title: Multimodal therapy concept and aerobic training in breast cancer patients with chronic cancer-related fatigue.
abstract: HYPOTHESE: Cancer-related fatigue (CRF) and sleep disorders are some of the most wearing and common symptoms in disease-free breast cancer patients (BC). Aerobic training (AT) is the treatment with the best available evidence, even though it seems to be insufficient with regards to improvements in cognitive fatigue. We introduced a new multimodal therapy concept (MM) consisting of psycho-, sleep-education and new approaches based on anthroposophic medicine such as eurythmy and painting therapy.
  
  
  METHODS
  This pilot study will test the implementation of MM and yield first results of the MM and AE in our centres.
  
  
  METHODS
  31 out of 34 patients suffering from BC and CRF were fully assessed in a ten-week intervention study. 21 patients chose MM and 10 decided on AT. CRF was measured with the help of the Cancer Fatigue Scale (CFS-D), and the global quality of sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). We also captured autonomic regulation (aR) and patients' satisfaction with questionnaires. Statistical analysis was done with SAS 9.1.3 for windows.
  
  
  RESULTS
  The new MM therapy can be implemented with high satisfaction among patients. Significant improvements were found in the MM group with regards to CFS-D, global quality of sleep, sleep efficiency (PSQI), aR and rest/activity regulation compared to baseline (all p<0.05). In the AT group aR orthostatic-circulatory and rest/activity regulation improved significantly (p<0.05), too. However, no improvement in cognitive fatigue was seen in either group.
  
  
  CONCLUSIONS
  The multimodal therapy concept was feasible and improved cancer fatigue, sleep quality, autonomic and rest-/activity regulation in breast cancer patients. It may therefore constitute a valuable treatment option in addition to aerobic training for BC patients with CRF. A further study with larger sample size needs to be carried out to assess the efficacy of combined multimodal-aerobic therapy.
authors.affiliation: Research Institute Havelhöhe (FIH), Berlin, Germany. matthias.kroez@havelhoehe.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Kröz
authors.forename: Matthias
authors.initials: M
authors.lastname: Fink
authors.forename: Marcus
authors.initials: M
authors.lastname: Reif
authors.forename: Siglinde
authors.initials: S
authors.lastname: Grobbecker
authors.forename: Roland
authors.initials: R
authors.lastname: Zerm
authors.forename: Michaele
authors.initials: M
authors.lastname: Quetz
authors.forename: Matthias
authors.initials: M
authors.lastname: Frühwirth
authors.forename: Benno
authors.initials: B
authors.lastname: Brinkhaus
authors.forename: Christian
authors.initials: C
authors.lastname: Bartsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Girke
authors.forename: Christoph
authors.initials: C
authors.lastname: Gutenbrunner
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D018567:Breast Neoplasms, Male / Q000150:complications / Q000628:therapy; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000009:adverse effects; D015444:Exercise; D005221:Fatigue / Q000209:etiology* / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects