Hogeschool van Amsterdam

Urban Vitality

Targeting Exercise Interventions to Patients With Cancer in Need: An Individual Patient Data Meta-Analysis

Other

<p>Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment.</p><p>Methods: Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided.</p><p>Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction < .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction < .001) were greater in patients with worse baseline values.</p><p>Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment.</p>

Reference Buffart, L. M., Sweegers, M. G., May, A. M., Chinapaw, M. J., van Vulpen, J. K., Newton, R. U., Galvão, D. A., Aaronson, N. K., Stuiver, M. M., Jacobsen, P. B., Verdonck-de Leeuw, I. M., Steindorf, K., Irwin, M. L., Hayes, S., Griffith, K. A., Lucia, A., Herrero-Roman, F., Mesters, I., van Weert, E., ... Courneya, K. S. (2018). Targeting Exercise Interventions to Patients With Cancer in Need: An Individual Patient Data Meta-Analysis. Journal of the National Cancer Institute, 110(11), 1190-1200. [djy161]. https://doi.org/10.1093/jnci/djy161
Published by  Urban Vitality 1 November 2018

Publication date

Nov 2018

Author(s)

Laurien M Buffart
Maike G Sweegers
Anne M May
Mai J Chinapaw
Jonna K van Vulpen
Rob U Newton
Daniel A Galvão
Neil K Aaronson
Paul B Jacobsen
Irma M Verdonck-de Leeuw
Karen Steindorf
Melinda L Irwin
Sandi Hayes
Kathleen A Griffith
Alejandro Lucia
Fernando Herrero-Roman
Ilse Mesters
Ellen van Weert
Hans Knoop
Martine M Goedendorp
Nanette Mutrie
Amanda J Daley
Alex McConnachie
Martin Bohus
Lene Thorsen
Karl-Heinz Schulz
Camille E Short
Erica L James
Ronald C Plotnikoff
Gill Arbane
Martina E Schmidt
Karin Potthoff
Marc van Beurden
Hester S Oldenburg
Gabe S Sonke
Wim H van Harten
Rachel Garrod
Kathryn H Schmitz
Kerri M Winters-Stone
Miranda J Velthuis
Dennis R Taaffe
Willem van Mechelen
Marie José Kersten
Frans Nollet
Jennifer Wenzel
Joachim Wiskemann
Johannes Brug
Kerry S Courneya

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