We hypothesized improvements in functional scores and increased daily energy expenditures post-exercise as compared to baseline. The secondary aim of the study is to assess its feasibility in the given population. Feasibility was evaluated based on: i) recruitment rate, ii) retention rates, iii) test performance, iv) exercise program tolerability, and v) adherence to prescription. Paired t-tests were used to assess pre-post intervention differences. Findings indicate statistical and clinical significant improvement in 6MWT distance. Pre-post reports of HRQOL were maintained with significant decrease in pain. Upper and lower body strength significantly improved over the 4 weeks. Daily energy expenditure and daily step-count also showed meaningful increase post-exercise intervention. Our findings suggest that, the proposed exercise prescription encourages a more active lifestyle and can improve functionality of supportive care cancer patients.