581P - The effect of exercise intervention on defecation related symptoms of colorectal cancer patients a randomized controlled trial

Background

Although colorectal cancer (CRC) survivors often suffer from defecation related symptoms (DRS), there are very few treatment options to improve DRS. Strengthening of abdominal muscles to increase intra-abdominal pressure and pelvic floor exercises to improve pelvic floor dyssynergia may improve DRS in colorectal cancer patients. However, the effects of exercise on DRS have not been studied fully. Therefore, the purpose of this study is to investigate the efficacy of exercise on DRS in CRC.

Methods

A total of 120 CRC who completed surgery and adjuvants therapy were recruited out of 441 approached. 120 participants were randomly assigned to either exercise (EG) or usual care group (CG). The combined weekly supervised and home-based exercise program (12 weeks) includes increase in physical activity (PA) levels to meet the ACSM guideline as well as daily calisthenics exercises. Calisthenics exercises include a total of 12 movements aimed to increase whole body muscle strengths which focused on core and pelvic floor muscles. The primary outcome was DRS score assessed the sum of blood and mucus in stool, stool frequency, abdominal pain, buttock pain, bloating, flatulence, fecal incontinence and embarrassment in EOTRC-QLQ-CR29. A two-way ANOVA repeated measures were used determine group and time interaction. Table: 581P

Effects of exercise on defecatory symptoms

Bolds were statistically significant different between pre and post (p<.05), p= Difference between control vs. exercise

Results

Among the 120 participants enrolled, 100 (96.6%) completed the trial with supervised exercise compliance rate of 95%. PA levels increased and fitness levels improved only in the exercise group. Exercise significantly decreased DRS score (6 week - 0 week: CG= -14.0 ± 54.7 vs. EG= - 56.1 ± 99.5, p for group and time interaction = 0.02). Symptom scores in EG include blood and mucus in stool, abdominal pain, buttock pain, bloating, flatulence and embarrassment were improved.

Conclusions

It is concluded that both combined supervised and home-based exercise significantly reduced bowel and defecatory problems in colorectal cancer patients.

Clinical trial identification

This study was approved by The Institutional Review Board of Severance Hospital (IRB No. 4-2018-0841).

Editorial acknowledgement

This study was funded by the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (HA16C0012020020) and Yonsei Signature Research Cluster Program of 2021-22-0009.

Legal entity responsible for the study

The authors.

Funding

The National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea, Yonsei Signature Research Cluster Program.

Disclosure

All authors have declared no conflicts of interest.