Feasibility and Outcomes of an Exercise Intervention for Chemotherapy-Induced Heart Failure

Abstract

Purpose: Cancer treatment-related heart failure (HF) is an emerging health concern, as the number of survivors is increasing rapidly, and cardiac health issues are a leading cause of mortality in this population. While there is general evidence for the efficacy of exercise rehabilitation interventions, more research is needed on exercise rehabilitation interventions for patients specifically with treatment-induced HF and whether such interventions are safe and well-accepted. This study provides feasibility and health outcomes of a pilot exercise intervention for cancer survivors with chemotherapy-induced HF.

Methods: Twenty-five participants were randomized to a clinic-based exercise intervention or a wait-list control group or, alternatively, allowed to enroll in a home-based exercise intervention if they declined the randomized study. For purposes of analysis, both types of exercise programs were combined into a single intervention group. Repeated-measures analysis of variance was conducted to assess for significant time and treatment group main effects separately and time × treatment group interaction effects.

Results: Significant improvements in maximum oxygen uptake ((Equation is included in full-text article.)O2max) were observed in the intervention group. Intervention satisfaction and adherence were high for both clinic- and home-based interventions, with no reported serious adverse events. Enrollment was initially low for the clinic-based intervention, necessitating the addition of the home-based program as an intervention alternative.

Conclusions: Results suggest that exercise rehabilitation interventions are feasible in terms of safety, retention, and satisfaction and have the potential to improve (Equation is included in full-text article.)O2max. To maximize adherence and benefits while minimizing participant burden, an ideal intervention may incorporate elements of both clinic-based supervised exercise sessions and a home-based program.

Trial registration: ClinicalTrials.gov NCT00633633.

Figure 1.

Study flow diagram * Only participants agreeing to enroll after first being approached with the randomized study to either a control or clinic-based exercise group were randomized. Participants in the home-based group were directly assigned to this group without being randomized, as they were individuals who refused the randomized study initially, but were offered the chance to still participate by being allowed to directly enroll in a home-based program. † For purposes of analyses, the clinic-based and home-based group were combined into a single intervention comparison group.