Andersen, C., Adamsen, L., Moeller, T., Midtgaard, J., Quist, M., Tveteraas, A., & Rorth, M. (2006). The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy—The use of semi-structured diaries. European Journal of Oncology Nursing, 10(4), 247-262.

To evaluate the effect of a multidimensional exercise program on managing symptoms in patients with cancer undergoing chemotherapy

Patients receiving chemotherapy participated in a structured, supervised exercise program, consisting of resistance-fitness training, massage, relaxation, and body-awareness training held in a workout room within the hospital, two to three times per week for a six-week period. Participants trained in mixed groups of seven to nine. Physiotherapists and a specially trained nurse, who participated in the physical training, supervised the program. Participants selected a total package of high or low intensity physical activity. They were not able select one activity over another.

• The study consisted of 54 patients with cancer.
• Participant ages ranged from 18-65 years.
• All patients had been diagnosed at least one month prior receiving chemotherapy for adjuvant or advanced disease and had World Health Organization (WHO) performance statuses of 0-1 (0-5 scale).
• Patients were excluded from the study if they had documented brain metastases, had received anticoagulation treatment or treatment for arrhythmia or myocardial infarction within the past three months, had dementia and psychotic conditions, or were unable to read and write in Danish.

The study was conducted at university outpatient and inpatient settings in Denmark.

This was a prospective, exploratory study.

Using semi-structured diaries, patients rated 12 symptoms, including lack of appetite, nausea and vomiting, diarrhea, paraesthesia, constipation, physical fatigue, treatment-related fatigue, muscle pain, arthralgia, and other pain, defined by Common Toxicity Criteria (CTC) daily using a 0-4 scale.

• During the intervention, patients reported decreases in 10 of 12 symptoms.
• Patients with evidence of disease scored symptoms higher than those without evidence of disease.
• Both groups responded positively to the intervention based on sum of symptom scores.

A six-week, multidimensional exercise intervention administered while patients were simultaneously receiving chemotherapy led to reductions in symptoms.

• The use of daily diaries is time consuming for patients.
• Some data was missing.
• Because this continued over time, participants may have recorded the previous score just to fill it in.
• An exercise program takes commitment. The length of time for classes varied between high- and low-intensity groups.
• Providing space for workout rooms accessible to inpatients and outpatients may be an issue for some centers.
• Each symptom was given equal weight whereas some symptoms may be perceived as more problematic for patients.
• This intervention requires a high level of knowledge and specific skills on the part of the individual who trains and supervises patients.