70% to 80% of cancer patients suffer from various kinds of fatigue. The exact cause ofcancer-related fatigue is uncertain; however, there are a few possible causes, which include the cancer treatment itself and the effects of the tumor. There are comorbid medical conditions including anemia, hypothyroidism, cytokines, and sleep problems; psychological factors such as anxiety and loss of functional status. A number of studies have identified some benefits of physical activity on fatigue in cancer both during and after treatment. A number of limitations in the original review show that an updated review is necessary.
The aim of this study is to evaluate the effect of exercise on cancer-related fatigue both during and after cancer treatment.
Aerobic exercise can help relieve fatigue related to breast and prostate cancer both during and after treatment, according to an updated review published on November 14, 2012 in the Cochrane Database of Systematic Reviews.
Fiona Cramp, PhD, from the Faculty of Health & Life Sciences, University of the West of England, and James Byron-Daniel, PhD, from the School of Psychology, University of West England, Bristol, United Kingdom state that the findings suggest that aerobic exercise should “be considered as one component of a management strategy for fatigue that may include other interventions and education as well.”
Previously, patients with cancer were encouraged to rest because of their fatigue. However, now this approach is considered counterproductive because the patient’s inactivity can lead to muscle wasting as well as a loss of cardiorespiratory fitness which can lead to increased fatigue.
Dr. Cramp and Dr. Byron-Daniel write that further research is necessary to determine the most effective parameters of exercise for fatigue management which should include multi-modal exercise (a combination of resistance and aerobic), duration and frequency of each exercise session, and the intensity of the exercise.
“It has yet to be determined whether the type of cancer treatment changes the effects of exercise on cancer-related fatigue”, the doctors note. Research is still needed to examine a broader range of cancer diagnoses, including patients that have an advanced form of the disease.
Most studies were from those with breast cancer although there were some with various cancer diagnoses. The exercises occurred during and after cancer treatment. The duration of the exercise intervention ranged from 3 weeks to 1 year and involved resistance training, aerobic activity or flexibility exercises.
The exercise intervention varied widely, from home-based to supervised programs, and the intensity varied from self-administration to programs that involved heart monitoring and oxygen uptake.
Some sessions were conducted daily and some just 2 times a week; some sessions lasted 10 minutes and others lasted 120 minutes.
Aerobic exercise like walking and cycling had a significant benefit over no exercise.
The authors state that the review should not be considered in isolation. Nonpharmacologic interventions can also be considered beneficial. Interventions that may be used together with an exercise program can include nutrition therapy, stress management and sleep therapy.
Breast and prostate are the two types of cancer where symptoms of fatigue can be reduced according to Dr. McNeely, assistant professor in the Department of Physical Therapy at the University of Alberta and in the Department of Oncology and the Rehabilitation Medicine Department at the Cross Cancer Institute in Edmonton, Canada.
It is not clear yet if other forms of exercises such as weight training and yoga can provide the same benefits. More evaluation is needed, according to Dr. McNeely.
Even if formal exercising is not possible it is still imperative that cancer patients stay as active as possible. Staying active will help to prevent losses in muscular strength and overall fitness and will reduce fatigue.
Dr. McNeely states that more vigorous exercise after cancer treatments may be appropriate but should be administered by an exercise specialist.
When exercises are recommended for cancer patients the most effective physical therapy solution should be utilized. The TUTOR system of exercise products provide just such a regimen. The HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR were originally devised for patients recovering from stroke, brain or spinal cord injuries, Parkinson’s, MS, CP and other upper and lower limb disabilities. The TUTORs are comfortable gloves and braces that are placed strategically on the affected limb and have sensors connected to especially created software containing challenging games. The patient is monitored by physical and/or occupational therapists who then design a customized exercise program for that patient.
The TUTORs are currently in use in leading U.S. and European hospitals and facilities and are fully certified by he FDA and CE. Available for use in the patient’s home they can be used by adults as well as children from the age of 5 and up.
See WWW.MEDITOUCH.CO.IL for further information.
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