title: Can a multimodal mind-body program enhance the treatment effects of physical activity in breast cancer survivors with chronic tumor-associated fatigue? A randomized controlled trial.
abstract: Background. Chronic fatigue is one of the most restricting symptoms following primary breast cancer treatment, but clinical studies on symptom management are rare. The objective was to evaluate the impact of a multimodal mind-body program (MMMT), including moderate physical activity as compared with a walking intervention alone, on chronic fatigue symptoms of women with stage I to IIIA breast cancer.
  
  
  METHODS
  Sixty-four women (mean age = 56.7 years) suffering from chronic fatigue after active tumor treatment were randomly assigned to either an experimental or a control (n = 32 each) intervention (10 weeks). Fatigue, quality of life (QoL), functional well-being, anxiety, and depression were measured with standard questionnaires at baseline, after 10 weeks, and after 3 months.
  
  
  RESULTS
  Compared with baseline, both groups had reduced fatigue scores after treatment without any significant difference between groups (posttreatment, Δ = -0.3, confidence interval = -1.6 to 1.0, P = .678; follow-up, Δ = -0.4, confidence interval = -1.8 to 0.9, P = .510). All patients also improved regarding QoL and general functional well-being.
  
  
  CONCLUSIONS
  Since both interventions reduced fatigue symptoms and enhanced QoL to a similar extent, we observed no verifiable add-on effect of the MMMT regarding fatigue symptoms. Considering the higher costs with additional expenditure related to MMMT, home-based walking intervention is recommended.
authors.affiliation: Clinic Öschelbronn CIMK, Center for Integrative Medicine and Cancer treatment, Niefern-Öschelbronn, Germany.
authors.forename: Günther
authors.initials: G
authors.lastname: Spahn
authors.forename: Kyung-Eun
authors.initials: KE
authors.lastname: Choi
authors.forename: Charlotte
authors.initials: C
authors.lastname: Kennemann
authors.forename: Rainer
authors.initials: R
authors.lastname: Lüdtke
authors.forename: Ulla
authors.initials: U
authors.lastname: Franken
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
authors.forename: Anna
authors.initials: A
authors.lastname: Paul
authors.forename: Gustav J
authors.initials: GJ
authors.lastname: Dobos
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005221:Fatigue / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D026441:Mind-Body Therapies; D009043:Motor Activity; D011788:Quality of Life; D017741:Survivors; D016896:Treatment Outcome
keywords: anxiety; cancer; compliance; exercise; mindfulness; mind–body medicine; naturopathy; walking