P08.09.b effects of a one-week skiing intervention on lower limb muscle strength in brain tumor patients and their caregivers

BACKGROUND Due to fatigue or feelings of insecurity, many brain tumor patients are not sufficiently active. Among other things, this puts patients at higher risk for sarcopenia predicting overall survival. Exercise interventions of various kinds could effectively counteract this problem. Here, we aim to present the impact of a one-week skiing intervention on leg muscle strength in brain tumor patients and their caregivers as well as feasibility and safety of the intervention. MATERIAL AND METHODS Ten brain tumor patients and their families participated in this one-week skiing intervention in a self-catering lodge at 1400m altitude. Daily 4-hour ski sessions (including approx. 1 hour rest) with professional ski instructors were performed in small groups (≤5 participants) divided by proficiency level. Participants could choose between downhill and cross-country skiing. Adverse events were noted daily. Muscle strength was determined 3-10 days pre- and postintervention on 5 different gym machines (knee extension, knee flexion, adductors, abductors, leg press) using Brzycki's equation. RESULTS 20 adults (10 patients, 10 caregivers) and 7 children participated in the ski-based intervention. All patients were surgically treated at least once and received chemo- and/or radiotherapy (ongoing chemotherapy in 6 patients). No severe adverse events were recorded throughout the week. 15 adults (9 patients, 56% female; 6 caregivers, 67% female) aged 21-69 years (mean 50 years) completed the muscle strength tests. Of those, most patients suffered from grade 4 brain tumors (67%), followed by grade 2 (22%) and grade 1 (11 %) tumors. Mean muscle strength increased in all muscle groups tested (knee extension +13.5%, p=.024, CI 95%: -0.5 - 29.1; knee flexion +7.1%, p=.048 CI 95%: -1.0 - 14.0; adductors +6.6%, p=.039, CI 95%: 1.3 - 13.4; abductors 20.0%, p=.004, CI 95%: 6.9 - 35.7; leg press +19.5%, p=.050, CI 95%: -5.6 - 44.6). Tumor grade, gender, type of ski intervention, and age did not affect the RESULTS . CONCLUSION During one week of intensive ski training, positive effects on leg muscle strength could be shown in both brain tumor patients and their families regardless of age, gender, downhill/cross-country ski, or WHO grading. Furthermore, this study demonstrates feasibility and safety of ski-based exercises in this patient population. Interventions such as these could help patients overcome (gait) insecurities and motivate them to become more physically active in their daily lives. In the longer term, this may lead to better management of everyday life and improved quality of life.