Conceptual development of an intensive exercise program for glioma patients (ActiNO): summary of clinical experience

Journal of Neuro-Oncology · 9 authors, 4 centres

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Participating glioblastoma patients had a median survival of 24.1 months, and the authors observed a trend towards prolonged survival with exercise.

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This is a retrospective analysis of a single-center, supervised exercise program (ActiNO) for 45 glioma patients, including those with glioblastoma (58%) and lower-grade astrocytoma (29%). The program involved two individualized weekly sessions of bicycle ergometry and resistance training. Patients achieved at least 75% of age-adjusted maximum heart rate during fitness assessment. The median survival for participating glioblastoma patients was 24.1 months. The authors note a trend towards prolonged survival with exercise, which is hypothesis-generating. Limitations include the retrospective design, potential selection bias (participants were motivated and had above-average initial fitness), and the heterogeneity of tumor types. The findings suggest intensive submaximal exercise is tolerable and warrants prospective study to objectify benefits in physical performance and quality of life.

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cohort

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neurology

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ORIGINAL PAPER

PMC10322750

Conceptual development of an intensive exercise program for glioma patients (ActiNO): summary of clinical experience

Journal of Neuro-Oncology

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ABSTRACT

Abstract Purpose Exercise proved to reduce cancer-related symptoms and prolong survival in some cancer types. However, brain tumor patients are often advised against strenuous exercise. Here, we summarize our experience with a submaximal exercise program for glioma patients: ActiNO ( Act ive i n N euro-Oncology). Methods Glioma patients were invited to participate in the program. Since 2011, a sports scientist individualized two one-hour sessions per week adapted to the patients’ symptoms. One session consisted of bicycle ergometry (average workload: 75% of maximum heart rate), the other of whole-body resistance training. Both sessions were further complimented by coordinative elements. Cardiorespiratory fitness was assessed using the ”Physical Work Capacity” procedure. Patients were followed up regularly to assess adherence to the program and disease activity. Results Until December 2019, 45 glioma patients, median-aged 49 years (IQR 42–59), were included in the analysis. Most patients suffered from glioblastoma (58%), followed by diffuse lower-grade astrocytoma (29%). In overall 1828 training sessions, two minor epileptic events occurred (1 speech arrest; 1 focal seizure). During fitness assessment, all patients achieved at least 75% of their age-adjusted maximum heart rate. Peak workload averaged 172 W (95% CI 156–187). Median survival of participating glioblastoma patients was 24.1 months (95% CI 8.6–39.5). Conclusion This supervised training program with submaximal exertion was feasible and safe in glioma regardless of WHO grading. Based on these experiences, we initiated a prospective multicenter study to objectify improvements in physical performance and quality of life in patients with glioblastoma. Supplementary Information The online version contains supplementary material available at 10.1007/s11060-023-04354-y. Keywords: Brain tumor, Glioblastoma, High-intensity training, Ergometry, Exercise

CITATION EXPORT

Johanna Jost, Michael Müther, Ralf Brandt et al.. Conceptual development of an intensive exercise program for glioma patients (ActiNO): summary of clinical experience. Journal of Neuro-Oncology. (2023). https://doi.org/10.1007/s11060-023-04354-y

AUTHORS

9 · 4 CENTRES

Johanna Jost, Michael Müther, Ralf Brandt, Ugur Altuner, Lars Lemcke, Walter Stummer, Klaus Völker, Rainer Wiewrodt, Dorothee Wiewrodt

1Department of Neurosurgery, University Hospital, University Münster, Münster, Germany
2Department of Medicine D, University Hospital, University Münster, Münster, Germany
3Institute of Sports Science, University Hospital, University Münster, Münster, Germany
4Pulmonary Research Division, Department of Medicine A, University Hospital, University, Münster, Germany