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Physical exercise and fatigue in advanced gastrointestinal cancer during chemotherapy
  1. Alfredo Navigante1,2,
  2. Pablo Cresta Morgado2,
  3. María Laura Daud3,
  4. Helca Dos Santos Regis4,
  5. Martín Kolberg3,
  6. Carla Marazzi4,
  7. Velia Lobbe5,
  8. Andrea Alejandra González6 and
  9. Gustavo De Simone1,6
  1. 1Pallium Latinoamérica Association, Buenos Aires, Argentina
  2. 2Translational Research Unit, Institute of Oncology Angel H Roffo, Buenos Aires, Argentina
  3. 3Pallium Latinoamérica Association Buenos Aires, AR, CABA, Argentina
  4. 4Section of Rehabilitation and Physiotherapist, Gastroenterology Hospital Dr Carlos Bonorino Udaondo, Buenos Aires, Argentina
  5. 5Nutrition Department, Gastroenterology Hospital Dr Carlos Bonorino Udaondo, Buenos Aires, Argentina
  6. 6Section of Palliative Care, Gastroenterology Hospital Dr Carlos Bonorino Udaondo, Buenos Aires, Argentina
  1. Correspondence to Dr Alfredo Navigante, Translational Research Unit, Institute of Oncology Angel H Roffo, Buenos Aires 5481 (1417), Argentina; alfredonavigante{at}yahoo.com.ar

Abstract

Objectives This study was aimed to analyse the effect of a patient-oriented modality of physical exercise (programmed and directed physical exercise (PDPE)) on cancer-related fatigue (CRF) and quality of life (QoL). The secondary aim was to evaluate changes in body composition and skeletal muscle function during the study in patients with and without PDPE.

Methods A prospective randomised study was conducted to analyse the impact of PDPE on CRF and QoL. Patients were selected before the development of CRF to set the intervention before its appearance. A high probability CRF population was chosen: patients with advanced gastrointestinal cancer undergoing chemotherapy with weight loss (≥5%) over the last 6 months. PDPE consisted of a programme of exercise delivered weekly and adjusted to patients’ medical conditions. Four visits were planned (weeks 0, 4, 8 and 12). QoL, CRF, body composition and skeletal muscle function were evaluated in each visit.

Results From 101 patients recruited, 64 were considered evaluable, with three or four visits completed (n=30 control, n=34 PDPE group). Satisfactory compliance of ≥50% to the PDPE programme was seen in 47%. A reduction in the severity of fatigue was detected in the PDPE group (p=0.019), being higher in the subgroup of satisfactory compliance (p<0.001). This latter group showed better results of QoL in comparison with the control group (p=0.0279). A significant increase in endurance was found in the PDPE group (p<0.001).

Conclusion PDPE reduced the severity of fatigue and improved QoL. The difference in endurance would explain the results seen in the severity of fatigue.

  • Quality of life
  • Supportive care
  • Fatigue
  • Gastrointestinal (upper)
  • Gastrointestinal (lower)

Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Footnotes

  • Contributors AN: conceptualisation: formulation of overarching research goals; data curation: management activities to produce metadata, scrab date and maintain research data and later reuse; methodology: design of methodology; funding acquisition: acquisition of the financial support; project administration: management and coordination for the research activity, planning and execution; supervision: oversight and leadership responsibility for the research activity planning and execution; validation: verification of reproducibility of results; writing: the original draft and review and editing the final manuscript. PCM: data curation: scrub data and maintain research data; formal analysis: application of statistical, mathematical, computational and several techniques to analyse study data; software: implementation of the computer code; visualisation: preparation, creation and presentation of the published work, specifically data visualisation; validation: verification of the data and reproducibility of the results; writing: original draft and review and editing the final manuscript. MLD: project administration: management and coordination for the research activity, planning and execution; investigation: conducting the research and investigation process, specifically performing the eligibility, management and evaluation of patients as well as data collection. HDSR: investigation: data collection and performing patients’ control during physical exercise; writing: the original draft. MK: project administration: management and coordination of the research activity; investigation: planning and execution of physical exercise programme as well as data collection. CM: investigation: performing the control during physical exercise and data collection. VL: investigation: data collection, performing nutritional intervention, control and follow-up of patients along the study; writing: the original draft and review and editing the final manuscript. AAG: investigation: data collection, performing nutritional intervention, control and follow-up of patients along the study. GDS: conceptualisation: formulation of overarching research goals and aims; funding acquisition: acquisition of the financial support; resources: provision of study materials, instrumentals and computing resources; writing: the original draft and review and editing the final manuscript. AN is the guarantor of this wrok.

  • Funding This study was conducted with a grant from the National Cancer Institute, Argentina (number 15001837). Additionally, it had the support of the Pallium Latinoamérica Association.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.