Effects of aerobic exercise performed the day before chemotherapy on cancer-related fatigue and active behavior in advanced cancer patients: a randomized crossover pilot study

Abstract Objectives To evaluate the effect of moderate-to-high-intensity aerobic exercise performed the day before chemotherapy session on cancer-related fatigue (CRF) and to compare active vs. sedentary behaviors over the subsequent 5 days. Methods Twelve metastatic cancer patients (45–65 years old) were recruited in a crossover study including three experimental conditions performed the day before chemotherapy: 1) Control (REST), 2) moderate continuous exercise (MOD), and 3) high-intensity interval exercise (HIIE). CRF and other symptoms were assessed using visual analog scales. Sedentary and active behaviors, including light (LPA) and moderate-vigorous physical activity (MVPA), were estimated using an accelerometer. All measures were collected over the 5 days following chemotherapy treatment. Results Mixed-effect linear models showed CRF fluctuated throughout the day. A significant time effect on CRF was found on Day 1 (p<0.02), Day 3 (p=0.04), and Day 4 (p=0.05), with a trend on Day 2 (0.06<p<0.09). The HIIE condition lessened perceived fatigue 5 days after the chemotherapy session (p=0.05). No effect of time, condition, or interaction on sedentary behaviors (p>0.20), LPA or MVPA was observed. Global ANOVA tests confirmed these patterns, with significant time effects on CRF (η 2 up to 0.56) and no global effect on sedentary behavior or physical activity. Conclusions Moderate to vigorous aerobic exercise the day before chemotherapy may help mitigate CRF without exacerbating it in the following days. These findings support our hypothesis that pre-chemotherapy exercise can better prepare the body for treatment, potentially boosting energy levels and reducing sedentary time by increasing LPA activity.