Exercise during Chemotherapy Improves Physical Function: Findings from EnACT: Exercise in All Chemotherapy

Abstract

Current research shows that exercise during chemotherapy is safe, feasible, and effective at improving physical function and managing symptom severity and interference in a number of different cancer types. Despite the positive findings of exercise during chemotherapy, referral for exercise during treatment has not yet become standard of care. Additionally, there is a lack of information on the effectiveness of an institute-wide exercise program for patients receiving chemotherapy. PURPOSE: To evaluate changes in objectively-measured physical function in patients receiving chemotherapy after receiving a personalized exercise prescription. METHODS: One hundred sixty eight subjects (65M, 103F; 59.32 ± 11.83 years) actively receiving chemotherapy enrolled in an out-patient exercise intervention. Participants were given home-based exercises that included resistance, aerobic, flexibility, and balance exercises. Exercise equipment included resistance bands and adjustable dumbbells. Physical function (PF), was measured using the 30-second chair stand (30CST), Timed-Up-and-Go (TUG), Hand-Grip Strength (HGS), and the 4-Stage Balance test (BAL). Data collection was performed prior to beginning the exercise program and following completion of their chemotherapy regimen (non-metastatic patients) or 6 months after starting EnACT (metastatic patients). RESULTS: Eighty two subjects completed physical function testing. A Paired-Samples T-test analysis showed a significant increase in the 30CST (MD= .74, SE= .34, p= .03) and a significant decrease in TUG (MD= -0.42, SE= .19, p= .03). There were no significant changes in HGS for either right or left hand. While the BAL also showed no significant changes after the exercise intervention, the Instep balance test showed a trend towards significant increases in performance time (MD= 0.31, SE= .17, p= .06). CONCLUSION: These preliminary results indicate that integrating a personalized exercise prescription into standard of care is efficacious in improving physical function despite the rigorous burden of receiving chemotherapy. Improving the physical function of patients during chemotherapy may prevent future treatment-related decrements in functional capacity and the need for rehabilitative measures.