The Potential Role of Periodised Resistance Training During Cancer Treatment

Metcalfe, James

Abstract

Cancer and its treatments are associated with numerous debilitating side effects, including increased fatigue and reductions in lean mass, muscular strength, physical function, and overall quality of life (QoL). Resistance training has been shown to be a safe and effective strategy for mitigating such side effects in patients undergoing cancer treatment. However, current resistance training guidelines in oncology settings are generic and do not account for the diverse nature of cancer and its treatments, thereby limiting its therapeutic potential. This highlights the need for more precise planning and manipulation of training variables, such as frequency, intensity, and volume (i.e. periodisation). Periodised resistance training has the potential to target numerous physical parameters while managing treatment-related side effects, thus reducing the risk of excessive fatigue, injury and illness. Overall, the aim of this thesis was to provide a rationale for the future investigation and implementation of home-based, virtually supervised, periodised resistance training in patients undergoing cancer treatment. Due to numerous setbacks and the COVID-19 pandemic, this rationale was presented through elderly and obese populations who share similar risk factors and characteristics including reduced physical function, elevated levels of fatigue and reduced QoL.
Chapter 3 systematically reviewed and meta-analysed the efficacy of resistance training on quality of life, fatigue, physical function, muscular strength and power in cancer patients undergoing chemotherapy. Seven randomised control trials (RCTs) including 561 participants demonstrated that resistance training statistically significantly improved lower-body strength (Standardised mean difference (SMD) = 0.33) compared to controls, but had no effect on QoL, fatigue, physical function, or upper-body strength. None of the studies included in this review assessed muscular power as an outcome highlighting limited research in this area.
Chapter 4 assessed the validity of a mobile application (App) (Sit-to-Stand) and Inertial measurement unit (IMU) (PUSHTM) to measure sit-to-stand (STS) velocity and power in older adults. This study demonstrated that the STS mobile App was a valid tool for measuring STS velocity (r = 0.89; ES = -0.19) and power (r = 0.74; ES = -0.11) in older adults. These findings suggest that a mobile App can be used to assess muscular power and function, especially in settings where time, money, and space are limited.
Chapter 5 evaluated the effects of an 8-week home-based, virtually supervised, weekly undulating periodised (WUP) resistance training programme on anthropometry, functional performance, and health-related quality of life (HRQoL) in obese adults. Pre to post within group changes demonstrated statistically significant improvements in waist circumference (gz = -2.09) and hip circumference (gz = -1.39). Functional performance significantly improved with reductions in 40 m fast pace walk (40m FPWT) test (gz = -2.41) and timed up and go (TUG) (gz = -2.20) and increases in seated basketball throw (SBT) (gz = 1.22) and six-minute walk test (6MWT) (gz = 2.12). Health related quality of life (HRQoL), assessed via 36 item short form (SF-36) demonstrated statistically significant improvements in physical functioning (gz = 2.15), role limit emotional (gz = 1.05), social functioning (gz = 2.14), pain (gz = 2.13), energy/fatigue (gz = 1.25), general health (gz = 2.77), and health change (gz = 2.35). The Weight Related Symptom Measure (WRSM) showed a significant decrease (gz = -1.45), as did the Multidimentail Assessment of Fatigue (MAF) (gz = -1.89). These findings demonstrate that an 8-week, home-based, virtually supervised WUP resistance training programme improves anthropometry, physical function, fatigue and HRQoL in obese adults.
Chapter 6 presents a study protocol to assess the feasibility and acceptability of a home-based, virtually delivered, WUP resistance training intervention during colorectal cancer (CRC) treatment. This mixed-methods study aims to address uncertainties relating to the feasibility and acceptability of delivering home-based, virtually supervised exercise sessions to patients with CRC. The findings of this study will inform whether the intervention is safe to perform and if any modifications are necessary to improve the delivery of the intervention and patient engagement. The assessment of outcome measures will provide information on the likely size and variability of intervention effects, as well as the feasibility of data collection and the appropriateness of the selected assessments. Collectively, the data generated will inform the design of a subsequent, adequately powered, randomised controlled trial to evaluate the efficacy of home-based, virtually delivered, WUP resistance training intervention in patients with CRC undergoing treatment.
Overall, this thesis aimed to provide a rationale for the future investigation into the feasibility and acceptability of a home-based, virtually delivered, periodised resistance training programme in patients with cancer undergoing treatment. Evidence from obese populations demonstrates that such an intervention has the potential to improve anthropometry, functional performance, fatigue and HRQoL. Given that obese populations share similar risk factors and characteristics including reduced physical function, elevated levels fatigue and reduced HRQoL, the delivery of such an intervention could prove beneficial for patients with cancer undergoing treatment.

Citation

Metcalfe, J. (2025). The Potential Role of Periodised Resistance Training During Cancer Treatment [Doctoral thesis, University of Hull]. https://hull-repository.worktribe.com/output/5292352

• Thesis Type: Thesis
• Deposit Date: Jul 31, 2025
• Publicly Available Date: Aug 5, 2025
• Keywords: Sports science
• Public URL: https://hull-repository.worktribe.com/output/5292352
• Additional Information: School of Sport, Exercise and Rehabilitation Science; University of Hull
• Award Date: Jun 11, 2025