TY - JOUR
T1 - Effects of an 18-week exercise programme started early during breast cancer treatment
T2 - A randomised controlled trial
AU - Travier, Noémie
AU - Velthuis, Miranda J.
AU - Steins Bisschop, Charlotte N.
AU - van den Buijs, Bram
AU - Monninkhof, Evelyn M.
AU - Backx, Frank
AU - Los, Maartje
AU - Erdkamp, Frans
AU - Bloemendal, Haiko J.
AU - Rodenhuis, Carla
AU - de Roos, Marnix A.J.
AU - Verhaar, Marlies
AU - ten Bokkel Huinink, Daan
AU - van der Wall, Elsken
AU - Peeters, Petra H.M.
AU - May, Anne M.
N1 - Publisher Copyright:
© 2015 Travier et al.
PY - 2015/12/12
Y1 - 2015/12/12
N2 - Background: Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within 6 weeks after diagnosis, on preventing an increase in fatigue. Methods: This multi-centre controlled trial randomly assigned 204 breast cancer patients to usual care (n = 102) or supervised aerobic and resistance exercise (n = 102). By design, all patients received chemotherapy between baseline and 18 weeks. Fatigue (i.e., primary outcome at 18 weeks), quality of life, anxiety, depression, and physical fitness were measured at 18 and 36 weeks. Results: Intention-to-treat mixed linear model analyses showed that physical fatigue increased significantly less during cancer treatment in the intervention group compared to control (mean between-group differences at 18 weeks: -1.3; 95 % CI -2.5 to -0.1; effect size -0.30). Results for general fatigue were comparable but did not reach statistical significance (-1.0, 95%CI -2.1; 0.1; effect size -0.23). At 18 weeks, submaximal cardiorespiratory fitness and several muscle strength tests (leg extension and flexion) were significantly higher in the intervention group compared to control, whereas peak oxygen uptake did not differ between groups. At 36 weeks these differences were no longer statistically significant. Quality of life outcomes favoured the exercise group but were not significantly different between groups. Conclusions: A supervised 18-week exercise programme offered early in routine care during adjuvant breast cancer treatment showed positive effects on physical fatigue, submaximal cardiorespiratory fitness, and muscle strength. Exercise early during treatment of breast cancer can be recommended. At 36 weeks, these effects were no longer statistically significant. This might have been caused by the control participants' high physical activity levels during follow-up. Trial registration: Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on December 9th, 2009.
AB - Background: Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within 6 weeks after diagnosis, on preventing an increase in fatigue. Methods: This multi-centre controlled trial randomly assigned 204 breast cancer patients to usual care (n = 102) or supervised aerobic and resistance exercise (n = 102). By design, all patients received chemotherapy between baseline and 18 weeks. Fatigue (i.e., primary outcome at 18 weeks), quality of life, anxiety, depression, and physical fitness were measured at 18 and 36 weeks. Results: Intention-to-treat mixed linear model analyses showed that physical fatigue increased significantly less during cancer treatment in the intervention group compared to control (mean between-group differences at 18 weeks: -1.3; 95 % CI -2.5 to -0.1; effect size -0.30). Results for general fatigue were comparable but did not reach statistical significance (-1.0, 95%CI -2.1; 0.1; effect size -0.23). At 18 weeks, submaximal cardiorespiratory fitness and several muscle strength tests (leg extension and flexion) were significantly higher in the intervention group compared to control, whereas peak oxygen uptake did not differ between groups. At 36 weeks these differences were no longer statistically significant. Quality of life outcomes favoured the exercise group but were not significantly different between groups. Conclusions: A supervised 18-week exercise programme offered early in routine care during adjuvant breast cancer treatment showed positive effects on physical fatigue, submaximal cardiorespiratory fitness, and muscle strength. Exercise early during treatment of breast cancer can be recommended. At 36 weeks, these effects were no longer statistically significant. This might have been caused by the control participants' high physical activity levels during follow-up. Trial registration: Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on December 9th, 2009.
KW - Breast cancer
KW - Exercise therapy
KW - Fatigue
KW - Randomised controlled trial
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U2 - 10.1186/s12916-015-0362-z
DO - 10.1186/s12916-015-0362-z
M3 - Article
C2 - 26050790
AN - SCOPUS:84938963851
SN - 1741-7015
VL - 13
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 121
ER -