title: Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial.
abstract: OBJECTIVE
  Self-directed and supervised exercise were compared with usual care in a clinical trial designed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer.
  
  
  METHODS
  One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life, aerobic capacity, and body weight. Participants were randomly allocated to one of three intervention groups: usual care (control group), self-directed exercise, or supervised exercise. Quality of life, aerobic capacity, and body weight measures were repeated at 26 weeks. The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks.
  
  
  RESULTS
  Physical functioning in the control group decreased by 4.1 points, whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups, respectively (P =.04). Post hoc analysis showed a moderately large (and clinically important) difference between the self-directed and control groups (9.8 points; P =.01) and a more modest difference between the supervised and control groups (6.3 points; P =.09). No significant differences between groups were observed for changes in quality of life scores. In a secondary analysis of participants stratified by type of adjuvant therapy, supervised exercise improved aerobic capacity (+3.5 mL/kg/min; P =.01) and reduced body weight (-4.8 kg; P <.05) compared with usual care only in participants not receiving chemotherapy.
  
  
  CONCLUSIONS
  Physical exercise can blunt some of the negative side effects of breast cancer treatment, including reduced physical functioning. Self-directed exercise is an effective way to improve physical functioning compared with usual care. In participants not receiving chemotherapy, supervised exercise may increase aerobic capacity and reduce body weight compared with usual care.
authors.affiliation: Department of Medical Oncology, Ottawa Regional Cancer Centre, Ottawa, Ontario, Canada. roanne_segal@cancercare.on.ca
authors.forename: R
authors.initials: R
authors.lastname: Segal
authors.forename: W
authors.initials: W
authors.lastname: Evans
authors.forename: D
authors.initials: D
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Colletta
authors.forename: J
authors.initials: J
authors.lastname: Gayton
authors.forename: S
authors.initials: S
authors.lastname: Woodard
authors.forename: G
authors.initials: G
authors.lastname: Wells
authors.forename: R
authors.initials: R
authors.lastname: Reid
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant