title: Quality of life and fatigue of patients with spinal bone metastases under combined treatment with resistance training and radiation therapy- a randomized pilot trial.
abstract: BACKGROUND
  The aim of this trial was to compare the effects of resistance training versus passive physical therapy on quality of life (QoL), fatigue, and emotional distress outcomes during radiation therapy in patients with spinal bone metastases under radiotherapy (RT).
  
  
  METHODS
  In this randomized trial, 60 patients were treated from September 2011 until March 2013 into one of the two groups: isometric resistance training or physical therapy with thirty patients in each group during RT. EORTC QLQ-BM22, EORTC QLQ-FA13, and FBK-R10 were assessed at baseline, three months, and six months after RT.
  
  
  RESULTS
  Psychosocial aspects in resistance training group (Arm A) were significantly improved after three (p = 0.001) and six months (p = 0.010). Other rated items of the QLQ-BM22 painful site, and pain characteristics were without significant differences. Functional interference showed a positive trend after six months (p = 0.081). After six months, physical fatigue (p = 0.013), and interference with daily life (p = 0.006) according to the QLQ-FA13 assessment improved in Arm A significantly. Emotional distress was in Arm A lower after six months (p = 0.016). The Cohen's effect size confirmed the clinically significant improvement of these findings.
  
  
  CONCLUSIONS
  In this group of patients we were able to show that guided isometric resistance training of the paravertebral muscles can improve functional capacity, reduce fatigue and thereby enhance QoL over a 6-months period in patients with stable spinal metastases. The results offer a rationale for future large controlled investigations to confirm these findings.
  
  
  BACKGROUND
  Clinical trial identifier NCT01409720.
authors.affiliation: Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, Heidelberg 69120, Germany. harald.rief@med.uni-heidelberg.de.
authors.forename: Harald
authors.initials: H
authors.lastname: Rief
authors.forename: Michael
authors.initials: M
authors.lastname: Akbar
authors.forename: Monika
authors.initials: M
authors.lastname: Keller
authors.forename: Georg
authors.initials: G
authors.lastname: Omlor
authors.forename: Thomas
authors.initials: T
authors.lastname: Welzel
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Stefan
authors.initials: S
authors.lastname: Rieken
authors.forename: Matthias F
authors.initials: MF
authors.lastname: Häfner
authors.forename: Ingmar
authors.initials: I
authors.lastname: Schlampp
authors.forename: Alexandros
authors.initials: A
authors.lastname: Gioules
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000009:adverse effects*; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis; D011788:Quality of Life; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000009:adverse effects*; D055070:Resistance Training / Q000009:adverse effects*; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult