Long-term effects on cancer survivors ' quality of life of physical training versus physical training combined with cognitive-behavioral therapy

Background We compared the effect of a 12-week groupbased multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitive-behavioral therapy (once weekly) with the effect of 12-week group-based physical training (twice weekly) on cancer survivors’ quality of life over a 1-year period. Materials and methods One hundred forty-seven survivors [48.8±10.9 years (mean±SD), all cancer types, medical treatment ≥3 months ago] were randomly assigned to either physical training (PT, n=71) or to physical training plus cognitive-behavioral therapy (PT+CBT, n=76). Quality of life and physical activity levels were measured before and immediately after the intervention and at 3and 9-month post-intervention using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 questionnaire and the Physical Activity Scale for the Elderly, respectively. Results Multilevel linear mixed-effects models revealed no differential pattern in change of quality of life and physical activity between PT and PT+CBT. In both PT and PT+ CBT, quality of life and physical activity were significantly and clinically relevantly improved immediately following the intervention and also at 3and 9-month post-intervention compared to pre-intervention (p<0.001). Conclusion Self-management physical training had substantial and durable positive effects on cancer survivors’ quality of life. Participants maintained physical activity levels once the program was completed. Combining physical training with our cognitive-behavioral intervention Support Care Cancer (2009) 17:653–663 DOI 10.1007/s00520-008-0519-9 A. M. May (*) :D. E. Grobbee :W. J. G. Ros Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands e-mail: a.m.may@umcutrecht.nl A. M. May : J. Passchier Department of Medical Psychology and Psychotherapy, Erasmus Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands I. Korstjens : B. van den Borne : I. Mesters Department of Health Education and Promotion, School for Public Health and Primary Care (Caphri), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands E. van Weert : J. E. H. M. Hoekstra-Weebers : C. P. van der Schans Comprehensive Cancer Centre North-East Netherlands, P. O. Box 330, 9700 AH Groningen, The Netherlands E. van Weert Centre for Rehabilitation, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands J. E. H. M. Hoekstra-Weebers Wenckebach Institute, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands C. P. van der Schans University for Professional Education, P.O. Box 30030, 9700 RM Groningen, The Netherlands did not add to these beneficial effects of physical training neither in the short-term nor in the long-term. Physical training should be implemented within the framework of standard care for cancer survivors.