A randomized trial to increase physical activity in breast cancer survivors.
ABSTRACT Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality. Therefore, we report the feasibility and preliminary outcomes of a pilot randomized trial designed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy.
Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I, II, or IIIA breast cancer were randomly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care.
Recruitment was 34%, intervention adherence was 99%, and complete follow-up data were obtained on 93%. Most participants (93%) were white with mean age of 53 +/- 9 yr. Differences favoring the intervention group were noted for accelerometer physical activity counts (mean difference = 72,103; 95% confidence interval (CI) = 25,383-119,000; effect size (d) = 1.02; P = 0.004), aerobic fitness (mean difference = 2.9; 95% CI = -0.1 to 5.8; d = 0.64; P = 0.058), back/leg muscle strength (mean difference = 12.3; 95% CI = 0.4-15.9; d = 0.81; P = 0.017), waist-to-hip ratio (mean difference = -0.05; 95% CI = -0.01 to -0.08; d = -0.77; P = 0.018), and social well-being (mean difference = 2.0; 95% CI = 0.3-3.8; d = 0.76; P = 0.03). However, the intervention group also reported a greater increase in joint stiffness (mean difference = 1.1; 95% CI = 0.1-2.2; d = 0.70; P = 0.04).
A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes. Confirmation in a larger study is warranted.
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ABSTRACT: Introduction: Physical exercise has increasingly been recognized as important supportive therapy for cancer patients. Scientific studies applied a variety of methods for endpoint assessment. In order to improve comparability between studies, this paper provides recommendations for outcome assessment in the oncological setting. Discussed endpoints are (1) strength, (2) cardiorespiratory fitness, (3) postural control, and, in addition, (4) patient-reported outcomes (PROs). Material/Methods: Based on a comprehensive literature search, the most important assessment methods were focused. Thereby, the relevant expertise of as many German institutions as possible was incorporated. Results: Consensus was achieved for all four areas. The recommendations considered variations in financial resources between institutions. Furthermore, possibilities to derive training prescriptions were discussed where appropriate. Overall, it was observed that some methods were already well established for cancer patients whereas for others empirical knowledge is still limited. Contraindications were defined in order to ensure safety of the recommended methods for cancer patients. Discussion: Better standardization of assessment methods in oncological exercise research projects enhances study quality, helps new research groups to work with high standards, and enables better comparability and overall evaluation of results. In addition, the understudied field of exercise prescription in cancer patients was covered. Overall, the recommendations may contribute to more targeted and effective supportive care for cancer patients.Deutsche Zeitschrift für Sportmedizin 11/2014; 65(11):304-313. · 0.58 Impact Factor
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ABSTRACT: To investigate the role of exercise training the past 25 years on major physiological-psychological outcomes studied thus far in this patient population. PubMed, MedlinePlus, the Cochrane Library, Web of Science, SportDiscus, Embase, Scorpus, and Google Scholar were searched from September to November 2013 to identify exercise training studies that used objective measurements of fitness and/or patient reported outcomes assessed pre and post-exercise training with statistical analyses performed in at least one of the following outcome measurements: Cardiorespiratory function, body composition, muscular strength, fatigue, depression, and overall quality of life. Five reviewers independently identified the studies that met the criteria for the review and discrepancies were resolved by consensus among all authors. Fifty-one studies were included in this review with 5 from the period between 1989-1999, 11 from 2000-2006, and 35 from 2007-2013. The evolution of study designs changed from aerobic only exercise training interventions (1989-1999), to a combination of aerobic and resistance training (2000-2006), to studies including an arm of resistance training or examining the effects of resistance training as the main mode of exercise (2007-2013). Overall, the benefits of exercise showed improvements in cardiorespiratory function, body composition, strength, and patient reported outcomes including fatigue, depression, and quality of life. Exercise training appears to be safe for most breast cancer patients and improvements in physiological, psychological, and functional parameters can be attained with regular participation in moderate intensity exercise.World journal of clinical oncology. 05/2014; 5(2):177-90.
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ABSTRACT: Adverse health outcomes are often seen in breast cancer survivors due to prolonged treatment with side effects such as loss of energy and lack of physical strength. Physical activity (PA) has been proposed as an adequate intervention for women with breast cancer. Therefore, this review summarizes the effects of physical activity on breast cancer survivors after diagnosis. We searched electronic databases including PubMed, Medline, Embase, and Google Scholar for articles published between January 1980 and May 2013. We included a variety of studies such as randomized controlled trials, pilot studies, and clinical trials. We reviewed these studies for three major outcomes: changes in breast cancer mortality, physiological functions, and metabolic biomarkers. Of 127 studies, 33 studies were selected as eligible studies. These studies included physical activities of varying type, duration, frequency, and intensity (e.g., aerobic and resistance training) and examined changes in three major outcomes among breast cancer survivors. Many of the studies suggest that breast cancer survivors benefit from engaging in physical activity, but some studies were limited in their ability to provide adequate evidence due to relatively small sample sizes, short intervention periods, or high attrition. Based on epidemiological evidence, recent studies demonstrated that those breast cancer survivors who engaged in physical activity significantly lowered their risk of breast cancer mortality and improved their physiological and immune functions. Some studies demonstrated changes in metabolic biomarkers such as insulin and insulin-like growth factors. However, further investigation is required to support these findings because these results are not consistent.Journal of cancer prevention. 09/2013; 18(3):193-200.