Cardiovascular training
Limited performance and severe fatigue caused by chemo- and radiotherapy – the Fatiguesyndrome – is a big problem of tumor patients and can often be difficult to distinguish from depression. About 70% of those affected suffer from this phenomenon during chemotherapy and radiation. In about 30%, these symptoms persist even after the therapy and limit their ability to perform in everyday life and at work.
Even simple activities like walking or climbing stairs become an insurmountable challenge. Many factors play a role in the development of the fatigue syndrome, including anemia (colloquially anemia, reduction of hemoglobin in the blood, restricted oxygen transport), loss of muscle mass and the interaction of drugs. Treating exhaustion with medication has so far had little success.
In addition, depending on the medication administered, some women suffer from cardiac arrhythmia caused by chemo, high blood pressure, heart attack or heart failure (cardiac insufficiency). The heart problems can still occur 20 years after the therapy. The doctor decides to what extent and with what load the affected patients may perform endurance training.
For a long time, physical activity in oncology was controversial and the uncertainty among doctors and therapists due to insufficient facts was so great that, as a precaution, rest and protection were propagated. This played into the hands of the retreat into passivity, into which many patients understandably take refuge anyway. Meanwhile one knows that rest and protection promote the exhaustion syndrome instead of alleviating it.
Thus a vicious circle develops, from which the patients find out again with difficulty. Today, endurance training in particular is recommended as a remedy for Fatiguesyndrome. Patients change from a passive, “enduring” role to an active position that intervenes in the healing process.
Active training helps the affected women to transform the negative body image caused by cancer into a positive one. With increasing performance, the affected self-confidence grows. The greatest difficulty to start training when there are no medical contraindications is to overcome the inner “pig dog”.
The cardiovascular training should be started as early as possible. Even in the acute phase of treatment, endurance training is possible, depending on your condition. It improves the general cardiovascular endurance, the vital capacity of the lungs and reduces the side effects of chemotherapy and radiotherapy.
Patients who train from the very beginning of the therapy are less exhausted, complain less about headaches and nausea, sleep better and have more appetite, thromboses occur less frequently. In addition, the postural and supporting activity improves due to an increase in muscle strength. By strengthening the immune system, susceptibility to infections is reduced.
If weakened patients are not able to train on the bicycle ergometer or cross walker, endurance training with the bed bicycle is also possible. When informing about sports activity as a health behaviour, it should be mentioned that sport can reduce the risk of recurrence.General principles:The training parameters have to be determined individually for each patient to avoid over- or understraining. To monitor the endurance training, the therapist is present and controls pulse rate, blood pressure and possibly lactate.
Interval training with a combination of load and recovery phases is useful. Exercise time and exercise pulse, as well as pauses and recovery pulse, distance and speed are recorded. The training should take place at about 75% of the maximum heart rate, the recovery pulse in the regeneration break should not exceed 100 beats/minute. If several participants have a similar performance level, the endurance training can take place under observation in a group, pulse control should be safe for the participants to perform independently.
