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Cancer-related FatigueNCT03049384

Tailored Exercise Interventions to Reduce Fatigue in Cancer Survivors

A study testing Traditional Exercise and Tailored Exercise in people with Cancer-related Fatigue, run by University of Calgary at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Cancer-related fatigue (CRF) is a common and distressing symptom of cancer and/or cancer treatment that can persist for months or years in cancer survivors. Exercise is beneficial for the management of CRF, and general exercise guidelines for cancer survivors are available. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Cancer-related Fatigue
What is being tested?
Traditional Exercise and Tailored Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
43 participants
Where
1 siteCanada
Study dates
9 Mar 2017to 31 Mar 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged between 18 and 75 years;
  • Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) score ≤ 34;
  • Completion of treatment in ≥ 3 months and ≤ 5 years preceding enrollment;
  • Approval received from personal physician and/or a Canadian Society for Exercise Physiology-Clinical Exercise Physiologist (CSEP-CEP);
  • Command of the English language.

Who cannot join

  • Contraindication to experimental procedures including transcranial magnetic stimulation (TMS);
  • Diagnosed as having obstructive sleep apnea or anemia;
  • Currently participating in a structured exercise intervention;
  • Participant is pregnant.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • University of Calgary

    Calgary, Alberta, T2N 1N4

Other trials in Canada

About this study

Cancer-related fatigue (CRF) is a common and distressing symptom of cancer and/or cancer treatment that can persist for months or years in cancer survivors. Exercise is beneficial for the management of CRF, and general exercise guidelines for cancer survivors are available. However, exercise interventions have not been tailored to alleviate CRF in fatigued cancer survivors, and thus the potential to alleviate CRF may not have been realized. The primary aim of this research is to investigate the effect of a traditional vs. tailored 12-week exercise intervention on self-reported CRF severity.

Read the detailed description

Background and Rationale

Approximately one-third of cancer survivors experience severe and persistent fatigue for a number of years post-treatment, but this distressing symptom is often under-treated by healthcare professionals due to a lack of mechanism-targeted interventions. The assessment of cancer-related fatigue (CRF) is reliant on subjective fatigue measurements such as self-report questionnaires. Less attention has been given to objective physiological measurements. However, there are well-established techniques which allow the assessment of neuromuscular fatigue and its peripheral and central origins which could be utilized in the study of CRF. Very few studies have considered these objective measures alongside self-report scales in the study of CRF and only two have used such techniques in cancer survivors. To date, no studies have investigated neuromuscular fatigue in whole body, dynamic activity as relevant to daily tasks (and involving the lower limb due to its functional relevance to locomotion). Novel testing developed in our laboratory could be used as part of a wider screening to develop individualized interventions to alleviate CRF. It is well accepted in the field that CRF is multidimensional and in addition to a potential neuromuscular component, the role of sleep disturbance may also be implicated. Interventions targeted at improving sleep quality are therefore warranted, and there is sound evidence for the efficacy of exercise interventions in particular for improving CRF in cancer survivors. As a non-pharmacological intervention, physical activity has the strongest evidence base for treating CRF. However, the mechanisms explaining the reduction of CRF with exercise are not understood. Due to the complex and multi-factorial nature of CRF, it would be of benefit to tailor exercise interventions to the specific deficits (in regards to neuromuscular mechanisms) or difficulties (for example sleep disturbance) experienced by the individual. Ultimately, mechanism-targeted exercise interventions could be translated to clinical rehabilitation programs and lead to an improved quality of for cancer survivors.

Research Question \& Objectives

The primary aim of this research is to investigate the effect of a traditional vs. tailored 12-week exercise intervention on self-reported CRF severity.

Methods

Fatigued cancer survivors who have completed primary treatment ≥ 3 months and ≤ 5 years from enrollment will be randomly allocated to one of two treatment arms: traditional (active control) and tailored exercise. Participants in the traditional exercise group will engage in aerobic and resistance exercise that is consistent with published recommendations. The tailored exercise group will be prescribed an intervention designed to address individual deficits (identified at baseline) that may be related to CRF. Participants will be assessed before and after the intervention for patient-reported outcomes, neuromuscular function and fatigue in response to whole-body exercise, sleep quantity and quality, physical activity levels, cardiorespiratory fitness and blood biomarkers.

Being tested
Traditional Exercise, Tailored Exercise

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Traditional ExerciseOther

    The traditional exercise group will undertake a supervised exercise intervention involving aerobic exercise and light resistance training, in line with published guidelines for exercise in cancer survivors.

  • Tailored ExerciseOther

    The tailored training group will be prescribed an individualized exercise intervention designed specifically to counteract deficits (e.g. neuromuscular) of difficulties (e.g. sleep disturbance) identified during pre-intervention testing.

Study groups in NCT03049384
Study groupRoleWhat they receive
Traditional ExerciseActive comparatorA classical exercise intervention based on current guidelines for cancer survivors.
Receives: Other: Traditional Exercise
Tailored ExerciseExperimentalA tailored and individualized exercise intervention based on the results of pre-intervention testing.
Receives: Other: Tailored Exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Assessment of change in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) Scale

    Self-report questionnaire for the assessment of cancer-related fatigue.

    Measured: Baseline to after the 12-week intervention, at 6 month and 12 month follow up.

Secondary outcomes (43)
  1. Assessment of change in The Functional Assessment of Cancer Therapy - General (FACT-G)

    General quality of life instrument intended for use with a variety of chronic illness conditions.

    Measured: Baseline and after the 12-week intervention.

  2. Assessment of change in Edmonton Symptom Assessment System-revised tiredness scale

    Self-report questionnaire for the assessment of of nine common symptoms experienced by cancer patients.

    Measured: Baseline and after the 12-week intervention, and during follow up (6 and 12 months).

  3. Maximal Isometric Force in the Knee Extensors

    A reduction in maximal isometric force in the knee extensors measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  4. Cortical Voluntary Activation

    A reduction voluntary activation (using transcranial magnetic stimulation) measured measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  5. Voluntary Activation

    A reduction voluntary activation (using femoral nerve stimulation) measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  6. Potentiated Doublet Twitch Force

    A reduction in potentiated quadriceps twitch force (from a high frequency doublet at 100 Hz) measured before, before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  7. Muscle Compound Action Potential (M-Wave) Peak-to Peak Amplitude

    Evoked from supra-maximal stimulation of the femoral nerve and measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  8. Muscle Compound Action Potential (M-Wave) Peak-to Peak Duration

    Evoked from supra-maximal stimulation of the femoral nerve and measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  9. Muscle Compound Action Potential (M-Wave) Area

    Evoked from supra-maximal stimulation of the femoral nerve and measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  10. Motor Evoked Potential (MEP) Peak-to Peak Amplitude

    Normalized to the maximal M-wave and measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  11. Motor Evoked Potential (MEP) Peak-to Peak Duration

    Normalized to the maximal M-wave and measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  12. Motor Evoked Potential (MEP) Area

    Normalized to the maximal M-wave and measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  13. Cortical Silent Period

    Evoked from TMS and measured (from stimulation artifact to the continuous resumption of EMG) before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  14. Voluntary Electromyography (EMG)

    Root mean square of the EMG signal during an MVC, measured before, during and after an intermittent cycling test.

    Measured: Baseline and after the 12-week intervention.

  15. Amplitude of the Sleep-Wake Cycle

    The mean difference between lowest and highest activity period, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  16. Peak Time of the sleep-wake Cycle

    Time of day of the highest estimated level of wake, recorded by actigraphy.

    Measured: Baseline and after the 12-week intervention.

  17. Mesor of the Sleep-Wake Cycle

    Mean level of activity over 24 hours, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  18. inter-daily stability

    the degree of regularity of the rest-activity patterns on individual days in the 24 h environment, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  19. intra-daily variability

    the fragmentation of periods of rest and activity, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  20. L5

    The mean activity counts in the least active 5 h period in the average 24 h pattern) recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  21. L5 mid

    The central time of the L5 period, usually referring to the through of the activity period), recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  22. Wake actigraphy

    Amount of activity during wake, recorded with actigraphy

    Measured: Baseline and after the 12-week intervention.

  23. Sleep Activity

    Amount of activity during sleep periods, recorded with actigraphy

    Measured: Baseline and after the 12-week intervention.

  24. Activity Index

    Percentage of activity per epoch for wake and sleep, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  25. Time in bed

    Time spent between the moment subject turn off the light to sleep and the moment he gets up, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  26. Actual Sleep Time

    Time spent asleep during the night, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  27. Actual Wake Time

    Time spent awaken during the night, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  28. Sleep Onset Latency

    Time to fall asleep, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  29. Sleep Efficiency

    Ratio between the time spent asleep and the total duration of sleep period, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  30. Fragmentation index

    Indication of the sleep quality based on movement during night, recorded with actigraphy.

    Measured: Baseline and after the 12-week intervention.

  31. Blood Biomarkers

    Blood count, catecholamines, serotonin, cortisol, inflammatory markers and markers of oxidative stress.

    Measured: Baseline and after the 12-week intervention.

  32. Assessment of change in the Centre for Epidemiological Studies Depression Scale (CES-D) questionnaire.

    Self-report questionnaire for the assessment of health-related quality of life, specific to cancer type.

    Measured: Baseline and after the 12-week intervention.

  33. Assessment of change in The Social Prevision Scale (SPS)

    Self-report questionnaire for the assessment of social support.

    Measured: Baseline and after the 12-week intervention.

  34. Assessment of change in The Functional Assessment of Cancer Therapy (FACT) Cancer Specific

    Self-report questionnaire for the assessment

    Measured: Baseline and after the 12-week intervention.

  35. Assessment of change in The Modified-Godin Leisure Time Exercise Questionnaire (GLTEQ)

    Self-report questionnaire for the assessment of leisure time physical activity.

    Measured: Baseline, after the 12-week intervention, and during follow up (6 and 12 months).

  36. Assessment of change in The Insomnia Severity Index (ISI)

    Self-report questionnaire for the assessment of insomnia severity.

    Measured: Baseline and after the 12-week intervention.

  37. Assessment of change in The Brief Pain Inventory Short Form (BPI-sf)

    Self-report questionnaire for the assessment of pain.

    Measured: Baseline and after the 12-week intervention.

  38. Assessment of change in Maximal Oxygen Uptake

    The highest 30 second average oxygen uptake measured during an an incremental cycling test.

    Measured: Baseline and after the 12-week intervention.

  39. Assessment of change in Muscle Cross-Sectional Area

    Ultrasound measurement of the vastus lateralis and rectus femoris.

    Measured: Baseline and after the 12-week intervention.

  40. Heart Rate Variability

    Variation in the time interval between heartbeats.

    Measured: Baseline and after the 12-week intervention.

  41. Assessment of change in Fat Mass

    Measured using dual energy X-ray absorptiometry (DXA).

    Measured: Baseline and after the 12-week intervention.

  42. Assessment of change in Fat Free Mass

    Measured using dual energy X-ray absorptiometry (DXA).

    Measured: Baseline and after the 12-week intervention.

  43. Assessment of change in Bone Mineral Density

    Measured using dual energy X-ray absorptiometry (DXA).

    Measured: Baseline and after the 12-week intervention.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Feb 2017
  2. Study start9 Mar 2017
  3. Primary completion31 Mar 2020
  4. Study completion31 Mar 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants are assigned to one of two groups in parallel for the duration of the study.
Masking
None (open label)
Enrolment
43 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03049384
Sponsor's protocol ID
HREBA.CC-16-1010
Status last verified
Oct 2021
First submitted
3 Feb 2017
Last updated
12 Oct 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Twomey R, Martin T, Temesi J, Culos-Reed SN, Millet GY. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer. 2018 Jul 24;18(1):757. doi: 10.1186/s12885-018-4668-z.

    PubMed 30041626

Questions about this trial

What is this clinical trial studying?

A study testing Traditional Exercise and Tailored Exercise in people with Cancer-related Fatigue, run by University of Calgary at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Assessment of change in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) Scale (time frame: Baseline to after the 12-week intervention, at 6 month and 12 month follow up.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03049384, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Oct 2021.

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