To investigate the feasibility and efficacy of exercise to improve physical functioning, body composition, and patient-rated outcomes in patients with malignant pleural disease (MPD).
Thirty patients with MPD were recruited to complete an exercise training intervention (final accrual of 35 has been met; data collection ongoing). The exercise intervention involved progressive resistance exercise training three times/week for 6-weeks. Outcomes assessed at baseline and post-intervention included muscular strength (1-repetition maximum leg press), functional capacity (6-Minute Walk Test), physical functioning (timed up and go), body composition (DXA scan), fatigue (FACIT-Fatigue), quality of life (Short-Form 36 Health Survey), ratings of intervention burden and acceptability (7-point Likert scale; 1, not at all, to 7, very much). The Wilcoxon Signed Rank Test or Paired T-test was used to assess changes over time.
Mean participant age was 65 (SD =10) years. The majority had mesothelioma (93%), ECOG performance status 0-1 (97%), and were male (70%). Twenty-four participants (80%) completed the intervention; 22 (73%) completed all post-intervention assessments. Median adherence to supervised exercise was 100% (range 11%-100%). Median ratings of trial evaluation were high (i.e., 7/7 for all measures) and intervention burden were low (i.e., <2/7 for all items). Post intervention, significant improvements were found for mean six-minute walk distance (+57.5 m; 95% CI 21.5-93.5; p=0.003), 1-repetition maximum leg press (+16.6 kg; 95% CI 10.6-22.7; p<0.001) and timed up and go (-0.52 sec; 95% CI -0.99 - -0.05; p=0.03). No significant changes were observed in mean lean mass (+0.6 kg; 95% CI -0.2 – 1.4; p=0.11) or fat mass (-1.7 kg; 95% CI -5.3-2.0; p=0.35). In patient-rated outcomes, only the mental health subscale of SF-36 improved post intervention (median change +1.3, IQR 0.0, 5.2; p=0.03).
Progressive resistance exercise training is a feasible intervention with measurable health benefits for patients with MPD.