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Physical activity levels in locally advanced rectal cancer patients following neoadjuvant chemoradiotherapy and an exercise training programme before surgery: a pilot study

Physical activity levels in locally advanced rectal cancer patients following neoadjuvant chemoradiotherapy and an exercise training programme before surgery: a pilot study
Physical activity levels in locally advanced rectal cancer patients following neoadjuvant chemoradiotherapy and an exercise training programme before surgery: a pilot study
BackgroundThe aim of this pilot study was to measure changes in physical activity level (PAL) variables, as well as sleep duration and efficiency in people with locally advanced rectal cancer (1) before and after neoadjuvant chemoradiotherapy (CRT) and (2) after participating in a pre-operative 6-week in-hospital exercise training programme, following neoadjuvant CRT prior to major surgery, compared to a usual care control group.MethodsWe prospectively studied 39 consecutive participants (27 males). All participants completed standardised neoadjuvant CRT: 23 undertook a 6-week in-hospital exercise training programme following neoadjuvant CRT. These were compared to 16 contemporaneous non-randomised participants (usual care control group). All participants underwent a continuous 72-h period of PA monitoring by SenseWear biaxial accelerometer at baseline, immediately following neoadjuvant CRT (week 0), and at week 6 (following the exercise training programme).ResultsOf 39 recruited participants, 23 out of 23 (exercise) and 10 out of 16 (usual care control) completed the study. In all participants (n = 33), there was a significant reduction from baseline (pre-CRT) to week 0 (post-CRT) in daily step count: median (IQR) 4966 (4435) vs. 3044 (3265); p < 0.0001, active energy expenditure (EE) (kcal): 264 (471) vs. 154 (164); p = 0.003, and metabolic equivalent (MET) (1.3 (0.6) vs. 1.2 (0.3); p = 0.010). There was a significant improvement in sleep efficiency (%) between week 0 and week 6 in the exercise group compared to the usual care control group (80 (13) vs. 78 (15) compared to (69 ((24) vs. 76 (20); p = 0.022), as well as in sleep duration and lying down time (p < 0.05) while those in active EE (kcal) (152 (154) vs. 434 (658) compared to (244 (198) vs. 392 (701) or in MET (1.3 (0.4) vs. 1.5 (0.5) compared to (1.1 (0.2) vs. 1.5 (0.5) were also of importance but did not reach statistical significance (p > 0.05). An apparent improvement in daily step count and overall PAL in the exercise group was not statistically significant.ConclusionsPAL variables, daily step count, EE and MET significantly reduced following neoadjuvant CRT in all participants. A 6-week pre-operative in-hospital exercise training programme improved sleep efficiency, sleep duration and lying down time when compared to participants receiving usual care.
2047-0525
1-8
Loughney, Lisa
9c3e7db1-468b-405c-b32f-cedd9cc251fe
West, Malcolm
98b67e58-9875-4133-b236-8a10a0a12c04
Dimitrov, Borislav
366d715f-ffd9-45a1-8415-65de5488472f
Kemp, Graham
daf4d5c6-b98c-4b6c-a1b1-00c68933501d
Grocott, Michael
1e87b741-513e-4a22-be13-0f7bb344e8c2
Jack, Sandy
3275b6b3-9f60-4901-9b2f-b03aab101638
Loughney, Lisa
9c3e7db1-468b-405c-b32f-cedd9cc251fe
West, Malcolm
98b67e58-9875-4133-b236-8a10a0a12c04
Dimitrov, Borislav
366d715f-ffd9-45a1-8415-65de5488472f
Kemp, Graham
daf4d5c6-b98c-4b6c-a1b1-00c68933501d
Grocott, Michael
1e87b741-513e-4a22-be13-0f7bb344e8c2
Jack, Sandy
3275b6b3-9f60-4901-9b2f-b03aab101638

Loughney, Lisa, West, Malcolm, Dimitrov, Borislav, Kemp, Graham, Grocott, Michael and Jack, Sandy (2017) Physical activity levels in locally advanced rectal cancer patients following neoadjuvant chemoradiotherapy and an exercise training programme before surgery: a pilot study. Perioperative medicine, 6 (3), 1-8. (doi:10.1186/s13741-017-0058-3).

Record type: Article

Abstract

BackgroundThe aim of this pilot study was to measure changes in physical activity level (PAL) variables, as well as sleep duration and efficiency in people with locally advanced rectal cancer (1) before and after neoadjuvant chemoradiotherapy (CRT) and (2) after participating in a pre-operative 6-week in-hospital exercise training programme, following neoadjuvant CRT prior to major surgery, compared to a usual care control group.MethodsWe prospectively studied 39 consecutive participants (27 males). All participants completed standardised neoadjuvant CRT: 23 undertook a 6-week in-hospital exercise training programme following neoadjuvant CRT. These were compared to 16 contemporaneous non-randomised participants (usual care control group). All participants underwent a continuous 72-h period of PA monitoring by SenseWear biaxial accelerometer at baseline, immediately following neoadjuvant CRT (week 0), and at week 6 (following the exercise training programme).ResultsOf 39 recruited participants, 23 out of 23 (exercise) and 10 out of 16 (usual care control) completed the study. In all participants (n = 33), there was a significant reduction from baseline (pre-CRT) to week 0 (post-CRT) in daily step count: median (IQR) 4966 (4435) vs. 3044 (3265); p < 0.0001, active energy expenditure (EE) (kcal): 264 (471) vs. 154 (164); p = 0.003, and metabolic equivalent (MET) (1.3 (0.6) vs. 1.2 (0.3); p = 0.010). There was a significant improvement in sleep efficiency (%) between week 0 and week 6 in the exercise group compared to the usual care control group (80 (13) vs. 78 (15) compared to (69 ((24) vs. 76 (20); p = 0.022), as well as in sleep duration and lying down time (p < 0.05) while those in active EE (kcal) (152 (154) vs. 434 (658) compared to (244 (198) vs. 392 (701) or in MET (1.3 (0.4) vs. 1.5 (0.5) compared to (1.1 (0.2) vs. 1.5 (0.5) were also of importance but did not reach statistical significance (p > 0.05). An apparent improvement in daily step count and overall PAL in the exercise group was not statistically significant.ConclusionsPAL variables, daily step count, EE and MET significantly reduced following neoadjuvant CRT in all participants. A 6-week pre-operative in-hospital exercise training programme improved sleep efficiency, sleep duration and lying down time when compared to participants receiving usual care.

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Accepted/In Press date: 4 January 2017
e-pub ahead of print date: 16 February 2017
Published date: 2017

Identifiers

Local EPrints ID: 416123
URI: https://eprints.soton.ac.uk/id/eprint/416123
ISSN: 2047-0525
PURE UUID: 9ed904da-7a8c-4b76-b032-1cbefec181c8
ORCID for Malcolm West: ORCID iD orcid.org/0000-0002-0345-5356
ORCID for Michael Grocott: ORCID iD orcid.org/0000-0002-9484-7581

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Date deposited: 05 Dec 2017 17:30
Last modified: 04 Oct 2019 00:34

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