Does walking protect against decline in cognitive functioning among breast cancer patients undergoing chemotherapy? Results from a small randomised controlled trial

Abstract

BackgroundCancer related cognitive impairments have been subjectively reported and objectively detected in breast cancer patients treated with chemotherapy and are known to have a profound negative impact on productivity, psychosocial well-being and overall quality of life. Moderate levels of walking are known to be of benefit to the psychosocial well-being of those affected by breast cancer and for managing cognitive impairment in healthy adults, children, and the elderly. The purpose of this study is to investigate the effects of a home-based, self-managed, moderate intensity walking intervention on subjective and objective cognitive functioning in breast cancer patients undergoing chemotherapy.MethodsA home-based, self-managed intervention that consisted of moderate levels of walking was compared to usual care among breast cancer patients treated with chemotherapy in a randomised controlled trial. Outcome measures included changes in subjective (CFQ) and objectively detected cognitive functioning (Stroop, SART and two subscales from the WAIS- Digit Span and Block Design). Fifty participants were randomised to either the intervention group (n = 25), who completed 12 weeks of moderate intensity walking, or to the control group (n = 25) mid-way through chemotherapy.ResultsCompared with the control group, the self-managed walking intervention had positive effects on perceived cognitive function but not on sustained attention, executive function, memory or visual spatial skills when assessed objectively using neuropsychological measures.ConclusionThis home-based, self-managed intervention is beneficial for protecting against perceived cognitive decline in breast cancer patients treated with chemotherapy. There is a need for further research to objectively assess cognitive decline within this population with larger sample sizes of patients.Trial registrationCurrent Controlled Trials ISRCTN50709297

Effects of Smartphone-Based Compensatory Cognitive Training and Physical Activity on Cognition, Depression, and Self-Esteem in Women with Subjective Cognitive Decline

“…Walking exercise increased the size of the hippocampus and improved memory in the elderly [24]. In addition, walking exercise reduced self-reported cognitive failure and improved subjective cognitive function in breast cancer patients [25]. These findings indicate that the application of nonpharmacologic interventions such as compensatory calendar training and walking-based exercise regimens can improve cognitive function and help maintain daily life functions.…”

“…After intervention, memory contentment increased in experimental group 1 and was maintained in experimental group 2, but decreased in the control group. Gokal et al [25] reported that walking exercise improved subjective evaluations of cognitive function in breast cancer patients receiving chemotherapy. This is consistent with the results of this study, and we concluded that walking exercises improve memory satisfaction.…”

Factors associated with cognitive impairment during the first year of treatment for nonmetastatic breast cancer

“…Physical activity has also proven beneficial for CI, which may be at least partially explained by improvements in symptoms of depression that result from increased behavioral activation 45 . Further, there is evidence that even low intensity exercises can benefit cognition 46 . Physicians and their patients would thus benefit from discussions around the incorporation of physical activity into the treatment plan at diagnosis and before beginning treatment.…”

Effects of acupuncture versus cognitive behavioral therapy on cognitive function in cancer survivors with insomnia: A secondary analysis of a randomized clinical trial

“…As such, the National Comprehensive Cancer Network recommends pharmacologic interventions as a last line of therapy for patients with CRCI, 68 highlighting the importance of developing and evaluating nonpharmacological approaches for this condition. Cognitive rehabilitation and/or training, 69‐73 physical activity, 74‐78 yoga, 79‐81 qi gong, 82 and mindfulness techniques 83,84 have demonstrated preliminary benefits for subjective and/or objective cognitive function in cancer populations, but these findings need to be confirmed in larger, rigorously designed trials. The results of the current study have contributed to this growing literature by highlighting 2 other nonpharmacological interventions that warrant further investigation in the development of effective treatments of CRCI.…”