Morten Quist - Academia.edu (original) (raw)

Papers by Morten Quist

Research paper thumbnail of The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue

European Journal of Oncology Nursing, 2013

Purpose: Cancer related fatigue (CRF) is a common problem for cancer patients across diagnoses du... more Purpose: Cancer related fatigue (CRF) is a common problem for cancer patients across diagnoses during chemotherapy and is associated with physical inactivity, lower functional level and lack of energy. Few RCT exercise intervention studies have included cancer patients undergoing chemotherapy. The objective of this study is to evaluate whether a six-week supervised multimodal exercise intervention, adjunct to chemotherapy and standard care, can reduce the patient's CRF level. Methods: Data is based on analyses of a prospective randomised controlled trial 'The Body & Cancer Trial'. 213 cancer patients with different diagnoses were randomised into an intervention group or wait-list control group. The primary outcome, Fatigue score (CRF), was evaluated by the Functional Assessment of Cancer Therapy-Anaemia Questionnaire (FACT-An-) (FACT-G score & FACT-An Anemia subscale). Intervention: Supervised exercise, comprising high-intensity cardiovascular and heavy resistance training, relaxation-and body awareness training and massage, 9 h weekly for 6 weeks. Results: CRF was significantly reduced in the intervention group, corresponding to a Fatigue score reduction of 3.04 (effect size of 0.44, 95% CI 0.17e0.72) (P ¼ .002), the FACT-An score by 5.40 (P ¼ .015), the FACT-An Toi score by 5.22 (P ¼ .009) and the Anaemia-ANS by 3.76 (P ¼ .002). There was no statistically significant effect on the General Quality of Life score (FACT-G) or on any of the individual wellbeing scores; Physical (P ¼ .13), Emotional (P ¼ .87), Social (P ¼ .83) and Functional (P ¼ .26). Conclusion: In summary, this six-week supervised multimodal exercise intervention can lead to significant reduction in self-reported CRF in cancer patients undergoing chemotherapy.

Research paper thumbnail of Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals

JCO Oncology Practice, 2022

PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the ... more PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, ...

Research paper thumbnail of Exercise for individuals with bone metastases: A systematic review

Critical Reviews in Oncology/Hematology, 2021

Background: Exercise has the potential to improve physical function and quality of life in indivi... more Background: Exercise has the potential to improve physical function and quality of life in individuals with bone metastases but is often avoided due to safety concerns. This systematic review summarizes the safety, feasibility and efficacy of exercise in controlled trials that include individuals with bone metastases. Methods: MEDLINE, Embase, Pubmed, CINAHL, PEDro and CENTRAL databases were searched to July 16, 2020. Results: A total of 17 trials were included incorporating aerobic exercise, resistance exercise or soccer interventions. Few (n = 4, 0.5%) serious adverse events were attributed to exercise participation, with none related to bone metastases. Mixed efficacy results were found, with exercise eliciting positive changes or no change. The majority of trials included an element of supervised exercise instruction (n = 16, 94%) and were delivered by qualified exercise professionals (n = 13, 76%). Conclusions: Exercise appears safe and feasible for individuals with bone metastases when it includes an element of supervised exercise instruction.

Research paper thumbnail of Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: A pilot study

Lung Cancer, 2012

To investigate the safety and feasibility of a six-week supervised structured exercise and relaxa... more To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy. A prospective, single-arm intervention study of supervised, hospital based muscle and cardiovascular group training and individual home-based training. Peak oxygen consumption (VO(2peak)) was assessed using an incremental exercise test. Muscle strength was measured with one repetition maximum test (1RM). HRQOL was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. Twenty-five patients with non-small cell cancer (NSCLC) stage III-IV and four patients with extensive disease small cell lung cancer (SCLC-ED) were recruited. Six patients (20.7%) dropped out leaving 23 patients for analysis. Exercise adherence in the group training was 73.0% and 8.7% in the home-based training. There were improvements in estimated VO(2peak) and six-minute walk distance (6 MWD) as well as increased muscle strength measurements (p<0.05). There was significant improvement in the "emotional well-being" parameter (FACT-L) while there were no significant changes in HRQOL. Exercise training produces significant improvements in physiological indices and emotional HRQOL and is safe and feasible in patients with advanced stage lung cancer, undergoing chemotherapy. No analysis on home-based training was done because of low adherence.

Research paper thumbnail of Effects of an exercise intervention for patients with advanced inoperable lung cancer undergoing chemotherapy: A randomized clinical trial

Lung Cancer, 2020

OBJECTIVE Exercise can improve treatment-related side effects, quality of life, and function in p... more OBJECTIVE Exercise can improve treatment-related side effects, quality of life, and function in patients with various types of cancer; however, more evidence is needed for patients with advanced inoperable lung cancer. MATERIAL AND METHODS We randomized 218 patients with advanced inoperable lung cancer to a 12-week supervised, structured exercise training program (aerobic, strength, and relaxation training) twice weekly versus usual care. Primary outcome was change in maximal oxygen uptake (VO2 peak). Secondary outcomes were muscle strength, functional capacity, forced expiratory volume in 1 s, health-related quality of life, anxiety, and depression. RESULTS There was no significant difference between the intervention and control groups in VO2 peak. There was a significant improvement in muscle strength. There was also a significant difference between the two for social well-being (Functional Assessment of Cancer Therapy-Lung, FACT-L), anxiety, and depression. CONCLUSION There was a significant reduction in the level of anxiety and depression and a significant increase in all muscle strength outcomes in the intervention group compared to patients randomized to usual care. There was a significant difference between the groups for social well-being. The primary outcome did not show a significant improvement in VO2 peak. Based on our results, future patients with advanced inoperable lung cancer should be considered for supervised exercise during the course of their disease.

Research paper thumbnail of OA04.07 Early Initiated Postoperative Rehabilitation Reduces Fatigue in Patients with Operable Lung Cancer: A Randomized Trial

Journal of Thoracic Oncology

Research paper thumbnail of Benefits and Rationale for Exercise During Cancer Therapy

Exercise, Energy Balance, and Cancer, 2012

In comparison with other areas of clinical medicine, exercise therapy has received comparably les... more In comparison with other areas of clinical medicine, exercise therapy has received comparably less attention in persons following a diagnosis of cancer. The precise reasons for this are unknown but likely stem from the prevailing dogma that a cancer diagnosis is associated with poor survival, a compromised immune system, that may be more compromised by exercise training, and other debilitating side-effects that preclude participation in and benefit from exercise training as reported by Jones and Peppercorn (Lancet Oncol 11(5):408–410, 2010). Nevertheless, the past two decades have witnessed a dramatic change in attitude with a significant increase in research and clinical interest in the role of exercise therapy following a cancer diagnosis as reported by Jones and Peppercorn (Lancet Oncol 11(5):408–410, 2010). The increased interest in exercise has occurred in conjunction with the emergence of cancer survivorship and the growing importance of managing the late-effects of cancer therapy in persons who are now living much longer following a cancer diagnosis.

Research paper thumbnail of 8161 POSTER “Sports were my whole life – I had a perfect body before getting cancer”: young athletes rediscover aspects of former body identity during exercise – qualitative findings

European Journal of Cancer Supplements, 2007

Research paper thumbnail of 1172 Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

European Journal of Cancer Supplements, 2003

Research paper thumbnail of Exercise and relaxation intervention for patients with advanced lung cancer: a qualitative feasibility study

Scandinavian Journal of Medicine and Science in Sports

Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psyc... more Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psychological distress. The aim of this study was to explore feasibility, health benefits and barriers of exercise in former sedentary patients with advanced stage lung cancer, non-small cell lung cancer (NSCLC) (III-IV) and small cell lung cancer (SCLC) (ED), undergoing chemotherapy. The intervention consisted of a hospital-based, supervised, group exercise and relaxation program comprising resistance-, cardiovascular- and relaxation training 4 h weekly, 6 weeks, and a concurrent unsupervised home-based exercise program. An explorative study using individual semi-structured interviews (n=15) and one focus group interview (n=8) was conducted among the participants. Throughout the intervention the patients experienced increased muscle strength, improvement in wellbeing, breathlessness and energy. The group exercise and relaxation intervention showed an adherence rate of 76%, whereas the patie...

Research paper thumbnail of Exercise may reduce depression but not anxiety in self-referred cancer patients undergoing chemotherapy. Post-hoc analysis of data from the 'Body & Cancer' trial

Acta oncologica (Stockholm, Sweden)

Abstract Background. The diagnosis and treatment of cancer may cause clinically significant and p... more Abstract Background. The diagnosis and treatment of cancer may cause clinically significant and persistent psychological morbidity. The objective of this study was to determine the short-term effect of a six week exercise intervention on anxiety and depression in cancer patients undergoing chemotherapy (The 'Body & Cancer' trial). Methods. Two hundred and nine self-referred patients (52 males, 157 females, mean age 47 years) were randomised into an intervention group and a waiting-list control group. Anxiety and depression was measured by the Hospital Anxiety and Depression Scale. Results. At baseline, 23.5% and 11.5% of the population scored >8 on the HADS and were classified as suspicious or definite cases of anxiety and depression, respectively. Adjusted for baseline score, disease and demographic covariates the estimated intervention effect showed improvement at six weeks for depression of -0.7 points (95% confidence interval [CI] -1.27 to -0.14, p = 0.0153). No signi...

Research paper thumbnail of Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial

BMJ (online)

To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional c... more To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease. Randomised controlled trial. Two university hospitals in Copenhagen, Denmark. 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow-up. Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Medical Outcomes Study Short Form (MOS SF-36), Leisure Time Physical Activity Questionnaire, m...

Research paper thumbnail of Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy

European journal of oncology nursing: the official journal of European Oncology Nursing Society

Physical activity is considered an important and determining factor for the cancer patient's ... more Physical activity is considered an important and determining factor for the cancer patient's physical well-being and quality of life. However, cancer treatment may disrupt the practice of physical activity, and the prevention of sedentary lifestyles in cancer survivors is imperative. The current study aimed at investigating self-reported physical activity behaviour, exercise motivation and information in cancer patients undergoing chemotherapy. Using a cross-sectional design, 451 patients (18-65 years) completed a questionnaire assessing pre-illness and present physical activity; motivation and information received. Patients reported a significant decline in physical activity from pre-illness to the time in active treatment (p<0.001). Amongst the respondents, 68% answered that they believed exercise to be beneficial; and 78% claimed not exercising as much as desired. Exercise barriers included fatigue (74%) and physical discomfort (45%). Present physical activity behaviour wa...

Research paper thumbnail of The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy--the use of semi-structured diaries

European Journal of Oncology Nursing

The aim of this study was to evaluate the effects of a 6-week intervention with structured physic... more The aim of this study was to evaluate the effects of a 6-week intervention with structured physical activity, relaxation, body-awareness techniques and massage on the symptoms/side-effects of cancer patients undergoing chemotherapy. The study was prospective and exploratory, and 54 patients completed assessments for all 6 weeks of the intervention. In order to obtain a continuous record of side-effects, a diary was developed for the patients' use throughout the intervention. The patients scored their symptoms/side-effects on a scale from 0 to 4, using the Common Toxicity Criteria and reported these scores in questionnaires. Twelve possible symptoms/side-effects were registered daily: lack of appetite, nausea, vomiting, diarrhea, paraesthesia, constipation, physical fatigue, mental fatigue, treatment-related fatigue, muscle pain, arthralgia and other pain. During the intervention a decrease in the scoring for 10 out of the 12 side-effects was found. Statistical significance was o...

Research paper thumbnail of The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: a phase II study

Palliative and Supportive Care

Little is known about the role of exercise in improving cancer patients' mood while undergoin... more Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91 patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p < 0.001) and depression (p = 0.042) was significantly reduced. The mean +/- SD of the change was -1.14 +/- 2.91 for anxiety and -0.44 +/- 2.77 for depression. Improvements in fitness were correlated with improvements in depression, chi2(1) = 3.966, p = 0.046, but not with improvements in anxiety, chi2(1) = 0.540, p = 0.462. The research suggests that exercise intervention may have a beneficial impact on psychological distress for cancer patients receiving chemotherapy with low to moderate levels of ba...

Research paper thumbnail of The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

Integrative cancer therapies, Jan 22, 2015

Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic p... more Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic physical and psychosocial symptoms. Despite several years of research in exercise oncology, few exercise studies have targeted advanced lung cancer patients undergoing chemotherapy. The aim of the present study was to investigate the benefits of a 6-week supervised group exercise intervention and to outline the effect on aerobic capacity, strength, health-related quality of life (HRQoL), anxiety, and depression. VO2peak was assessed using an incremental exercise test. Muscle strength was measured with one repetition maximum test (1RM). HRQoL, anxiety, and depression were assessed using Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the Hospital Anxiety and Depression Scale (HADS). One hundred and forthteen patients with advanced stage lung cancer were recruited. Forty-three patients dropped out. No serious adverse events were reported. Exercise adherence in the group trai...

Research paper thumbnail of Prognostic significance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer

Lung Cancer, 2012

Background-To investigate the prognostic importance of functional capacity and exercise behavior ... more Background-To investigate the prognostic importance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer (NSCLC).

Research paper thumbnail of The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy

Supportive Care in Cancer, 2006

The aim of the present study was to investigate the impact of a multidimensional exercise interve... more The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity; one-repetition maximum (1RM) and maximum oxygen uptake (VO 2 Max), activity level, general well-being and quality of life in cancer patients undergoing chemotherapy. The intervention comprised resistance and fitness training, massage, relaxation and body-awareness training.

Research paper thumbnail of Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

Supportive Care in Cancer, 2003

terms of repetition maximum (RM) and maximal oxygen uptake (VO 2 max), physical activity level an... more terms of repetition maximum (RM) and maximal oxygen uptake (VO 2 max), physical activity level and psychosocial wellbeing (EORTC QLQ-C30, SF-36, HAD) were compared prior to and after completion of the program. The program was safe and well tolerated. The completion rate was 85.2%. Highly significant increases in physical capacity (1RM, VO 2 max) and an improved level of physical activity were achieved. Quality of life and general wellbeing assessments indicated improvements in several measures, but without reaching significance. It is concluded that an exercise program, which combines high-and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy.

Research paper thumbnail of Maximum physical capacity testing in cancer patients undergoing chemotherapy: qualitative findings from an exercise program

Scandinavian Journal of Medicine and Science in Sports, 2006

Background: Over the past few years there has been a growing interest in the field of physical ex... more Background: Over the past few years there has been a growing interest in the field of physical exercise in rehabilitation of cancer patients, leading to requirements for objective maximum physical capacity measurement (maximum oxygen uptake (VO 2max ) and one-repetition maximum (1RM)) to determine dose-response levels in different cancer diagnoses. Aim: To explore the patients' experiences of maximum physical capacity testing while concurrently undergoing chemotherapy and participating in a 6-week, 9 h weekly multidimensional exercise program. Design and method: Prospective, exploratory study using semi-structured qualitative interviews conducted prior to and at termination of the program. The study included 100 Scand J Med Sci Sports

Research paper thumbnail of The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue

European Journal of Oncology Nursing, 2013

Purpose: Cancer related fatigue (CRF) is a common problem for cancer patients across diagnoses du... more Purpose: Cancer related fatigue (CRF) is a common problem for cancer patients across diagnoses during chemotherapy and is associated with physical inactivity, lower functional level and lack of energy. Few RCT exercise intervention studies have included cancer patients undergoing chemotherapy. The objective of this study is to evaluate whether a six-week supervised multimodal exercise intervention, adjunct to chemotherapy and standard care, can reduce the patient's CRF level. Methods: Data is based on analyses of a prospective randomised controlled trial 'The Body & Cancer Trial'. 213 cancer patients with different diagnoses were randomised into an intervention group or wait-list control group. The primary outcome, Fatigue score (CRF), was evaluated by the Functional Assessment of Cancer Therapy-Anaemia Questionnaire (FACT-An-) (FACT-G score & FACT-An Anemia subscale). Intervention: Supervised exercise, comprising high-intensity cardiovascular and heavy resistance training, relaxation-and body awareness training and massage, 9 h weekly for 6 weeks. Results: CRF was significantly reduced in the intervention group, corresponding to a Fatigue score reduction of 3.04 (effect size of 0.44, 95% CI 0.17e0.72) (P ¼ .002), the FACT-An score by 5.40 (P ¼ .015), the FACT-An Toi score by 5.22 (P ¼ .009) and the Anaemia-ANS by 3.76 (P ¼ .002). There was no statistically significant effect on the General Quality of Life score (FACT-G) or on any of the individual wellbeing scores; Physical (P ¼ .13), Emotional (P ¼ .87), Social (P ¼ .83) and Functional (P ¼ .26). Conclusion: In summary, this six-week supervised multimodal exercise intervention can lead to significant reduction in self-reported CRF in cancer patients undergoing chemotherapy.

Research paper thumbnail of Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals

JCO Oncology Practice, 2022

PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the ... more PURPOSE: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. METHODS: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. RESULTS: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, ...

Research paper thumbnail of Exercise for individuals with bone metastases: A systematic review

Critical Reviews in Oncology/Hematology, 2021

Background: Exercise has the potential to improve physical function and quality of life in indivi... more Background: Exercise has the potential to improve physical function and quality of life in individuals with bone metastases but is often avoided due to safety concerns. This systematic review summarizes the safety, feasibility and efficacy of exercise in controlled trials that include individuals with bone metastases. Methods: MEDLINE, Embase, Pubmed, CINAHL, PEDro and CENTRAL databases were searched to July 16, 2020. Results: A total of 17 trials were included incorporating aerobic exercise, resistance exercise or soccer interventions. Few (n = 4, 0.5%) serious adverse events were attributed to exercise participation, with none related to bone metastases. Mixed efficacy results were found, with exercise eliciting positive changes or no change. The majority of trials included an element of supervised exercise instruction (n = 16, 94%) and were delivered by qualified exercise professionals (n = 13, 76%). Conclusions: Exercise appears safe and feasible for individuals with bone metastases when it includes an element of supervised exercise instruction.

Research paper thumbnail of Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: A pilot study

Lung Cancer, 2012

To investigate the safety and feasibility of a six-week supervised structured exercise and relaxa... more To investigate the safety and feasibility of a six-week supervised structured exercise and relaxation training programme on estimated peak oxygen consumption, muscle strength and health related quality of life (HRHRQOL) in patients with inoperable lung cancer, undergoing chemotherapy. A prospective, single-arm intervention study of supervised, hospital based muscle and cardiovascular group training and individual home-based training. Peak oxygen consumption (VO(2peak)) was assessed using an incremental exercise test. Muscle strength was measured with one repetition maximum test (1RM). HRQOL was assessed using the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. Twenty-five patients with non-small cell cancer (NSCLC) stage III-IV and four patients with extensive disease small cell lung cancer (SCLC-ED) were recruited. Six patients (20.7%) dropped out leaving 23 patients for analysis. Exercise adherence in the group training was 73.0% and 8.7% in the home-based training. There were improvements in estimated VO(2peak) and six-minute walk distance (6 MWD) as well as increased muscle strength measurements (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). There was significant improvement in the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;emotional well-being&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; parameter (FACT-L) while there were no significant changes in HRQOL. Exercise training produces significant improvements in physiological indices and emotional HRQOL and is safe and feasible in patients with advanced stage lung cancer, undergoing chemotherapy. No analysis on home-based training was done because of low adherence.

Research paper thumbnail of Effects of an exercise intervention for patients with advanced inoperable lung cancer undergoing chemotherapy: A randomized clinical trial

Lung Cancer, 2020

OBJECTIVE Exercise can improve treatment-related side effects, quality of life, and function in p... more OBJECTIVE Exercise can improve treatment-related side effects, quality of life, and function in patients with various types of cancer; however, more evidence is needed for patients with advanced inoperable lung cancer. MATERIAL AND METHODS We randomized 218 patients with advanced inoperable lung cancer to a 12-week supervised, structured exercise training program (aerobic, strength, and relaxation training) twice weekly versus usual care. Primary outcome was change in maximal oxygen uptake (VO2 peak). Secondary outcomes were muscle strength, functional capacity, forced expiratory volume in 1 s, health-related quality of life, anxiety, and depression. RESULTS There was no significant difference between the intervention and control groups in VO2 peak. There was a significant improvement in muscle strength. There was also a significant difference between the two for social well-being (Functional Assessment of Cancer Therapy-Lung, FACT-L), anxiety, and depression. CONCLUSION There was a significant reduction in the level of anxiety and depression and a significant increase in all muscle strength outcomes in the intervention group compared to patients randomized to usual care. There was a significant difference between the groups for social well-being. The primary outcome did not show a significant improvement in VO2 peak. Based on our results, future patients with advanced inoperable lung cancer should be considered for supervised exercise during the course of their disease.

Research paper thumbnail of OA04.07 Early Initiated Postoperative Rehabilitation Reduces Fatigue in Patients with Operable Lung Cancer: A Randomized Trial

Journal of Thoracic Oncology

Research paper thumbnail of Benefits and Rationale for Exercise During Cancer Therapy

Exercise, Energy Balance, and Cancer, 2012

In comparison with other areas of clinical medicine, exercise therapy has received comparably les... more In comparison with other areas of clinical medicine, exercise therapy has received comparably less attention in persons following a diagnosis of cancer. The precise reasons for this are unknown but likely stem from the prevailing dogma that a cancer diagnosis is associated with poor survival, a compromised immune system, that may be more compromised by exercise training, and other debilitating side-effects that preclude participation in and benefit from exercise training as reported by Jones and Peppercorn (Lancet Oncol 11(5):408–410, 2010). Nevertheless, the past two decades have witnessed a dramatic change in attitude with a significant increase in research and clinical interest in the role of exercise therapy following a cancer diagnosis as reported by Jones and Peppercorn (Lancet Oncol 11(5):408–410, 2010). The increased interest in exercise has occurred in conjunction with the emergence of cancer survivorship and the growing importance of managing the late-effects of cancer therapy in persons who are now living much longer following a cancer diagnosis.

Research paper thumbnail of 8161 POSTER “Sports were my whole life – I had a perfect body before getting cancer”: young athletes rediscover aspects of former body identity during exercise – qualitative findings

European Journal of Cancer Supplements, 2007

Research paper thumbnail of 1172 Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

European Journal of Cancer Supplements, 2003

Research paper thumbnail of Exercise and relaxation intervention for patients with advanced lung cancer: a qualitative feasibility study

Scandinavian Journal of Medicine and Science in Sports

Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psyc... more Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psychological distress. The aim of this study was to explore feasibility, health benefits and barriers of exercise in former sedentary patients with advanced stage lung cancer, non-small cell lung cancer (NSCLC) (III-IV) and small cell lung cancer (SCLC) (ED), undergoing chemotherapy. The intervention consisted of a hospital-based, supervised, group exercise and relaxation program comprising resistance-, cardiovascular- and relaxation training 4 h weekly, 6 weeks, and a concurrent unsupervised home-based exercise program. An explorative study using individual semi-structured interviews (n=15) and one focus group interview (n=8) was conducted among the participants. Throughout the intervention the patients experienced increased muscle strength, improvement in wellbeing, breathlessness and energy. The group exercise and relaxation intervention showed an adherence rate of 76%, whereas the patie...

Research paper thumbnail of Exercise may reduce depression but not anxiety in self-referred cancer patients undergoing chemotherapy. Post-hoc analysis of data from the 'Body & Cancer' trial

Acta oncologica (Stockholm, Sweden)

Abstract Background. The diagnosis and treatment of cancer may cause clinically significant and p... more Abstract Background. The diagnosis and treatment of cancer may cause clinically significant and persistent psychological morbidity. The objective of this study was to determine the short-term effect of a six week exercise intervention on anxiety and depression in cancer patients undergoing chemotherapy (The 'Body & Cancer' trial). Methods. Two hundred and nine self-referred patients (52 males, 157 females, mean age 47 years) were randomised into an intervention group and a waiting-list control group. Anxiety and depression was measured by the Hospital Anxiety and Depression Scale. Results. At baseline, 23.5% and 11.5% of the population scored >8 on the HADS and were classified as suspicious or definite cases of anxiety and depression, respectively. Adjusted for baseline score, disease and demographic covariates the estimated intervention effect showed improvement at six weeks for depression of -0.7 points (95% confidence interval [CI] -1.27 to -0.14, p = 0.0153). No signi...

Research paper thumbnail of Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial

BMJ (online)

To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional c... more To assess the effect of a multimodal group exercise intervention, as an adjunct to conventional care, on fatigue, physical capacity, general wellbeing, physical activity, and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease. Randomised controlled trial. Two university hospitals in Copenhagen, Denmark. 269 patients with cancer; 73 men, 196 women, mean age 47 years (range 20-65) representing 21 diagnoses. Main exclusion criteria were brain or bone metastases. 235 patients completed follow-up. Supervised exercise comprising high intensity cardiovascular and resistance training, relaxation and body awareness training, massage, nine hours weekly for six weeks in addition to conventional care, compared with conventional care. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Medical Outcomes Study Short Form (MOS SF-36), Leisure Time Physical Activity Questionnaire, m...

Research paper thumbnail of Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy

European journal of oncology nursing: the official journal of European Oncology Nursing Society

Physical activity is considered an important and determining factor for the cancer patient's ... more Physical activity is considered an important and determining factor for the cancer patient's physical well-being and quality of life. However, cancer treatment may disrupt the practice of physical activity, and the prevention of sedentary lifestyles in cancer survivors is imperative. The current study aimed at investigating self-reported physical activity behaviour, exercise motivation and information in cancer patients undergoing chemotherapy. Using a cross-sectional design, 451 patients (18-65 years) completed a questionnaire assessing pre-illness and present physical activity; motivation and information received. Patients reported a significant decline in physical activity from pre-illness to the time in active treatment (p<0.001). Amongst the respondents, 68% answered that they believed exercise to be beneficial; and 78% claimed not exercising as much as desired. Exercise barriers included fatigue (74%) and physical discomfort (45%). Present physical activity behaviour wa...

Research paper thumbnail of The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy--the use of semi-structured diaries

European Journal of Oncology Nursing

The aim of this study was to evaluate the effects of a 6-week intervention with structured physic... more The aim of this study was to evaluate the effects of a 6-week intervention with structured physical activity, relaxation, body-awareness techniques and massage on the symptoms/side-effects of cancer patients undergoing chemotherapy. The study was prospective and exploratory, and 54 patients completed assessments for all 6 weeks of the intervention. In order to obtain a continuous record of side-effects, a diary was developed for the patients' use throughout the intervention. The patients scored their symptoms/side-effects on a scale from 0 to 4, using the Common Toxicity Criteria and reported these scores in questionnaires. Twelve possible symptoms/side-effects were registered daily: lack of appetite, nausea, vomiting, diarrhea, paraesthesia, constipation, physical fatigue, mental fatigue, treatment-related fatigue, muscle pain, arthralgia and other pain. During the intervention a decrease in the scoring for 10 out of the 12 side-effects was found. Statistical significance was o...

Research paper thumbnail of The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: a phase II study

Palliative and Supportive Care

Little is known about the role of exercise in improving cancer patients' mood while undergoin... more Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91 patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p < 0.001) and depression (p = 0.042) was significantly reduced. The mean +/- SD of the change was -1.14 +/- 2.91 for anxiety and -0.44 +/- 2.77 for depression. Improvements in fitness were correlated with improvements in depression, chi2(1) = 3.966, p = 0.046, but not with improvements in anxiety, chi2(1) = 0.540, p = 0.462. The research suggests that exercise intervention may have a beneficial impact on psychological distress for cancer patients receiving chemotherapy with low to moderate levels of ba...

Research paper thumbnail of The Impact of a Multidimensional Exercise Intervention on Physical and Functional Capacity, Anxiety, and Depression in Patients With Advanced-Stage Lung Cancer Undergoing Chemotherapy

Integrative cancer therapies, Jan 22, 2015

Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic p... more Patients with advanced-stage lung cancer face poor survival and experience co-occurring chronic physical and psychosocial symptoms. Despite several years of research in exercise oncology, few exercise studies have targeted advanced lung cancer patients undergoing chemotherapy. The aim of the present study was to investigate the benefits of a 6-week supervised group exercise intervention and to outline the effect on aerobic capacity, strength, health-related quality of life (HRQoL), anxiety, and depression. VO2peak was assessed using an incremental exercise test. Muscle strength was measured with one repetition maximum test (1RM). HRQoL, anxiety, and depression were assessed using Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the Hospital Anxiety and Depression Scale (HADS). One hundred and forthteen patients with advanced stage lung cancer were recruited. Forty-three patients dropped out. No serious adverse events were reported. Exercise adherence in the group trai...

Research paper thumbnail of Prognostic significance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer

Lung Cancer, 2012

Background-To investigate the prognostic importance of functional capacity and exercise behavior ... more Background-To investigate the prognostic importance of functional capacity and exercise behavior in patients with metastatic non-small cell lung cancer (NSCLC).

Research paper thumbnail of The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy

Supportive Care in Cancer, 2006

The aim of the present study was to investigate the impact of a multidimensional exercise interve... more The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity; one-repetition maximum (1RM) and maximum oxygen uptake (VO 2 Max), activity level, general well-being and quality of life in cancer patients undergoing chemotherapy. The intervention comprised resistance and fitness training, massage, relaxation and body-awareness training.

Research paper thumbnail of Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy

Supportive Care in Cancer, 2003

terms of repetition maximum (RM) and maximal oxygen uptake (VO 2 max), physical activity level an... more terms of repetition maximum (RM) and maximal oxygen uptake (VO 2 max), physical activity level and psychosocial wellbeing (EORTC QLQ-C30, SF-36, HAD) were compared prior to and after completion of the program. The program was safe and well tolerated. The completion rate was 85.2%. Highly significant increases in physical capacity (1RM, VO 2 max) and an improved level of physical activity were achieved. Quality of life and general wellbeing assessments indicated improvements in several measures, but without reaching significance. It is concluded that an exercise program, which combines high-and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy.

Research paper thumbnail of Maximum physical capacity testing in cancer patients undergoing chemotherapy: qualitative findings from an exercise program

Scandinavian Journal of Medicine and Science in Sports, 2006

Background: Over the past few years there has been a growing interest in the field of physical ex... more Background: Over the past few years there has been a growing interest in the field of physical exercise in rehabilitation of cancer patients, leading to requirements for objective maximum physical capacity measurement (maximum oxygen uptake (VO 2max ) and one-repetition maximum (1RM)) to determine dose-response levels in different cancer diagnoses. Aim: To explore the patients' experiences of maximum physical capacity testing while concurrently undergoing chemotherapy and participating in a 6-week, 9 h weekly multidimensional exercise program. Design and method: Prospective, exploratory study using semi-structured qualitative interviews conducted prior to and at termination of the program. The study included 100 Scand J Med Sci Sports