Development of Low-intensity Home-based Resistance Training for Elderly Patients with Advanced Cancer: The Exercise Component of the NEXTAC Program

Noriatsu Tatematsu; Taro Okayama; Tetsuya Tsuji; Akira Iwamura; Akira Tanuma; Tateaki Naito; Shuichi Mitsunaga; Satoru Miura; Katsuhiro Omae; Keita Mori; Koichi Takayama

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Development of Low-intensity Home-based Resistance Training for Elderly Patients with Advanced Cancer: The Exercise Component of the NEXTAC Program

VernacularTitle:悪液質高リスクの高齢進行がん患者に対する在宅ベースの下肢筋力トレーニングプログラムの開発─NEXTAC-ONE試験の運動介入の詳細─
Author: Noriatsu TATEMATSU ¹ ; Taro OKAYAMA ² ; Tetsuya TSUJI ³ ; Akira IWAMURA ⁴ ; Akira TANUMA ² ; Tateaki NAITO ⁵ ; Shuichi MITSUNAGA ⁶ ; Satoru MIURA ⁷ ; Katsuhiro OMAE ⁸ ; Keita MORI ⁹ ; Koichi TAKAYAMA ¹⁰
Author Information

1. Department of Rehabilitation, National Cancer Center Hospital East
2. Division of Rehabilitation Medicine, Shizuoka Cancer Center
3. Department of Rehabilitation Medicine, Keio University School of Medicine
4. Department of Rehabilitation, Niigata Cancer Center Hospital
5. Division of Thoracic Oncology, Shizuoka Cancer Center
6. Department of Hepatobiliary Pancreatic Oncology, National Cancer Center Hospital East
7. Department of Internal Medicine, Niigata Cancer Center Hospital
8. Department of Clinical Biostatistics, Kyoto University
9. Clinical Research Center, Shizuoka Cancer Center
10. Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine
Keywords: cancer cachexia; elderly; advanced cancer; multimodal interventions; resistance training
From:Palliative Care Research 2018;13(4):373-381
CountryJapan
Language:Japanese
Abstract: Objectives: We developed the multimodal program Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC program). The aim of our study is to show algorithm of the home-based resistance training prescription and its compliance. Methods: We recruited 30 patients aged≥70 years scheduled to receive first-line chemotherapy for advanced pancreatic or non-small-cell lung cancer. Three educational sessions were planned in 8-week study period. Our resistance training consists of 3 or 5 of following 5 exercises components: (1) sit-to-stand, (2) calf raise, (3) knee extension, (4) knee raise, (5) side leg raise. Physiotherapist chose optimal prescription according to the modified Borg-scale. We assessed patient compliance, and safety. Results: Median proportion of days in which patients performed full or modified exercise program was 91%. Adverse events possibly related to the NEXTAC program were observed in 5 patients and included muscle pain (grade 1 in 2 patients), arthralgia (grade 1 in one patient), dyspnea on exertion (grade 1 in one patient), and plantar aponeurositis (grade 1 in one patient). Patient physical function and physical activity were maintained during the study period. Conclusion: Our resistance training showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. Although this study was not designed to show the efficacy of the resistance training, our data indicate a potential protective effect on physical function and physical activity.