Institute for Exercise- and Occupational Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Medicine I (Specialties: Hematology, Oncology, and Stem-Cell Transplantation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Support Care Cancer. 2019 Mar;27(3):1071-1079. doi: 10.1007/s00520-018-4396-6. Epub 2018 Aug 18.
Acute leukemia (AL) and its initial treatment can impair physical functioning and capacity significantly. Exercise as a countermeasure has been investigated in few studies confirming its feasibility and safety during intensive induction chemotherapy, but the relative effects of diverse exercise programs have not been analyzed. Therefore, we aimed to investigate independent effects of endurance and resistance training on physical capacity and quality of life (QOL).
Twenty-nine adult AL patients were randomly allocated to an endurance (EG), resistance (RG), or control (CG) group. The intervention took place during induction chemotherapy with three exercise sessions per week for 30-45 min each. Endurance capacity at individual anaerobic threshold, maximum knee extension and flexion strength, standardized phase angle (SPA), and QOL were measured at baseline prior to induction chemotherapy and before discharge.
Endurance capacity changed in neither the EG, RG, or CG (P = 0.104); descriptively, the EG (- 0.05 W/kg) and RG (- 0.04 W/kg) exhibited a smaller decrease than CG (- 0.22 W/kg). We noted a significant difference in knee extension strength (P = 0.002); RG improved their maximum strength (+ 0.14 Nm/kg), while the EG's (- 0.13 Nm/kg) and CG's (- 0.19 Nm/kg) was significantly reduced. QOL and SPA revealed no change after the intervention.
We conclude that resistance training is a key component when exercising during induction chemotherapy: it improved maximum strength, but also influenced endurance capacity even during intensive treatment. Considering the prognostic value of physical function, we strongly propose integrating exercise, especially resistance-based training, already during induction chemotherapy to preserve AL patients' physical capacity and functional status.
急性白血病（AL）及其初始治疗可显著损害身体功能和能力。运动作为一种对策已在少数研究中进行了研究，证实了其在强化诱导化疗期间的可行性和安全性，但尚未分析各种运动方案的相对效果。因此，我们旨在研究耐力和抗阻训练对身体能力和生活质量（QOL）的独立影响。
29 名成年 AL 患者被随机分配到耐力（EG）、抗阻（RG）或对照组（CG）。干预措施在诱导化疗期间进行，每周进行 3 次运动，每次 30-45 分钟。在诱导化疗前和出院前测量个体无氧阈的耐力能力、最大膝关节伸展和屈曲强度、标准化相角（SPA）和 QOL。
EG、RG 或 CG 中的耐力能力均无变化（P = 0.104）；描述性地，EG（- 0.05 W/kg）和 RG（- 0.04 W/kg）的下降幅度小于 CG（- 0.22 W/kg）。我们注意到膝关节伸展强度有显著差异（P = 0.002）；RG 提高了最大力量（+ 0.14 Nm/kg），而 EG（- 0.13 Nm/kg）和 CG（- 0.19 Nm/kg）的力量显著降低。干预后 QOL 和 SPA 没有变化。
我们得出结论，抗阻训练是诱导化疗期间运动的关键组成部分：它提高了最大力量，但即使在强化治疗期间，也会影响耐力能力。考虑到身体功能的预后价值，我们强烈建议在诱导化疗期间就已经整合运动，特别是基于抗阻的训练，以维持 AL 患者的身体能力和功能状态。
