{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:30:03Z","timestamp":1792794603352,"version":"4.5.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"M\u00fcnster University Hospital Central Nervous System Association","id":[{"id":"https:\/\/ror.org\/01856cw59","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High-grade glioma (HGG) patients experience enormous disease burden both from tumor- and treatment-related symptoms. Exercise can improve physical fitness and quality of life (QoL); yet experience in neuro-oncology, especially with high-intensity exercise, remains limited. This study evaluated feasibility, safety, and efficacy of the intensive, structured 16-week strength and endurance program, \u201cActive in Neuro-Oncology\u201d (ActiNO) for HGG patients undergoing chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, oligocentric, single-arm proof-of-concept trial, 54 HGG patients participated in ActiNO, with twice-weekly supervised exercise sessions. The primary endpoint was cardiorespiratory fitness, assessed via physical working capacity (PWC75%)\u2014the workload (W\/kg body weight) achieved at 75% of age-adjusted maximum heart rate during a maximal cardiopulmonary exercise test. Secondary endpoints included peak oxygen uptake (VO2peak), peak power output (Ppeak), and QoL (EORTC QLQ-C30). Analyses focused on within-subject changes from pre- to post-intervention. Additionally, comparisons to normative data were performed. Feasibility was assessed via accrual, adherence, and attrition; safety via adverse event monitoring (CTCAE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Program tolerance was high, with few exercise-related adverse events (all CTCAE grade 1-2). Over 16 weeks, significant improvements were observed in PWC75% (1.023-1.256 W\/kg BW, +23%), VO2peak (23.04-26.09\u00a0ml\/min\/kg BW, +13%), and Ppeak (1.771-2.104 W\/kg BW, +19%). QoL, including global health and physical functioning, improved, reaching normative values. Adherence was high (85%), though attrition was 48%, mainly due to disease progression or physical constraints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High-intensity exercise is feasible and safe in HGG patients undergoing chemotherapy. The observed improvements in physical fitness and QoL support incorporating structured exercise into neuro-oncology care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noaf176","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:53:18Z","timestamp":1753271598000},"page":"2977-2990","source":"Crossref","is-referenced-by-count":5,"title":["Enhancing cardiorespiratory fitness and quality of life in high-grade glioma through an intensive exercise intervention during chemotherapy: Proof of concept"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1306-4852","authenticated-orcid":false,"given":"Johanna","family":"Jost-Engl","sequence":"first","affiliation":[{"name":"Pulmonary Research Division, Department of Medicine A, University Hospital, University M\u00fcnster , M\u00fcnster ,","place":["Germany"]},{"name":"Department of Neurosurgery, University Hospital, Saarland University , Homburg\/Saar 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