Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial

Abstract

BackgroundExercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within 6 weeks after diagnosis, on preventing an increase in fatigue.MethodsThis multi-centre controlled trial randomly assigned 204 breast cancer patients to usual care (n = 102) or supervised aerobic and resistance exercise (n = 102). By design, all patients received chemotherapy between baseline and 18 weeks. Fatigue (i.e., primary outcome at 18 weeks), quality of life, anxiety, depression, and physical fitness were measured at 18 and 36 weeks.ResultsIntention-to-treat mixed linear model analyses showed that physical fatigue increased significantly less during cancer treatment in the intervention group compared to control (mean between-group differences at 18 weeks: −1.3; 95 % CI −2.5 to −0.1; effect size −0.30). Results for general fatigue were comparable but did not reach statistical significance (-1.0, 95%CI -2.1; 0.1; effect size -0.23). At 18 weeks, submaximal cardiorespiratory fitness and several muscle strength tests (leg extension and flexion) were significantly higher in the intervention group compared to control, whereas peak oxygen uptake did not differ between groups. At 36 weeks these differences were no longer statistically significant. Quality of life outcomes favoured the exercise group but were not significantly different between groups.ConclusionsA supervised 18-week exercise programme offered early in routine care during adjuvant breast cancer treatment showed positive effects on physical fatigue, submaximal cardiorespiratory fitness, and muscle strength. Exercise early during treatment of breast cancer can be recommended. At 36 weeks, these effects were no longer statistically significant. This might have been caused by the control participants’ high physical activity levels during follow-up.Trial registrationCurrent Controlled Trials ISRCTN43801571, Dutch Trial Register NTR2138. Trial registered on December 9th, 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0362-z) contains supplementary material, which is available to authorized users.

Effectiveness of Physiotherapy Intervention on the Quality of Life of Women with Breast Cancer who Underwent Sentinel Lymph Node Biopsy.

“…However, the estimate direction with an effect favorable to the Experimental Group was maintained. These results are similar to those obtained in other studies in which 6 months after surgery women with breast cancer undergoing physiotherapy or a specific exercise program presented better scores, or a higher ratio with clinical improvement when compared to a Control Group (without the intervention of physiotherapy or an exercise program), but there were no statistically significant differences between groups in the Global Health Status [21,23,29], Physical Functioning [23,50], Future Perspective [23], Fatigue [21,23] or Arm Symptoms [23]. However, in other studies, 6 months after surgery women with breast cancer who had the support of physiotherapy or a specific exercise program, compared to a Control Group, showed statistically significant or clinically important improvement in Global Health Status [20,22], Role Functioning [20,22], Emotional Functioning, Social Functioning [22,26], Fatigue [20], Pain [21], Future Perspective, Breast Symptoms, and Arm Symptoms [26].…”

“…This matches other studies in which 6 months after the surgery, women with breast cancer who did not undergo physiotherapy, when compared to a group who did, registered a greater degradation in the Global Health Status [26,27,51], Physical Functioning, Role Functioning, Emotional and Social Functioning [50,51], Body Image, Future Perspective [26], and Fatigue [51].…”

Effectiveness of specific types of structured physical activities in the rehabilitation of post-mastectomy women: a systematic review

“…Biskup et al, in their study addressing physical activity as a contributive factor in maintaining post-mastectomy health, showed a challenging nature of the research focused on comparing academical studies evaluating overall effectiveness of post-surgical intervention outcomes, while using the diversity of research tools [25]. In the present, systematic review of literature, the research tools applied in the assessment of different components of physical activity differ significantly between studies.…”

The effects of exercise on the quality of life of patients with breast cancer (the UMBRELLA Fit study): study protocol for a randomized controlled trial

“…Patients with cancer in particular are often motivated to change their lifestyle after diagnosis and, therefore, already intend to increase physical activity levels or attend an exercise programme in the near future [21]. For example, in the Physical Activity during Cancer Treatment (PACT) study, about 50% of the patients with breast cancer randomized to the control group adopted the behaviour of the intervention group [22]. A high level of contamination due to cross-over of controls who adopt the behaviour of the intervention group may decrease the statistical power to detect an intervention effect.…”