title: Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study.
abstract: Fatigue is a common and distressing symptom in cancer patients, especially in lymphoma patients. One hypothesized mechanism in the etiology of fatigue is a vicious circle between fatigue, physical inactivity, and deconditioning. However, the natural evolution of physical activity and physical fitness over the course of treatment is unknown. Therefore, the aim of this longitudinal study was to assess fatigue, physical activity, and physical fitness in lymphoma patients before, during, and after treatment. Fatigue was measured with the EORTC-QLQ-C30, physical activity with an accelerometer, and physical fitness with a maximal incremental cycle ergometer test, 6-min walking distance test, and muscle strength measurements. Differences between the three measurement moments and baseline differences between Hodgkin lymphoma and non-Hodgkin lymphoma, early and advanced disease, were analyzed. Twenty-nine patients were included. Functional exercise capacity and quadriceps force were impaired before the start of treatment (86 ± 15 and 82 ± 16 % of predicted value, respectively). Over the course of treatment, significant declines were found in hemoglobin, quadriceps force, handgrip force, and maximal oxygen uptake, while patients reported more fatigue (p values < 0.016). Fatigue was significantly correlated with hemoglobin (r = -0.49), physical activity (r = 0.81), and physical functioning (r = -0.44). Large interindividual variations were found. The present study partially confirmed the hypothesized vicious circle between fatigue, physical inactivity, and deconditioning. Further research with larger samples and longer follow-up is needed to identify factors associated with individual variation in the evolution of fatigue, physical activity, and physical fitness.
authors: Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, KU Leuven, 3001, Leuven, Belgium.
authors: Nele
authors: N
authors: Vermaete
authors: Pascal
authors: P
authors: Wolter
authors: Gregor
authors: G
authors: Verhoef
authors: Rik
authors: R
authors: Gosselink
mesh_terms: D061725:Accelerometry; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D005221:Fatigue / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D053580:Muscle Strength / Q000187:drug effects; D009367:Neoplasm Staging; D010809:Physical Fitness; D011788:Quality of Life; D011795:Surveys and Questionnaires