Aaronson, Neil K.

Sonke, Gabe S.

Stuiver, Martijn M.

van Harten, Willem H.

van Waart, Hanna

English

NARCIS 

Effect of low versus high intensity physical exercise during chemotherapy on physical fitness, fatigue and chemotherapy completion rates: Results of a randomized, controlled trial

University of Twente Research Information

Research (DIW); Gert G. Wagner, German Institute for EconomicResearch (DIW)AIMS: Both psychologists and sociologists highlight the role con-text plays in shaping individual development across the life span.Operationalizing regional context as the characteristics of care ser-vices in one’s county, we aim to examine associations between localcare amenities and late-life development, operationalized as terminaldecline in life satisfaction. METHODS: We combine 22 waves ofyearly, longitudinal reports of life satisfaction obtained from nowdeceased participants (n = 4,159) in the Socio-Economic PanelStudy (SOEP) with German Statistics of Care (German FederalBureau of Statistics) and run three-level growth curve models.RESULTS: We find that between-county differences contribute 7 %of variance to between-person differences in both level and rates ofchange in life satisfaction. Specifically, availability of beneficialcare services (e.g., lower working load in inpatient facilities)contributes to more positive life satisfaction trajectories. CON-CLUSIONS: Our results support long-standing notions that localamenities play a role for individual late-life development, and wediscuss possible routes through which local care services can shapewell-being trajectories. In follow-up analyses we will check whetheravailability of care characteristics contributes differently to well-being trajectories of individuals who receive care and those whodon’t.(104.5) Community Aged Care Assessment: Results froma National Field TrialJanet E. Sansoni, MSc, University of Wollongong, Fadden, Australia;Peter Samsa, University of Wollongong; Cathy Duncan, Centre forHealth Service Development, University of Wollongong,Wollongong, Australia; Kathy Eagar, University of Wollongong;Bruce Shadbolt, Faculty of Medicine, Australian National UniversityAIMS: An aged care assessment suite to enable elderly people toaccess community aged care services was redesigned for nationalapplication and field tested across Australia (N = 1,011). A 3-tieredmodel for assessment related to the need for services underpinned theassessment battery: * Level 1—for those requiring basic services suchas domestic assistance or transport etc.; * Level 2—for thoserequiring more substantial use of services including elements ofpersonal care; * Level 3—for those requiring a comprehensive clin-ical assessment to obtain higher levels of care. The field trial wasconcerned with the first two levels of assessment and referral to aLevel 3 agency. METHODS: The Level 1 assessment includedbackground information, a Functional Profile (FP) containing vali-dated items concerning ADL and IADL function and seven triggeritems to determine whether a Level 2 assessment was required. TheLevel 2 assessment contained supplementary profiles (dementia,health, psychosocial, carer need, caring role and financial/legal issuesprofiles) which were only completed if triggered. Most assessmentswere undertaken by telephone. Assessors used a customized, knowl-edge-management, web-based platform to provide decision supportand to record the assessment. Consecutive applicants at sevenassessment locations throughout Australia were assessed over the twomonth trial period. RESULTS: Overall 49 % of applicants received aLevel 1 Assessment, 51 % a Level 2 Assessment and 10 % ofapplicants were referred to a Level 3 agency. There was a significantdifference in the FP scores between Level 1, Level 2 and applicantsreferred to Level 3. Most Level 1 applicants (89 %) required only 1basic service whereas most Level 2 applicants (65 %) required mul-tiple services.The FP score was significantly associated with the number of casecomplexity profiles triggered and with referral to Level 3. Althoughthe internal consistency of the FP was alpha = 0.82 item analysisindicated the scale could be streamlined by the removal of one itemwhich slightly increased the alpha. CONCLUSIONS: A tiered web-based assessment system with various exit points for referral wasuseful in assigning people to services and in tailoring the level ofassessment to client need.105: New Approaches to Evaluating Cancer Treatments(105.1) Effect of low versus high intensity physical exerciseduring chemotherapy on physical fitness, fatigueand chemotherapy completion rates: Results of a randomized,controlled trialHanna Van Waart, The Netherlands Cancer Institute, Amsterdam,Netherlands; Martijn M. Stuiver, The Netherlands Cancer Institute;Gabe S. Sonke, The Netherlands Cancer Institute; Wim H. VanHarten, The Netherlands Cancer Institute; Neil K. Aaronson, PhD,The Netherlands Cancer Institute, Amsterdam, NetherlandsAIMS: Cancer chemotherapy is frequently associated with a decline inphysical condition and muscle strength, and an increase in fatigue.Exercise programs have been shown to have a beneficial effect onpatients undergoing chemotherapy. The optimal intensity of such pro-grams is as yet unknown. This study evaluated the efficacy of a lowintensity, home-based, self-management physical activity program(Onco-Move), and a high intensity, structured, supervised exerciseprogram (OnTrack) in terms of maintaining or enhancing cardiorespi-ratory fitness and muscle strength, minimizing fatigue, enhancinghealth-related quality of life (HRQOL), and maximizing chemotherapycompletion rates of patients undergoing adjuvant chemotherapy forbreast and colon cancer. METHODS: In this multicenter, prospective,253 patients were randomized to: Onco-Move (n = 85), OnTrack(n = 83) or a Usual Care (n = 85). Outcomes included both perfor-mance and self-report measures of cardiorespiratory fitness and musclestrength, self-reported fatigue, HRQOL and chemotherapy completionrates as determined by medical record review. Outcome measures wereassessed prior to chemotherapy, at the end of chemotherapy, and6 months later. RESULTS: Participants in OnTrack had significantlyless decline in cardiorespiratory fitness (ES = 0.52 and ES = 1.17),enhanced muscle strength (ES = 0.59) and experienced less physicalfatigue (ES = 0.64) as compared to the control group. Both exercisegroups reported better physical functioning (ES = 0.62), less nausea(ES = 0.43) and pain (ES = 0.33). Only participants in OnTrackreported less constipation (ES = 0.78) at follow-up than the controlgroup. Significantly more participants in OnTrack completed theirprescribed chemotherapy regimen without dose adjustments than thosein the control group (84 % versus 62 %) (OR 3.3). CONCLUSIONS:High intensity physical exercise during chemotherapy enhances musclestrength, reduces the decline in cardiorespiratory fitness and fatigue,and leads to less dose reductions in chemotherapy regimens. Lowintensity exercise also has a salutary effect on physical fatigue and othersymptoms, but less so than high intensity exercise.(105.2) Quality of life among patients after bilateral prophylacticmastectomy: A systematic review of patient-reported outcomesShantanu N. Razdan, MD MSPH, Memorial Sloan-Kettering CancerCenter, New York, NY, United States; Vishal Patel, BS, WeillCornell Medical College; Colleen McCarthy, MD MS, MemorialSloan Kettering Cancer Center, New York, NY, United StatesQual Life Res (2014) 23:1–184 21123

Effect of low versus high intensity physical exercise during chemotherapy on physical fitness, fatigue and chemotherapy completion rates:Results of a randomized, controlled trial

Effect of low versus high intensity physical exercise during chemotherapy on physical fitness, fatigue and chemotherapy completion rates:Results of a randomized, controlled trial

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