Courneya, K.S., Segal, R.J., Mackey, J.R., Gelmon, K., Reid, R.D., Friedenreich, C.M., . . . McKenzie, D.C. (2007). Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: A multicenter randomized controlled trial. Journal of Clinical Oncology, 25, 4396–4404.

The three-armed study reported on an exercise intervention with supervised aerobic exercise (AET) and supervised resistance exercise (RET) versus usual care (UC). The exercise sessions were started one to two weeks after starting chemotherapy and ended three weeks after completion of chemotherapy. Exercise trainers administered the intervention.

• AET group participants (n = 78) exercised three times per week on a cycle, a treadmill, or an elliptical machine, beginning at 60% of their maximal oxygen consumption for weeks 1–6 and then progressing to 70% during weeks 7–12, and 80% beyond week 12. Exercise duration began at 15 minutes for weeks 1–3 and increased by five minutes every three weeks until the duration reached 45 minutes at week 18.
• RET group participants (n = 82) exercised three times per week, performing two sets of 8–12 repetitions of nine different exercises at 60%–70% of their estimated one-repetition maximum. Resistance was increased by 10% when participants completed more than 12 reps.
• UC group participants (n = 82) were asked not to initiate an exercise program and were offered a one-month exercise program after postintervention assessments.

Data were collected at three time points: baseline (one to two weeks after starting chemotherapy), midpoint (three to four weeks after starting chemotherapy), and at six-month follow-up.

The study reported on a sample of 242 women with breast cancer receiving adjuvant chemotherapy.

Multiple centers in Canada

A randomized controlled trial (RCT) design was used.

• Functional Assessment of Cancer Therapy–Anemia scale (FACT-A)
• Rosenberg Self-Esteem Scale
• Center for Epidemiologic Studies–Depression scale (CES-D)
• Spielberger State Anxiety Inventory (STAI)
• Peak oxygen consumption
• Expired gases
• Body weight and height
• Dual x-ray absorptiometry scan for assessment of whole body fat and lean tissue
• Lymphedema measurements
• Chemotherapy completion rate assessed as the average relative dose intensity for the originally planned regimen based on standard formulas

Mixed-model analysis measured at three time points compared the differences across groups in changes over time. Neither AET nor RET interventions significantly improved cancer-specific quality of life, fatigue, depression, or anxiety, although the trends favored the exercise groups. AET improved self-esteem, aerobic fitness, and percent of body fat. RET improved self-esteem, muscle strength, lean body mass, and chemotherapy completion rates.

The study is an RCT with an adequate sample size but null findings for anxiety levels.

The intervention required exercise trainers.