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Differential effects of cardiovascular and resistance exercise on functional mobility in individuals with advanced
Amy J Litterini1, Vickie K Fieler1, James T Cavanaugh2
1Center for Cancer Care, Exeter Hospital, Exeter, NH.
Objective:
To compare the effects of resistance and cardiovascular exercise on functional mobility in individuals with advanced cancer.
Design:
Prospective, 2-group pretest-posttest pilot study with randomization to either resistance or cardiovascular exercise mode.
Setting:
Comprehensive community cancer center and a hospital-based fitness facility.
Participants:
Volunteer sample of individuals (N=66; 30 men; 36 women; mean age, 62y) with advanced cancer recruited through the cancer center, palliative care service, rehabilitation department, and a local hospice.
Interventions:
Ten weeks of individualized resistance or cardiovascular exercise, prescribed and monitored by oncology-trained exercise personnel.
Main Outcome Measures:
Functional mobility was assessed using the Short Physical Performance Battery (SPPB); self-reported pain and fatigue were assessed secondarily using visual analog scales. Data were analyzed using a split plot 2×2 analysis of variance (α=.05).
Results:
Fifty-two patients (78.8%) completed the study: 23 (67.7%) of 34 patients in the resistance arm and 29 (90.6%) of 32 patients in the cardiovascular arm. No participant withdrew because of study adverse events. Ten-week outcomes (n=52) included a significant increase in SPPB total score (P<.001), increase in gait speed (P=.001), and reduction in fatigue (P=.05). Although cardiovascular exercise participants had a modestly greater improvement in SPPB total score than resistance training participants (F1,49=4.21, P=.045), the difference was not confirmed in a subsequent intention-to-treat analysis (N=66).
Conclusions:
Individuals with advanced cancer appear to benefit from exercise for improving functional mobility. Neither resistance nor cardiovascular exercise appeared to have a strong differential effect on outcome.
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