title: Quality of life after self-management cancer rehabilitation: a randomized controlled trial comparing physical and cognitive-behavioral training versus physical training.
abstract: OBJECTIVE
  To conduct a randomized controlled trial and compare the effects on cancer survivors' quality of life in a 12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitive-behavioral training (once weekly) with those of a 12-week group-based physical training (twice weekly). In addition, both interventions were compared with no intervention.
  
  
  METHODS
  Participants (all cancer types, medical treatment completed > or = 3 months ago) were randomly assigned to multidisciplinary rehabilitation (n = 76) or physical training (n = 71). The nonintervention comparison group consisted of 62 patients on a waiting list. Quality of life was measured using the RAND-36. The rehabilitation groups were measured at baseline, after rehabilitation, and 3-month follow-up, and the nonintervention group was measured at baseline and 12 weeks later.
  
  
  RESULTS
  The effects of multidisciplinary rehabilitation did not outperform those of physical training in role limitations due to emotional problem (primary outcome) or any other domains of quality of life (all p > .05). Compared with no intervention, participants in both rehabilitation groups showed significant and clinically relevant improvements in role limitations due to physical problem (primary outcome; effect size (ES) = 0.66), and in physical functioning (ES = 0.48), vitality (ES = 0.54), and health change (ES = 0.76) (all p < .01).
  
  
  CONCLUSIONS
  Adding a cognitive-behavioral training to group-based self-management physical training did not have additional beneficial effects on cancer survivors' quality of life. Compared with the nonintervention group, the group-based self-management rehabilitation improved cancer survivors' quality of life.
authors.affiliation: Department of Health Education and Promotion, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: Korstjens
authors.forename: Anne M
authors.initials: AM
authors.lastname: May
authors.forename: Ellen
authors.initials: E
authors.lastname: van Weert
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.forename: Frans
authors.initials: F
authors.lastname: Tan
authors.forename: Wynand J G
authors.initials: WJ
authors.lastname: Ros
authors.forename: Josette E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
authors.forename: Cees P
authors.initials: CP
authors.lastname: van der Schans
authors.forename: Bart
authors.initials: B
authors.lastname: van den Borne
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D010348:Patient Care Team; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D012803:Sick Role