Differential Effects of Cardiovascular and Resistance Exercise on Functional Mobility in Individuals With Advanced Cancer: A Randomized Trial

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 2x2 analysis of variance (alpha = .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 (F-1,F-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. (C) 2013 by the American Congress of Rehabilitation Medicine