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Determinants of exercise adherence and contamination in a randomized controlled trial in cancer patients during and after allogeneic HCT

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Abstract

Background

Evidence from randomized controlled trials is growing that exercise interventions are beneficial in cancer patients receiving allogeneic stem cell transplantation (allo-HCT). However, information about adherence to exercise interventions and exercise contamination in control groups is lacking. This information is crucial for the interpretation of study results. We therefore examined the determinants of exercise adherence and contamination in different treatment periods during (inpatient) and after (outpatient) allo-HCT.

Methods

One hundred fifty-three patients scheduled for allo-HCT were randomized to a 1-year partly supervised exercise intervention (endurance and resistance exercise) or to a control group. Adherence was assessed via exercise logs and contamination via questionnaires.

Results

Adherence varied between 66 % (inpatient) and 78 % (outpatient) in different treatment periods. During (inpatient) transplantation period, higher adherence was significantly associated with lower fatigue (P = 0.004) and with having children at home (P = 0.049). Adherence after discharge was positively associated with endurance performance (P = 0.003); higher adherence after day 100 was associated with exercise activity prior allo-HCT (P = 0.010) and higher adherence after discharge (P = 0.001). Contamination among controls was high with 54 % and significantly associated with muscle strength (P = 0.025) and fatigue (P = 0.050).

Conclusion

Exercise adherence in different treatment periods was determined by different variables, and contamination among controls was evident. These findings may have important implications for correct interpretation of randomized exercise intervention trials.

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Authors and Affiliations

  1. Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany

    Rea Kuehl & Joachim Wiskemann

  2. Department of Preventive Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany

    Rea Kuehl, Martina E. Schmidt, Karen Steindorf & Joachim Wiskemann

  3. Department of Medicine V, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Peter Dreger

  4. Department of Psychiatric and Psychosomatics Psychotherapy, Central Institute of Mental Health, J5, 68159, Mannheim, Germany

    Martin Bohus

  5. Faculty of Health, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium

    Martin Bohus

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  1. Rea Kuehl
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  4. Karen Steindorf
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  6. Joachim Wiskemann
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Correspondence to Joachim Wiskemann.

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Funding

Deutsche José Carreras Leukämie-Stiftung e. V. (project no. R10/42pf).

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The authors declare that they have no conflict of interest.

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Kuehl, R., Schmidt, M.E., Dreger, P. et al. Determinants of exercise adherence and contamination in a randomized controlled trial in cancer patients during and after allogeneic HCT. Support Care Cancer 24, 4327–4337 (2016). https://doi.org/10.1007/s00520-016-3271-6

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  • DOI: https://doi.org/10.1007/s00520-016-3271-6

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