Download evidence table 9

Tabel 9. Uitgangsvraag 9 – Welke meetinstrumenten zijn valide en bruikbaar in Nederland voor de effectevaluatie van oncologische revalidatie tijdens en
na afronding van de in opzet curatieve behandeling en in de (ziekte- en symptoomgerichte) palliatieve fase?,
Overzicht van RCT’s en gebruikte meetinstrumenten
Author
year
Population
Design, N
Intervention
Control
Primairy outcome(s)
Battaglini
2008
Breast cancer +
chemo- or radiothereapy,Italy
RCT N=20 F
Usual care
Total caloric intake (3-day food diary), %BF (skinfolds),
fatigue (revised Piper Fatigue Scale
Battaglini
2007
Inactive breast
cancer patients,
Italy
Eighteen survivors
of breast or colon
cancer, USA
RCT N=20 F
Cardiovascular activity (6-12 min),
followed by stretching (5-10 min),
resistance training (15-30 min),
and a cool-down (approximately 8
min) x 6 months
21-week exercise low to moderate
intensity for 60 minutes on two
days/week
moderate- (40–50% HRR) intensity
exercise group; low-body aerobic
exercise three times a week for 10
wk
Cadmus
2009
Newly diagnosed
breast cancer
survivors, USA
RCT N=45 F
Usual care
Cadmus
2009
Post-treatment
survivors breast
cancer, USA
RCT N=67 F
6-month, home-based exercise
program. 30 min of moderatetovigorous physical activity 5 days
per week.At the beginning of the
program, each participant received
an educational book, a binder
containing specialized weekly
informational handout and a Polar
heart rate monitor (used to
maintain activity at 60–80% of
predicted maximal heart rate in
accordance with American College
of Sports Medicine guidelines
Idem
Idem
Aerobic capacity (treadmill) comfortable walking pace (1.5–4
mph) on the treadmill, then the grade of the treadmill increased
1° every minute. Quality of Life Index for Cancer Patients
Linear Analog Self-Assessment (LASA) (100-mm analog, measuring fatigue, anxiety, confusion, depression, energy, and
anger)
Physical activity: recorded the type, duration, and perceived
intensity of any recreational/fitness activity performed on each
of seven consecutive days on the 7-Day Physical
Activity Log (PAL) + daily steps on a 7-day pedometer log.
Exercise group participants also completed the PAL (including
average heart rate from each workout) for each of the 26
weeks of the intervention. Height, Weight, % body fat: wholebody dual energy X-ray, absorptiometry scans, QOL:
happiness: Fordyce Happiness Measure, Self-esteem:
Rosenberg Self-Esteem Scale, Depression CES-D, Anxiety :
State-Trait Anxiety Index (STAI), Stress: Cohen’s 10item Perceived Stress Scale, physical, emotional, social, and
functional well-being: FACT-B, SF-36
Idem
Author
year
Campbell
2005
Population
Design, N
Intervention
Control
Primairy outcome(s)
Women undergoing chemoheapy and/or radiotherapy+ early
RCT N=22 F
Supervised exercise programme
twice weekly for 12 weeks.
Warm-up, 10–20 minutes exercise
(which varied from week to week
Usual care
FACT-G, FACT-B, Satisfaction with Life Scale (SWLS),
Revised Piper Fatigue Scale (PFS), The Scottish Physical
Activity Questionnaire (SPAQ), The 12-minute walking test
Burnham
2002
RCT, matched for
VO2peak, QoL
(15 female and 3
male, 40–65 yr of
age)
Secondairy
outcome(s)
Body composition (skinfold method); muscle strength (one
repetition maximum).
Low- (25–35% heart rate
reserve (HRR) exercise
low-body aerobic exercise
three times a week for 10
wk
Secondairy
outcome(s)
stage breast
cancer, UK
Cho
2006
Women with early
breast cancer post
treatment, post
mastectomy,
Korea
RCT N=55 F
Mean age 49.1 yr
Cinar
2008
Women with modified radical mastectomy, Turkey
RCT N=57
Coleman
2008
Author
year
Coleman
2003
(feasibility)
135 patients with
multiple myeloma,
USA
Population
RCT N=135
Design, N
Patients receiving RCT N=24 10 F
high-dose chemo- 14 M
therapy and tandem peripheral
blood stem cell
transplantations for
the treatment of
and included walking, cycling, lowlevel aerobics, muscle-strengthening exercises, circuits etc.), a
cool down and relaxation period
Intervention was provided three
times per week for 10 weeks
consisted of psychology based
education, exercise (group and
home-based), and peer support
group activity. Ninety minutes of
education was provide once per
week for 10 weeks in a group
Individual 15 sessions of physiotherapy program in physical
medicine and rehabilitation
department, including pendulum,
wall climbing, overhead pulley,
horizontal abduction, posture,
wand, dorsal strengthening, and
stretching exercises for levator
scapula. The patients performed
the exercises at home in the
following 8 weeks.
Exercise group received an
individualized exercise prescripttion, a set of color-coded exercise
stretch bands with varying resistance, and a notebook and videotape illustrating the exercises.
Strength resistance training was
included to strengthen muscles so
patients could improve the aerobic
component of the exercise
program
Intervention
ROM of the affected shoulder joint: goniometer
Psychosocial adjustment, 18-item,
4-point scale revised by Lee (1999)
Quality of life: the instrument developed by Chae & Choe
(2001a) on the subject of South Korean breast cancer patients
domestically
The HG received a form to Rom shoulder: goniometer
perform the exercises by
themselves after removal Lymphedema: circumferential measurements of operated and
of the drains
unoperated extremities were taken preoperatively and then
postoperatively
Function: Wingate upper extremity function questionnaire
Usual care group were
advised to follow the
written exercise recommendations provided by
their physician. The paients were generally advised to remain as active
as possible and to try to
walk 20 minutes per day.
Number of red blood cell and platelet transfusions during
transplantation
Control
Primairy outcome(s)
Home based exercise, see above 6 Usual care, see above
months
Number of attempts at and total number of days of stem cell
collection, time to recovery after transplantation,
Weekly activity
logs, aerobic
capacity: 6 minute
walk, Borg scale
Response to intensive therapy for multiple myeloma.
Exercise log, Aerobic capacity: Modified Balke protocol (min
walked), Strength: 1RM, lean body weight: air displacement
plethysmography, fatigue: POMS, mood: POMS, sleep
measurements: Actigraph, Epworth Sleepiness Scale
Secondairy
outcome(s)
Coleman
2003 (adherence)
Courneya
2008
multiple myeloma,
USA
Idem
Idem
Mild-to-moderately RCT N=55
anemic patients
with solid tumors,
Canada
Courneya Breast cancer
2007b (f/u) patients initiating
adjuvant chemotherapy
RCT N=242
Idem
Idem
Idem
Darbepoetin alfa + exercise
aerobic exercise training three
times per week at 60%-100% of
baseline exercise capacity for 12
weeks
Darbepoetin alfa
QoL: Functional Assessment of Cancer Therapy-Anemia scale
(FACT-A)
Resistance exercise training: thrice Usual care
per week performing two sets of 8
to 12 repetitions of nine different
exercises at 60% to 70% of their
estimated one repetition maximum
and to progress the weight by 10%
when they could complete >12
repetitions
QoL: FACT-AN
OR
Aerobic exercise training: thrice per
week on a cycle ergometer,
treadmill, or elliptical trainer
beginning at 60% of VO2peak for 15
min and progressing to 80% of
VO2peak for 45 min. Duration
chemotherapy
Author
year
Courneya
2007b
(multicenter)
Fatigue, Cardiorespiratory fitness
(VO(2peak)),
Hemo-globin (Hb)
response, darbepoetin alfa dosing
(full text N/A)
Self-esteem,
Rosenberg SelfEsteem Scale
fatigue: FACT-AN
anxiety: Spielberger State
Anxiety Inventory
depression: Center
for Epidemiological
Studies-Depression Scale
Godin Leisure
Time Exercise
Questionnaire @ 6
months f/u
Population
Design, N
Intervention
Control
Primairy outcome(s)
Idem
Idem
Idem
Idem
Idem
Secondairy
outcome(s)
Idem + VO2peak
treadmill max test
+ O2 uptake
Strength: estimated 1 RM
Body weight:
balance beam
scale, Whole body
fat and lean tissue:
dual x-ray absorptiometry scan,
Lymphedema :
CulosReed
2010
Prostate cancer
RCt
patients receiving N=100 M
androgen
deprivation therapy
> 6 months
16 weeks home-based portion
three to five times per week at
moderate intensity and weekly
group sessions
Wait list
QoL : EORTC QLQ C30
Expanded prostate cancer index composite (EPIC)
Fatigue: Fatigue severity scale (FSS)
Canada
Depression: center for epidemiological studies depression
scale (CES-D)
Godin’s leisure score index
CulosReed
2007
Author
year
Daley
2007a
N/A
RCT
Population
Design, N
Intervention
Control
Primairy outcome(s)
Lokalised breast
cancer, post treatment, UK
RCT N=108 F
Supervised aerobic exercise
therapy or Exercise-placebo
three times per week for 8 weeks
Usual care
QoL: FACT-G and FACT-B
standard volumetric arm measurements based on
water displacement. Chemotherapy completion
rate was assessed
as the average
relative doseintensity (RDI) for
the originally planned regimen
based on standard
formulas
aerobic capacity
(6-min walk test),
Grip strength (grip
dynamometer),
flexibility (modified
sit and reach).
Height
Weight
Waist and hip
circumference
Blood pressure
Heart rate
Secondairy
outcome(s)
Heart rate, RPE
Fatigue: revised
Piper, satisfaction
with life scale, Depression: Beck
Depression, Inventory Physical
Self-Perception
Profile exercise
behavior: stage of
change for exercise ladder questionnaire (SOC).
aerobic fitness: 8minute, single-sta-
ge walking test
performed on a
treadmill, height
weight, % body fat:
bioelectrical impedance analysis
muscle function:
Biodex adherence:
session attendance and the amount
(duration, RPE,
HR) of exercise
Dimeo
2004
Author
year
Dimeo
1999
Drouin
2006
Hayes
2009
Patients who underwent surgery
for lung or gastrointestinal tumours
120 days post
treatment,
Germany
RCT N=72
51 M, 19 F
mean age 55
(exerc), 60 (relax)
Aerobic exercise group (stationary
biking 30 min five times weekly)
Progressive relaxation
training group (45 min
three times per week).
Both interventions were
carried out for 3 weeks
Physical, cognitive and emotional status and somatic
complaints with the European Organization for Research and
Treatment of Cancer Quality of Life Questionnaire Core Module
(EORTC-QLQ-30) questionnaire
Physical capacity: bike ergometry start 25 watts and increased
by 25 watts every 3 minutes until exhaustion (wattsmax)
Population
Design, N
Intervention
Control
Primairy outcome(s)
Cancer patients
with solid tumours
receiving high
dose chemotherapy followed by
autologous peripheral blood stem
cell transplantation
Germany
Twenty sedentary
females with
breast carcinoma
during 7 wks radiation therapy, USA
Women younger
than 76 yr, who
completed breast
cancer treatment
at least 6 months
prior and had subsequently developed unilateral,
upper-limb lymph-
RCT N=59
Hospital setting
Biking on an ergometer in the
supine position following an
interval training pattern for 30
minutes daily 50% of the cardiac
reserve (duration?)
Usual care
Psychologic distress: POMS, SCL-90
RCT N=20 F
Aerobic exercise (AE) of walking
for 20 to 45 minutes, 3 to 5 times
per week, at 50% to 70% of measured maximum heart rates
Placebo stretching (PS)
activities 3 to 5 days per
week
Erythrocyte measures, Physical capacity: VO2peak + modified
Bruce treadmill protocol + O2 uptake
RCT N=32 F
20 supervised, group, aerobic and
resistance exercise sessions over
12 wk
Instructed to continue
habitual activities.
Lymphedema status: bioimpedance spectroscopy (impedance
ratio between limbs) and perometry (volume difference
between limbs)
Secondairy
outcome(s)
Headley
2004
Hwang
2008
Irwin
2009a
Author
year
Irwin
2009b
Jarden
2009
Kim
2006
Korstjens
2008
Ligibel
2008
edema, Australia
Women with metastatic breast cancer beginning
outpatient chemotherapy, USA
Postoperative
radiotherapy for
breast cancer,
Korea
Breast cancer survivors, USA
RCT N=38 F
Performance of a seated exercise
program using home videotape
three times per week for four
cycles of chemotherapy
Continue any usual
physical activity
RCT N=40 F
Supervised moderate-intensity
Self-shoulder stretching
exercise therapy for 50 min 3 times exercise
per week for 5 weeks.
Fatigue: FACIT-F
QoL: WHOQOL-BREF), Fatigue: brief fatigue inventory (BFI),
range of motion (ROM) of the shoulder:goniometer
pain score: VAS 0-100 worst pain past week
RCT N=75 F
150 min/week of supervised gym- Usual physical activity
physically inactive and home-based moderateintensity aerobic exercise 6 months
Body composition: dual-energy X-ray absorptiometry (DXA)
% body fat,lean mass, Bone mineral density
Population
Design, N
Intervention
Primairy outcome(s)
Postmenopausal
breast cancer
survivors, USA
Allogeneic hemaopoietic cell transplantation,
Denmark
RCT N=75 F
150 minutes per week of
Usual physical activity
moderate-intensity aerobic
exercise 6 months
Supervised multimodal intervention Usual care
exercise, psychoeducation,
progressive exercise 4-6 weeks
Blood levels of insulin and IGF: ELISA
Newly diagnosed
RCT N=41 F
with breast cancer Mean age 50 yrs
undergoing adjuvant therapy,
South Korea
Mixed cancer, post RCT N=209
treatment,
Netherlands
8-week moderate intensity (60Usual care
70% VO2 peak) supervised aerobic
exercise program 3 times a week
Physical capacity: Bruce treadmill protocol + O2 uptake
Resting HR, HRmax, BP, Post intervention: 7-day Physical
Activity Questionnaire
12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and
cognitive-behavioral therapy (once
weekly)
QOL: SF-36
Sedentary, oveRCT N=101 F
weight breast cancer survivors, USA
16-week cardiovascular and
strength training exercise intervention
RCT, N=42
Hospital based
Control
12-week group-based
physical training (twice
weekly) aerobic bicycle
training (30 min) and
muscle strength training
(30 min)] followed by
group sports (60 min).
Usual care
Intensity of exercise : RPE monthly
calender log
Aerobic capacity measured in VO(2) max: Astrand test
Secondairy
outcome(s)
muscle strength: 1
RM, functional
performance 2 min
stairclimb, physical
activity level: QOL,
EORTC QLQ-C30
fatigue, FACT-AN
psychological wellbeing HADS clinial outcomes
Fasting insulin and glucose levels, weight, body composition,
Daily minutes of
bioelectric impedance analyzer height, weight: calibrated Scale- aerobic activity in
Tronix scale circumference at the waist and hip
exercise logs for
the duration of the
study strength: 1
RM
Matthews
2007
Early-stage breast
cancer post treatment, USA
RCT N=36 F
Author
year
May
2009
Population
Design, N
Mixed cancer, post RCT N=147
treatment, Nether- Mean age 48.8
ands
yrs
12-week group-based multidiscciplinary self-management rehabilitation program, combining physical training (twice weekly) and
cognitive-behavioral therapy (once
weekly)
McNeely
2008
Post-surgical head RCT N=52
and neck cancer
15 F, 37 M
survivors, Canada
Progressive resistance exercise
training 12 wk supervised active
and passive ROM/stretching exercises, postural exercises + 2 sets
of 10 to 15 repetitions of 5 to 8
exercises, starting at 25% to 30%
of their 1-repetition maximum (1RM) strength and slowly progresssing to 60% to 70% of their 1-RM
strength by the end of the intervention period
McNeely
2004
Mello
2003
Idem
Idem
Milne
2008b
RCT N=20
Patients post
RCT N=18
allogeneic bone
marrow transplanttation, Brazil
Breast cancer sur- RCT N=58 F
vivors post treatment, Australia
12-week home-based walking
Usual care
intervention single in-person
counseling visit (30 min) followed
by up to five short telephonecounseling calls in weeks 1, 2, 4, 7,
and 10 after randomization
Intervention
Control
12-week group-based
physical training (twice
weekly) aerobic bicycle
training (30 min) and
muscle strength training
(30 min)] followed by
group sports (60 min).
Standardized therapeutic
exercise protocol 12 wk
supervised active and
passive ROM/stretching
exercises, postural exercises, and basic strengthening exercises with
light weights (1-5 kg) and
elastic resistance bands
Idem
Physical activity: Community Health Activities Model Program
for Seniors Physical Activity Questionnaire (CHAMPS),
Actigraph, Diet intake : 21-item diet habits questionnaire (DHQ)
19-item National Cancer Institute (NCI) all day fruit and
vegetable screener, Body composition: dual X-ray
absorptiometry (DEXA)
Primairy outcome(s)
Secondairy
outcome(s)
QOL: European Organization for Research and Treatment of
Muscle strength 1
Cancer Quality of Life Questionnaire C30 questionnaire
RM, HR peak (see
Physical activity: Physical Activity Scale for the Elderly (PASE) Korstjens)
Patient-rated shoulder pain: 0-100 (VAS?), shoulder disability:
SPADI
Idem
Muscle strength: 1
RM, Shoulder
ROM: goniometer,
Generic QOL and
fatigue: Functional
Assessment of
Cancer TherapyAnemia (FACTAn), Specific QOL:
Neck Dissection
Impairment Index
(NDII)
Idem
6-week exercise program with acti- Usual care
ve exercise, muscle stretching and
treadmill walking in- and outpatient
Muscle strength test: Chatillon Inc. strain-gauge dynamometer
Immediate exercise group 12
weeks of supervised aerobic and
resistance exercise, three times
per week
QoL: Functional Assessment of Cancer Therapy-Breast (FACT- Fatigue: Schwartz
B)
Cancer Fatigue
Scale (SCFS)
social physique
and anxiety: Social
Physique Anxiety
Scale-7 items
(SPAS-7), Aerobic
fitness using the
Aerobic Power
Delayed exercise group
(same therapy 12 weeks
later)
Index (API) cycle
test. Submaximal
test, starting at
25 W increased by
25 W every minute
Author
year
Mock
2005
Population
Design, N
Intervention
Control
Primairy outcome(s)
Sedentary women RCT N=119 F
with Stage 0-III
breast cancer receiving out-patient
adjuvant chemoherapy or radiation
therapy, USA
Home-based moderate-intensity
walking exercise program duration
treatment written prescription to
walk five to six times per week at a
moderate pace in the target heart
rate range (approximately 50–70%
of maximum heart rate)
Usual care
Fatigue: Total Score of the Piper Fatigue Scale (PFS)
Mock
2001
Monga
2007
Idem
RCT N=52
Full text n/a
Localized prostate
cancer patients
undergoing radiotherapy, USA
RCT N=21
Mutri
2007
Early stage breast
cancer during
treatment chemoor radiotherapy,
UK
RCT N=203 F
Payne
2008
Older women receiing hormonal
treatment for
breast cancer,
USA
RCT N=20 F
10-minute warm-up, a 30-minute
Usual care
aerobic segment consisting of
walking on a treadmill, and a 5-10minute cool down period 3x week
for 8 weeks Target HR 65%
12 week supervised group exercise Usual care
programme: exercise intervention
was based on guidelines for
prescription of exercise for cancer
patients and survivors. The classes
consisted of a warm-up of 5-10
minutes, 20 minutes of exercise
(for example walking, cycling, low
level aerobics, muscle strengthening exercises, or circuits of
specifically tailored exercises), and
a cool-down and relaxation period.
The exercise class lasted 45
minutes in total. Exercise at a
moderate level (50-75% of age
adjusted maximum heart rate).
Prescribed home-based walking
Usual care
exercise intervention x 12 wks
fFtness, modified Bruce treadmill test protocol (METS)
fatigue: Piper Fatigue Scale (PFSRevised), depression: Beck
Depression, QOL: FACT-P, leg strength: time it takes to stand
up and sit down 5 times from an armless chair, flexibility:
modified sit-and-reach test
Functional assessment of cancer therapy (FACT-G)
questionnaire, incl. FACT-B, FACT-F, and FACT-ES.
Sleep: Pittsburgh Sleep Quality Index (PSQI),
Fatigue: Piper Revised Fatigue Scale, Depression : CES-D
Secondairy
outcome(s)
Physical functioning and activity
levels: 12-min
Walk Test, SF-36
Physical Activity
Questionnaire
(PAQ), Adherence:
weekly dairies +
measures above.
Beck depression
inventory, positive
and negative affect
scale, body mass
index, seven day
recall of physical
activity (Scottish
physical activity
questionnaire) 12
minute walk test,
assessment of
shoulder mobility.
Author
year
Pinto
2005
Population
Design, N
Intervention
Sedentary women
with breast cancer
post treatment
RCT N=86 F
12 weeks of PA counseling deliUsual care, Usual activity
vered via telephone, as well as
weekly exercise tip sheets + pedometer moderate- intensity activities
at 55% to 65% of maxi-mum heart
rate
12-week supervised aerobic exer- Wait list control
cise program in a hospital setting
Pinto 2003 Sedentary women RCT N=24 F
Breast cancer post
treatment
Schmitz
2009
Segal
2001
Author
year
Control
Primairy outcome(s)
Secondairy
outcome(s)
Seven-Day Physical Activity Recall. The Seven-Day Physical
Activity Recall (7-Day PAR), Physical fitness: Rockport 1-mile
walk test. Objective activity monitoring: Caltrac accelerometer
Stage of Motivational Readiness for PA, Mood: POMS
Fatigue: 0-10 VAS, Body esteem : Body Esteem Scale
Physical capacity: 50 rpm on a calibrated cycle ergometer with
an increase in workload of 25W every 2 min (in watts and time)
Mood: POMS, Positive and Negative Affect Scale (PANAS),
Body Esteem Scale
Limb volume: water displacement, circumferential
measurement, Bioelectrical spectroscopy, Pain: VAS 0-10
(recall?), Pain questions from revised Brief Pain Inventory
(validity?), Coordination: Nine Hole Peg Test of Finger Dexterity
ROM: goniometer, Body fat (percent and total), fat free mass,
and bone density: dual energy X-ray absorptiometry (DeXA)
Muscle strength: 1 RM, QoL: Health and Attitudes Survey
(home made) incl: Pittsburgh sleep quality index ,Relationship
and body image, Fatigue symptom Inventory, SF-36,
Coopersmith self-esteem inventory Life orientation test
Visual analog scale (QOL), Medical outcome study social
support, Temporal satisfaction with Life scale Depression
survey, International physical activity questionnaire
Diet history questionnaire, Demographics Menstrual tracking
Medical history
RCT N=295 F
Female breast
cancer survivors 1
to 15 years postdiagnosis among
those with stable
lymphedema and
1–5 years postdiagnosis for those
without lymphedema at study
entry. Eligible women were free of
cancer at study entry and had had at
least 1 lymph node
removed, USA
RCT N=123
Women with stages I and II breast
cancer within 2
weeks of the initiation of their prescribed adjuvant
therapy (radiotherapy, hormonal
therapy, or chemotherapy, Canada
Participants attended twice-weekly 12 months later
strength training sessions for
12 months, supervised in small
groups of 2–6 for the first 3 months
YMCA, and then unsupervised for
the remaining 9 months.
Self-directed exercise, home
exercise prescription and were
asked to exercise five times per
week for a 26-week or
Supervised exercise supervised
exercise program three times per
week for 26 weeks in the
rehabilitation
Usual care
QOL: SF-36, FACT-G, FACT-B
Weight aerobic
capacity: modified
Canadian Aerobic
Fitness Test
(mCAFT).
Population
Intervention
Control
Primairy outcome(s)
Secondairy
outcome(s)
Design, N
Segal
2009
Segal
2003
Men with prostate N=121 M
cancer receiving
radiotherapy with
or without androen deprivation therapy, Canada
Men with prostate RCT N=155 M
cancer who were
scheduled to receive androgen deprivation therapy for
at least 3 months
after recruitment,
Canada
Van Weert Cancer survivors
RCT N=72 M/F
2006
with different diagnoses, and cancerrelated physical
and psychosocial
problems, Netherlands
Windsor
Radiotherapy for
N=66 M
2004
localized prostate
carcinoma, UK
24 weeks of resistance three times Usual care
per week performing two sets of
eight to12 repetitions of 10 different
exercises at 60% to 70% of their
estimated one-repetition maximum
(1 RM) or Aaerobic training: three
times per week on a cycle ergometer, treadmill, or elliptical trainer
beginning at 50% to 60% of their
predetermined peak oxygen
consumption (VO2peak) for weeks 1
to 4 and progressing to 70% to
75% for weeks 5 to 24.
Fatigue: FACT-F, QOL: Prostate (FACT-P), and General
(FACT-G) scales
Resistance exercise program three Wait list
times per week for 12 weeks: nine
strength-training exercises carried
out under supervision three times
per week, at 60% to 70% of onerepetition maximum
Fatigue: FACT-F, and disease-specific quality of life: FACT-P
15-week rehabilitation program
including individual exercise,
sports, psycho-education, and
information full program
Choose components
considered relevant
Health-Related Quality of Life [RAND-36 and Rotterdam
Symptom Check List (RSCL)], exercise capacity (symptom
limited bicycle ergometry), muscle force (hand-held dynamometry), patient preferences
Hme-based, moderate-intensity,
continuous walking for 30 minutes
on at least 3 days of each week of
radiotherapy at a target heart rate
of 60-70% calculated maximum
heart rate x 4 weeks
Usual care
Fatigue: Brief Fatigue Index, distance walked in a modified
shuttle test 10 meter course, Physical activity: Scottish Physical
Activity Questionnaire (SPAQ), Adherence: patient-activity diary
during radiotherapy detailing the frequency and duration of the
walking intervention together with the heart rate achieved /
frequency and duration of everyday aerobic activity
Physical fitness:
maximal incremental exercise
protocol on a
tread-mill with O2
uptake (?protocol)
body composition,
DEXA scan,
strength: 1 RM
(estimated from 8
RM), prostatespecific antigen,
testosterone,
hemoglobin, and
lipid levels
Body weight, body
mass index, waist
circumference,
subcutaneous
skinfolds