The impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy: a randomized controlled trial

Abstract

BackgroundThis study evaluated the impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy.MethodsOlder breast cancer survivors were randomized into two groups: combined training: resistance + aerobic exercise program for nine months (n = 18) or control group (n = 18). Quality of life was assessed by the questionnaires SF36, EORTC QLQ-C30, and EORTC QLQ-BR23 at baseline, and at three, six, and nine months. The exercise group performed 40 min of resistance exercises on machines followed by 30 min of aerobic training on a treadmill 3x/wk. Repeated measures ANOVA was used to compare the groups over time.ResultsSignificant time x group interactions and moderate to high effect sizes were found for physical functioning, physical health, bodily pain, general health perception, vitality, social functioning, fatigue, sleep disturbance, body image, and upset by hair loss, favoring the exercise group.ConclusionThis study demonstrated the potential benefits and high clinical relevance of exercise programs to improve quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy.

Effect of exercise on cancer-related fatigue: A systematic review

“…Thirteen RCTs found improvements in CRF (Adams et al, 2018;Cormie et al, 2015;Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Hojan et al, 2016;Hwang et al, 2008;Kampshoff et al, 2015;Monga et al, 2007;Paulo et al, 2019;Pinto et al, 2005;Segal et al, 2009;Shobeiri et al, 2016;Steindorf et al, 2014), one trial found improvements only in patients who were not affected of depression (Schmidt et al, 2015) and other one trial found improvements in patients who changed intensity of exercise or physical performance (Penttinen et al, 2019). Four types of exercise intervention were used: Aerobic (Monga et al, 2007;Pinto et al, 2005;Segal et al, 2009;Shobeiri et al, 2016); Resistance (Schmidt et al, 2015;Segal et al, 2009;Steindorf et al, 2014); Endurance (i.e., High Intensity Interval Training) (Adams et al, 2018), Combined (Cormie et al, 2015;Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Hojan et al, 2016;Kampshoff et al, 2015;Mendes et al, 2018;Paulo et al, 2019;Penttinen et al, 2019). One of these trials (Segal et al, 2009) found improvements in CRF with aerobic VOLUME --| ISSUE -| 2020 | 7 (Jacobsen & al., 1999) RCT ( FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue Scale; BFI, Brief Fatigue Inventory; PFS, Piper Fatigue Scale; MFI, Multidimensional Fatigue Inventory; FAQ, Fatigue Assessment Questionnaire; LASA, Linea...…”

“…One of these trials (Segal et al, 2009) found improvements in CRF with aerobic VOLUME --| ISSUE -| 2020 | 7 (Jacobsen & al., 1999) RCT ( FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue Scale; BFI, Brief Fatigue Inventory; PFS, Piper Fatigue Scale; MFI, Multidimensional Fatigue Inventory; FAQ, Fatigue Assessment Questionnaire; LASA, Linear Analogue Self-Assessment; IG, Intervention Group; CG, Control Group; Sm, Simple mean; HI, High Intensity; LMI, Low-To-Moderate Intensity; WLC, Wait List Control; HIIT, High Intensity Interval Training; ACSM, American College of Sport Medicine. 10 | 2020 | ISSUE -| VOLUME --© 2020 University of Alicante exercise at first follow-up and with resistance exercise at last follow-up. Intensity of the exercise varied from low (Galiano-Castillo et al, 2016;Hwang et al, 2008;Pinto et al, 2005;Shobeiri et al, 2016) to moderate (Cormie et al, 2015;Dieli-Conwright et al, 2018;Hojan et al, 2016;Monga et al, 2007;Segal et al, 2009;Paulo et al, 2019;Schmidt et al, 2015;Steindorf et al, 2014) to high (Adams et al, 2018) or changed during treatment (Kampshoff et al, 2015;Penttinen et al, 2019). The most important outcomes were shown in two Aerobic treatment trials (Monga et al, 2007;Shobeiri et al, 2016) and two Combined treatment trials (Dieli-Conwright et al, 2018;Paulo et al, 2019).…”

“…All 15 trials were RCTs (Adams et al, 2018;Cormie et al, 2015;Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Hojan et al, 2016;Hwang et al, 2008;Kampshoff et al, 2015;Monga et al, 2007;Paulo et al, 2019;Penttinen et al, 2019;Pinto et al, 2005;Schmidt et al, 2015;Segal et al, 2009;Shobeiri et al, 2016;Steindorf et al, 2014). Table 2 reviews all patient details.…”

“…905 patients were randomized in an intervention group (IG1+IG2) and 749 were randomized in a control group of which 36 received a basic recommendation for exercise (Galiano-Castillo et al, 2016) and 142 followed relaxation treatment (Paulo et al, 2019;Schmidt et al, 2015;Steindorf et al, 2014 (Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Hwang et al, 2008;Paulo et al, 2019;Penttinen et al, 2019;Pinto et al, 2005;Schmidt et al, 2015;Shobeiri et al, 2016;Steindorf et al, 2014), in 4 reported prostate cancer (Cormie et al, 2015;Hojan et al, 2016;Monga et al, 2007;Segal et al, 2009), in 1 reported testicular cancer (Adams et al, 2018), in 1 multiple cancer (Kampshoff et al, 2015). In 8 trials patients were still undergoing different therapies (Cormie et al, 2015;Hojan et al, 2016;Hwang et al, 2008;Monga et al, 2007;Paulo et al, 2019;Schmidt et al, 2015;Segal et al, 2009;Steindorf et al, 2014), in 3 trials patients completed therapies (Kampshoff et al, 2015;Penttinen et al, 2019;Shobeiri et al, 2016) and in 4 trials patients were analysed after therapies (Adams et al, 2018;Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Pinto et al, 2005). Exercise interventions lasted from 5 weeks (Mendes et al, 2018) to 5 years (Penttinen et al, 2019), of which 11 trials did follow-up at baseline and after treatment…”

“…In 8 trials patients were still undergoing different therapies (Cormie et al, 2015;Hojan et al, 2016;Hwang et al, 2008;Monga et al, 2007;Paulo et al, 2019;Schmidt et al, 2015;Segal et al, 2009;Steindorf et al, 2014), in 3 trials patients completed therapies (Kampshoff et al, 2015;Penttinen et al, 2019;Shobeiri et al, 2016) and in 4 trials patients were analysed after therapies (Adams et al, 2018;Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Pinto et al, 2005). Exercise interventions lasted from 5 weeks (Mendes et al, 2018) to 5 years (Penttinen et al, 2019), of which 11 trials did follow-up at baseline and after treatment (Adams et al, 2018;Cormie et al, 2015;Dieli-Conwright et al, 2018;Galiano-Castillo et al, 2016;Hojan et al, 2016;Hwang et al, 2008;Kampshoff et al, 2015;Pinto et al, 2005;Shobeiri et al, 2016;Schmidt et al, 2015), 3 RCTs did 3 different follow-up (baseline, T1 and T2) (Paulo et al, 2019;Segal et al, 2009;Steindorf et al, 2014) and other one trial did 6 follow-ups (Penttinen et al, 2019).…”