Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients

Purpose Lymphoma patients commonly experience declines in physical functioning and quality of life (QoL) that may be reversed with exercise training. Patients and Methods We conducted a randomized controlled trial in Edmonton, Alberta, Canada, between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and randomly assigned them to usual care (UC; n 62) or 12 weeks of supervised aerobic exercise training (AET; n 60). Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia. Secondary end points were overall QoL, psychosocial functioning, cardiovascular fitness, and body composition. Results Follow-up assessment for our primary end point was 96% (117 of 122) at postintervention and 90% (110 of 122) at 6-month follow-up. Median adherence to the supervised exercise program was 92%. At postintervention, AET was superior to UC for patient-rated physical functioning (mean group difference, 9.0; 95% CI, 2.0 to 16.0; P .012), overall QoL (P .021), fatigue (P .013), happiness (P .004), depression (P .005), general health (P .001), cardiovascular fitness (P .001), and lean body mass (P .008). Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning. AET did not interfere with chemotherapy completion rate or treatment response. At 6-month follow-up, AET was still borderline or significantly superior to UC for overall QoL (P .054), happiness (P .034), and depression (P .009) without an increased risk of disease recurrence/progression. Conclusion AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response. Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients

Effects of supervised exercise on motivational outcomes and longer-term behaviour

Introduction: Supervised exercise may have positive effects on motivation and continued exercise in cancer survivors, but few randomized controlled trials have examined this issue. Here, we report the motivational outcomes and longer-term exercise behavior from the Healthy Exercise for Lymphoma Patients trial. Methods: Lymphoma patients were randomly assigned to 12 wk of supervised aerobic exercise (SUP, n = 60) or usual care (UC, n = 62). Motivational outcomes from the theory of planned behavior were assessed at baseline, after intervention, and at 6-month follow-up using standardized measures. Exercise behavior was self-reported at baseline and 6-month follow-up using the Godin Leisure Time Exercise Questionnaire. Results: Data were available from 95% of participants after intervention and 90% at 6-month follow-up. SUP attended a median of 92% of the supervised exercise sessions. After intervention, SUP was superior to UC for intention (+0.41 (+0.09 to +0.72), P = 0.012) and perceived behavioral control (+0.36 (+0.01 to +0.72), P = 0.047) and borderline superior for self-efficacy (+0.35 (j0.02 to +0.72), P = 0.060). At 6-month follow-up, SUP reported significantly more exercise minutes compared with UC (+133 (+38 to +227), P = 0.006), and a higher percentage of SUP participants were meeting public health exercise guidelines (+25.6% (+8.2% to +43.0%), P = 0.004). Path analysis showed that perceived behavioral control partially mediated the effects of supervised exercise (group assignment) on exercise behavior at 6-month follow-up (meeting exercise guidelines). Conclusions: Supervised exercise has motivational effects in lymphoma patients and improves longer-term exercise behavior. Strategies to further enhance the motivational value of supervised exercise are warranted