Feasibility of an exercise intervention for fatigued breast cancer patients at a community-based cardiac rehabilitation program

Abstract

PurposeExercise is beneficial to quality of life after cancer treatment, yet few cancer survivors meet exercise guidelines. Our study sought to determine the feasibility of an oncology rehabilitation exercise program embedded within a cardiac rehabilitation program.MethodsPatients who rated their fatigue >4/10 after completion of adjuvant chemotherapy for breast cancer were screened for eligibility and the outcomes were assessed (Piper Fatigue Scale, Functional Assessment of Cancer Therapy-Breast [FACT-B], Edmonton Symptom Assessment System, body composition, stress test, and physical activity measurement [accelerometer]). Participants received individualized exercise prescription. Following the 16-week program, repeat assessment plus patient acceptance and satisfaction survey was completed. The primary end point was the composite of accrual rate >25%, program adherence >80%, and mean compliance with accelerometer use >80%.ResultsTwenty of 24 screened patients consented to the study and completed the baseline assessment. Adherence was 30.3%. Mean accelerometer use was 3.88/7 days (78%). Fatigue at baseline was rated at 4.82/10, and at 3.59 (p = 0.09) after the intervention. Overall well-being (FACT-B) score changed from 92.7 to 98.3 (p = 0.05). There were no significant changes in body composition (except for bone mineral content), aerobic exercise capacity, or activity patterns.ConclusionAlthough the primary outcome was not met, our study indicates that an oncology exercise rehabilitation program can be incorporated into an existing cardiac rehabilitation program. Based on feedback received, we propose that in order to achieve exercise goals, frequent, encouraging, and tailored feedback and group sessions to foster a sense of community may additionally be needed to strengthen adherence to a prescribed exercise program.

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“…Current guidelines for all cancer survivors include regular performance of an exercise program as a strategy for maintaining a healthy weight and decreasing cancer recurrence. 28,29 Although evidence points to improvement in QOL and symptoms with physical exercise, the majority of breast cancer survivors do not adhere to regular physical activity regimens after treatment. 30 One obstacle to adherence may be a lack of exercise options.…”

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Physical Activity, Exercise and Breast Cancer - What Is the Evidence for Rehabilitation, Aftercare, and Survival A Review

“…One single-arm study indicated that an oncology rehabilitation exercise program with 20 breast cancer patients could be integrated in a cardiac rehabilitation program, but did not meet the primary outcome in terms of adherence and significant changes in aerobic exercise capacity [23]. Dittus et al [24] showed that topics like exercise training, physical activity, nutrition counseling, psychosocial management, and weight management are the same in cancer and cardiac rehabilitation, also demonstrating usability of cardiac rehabilitation structures.…”