Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

Feasibility and preliminary efficacy of a six-week exercise intervention in patients with malignant pleural disease. (#401)

Carolyn J McIntyre 1 , Emily Jeffery 1 , Y C Gary Lee 2 3 4 , Anna K Nowak 4 5 6 , Bella Nguyen 5 , Rob U Newton 1 7
  1. Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
  2. Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  3. Institute for Respiratory Health, Nedlands, Western Australia, Australia
  4. School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia
  5. Medical Oncology Department, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
  6. National Centre for Asbestos Related Diseases, Nedlands, WA, Australia
  7. UQ Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia

Aim:

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).

Methods:

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.

Results:

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).

Conclusion:

Progressive resistance exercise training is a feasible intervention with measurable health benefits for patients with MPD.