title: Can physical activity help to maintain cognitive functioning and psychosocial well-being among breast cancer patients treated with chemotherapy? A randomised controlled trial: study protocol.
abstract: BACKGROUND
  Evidence suggests chemotherapy treatment for breast cancer is associated with side effects such as cognitive impairment in domains of memory, attention, concentration and executive function. Cognitive impairments reported by patients have been associated with higher levels of emotional distress. To date, intervention studies to alleviate cognitive impairment associated with chemotherapy have focused on psycho-educational techniques or cognitive training. Studies have not yet considered physical activity as a potential for alleviating cognitive problems. Physical activity interventions are reported to be effective in alleviating emotional distress and fatigue in those with breast cancer. They have also been reported to improve cognitive functioning in the elderly, in those suffering with dementia and in children. We propose that physical activity could also help to alleviate cognitive impairments in women diagnosed with breast cancer. The study has been designed using a recently developed taxonomy of behaviour change techniques to reliably report the content of the intervention to allow future replication.
  
  
  METHODS
  This study will deliver a home-based moderate intensity walking intervention to women diagnosed with breast cancer mid-way through their chemotherapy treatment and will compare them to patients receiving usual care alone. The primary outcome measure for this intervention is changes in an objective measure of memory assessed using the Digit Span. Secondary outcome measures include: objective measures of executive function; attention; visual spatial skills; self report cognitive function; self-report fatigue; anxiety; depression; mood and self-esteem. As emotional distress has been associated with self-reporting of cognitive problems, this intervention will further test whether emotional distress mediates between the amount of walking undertaken during the intervention period and levels of self-reported cognitive functioning.
  
  
  CONCLUSIONS
  The development of an effective intervention for preventing difficulties in emotional and cognitive functioning of cancer patients' post-treatment will help to guide health care professionals to improve patients' overall quality of life. It will also provide direction for future research, ultimately to improve the day to day functioning of breast cancer survivors.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN50709297.
authors.affiliation: School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. k.gokal@lboro.ac.uk.|National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. k.gokal@lboro.ac.uk.
authors.forename: Kajal
authors.initials: K
authors.lastname: Gokal
authors.affiliation: School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. f.munir@lboro.ac.uk.|National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. f.munir@lboro.ac.uk.
authors.forename: Fehmidah
authors.initials: F
authors.lastname: Munir
authors.affiliation: School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. d.wallis@lboro.ac.uk.|National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. d.wallis@lboro.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: Wallis
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK. samreen.ahmed@uhl-tr.nhs.uk.
authors.forename: Samreen
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK. ion.boiangiu@uhl-tr.nhs.uk.
authors.forename: Ion
authors.initials: I
authors.lastname: Boiangiu
authors.affiliation: Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK. kiran.kancherla@uhl-tr.nhs.uk.
authors.forename: Kiran
authors.initials: K
authors.lastname: Kancherla
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D015444:Exercise / Q000523:psychology*; D005221:Fatigue / Q000150:complications / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D017741:Survivors / Q000523:psychology; D016138:Walking / Q000523:psychology; D055815:Young Adult