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Randomized Controlled Trial
. 2022 Jul;30(7):5949-5963.
doi: 10.1007/s00520-022-07016-3. Epub 2022 Apr 7.

Short- and long-term effect of high versus low-to-moderate intensity exercise to optimise health-related quality of life after oncological treatment-results from the Phys-Can project

Anna-Karin Ax  1 , Birgitta Johansson  2 , Johan Lyth  3 , Karin Nordin  4 , Sussanne Börjeson  3
Affiliations
Randomized Controlled Trial

Short- and long-term effect of high versus low-to-moderate intensity exercise to optimise health-related quality of life after oncological treatment-results from the Phys-Can project

Anna-Karin Ax et al. Support Care Cancer. 2022 Jul.

Abstract

Purpose: This study aimed to evaluate the effect of high intensity (HI) vs low-to-moderate intensity (LMI) exercise on health-related quality of life (HRQoL) up to 18 months after commencement of oncological treatment in patients with breast, colorectal or prostate cancer. In addition, we conducted a comparison with usual care (UC).

Methods: Patients scheduled for (neo)adjuvant oncological treatment (n = 577) were randomly assigned to 6 months of combined resistance and endurance training of HI or LMI. A longitudinal descriptive study (UC) included participants (n = 89) immediately before the RCT started. HRQoL was assessed by EORTC QLQ-C30 at baseline, 3, 6 and 18 months (1 year after completed exercise intervention) follow-up. Linear mixed models were used to study the groups over time.

Results: Directly after the intervention, HI scored significant (P = 0.02), but not clinically relevant, higher pain compared with LMI. No other significant difference in HRQoL was found between the exercise intensities over time. Clinically meaningful improvements in HRQoL over time were detected within both exercise intensities. We found favourable significant differences in HRQoL in both exercise intensities compared with UC over time.

Conclusion: This study adds to the strong evidence of positive effect of exercise and shows that exercise, regardless of intensity, can have beneficial effects on HRQoL during oncological treatment and also for a substantial time after completion of an exercise intervention. In this study, for one year after.

Implications for cancer survivors: Patients can be advised to exercise at either intensity level according to their personal preferences, and still benefit from both short-term and long-term improvements in HRQoL.

Keywords: Cancer; Exercise; HRQoL; Oncological treatment.

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Conflict of interest statement

The authors no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT diagram of flow of participants through the Phys-Can HRQoL study, including Phys-Can non-randomized study (usual care) and Phys-Can RCT (allocated to HI: High intensity exercise intervention or LMI: Low-to-moderate intensity for six months). Numbers at each time measurement refer to participants remaining in the study. Numbers for missing data refer to the EORTC QLQ C30 questionnaire
Fig. 2
Fig. 2
Significant p-values of functioning and symptoms of EORTC QLQ C30 for high intensity (HI), low-to-moderate intensity (LMI) and usual care (UC) over time. Note: Baseline measurements were scaled to 100, and changes are presented in percentages. A high score for the global health status and functional scale represents a high QoL and a high level of functioning. A high score for the symptom scale/item represents a high level of symptoms/problems. Unscaled observed mean differences between groups are presented within the brackets. Clinically relevant differences were defined as T = trivial (unlikely to have a clinically relevance), S = small (subtle but nevertheless clinically relevant), M = medium (likely to be clinically relevant but to a lesser extent) and N/A = No guidelines applicable, by Cocks et al. 2010
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