title: Physical exercise for cancer patients with advanced disease: a randomized controlled trial.
abstract: BACKGROUND
  Physical exercise can improve cancer patients' functioning and reduce their symptom levels. A randomized, controlled trial was launched to test the hypothesis that physical exercise reduces fatigue and improves physical performance in cancer patients with advanced and incurable disease.
  
  
  METHODS
  Cancer patients (n = 231) with a life expectancy ≤2 years were randomized to a physical exercise group (PEG, n = 121) or a control usual care group (UCG, n = 110). The PEG exercised under supervision 60 minutes twice a week for 8 weeks. Assessments were performed before and after the intervention. The primary outcome was physical fatigue (PF) measured by the Fatigue Questionnaire. Physical performance was a secondary outcome measured by the Shuttle Walk Test (SWT) and hand grip strength (HGS) test. Analyses were performed after multiple imputations for missing data. The trial is registered with ClinicalTrials.gov (identifier, NCT00397774).
  
  
  RESULTS
  Thirty-six percent of the PEG were lost to follow-up compared with 23% of the UCG, primarily as a result of disease progression. Seventy-eight PEG and 85 UCG patients completed the intervention. Analyses showed no significant between-group effects in PF. However, clinically and statistically significant between-group effects were found for the SWT and HGS test.
  
  
  CONCLUSIONS
  Fatigue was not reduced but physical performance (SWT and HGS test) was significantly improved after 8 weeks of physical exercise. Physical exercise might therefore be a suitable approach for maintaining physical capacity in cancer patients with incurable and advanced disease.
authors.affiliation: European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. line.oldervoll@ntnu.no
authors.forename: Line M
authors.initials: LM
authors.lastname: Oldervoll
authors.forename: Jon H
authors.initials: JH
authors.lastname: Loge
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.forename: Hanne
authors.initials: H
authors.lastname: Paltiel
authors.forename: May B
authors.initials: MB
authors.lastname: Asp
authors.forename: Unni V
authors.initials: UV
authors.lastname: Nygaard
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Oredalen
authors.forename: Tone L
authors.initials: TL
authors.lastname: Frantzen
authors.forename: Ingvild
authors.initials: I
authors.lastname: Lesteberg
authors.forename: Lise
authors.initials: L
authors.lastname: Amundsen
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: Dagny F
authors.initials: DF
authors.lastname: Haugen
authors.forename: Ørnulf
authors.initials: Ø
authors.lastname: Paulsen
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
mesh_terms: D000368:Aged; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D016019:Survival Analysis