Andersen, C., Rørth, M., Ejlertsen, B., Stage, M., Møller, T., Midtgaard, J., . . . Adamsen, L. (2013). The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue. European Journal of Oncology Nursing, 17, 331–339.

To evaluate whether a six-week supervised multimodal exercise intervention can reduce cancer-related fatigue levels.

The intervention involved having patients exercise for 2.25 hours for four days per week for a total of six weeks in a group session of dynamic exercises using heavy resistance, cardiovascular training, relaxation techniques, body awareness (i.e., stretching, breathing, yoga, and Pilates), and massage.  The study was wait-list controlled.

• The sample was comprised of 213 patients.
• Mean age was 47.5 years (range 20–65).
• In the control, 28% of patients were male and 72% were female. In the intervention, 20.8% of patients were male and 79.2% were female. 
• Mean days since diagnosis was 82/86.5, and 52% to 58% of patients had no evidence of disease at baseline.
• Of the patients, 103 had breast cancer and 29 had bowel cancer.
• Of the patients, 83.7% of the control and 82.7% of the intervention reported some kind of exercise at baseline.

• Single site 
• Outpatient 
• Copenhagen

Patients were undergoing the active antitumor treatment phase of care. 

This was a randomized, controlled trial.

Functional Assessment of Cancer Therapy-Anaemia Questionnaire (FACT-An) 

Improvement occurred in fatigue score in the intervention compared to the control (p = 0.002; effect size = 0.44).  FACT-An subscale score (13 items were related to fatigue, and seven were indirectly related) was also improved in the intervention compared to the control (p = 0.015). FACT-An improved (p = 0.009), and Anemia-ANS improved (p = 0.002). Well-being scores of Quality of Life (QOL) scores showed no difference.

Supervised exercise can have an effect on fatigue levels for patients during chemotherapy. Specific diagnoses and fatigue after treatment were not evaluated.

• There were risks of bias due to no blinding, lack of an appropriate attentional control condition, and sample characteristics [patients were self-referred to the program, suggesting a highly motivated group]).
• Participant withdrawals were 10% or greater.

 Patients experiencing fatigue during active treatment may benefit from supervised multimodal exercise.