The safety, feasibility, and efficacy of an 18-week exercise intervention for adults with primary brain cancer - the BRACE study

Carolina X Sandler; Gabrielle C Gildea; Rosalind R Spence; Tamara L Jones; Paul Eliadis; David Walker; Amanda Donaghue; Catherine Bettington; Jacqui Keller; Deb Pickersgill; Molly Shevill; Vivien Biggs; Beth Morrison; Fiona Jonker; Matthew Foote; John Bashford; Sandra C Hayes

doi:10.1080/09638288.2023.2221041

The safety, feasibility, and efficacy of an 18-week exercise intervention for adults with primary brain cancer - the BRACE study

Disabil Rehabil. 2023 Jun 13:1-10. doi: 10.1080/09638288.2023.2221041. Online ahead of print.

Authors

Carolina X Sandler^{1

2

3}, Gabrielle C Gildea¹, Rosalind R Spence¹, Tamara L Jones^{1

4}, Paul Eliadis⁵, David Walker⁶, Amanda Donaghue⁷, Catherine Bettington⁸, Jacqui Keller⁸, Deb Pickersgill⁷, Molly Shevill⁷, Vivien Biggs⁶, Beth Morrison⁶, Fiona Jonker⁹, Matthew Foote⁵, John Bashford^{5

9}, Sandra C Hayes¹

Affiliations

¹ Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
² School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia.
³ Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁴ Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
⁵ Icon Cancer Centre, Brisbane, Queensland, Australia.
⁶ Newro foundation, Brisbane, Queensland, Australia.
⁷ Queensland Sports Medicine Centre, Brisbane, Queensland, Australia.
⁸ Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
⁹ Icon Cancer Foundation, Brisbane, Queensland, Australia.

PMID: 37310040
DOI: 10.1080/09638288.2023.2221041

Abstract

Purpose: To determine the safety, feasibility, and potential effect of an 18-week exercise intervention for adults with primary brain cancer.

Materials and methods: Eligible patients were 12-26-weeks post-radiotherapy for brain cancer. The individually-prescribed weekly exercise was ≥150-minutes of moderate-intensity exercise, including two resistance-training sessions. The intervention was deemed "safe" if exercise-related, serious adverse events (SAE) were experienced by <10% of participants, and feasible if recruitment, retention, and adherence rates were ≥75%, and ≥75% compliance rates were achieved in ≥75% of weeks. Patient-reported and objectively-measured outcomes were assessed at baseline, mid-intervention, end-intervention, and 6-month follow-up, using generalized estimating equations.

Results: Twelve participants enrolled (51 ± 19.5 years, 5 females). There were no exercise-related SAEs. The intervention was feasible (recruitment:80%, retention:92%, adherence:83%). Participants completed a median of 172.8 (min:77.5, max:560.8) minutes of physical activity per week. 17% met the compliance outcome threshold for ≥75% of the intervention. Improvements in quality of life (mean change (95% CI): 7.9 units (1.9, 13.8)), functional well-being (4.3 units (1.4, 7.2)), depression (-2.0 units (-3.8, -0.2)), activity (112.8 min (42.1, 183.4)), fitness (56.4 meters (20.4, 92.5)), balance (4.9 s (0.9, 9.0)), and lower-body strength (15.2 kg (9.3, 21.1)) were observed end-intervention.

Conclusion: Preliminary evidence support that exercise is safe and beneficial to the quality of life and functional outcomes for people with brain cancer.Registration: ACTRN12617001577303.

Keywords: Exercise; brain cancer; feasibility; safety; survivorship.

Plain language summary

The BRAin Cancer and Exercise (BRACE) study highlights the need for regular monitoring of disease- and treatment-related side effects which may present as barriers to exercise.Exercise prescription should be modified according to the presence and severity of disease- and treatment-related barriers.Adverse events observed, such as dizziness, highlight the importance of supervised exercise for people with brain cancer.If supervision is not possible, then exercise modes with low risk of harm from falls are recommended (e.g., walking, machine-based resistance training).