Effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy — A pilot study

Journal article


Zopf, Eva M., Schulz, Holger, Poeschko, Jonas, Aschenbroich, Kerstin, Wilhelm, Thomas, Eypasch, Ernst, Kleimann, Elmar, Severin, Kai, Benz, Jutta, Liu, Enwu, Bloch, Wilhelm and Baumann, Freerk T.. (2022). Effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy — A pilot study. Supportive Care in Cancer. 30(3), pp. 1945-1955. https://doi.org/10.1007/s00520-021-06608-9
AuthorsZopf, Eva M., Schulz, Holger, Poeschko, Jonas, Aschenbroich, Kerstin, Wilhelm, Thomas, Eypasch, Ernst, Kleimann, Elmar, Severin, Kai, Benz, Jutta, Liu, Enwu, Bloch, Wilhelm and Baumann, Freerk T.
Abstract

Purpose
Colorectal cancer and its treatment are associated with debilitating side effects. Exercise may improve the physical and psychological wellbeing of cancer patients; however, evidence in colorectal cancer patients undergoing adjuvant chemotherapy is limited. This pilot study aimed to explore the effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy.

Methods
Patients who had undergone curative resection for colorectal cancer (stages II–III) and were scheduled to receive adjuvant chemotherapy were enrolled into this non-randomized controlled trial. Patients in the intervention group (IG) took part in a 6-month supervised aerobic exercise program, while the control group (CG) received usual care. Cardiorespiratory fitness (measured by peak oxygen consumption) was assessed at baseline and 6 months. Fatigue, quality of life, and physical activity levels were additionally assessed at 3 months.

Results
In total, 59 patients (33 in IG vs. 26 in CG) were enrolled into this study. Eighteen patients (9 in IG vs. 9 in CG) dropped out of the study prior to the 6-month follow-up. Significant improvements in cardiorespiratory fitness (p = .002) and selected patient-reported health outcomes, such as reduced motivation (p = .015) and mental fatigue (p = .018), were observed in the IG when compared to the CG.

Conclusion
To our knowledge, this is the first study to investigate the effects of a supervised aerobic exercise program in colorectal cancer patients undergoing adjuvant chemotherapy. The significant and clinically meaningful improvements in CRF warrant further randomized controlled trials to confirm these findings.

Trials registration
German Clinical Trials Register Identifier: DRKS00005793, 11/03/2014, retrospectively registered.

Keywordsphysical activity; physical fitness; fatigue; quality of life; colorectal neoplasms
Year2022
JournalSupportive Care in Cancer
Journal citation30 (3), pp. 1945-1955
PublisherSpringer
ISSN0941-4355
Digital Object Identifier (DOI)https://doi.org/10.1007/s00520-021-06608-9
PubMed ID34623488
Scopus EID2-s2.0-85116811643
PubMed Central IDPMC8795052
Open accessPublished as ‘gold’ (paid) open access
Page range1945-1955
FunderRoche Pharma AG
Ribosepharm
Bendalis GmbH
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online08 Oct 2021
Publication process dates
Accepted29 Sep 2021
Deposited22 Nov 2022
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Harrison, Stephanie L., Bradley, Clare E., Milte, Rachel, Liu, Enwu, O'Donnell, Lisa K., Hilmer, Sarah N. and Crotty, Maria. (2018). Psychotropic medications in older people in residential care facilities and associations with quality of life: a cross-sectional study. BMC Geriatrics. 18(60), pp. 1 - 8. https://doi.org/10.1186/s12877-018-0752-0
Costs of potentially inappropriate medication use in residential aged care facilities
Harrison, S. L., O'Donnell, L. K., Milte, R., Dyer, S. M., Gnanamanickam, E. S., Bradley, C., Liu, Enwu, Hilmer, S. N. and Crotty, M.. (2018). Costs of potentially inappropriate medication use in residential aged care facilities. BMC Geriatrics. 18(9), pp. 1 - 10. https://doi.org/10.1186/s12877-018-0704-8
Diagnosis of dementia in residential aged care settings in Australia: An opportunity for improvements in quality of care?
Dyer, Suzanne M., Gnanamanickam, Emmanuel S., Liu, Enwu, Whitehead, Craig and Crotty, Maria. (2018). Diagnosis of dementia in residential aged care settings in Australia: An opportunity for improvements in quality of care? Australasian Journal on Ageing. 37(4), pp. e155 - e158. https://doi.org/10.1111/ajag.12580
Effects of KYUSHO JITSU on physical activity-levels and quality of life in breast cancer patients
Strunk, Maximilian A., Zopf, Eva, Steck, Jule, Hamacher, Stefanie, Hallek, Michael and Baumann, Freerk T.. (2018). Effects of KYUSHO JITSU on physical activity-levels and quality of life in breast cancer patients. In Vivo: international journal of experimental and clinical pathophysiology and drug research. 32(4), pp. 819 - 824. https://doi.org/10.21873/invivo.11313
Clustered domestic model of residential care is associated with better consumer rated quality of care
Gnanamanickam, Emmanuel S., Dyer, Suzanne M., Milte, Rachel, Liu, Enwu, Ratcliffe, Julie and Crotty, Maria. (2018). Clustered domestic model of residential care is associated with better consumer rated quality of care. International Journal for Quality in Health Care. https://doi.org/10.1093/intqhc/mzy181
An empirical comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a post-hospitalisation population of frail older people living in residential aged care
Ratcliffe, Julie, Flint, Thomas, Easton, Tiffany, Killington, Maggie, Cameron, Ian, Davies, Owen, Whitehead, Craig, Kurrle, Susan, Miller, Michelle D., Liu, Enwu and Crotty, Maria. (2017). An empirical comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a post-hospitalisation population of frail older people living in residential aged care. Applied Health Economics and Health Policy. 15(3), pp. 399 - 412. https://doi.org/10.1007/s40258-016-0293-7
Sustainable impact of an individualized exercise program on physical activity level and fatigue syndrome on breast cancer patients in two German rehabilitation centers
Baumann, Freerk T., Bieck, Oliver, Oberste, Max, Kuhn, Rafaela, Schmitt, Joachim, Wentrock, Steffen, Zopf, Eva, Bloch, Wilhelm, Schüle, Klaus and Reuss-Borst, Monika. (2017). Sustainable impact of an individualized exercise program on physical activity level and fatigue syndrome on breast cancer patients in two German rehabilitation centers. Supportive Care in Cancer. 25(4), pp. 1047 - 1054. https://doi.org/10.1007/s00520-016-3490-x
The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects
Cormie, Prue, Zopf, Eva, Zhang, Xiaochen and Schmitz, Kathryn H.. (2017). The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiologic Reviews. 39(1), pp. 71 - 92. https://doi.org/10.1093/epirev/mxx007
Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: A cross-sectional investigation
Zopf, Eva M., Newton, Robert, Taaffe, Dennis R., Spry, Nigel A., Cormie, Prue, Joseph, David, Chambers, Suzanne, Baumann, Freerk T., Bloch, W. and Galvao, Daniel. (2017). Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: A cross-sectional investigation. European Journal of Cancer Care. 26(6), pp. 1 - 7. https://doi.org/10.1111/ecc.12575
Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia
Liu, Enwu, Dyer, Suzanne M., O'Donnell, Lisa Kouladjian, Milte, Rachel, Bradley, Clare E., Harrison, Stephanie L., Gnanamanickam, Emmanuel S., Whitehead, Craig and Crotty, Maria. (2017). Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia. Journal of Geriatric Cardiology. 14(6), pp. 407 - 415. https://doi.org/10.11909/j.issn.1671-5411.2017.06.009
Early supported discharge by caregiver-mediated exercise and e-Health support after stroke - A proof-of-concept trial
Van Den Berg, Maayken, Crotty, Maria, Liu, Enwu, Killington, Maggie, Kwakkel, Gert and van Wegen, Erwin. (2016). Early supported discharge by caregiver-mediated exercise and e-Health support after stroke - A proof-of-concept trial. Stroke. 47(7), pp. 1885 - 1892. https://doi.org/10.1161/STROKEAHA.116.013431
Impact of physical inactivity on the multifactorial process of developing cancer-related cognitive impairments
Pesendorfer, L. M., Zimmer, Philipp, Galvao, Daniel, Zopf, Eva M., Bloch, Wilhelm and Baumann, Freerk T.. (2016). Impact of physical inactivity on the multifactorial process of developing cancer-related cognitive impairments. Journal of Cancer Science and Therapy (online). 8(8), pp. 222 - 227. https://doi.org/10.4172/1948-5956.1000417
Hemiplegic shoulder pain reduces quality of life after acute stroke - A prospective population-based study
Adey-Wakeling, Zoe, Liu, Enwu, Crotty, Maria, Leyden, James, Kleinig, Timothy, Anderson, Craig and Newbury, Jonathon. (2016). Hemiplegic shoulder pain reduces quality of life after acute stroke - A prospective population-based study. American Journal of Physical Medicine and Rehabilitation. 95(10), pp. 758 - 763. https://doi.org/10.1097/PHM.0000000000000496
New South Wales Child Development Study (NSW-CDS): An Australian multiagency, multigenerational, longitudinal record linkage study
Carr, Vaughan J., Harris, Felicity, Raudino, Alessandra, Luo, Luming, Kariuki, Maina, Liu, Enwu, Tzoumakis, Stacy, Smith, Maxwell, Holbrook, Allyson, Bore, Miles, Brinkman, Sally, Lenroot, Rhoshel, Dix, Katherine, Dean, Kimberlie, Laurens, Kristin R. and Green, Melissa J.. (2016). New South Wales Child Development Study (NSW-CDS): An Australian multiagency, multigenerational, longitudinal record linkage study. BMJ Open. 6(2), pp. 1 - 9. https://doi.org/10.1136/bmjopen-2015-009023
Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years
Kariuki, Maina, Raudino, Alessandra, Green, Melissa, Laurens, Kristin, Dean, Kimberlie, Brinkman, Sally, Lenroot, Rhoshel, Liu, Enwu, Harris, Felicity, Luo, Luming and Carr, Vaughn J.. (2016). Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years. Journal of Paediatrics and Child Health. 52(9), pp. 882 - 888. https://doi.org/10.1111/jpc.13239
Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years
Kariuki, Maina, Raudino, Alessandra, Green, Melissa J., Laurens, Kristin R., Dean, Kimberlie, Brinkman, Sally A., Lenroot, Rhoshel K., Liu, Enwu, Harris, Felicity, Luo, Luming and Carr, Vaughn J.. (2016). Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years. Journal of Paediatrics and Child Health. 52(9), pp. 882 - 888. https://doi.org/10.1111/jpc.13239
New South Wales child development study (NSW-CDS): An Australian multiagency, multigenerational, longitudinal record linkage study
Carr, Vaughn J., Harris, Felicity, Raudino, Alessandra, Luo, Luming, Kariuki, Maina, Liu, Enwu, Tzoumakis, Stacy, Smith, Maxwell, Holbrook, Allyson, Bore, Miles, Brinkman, Sally, Lenroot, Rhoshel, Dix, Katherine, Dean, Kimberlie, Laurens, Kristin R. and Green, Melissa J.. (2016). New South Wales child development study (NSW-CDS): An Australian multiagency, multigenerational, longitudinal record linkage study. BMJ Open. 6(2), pp. 1 - 9. https://doi.org/10.1136/bmjopen-2015-009023
Baseline HCV antibody prevalence and risk factors among drug users in China's National Methadone Maintenance Treatment Program
Wang, Changhe, Shi, Cynthia X., Rou, Keming, Zhao, Yan, Cao, Xiaobin, Luo, Wei, Liu, Enwu and Wu, Zunyou. (2016). Baseline HCV antibody prevalence and risk factors among drug users in China's National Methadone Maintenance Treatment Program. PLoS ONE. 11(2), pp. 1 - 14. https://doi.org/10.1371/journal.pone.0147922
Who uses methadone services in China? Monitoring the world's largest methadone programme
Sullivan, Sheena G., Wu, Zunyou, Rou, Keming, Pang, Lin, Luo, Wei, Wang, Changhe, Cao, Xiaobin, Yin, Wenyuan, Liu, Enwu and Mi, Guodong. (2015). Who uses methadone services in China? Monitoring the world's largest methadone programme. Addiction. 110(Suppl. 1), pp. 29 - 39. https://doi.org/10.1111/add.12781
Exercise-induced natural killer cell activation is driven by epigenetic modifications
Zimmer, Philipp, Bloch, Wilhelm, Schenk, Alexander, Zopf, Eva M., Hildebrandt, U., Streckmann, F., Beulertz, J., Koliamitra, C., Schollmayer, Friederike and Baumann, F.. (2015). Exercise-induced natural killer cell activation is driven by epigenetic modifications. International Journal of Sports Medicine. 36(6), pp. 510 - 515. https://doi.org/10.1055/s-0034-1398531
Continued drug use during methadone treatment in China: A retrospective analysis of 19,026 service users
Sullivan, Sheena G., Wu, Zunyou, Cao, Xiaobin, Liu, Enwu and Detels, Roger. (2014). Continued drug use during methadone treatment in China: A retrospective analysis of 19,026 service users. Journal of Substance Abuse Treatment. 47(1), pp. 86 - 92. https://doi.org/10.1016/j.jsat.2013.12.004
Recommendations for assessment methods for exercise trials with cancer patients
Scharhag-Rosenberger, F., Becker, T., Streckmann, F., Schmidt, K., Berling, A., Bernardi, A., Engeroff, T., Exner, A. K., Gutekunst, K., Hofmeister, D., Jensen, W., Kähnert, H., Kneis, S., Limbach, M., Mau-Möller, A., Röcker, K., Schmidt, M. E., Schmidt, T., Stöckel, T., ... Karen, Steindorf. (2014). Recommendations for assessment methods for exercise trials with cancer patients. Deutsche Zeitschrift fur Sportmedizin. 65(11), pp. 304 - 313. https://doi.org/10.5960/dzsm.2014.148
Physical activity and exercise recommendations for cancer patients during rehabilitation
Zopf, Eva M., Baumann, Freerk T. and Pfeifer, K.. (2014). Physical activity and exercise recommendations for cancer patients during rehabilitation. Rehabilitation (Germany). 53(1), pp. 2 - 7. https://doi.org/10.1055/s-0033-1334916
Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment : A comparison of three models
Yan, Liping, Liu, Enwu, McGoogan, Jennifer M., Duan, Song, Wu, Li-Tzy, Comulada, Scott and Wu, Zunyou. (2013). Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment : A comparison of three models. BMC Public Health. 13(1), pp. 1-8. https://doi.org/10.1186/1471-2458-13-747
HIV and syphilis prevalence among men who have sex with men : A cross-sectional survey of 61 cities in China
Wu, Zunyou, Xu, Jie, Liu, Enwu, Mao, Yurong, Xiao, Yan, Sun, Xinhua, Liu, Yufen, Jiang, Yan, McGoogan, Jennifer M., Dou, Zhi, Mi, Guodong, Wang, Ning, Sun, Jiangping, Liu, Zhongfu, Wang, Lu, Rou, Keming, Pang, Lin, Xing, Wenge, Xu, Juan, ... National MSM Survey Group. (2013). HIV and syphilis prevalence among men who have sex with men : A cross-sectional survey of 61 cities in China. Clinical Infectious Diseases. 57(2), pp. 298-309. https://doi.org/10.1093/cid/cit210
Feasibility of an isometric maximal voluntary contraction test in hematological cancer patients during thrombocytopenia
Zimmer, Philipp, Baumann, Freerk T., Ebel, Janis, Zopf, Eva Maria, Bloch, Wilhelm and Elter, Thomas. (2013). Feasibility of an isometric maximal voluntary contraction test in hematological cancer patients during thrombocytopenia. Journal of Sports Medicine. 2013(Article ID 470489), pp. 1-6. https://doi.org/10.1155/2013/470489
Factors associated with mortality of HIV-positive clients receiving methadone maintenance treatment in China
Liu, Enwu, Rou, Keming, McGoogan, Jennifer M., Pang, Lin, Cao, Xiaobin, Wang, Changhe, Luo, Wei, Sullivan, Sheena G., Montaner, Julio S. G., Bulterys, Marc, Detels, Roger, Wu, Zunyou and China’s National Working Group on Methadone Maintenance Treatment. (2013). Factors associated with mortality of HIV-positive clients receiving methadone maintenance treatment in China. Journal of Infectious Diseases. 3(1), pp. 442-453. https://doi.org/10.1093/infdis/jit163
Antiretroviral therapy to prevent HIV transmission in serodiscordant couples in China (2003-11) : A national observational cohort study
Jia, Zhongwei, Mao, Yurong, Zhang, Fujie, Ruan, Yuhua, Ma, Ye, Li, Jian, Guo, Wei, Liu, Enwu, Dou, Zhihui, Zhao, Yan, Wang, Lu, Li, Qianqian, Xie, Peiyan, Tang, Houlin, Han, Jing, Jin, Xia, Xu, Juan, Xiong, Ran, Zhao, Decai, ... Shao, Yiming. (2013). Antiretroviral therapy to prevent HIV transmission in serodiscordant couples in China (2003-11) : A national observational cohort study. The Lancet. 382(9899), pp. 1195-1203. https://doi.org/10.1016/S0140-6736(12)61898-4
Clinical exercise interventions in prostate cancer patients-a systematic review of randomized controlled trials
Baumann, Freerk T., Zopf, Eva M. and Bloch, Wilhelm. (2012). Clinical exercise interventions in prostate cancer patients-a systematic review of randomized controlled trials. Supportive Care in Cancer. 20(2), pp. 221 - 233. https://doi.org/10.1007/s00520-011-1271-0
Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: Study protocol of the ProRehab Study
Zopf, Eva M., Braun, Moritz, Machtens, Stefan, Zumbé, Jürgen, Bloch, Wilhelm and Baumann, Freerk T.. (2012). Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: Study protocol of the ProRehab Study. BMC Cancer. 12(312), pp. 1 - 7. https://doi.org/10.1186/1471-2407-12-312
Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: Benefits of a moderate exercise intervention
Baumann, Freerk T., Zopf, Eva M., Nykamp, Eike, Kraut, Ludwig, Schüle, Klaus, Elter, Thomas, Fauser, Axel A. and Bloch, Wilhelm. (2011). Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: Benefits of a moderate exercise intervention. European Journal of Haematology. 87(2), pp. 148 - 156. https://doi.org/10.1111/j.1600-0609.2011.01640.x