Exercise Tailored to Chemotherapy Cycle Improves Adherence

By Reuters Staff

October 24, 2019

NEW YORK (Reuters Health) - Changing exercise intensity to accommodate chemotherapy-induced fatigue improves adherence to the program, researchers report.

Increased feelings of fatigue following chemotherapy infusions commonly affect a patient's physical capacity and willingness to engage in exercise. Periodization is an exercise strategy that varies training intensity or volume in order to maximize fitness improvements and allow optimal recovery.

Dr. Kristin L. Campbell of the University of British Columbia, in Vancouver, Canada, and colleagues investigated whether periodization of exercise around chemotherapy cycles (i.e., reduced intensity and duration during chemotherapy weeks) improved adherence to the exercise program, compared with exercise that progressed without regard to chemotherapy timing.

They randomly assigned 12 patients to a supervised aerobic and resistance exercise program following a chemotherapy-periodized exercise prescription and 15 to usual care during chemotherapy.

Fatigue, assessed by the total fatigue score from the revised Piper Fatigue scale (range, 0-10), increased from baseline (marginal mean, 3.2) to prior to the third chemotherapy cycle (4.1), further increased and peaked three to five days after the third cycle (5.1), and decreased just prior to the fourth cycle of chemotherapy (4.3).

Overall attendance during chemotherapy was higher in the chemotherapy-periodized group than in the standard exercise prescription group (78% vs. 63%, P=0.05), the researchers report in Medicine and Science in Sports and Exercise, online September 4.

During chemotherapy weeks, attendance was significantly higher in the periodized group than in the standard exercise group (77% vs. 57%, P=0.04), whereas attendance only trended higher during non-chemotherapy weeks (79% vs. 65%, P=0.09).

Overall adherence to aerobic intensity and duration did not differ between the programs, but adherence to resistance training was significantly higher for the periodized program than for the standard program.

"In the current study, we utilized a chemotherapy-periodized approach to exercise during chemotherapy in women with early stage breast cancer and found that this prescription may optimize adherence by accommodating for treatment side effects," the authors conclude. "Findings reported in this paper provide a part of the foundation from which to further refine and target the optimal approach to exercise prescriptions within oncology populations."

Dr. Campbell did not respond to a request for comments.

SOURCE: https://bit.ly/2kKMCnJ

Med Sci Sports Exerc 2019.