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Resistance training in advanced cancer: a phase II safety and feasibility trial—home versus hospital
  1. Catarina Ribeiro1,2,
  2. Rui Santos3,
  3. Pedro Correia4,
  4. Matthew Maddocks1 and
  5. Barbara Gomes1,2
  1. 1Cicely Saunders Institute of Palliative Care and Rehabilitation, King's College London, London, UK
  2. 2Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal
  3. 3Medicina Fisica e de Reabilitação, Centro Hospitalar de Lisboa Central EPE, Lisbon, Portugal
  4. 4Exercise Physiology, The Strength Clinic, Lisbon, Portugal
  1. Correspondence to Dr Catarina Ribeiro, Cicely Saunders Institute of Palliative Care and Rehabilitation, King's College London, London SE5 9PJ, London, UK; catarinaribeiroa{at}gmail.com

Abstract

Background Resistance training (RT) is an effective way to increase muscle mass but little is known about its role to prevent sarcopenia in advanced cancer. Furthermore, the preferred setting for this training is not known. Considering home is frequently the place of care and death preferred by cancer patients, it is important to find out whether this would also be the best training setting as opposed to the most common one, hospital.

Objectives We aimed to test if RT at home and in hospital is feasible (primary outcome) and safe in advanced cancer, with a view to inform a phase III trial.

Methods Phase II randomised controlled trial including adults (≥18 years) with incurable solid tumours, randomised into one of three arms: (1) supervised RT at home; (2) supervised RT in hospital; (3) standard care with information leaflet. Both training programmes were similar, ran one-to-one with therapists and planned to last 12 weeks (three sessions/week). Feasibility included adherence (proportion of completed sessions) and acceptability (proportion of completed exercises), compared using Fisher’s test.

Results We included 15 patients (53% men, median age 68), 5 per arm. The home intervention had higher adherence (49% vs 9% in hospital; p<0.001). Acceptability was similar (93% in home and 95% in hospital; p=0.179). No adverse events were recorded.

Conclusions RT is a safe intervention, more feasible at home than in hospital in advanced cancer. Ways to increase adherence to the home intervention could further improve its potential benefit.

Trial registration number NCT02930876.

  • cancer
  • home care
  • hospital care
  • quality of life
  • rehabilitation
  • supportive care
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Footnotes

  • Twitter @catarinaribeiroa

  • Contributors CR: concept, design, literature search, data acquisition, data analysis, manuscript preparation and review; RS: design, data acquisition, manuscript review; PC: concept, design, manuscript review; MM: concept, design, manuscript review; BG: concept, design, data analysis, manuscript review.

  • Funding This work was supported by the Calouste Gulbenkian Foundation as part of the DINAMO Project, which aimed to enhance advanced training and research to optimise home palliative care in Portugal (Principal Investigator—BG, Scientific Director—Irene J Higginson, other members—Pedro L Ferreira, Helder Aguiar, Ana F Lacerda, Vera P Sarmento, Duarte Soares, Rita Canário, Maja de Brito, Catarina Ribeiro, Diogo M Branco).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Full ethical approval was warranted by the researchers’ host institution (HR-15/16-2960), the hospital ethics committee (303/2016) and the Portuguese data protection agency (5090/2016).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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