A randomized controlled trial of home-based exercise for cancer-related fatigue in women during and after chemotherapy with or without radiation therapy.
BACKGROUND
Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment.


OBJECTIVE
The purpose of this study was to evaluate the effectiveness of a home-based exercise training intervention, the Pro-self Fatigue Control Program on the management of cancer-related fatigue.


METHODS
Participants (N = 119) were randomized into 1 of 3 groups: group 1 received the exercise prescription throughout the study; group 2 received their exercise prescription after completing cancer treatment; and group 3 received usual care. Patients completed the Piper Fatigue Scale, General Sleep Disturbance Scale, Center for Epidemiological Studies-Depression Scale, and Worst Pain Intensity Scale.


RESULTS
All groups reported mild fatigue levels, sleep disturbance, and mild pain, but not depression. Using multilevel regression analysis, significant linear and quadratic trends were found for change in fatigue and pain (ie, scores increased, then decreased over time). No group differences were found in the changing scores over time. A significant quadratic effect for the trajectory of sleep disturbance was found, but no group differences were detected over time. No significant time or group effects were found for depression.


CONCLUSIONS
Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment. The optimal timing of exercise remains to be determined.


CONCLUSIONS
Clinicians need to be aware that some physical activity is better than none, and there is no harm in exercise as tolerated during cancer treatment. Further analysis is needed to examine the adherence to exercise. More frequent assessments of fatigue, sleep disturbance, depression, and pain may capture the effect of exercise.
Dodd
Marylin J
MJ
School of Nursing, University of California, San Francisco, CA, USA. Marylin.dodd@nursing.ucsf.edu
Cho
Maria H
MH
Miaskowski
Christine
C
Painter
Patricia L
PL
Paul
Steven M
SM
Cooper
Bruce A
BA
Duda
John
J
Krasnoff
Joanne
J
Bank
Kayee A
KA
D003863:Depression / Q000209:etiology; D005081:Exercise Therapy / Q000458:organization & administration*; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D017567:Karnofsky Performance Status; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy; D015403:Nursing Evaluation Research; D010146:Pain / Q000209:etiology; D010349:Patient Compliance; D055656:Prescriptions; D012044:Regression Analysis; D012495:San Francisco; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012893:Sleep Wake Disorders / Q000209:etiology; D016896:Treatment Outcome
Breast Cancer Res Treat. 1998 Mar;48(1):53-64
9541189
Ann Behav Med. 2008 Feb;35(1):116-22
18347912
Eur J Oncol Nurs. 2005 Mar;9(1):56-63
15774341
Nurs Res. 1989 Nov-Dec;38(6):348-51
2587289
Oncol Nurs Forum. 1998 Jan-Feb;25(1):107-13
9460778
Psychooncology. 2002 Sep-Oct;11(5):447-56
12228878
J Altern Complement Med. 1997 Fall;3(3):215-26
9430325
J Clin Oncol. 2005 Jun 1;23(16):3830-42
15923576
Oncol Nurs Forum. 1998 Apr;25(3):485-91
9568604
Med Sci Sports Exerc. 2001 May;33(5):718-23
11323538
Bone Marrow Transplant. 1996 Dec;18(6):1157-60
8971388
Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006145
18425939
Oncol Nurs Forum. 2001 Oct;28(9):1393-6
11683309
Oncol Nurs Forum. 2006 Sep 01;33(5):937-47; quiz 948-50
16955122
Semin Oncol Nurs. 2008 Aug;24(3):164-70
18687262
Oncol Nurs Forum. 2009 Sep;36(5):563-70
19726396
Oncol Nurs Forum. 1997 Jan-Feb;24(1):43-8
9007906
Cancer. 2007 Aug 15;110(4):918-25
17582616
Oncol Nurs Forum. 1998 May;25(4):677-84
9599351
Semin Oncol Nurs. 1987 Nov;3(4):257-62
3423447
Sleep. 1992 Dec;15(6):493-8
1475563
Oncol Nurs Forum. 1987 Nov-Dec;14(6):17-23
3320981
Oncol Nurs Forum. 1994 Jun;21(5):899-907; discussion 908
7937251
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):39-47
10884634
J Clin Oncol. 2005 Feb 1;23(4):899-909
15681536
Cancer. 1999 May 15;85(10):2273-7
10326708
Cancer. 1984 May 1;53(9):2002-7
6704925
J Clin Oncol. 2003 May 1;21(9):1660-8
12721239
Evid Rep Technol Assess (Summ). 2004 Jun;(102):1-8
15307691
Psychol Bull. 2008 Sep;134(5):700-741
18729569
Eur J Cancer. 2006 May;42(7):846-63
16460928
Oncol Nurs Forum. 1987 Nov-Dec;14(6):25-30
3320982
J Pain. 2003 Feb;4(1):2-21
14622723
Support Care Cancer. 2006 Jul;14(7):699-712
16447036
Phys Sportsmed. 2002 Aug;30(8):33-42
20086538
Crit Rev Oncol Hematol. 2004 Sep;51(3):249-61
15331082
J Pain Symptom Manage. 1999 May;17(5):320-32
10355211
Oncol Nurs Forum. 2004 Sep 17;31(5):963-76
15378097
J Clin Oncol. 2005 May 20;23(15):3577-87
15908668
Oncol Nurs Forum. 2006 Sep 01;33(5):E79-89
16955115
Psychooncology. 2005 Jun;14(6):464-77
15484202
Oncol Nurs Forum. 1991 May-Jun;18(4):751-7
2067964
Am J Obstet Gynecol. 2004 Dec;191(6):2041-6
15592289
Oncol Nurs Forum. 1988 Jul-Aug;15(4):447-50
3399417
Oncol Nurs Forum. 2000 Oct;27(9):1443-8
11058976
J Clin Oncol. 2001 Feb 1;19(3):657-65
11157015
Semin Oncol Nurs. 2000 Nov;16(4):300-8; discussion 308-16
11109273
Oncol Nurs Forum. 2001 Apr;28(3):465-70
11338755
Chest. 1973 Sep;64(3):309-12
4749374
Med Sci Sports Exerc. 2003 Nov;35(11):1846-52
14600549
Med Sci Sports Exerc. 2002 Dec;34(12):1863-7
12471288
Support Care Cancer. 2005 Jul;13(7):493-502
15824880
Support Care Cancer. 2008 Sep;16(9):987-97
18274783
J Clin Oncol. 1984 Mar;2(3):187-93
6699671
Cancer Epidemiol Biomarkers Prev. 2005 Jul;14(7):1588-95
16030088
Sao Paulo Med J. 2007 Jan 4;125(1):22-8
17505681
Cancer Pract. 1996 Nov-Dec;4(6):331-40
9128486
Health Psychol. 2007 Nov;26(6):660-7
18020836
Cancer Pract. 2001 May-Jun;9(3):119-27
11879296
Oncol Nurs Forum. 1997 Jul;24(6):991-1000
9243585
Onkologie. 2007 Sep;30(8-9):429-34
17848814
J Clin Oncol. 2007 Oct 1;25(28):4396-404
17785708
CMAJ. 2006 Jul 4;175(1):34-41
16818906
Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005001
17054230
J Pain Symptom Manage. 2008 Feb;35(2):162-70
18082357
J Natl Cancer Inst Monogr. 2004;(32):40-50
15263040
Integr Cancer Ther. 2007 Sep;6(3):235-41
17761636
J Clin Epidemiol. 1990;43(12):1327-35
2254769
Anticancer Res. 1994 May-Jun;14(3A):1033-6
8074446
Cancer. 1997 May 1;79(9):1717-22
9128987
J Clin Oncol. 2003 May 1;21(9):1653-9
12721238