Cuesta-Vargas, A.I., Buchan, J., & Arroyo-Morales, M. (2014). A multimodal physiotherapy programme plus deep water running for improving cancer-related fatigue and quality of life in breast cancer survivors. European Journal of Cancer Care, 23, 15–21.  

DOI Link

Study Purpose

To assess feasibility and effectiveness of aquatic-based exercise in the form of deep water running as part of a multimodal physiotherapy program for breast cancer survivors in an effort to decrease cancer-related fatigue

Intervention Characteristics/Basic Study Process

Eight week program of one hour sessions, three times per week, of multimodal physiotherapy program combined with deep water running delivered by physiotherapists in groups of 8–10 participants. Each session included 30 minutes of land-based exercise, followed by 20 minutes of deep water running.

Sample Characteristics

  • N = 42  
  • MEAN AGE = 47.27 years for the intervention group and 48.67 years for the control group
  • FEMALES:100%
  • KEY DISEASE CHARACTERISTICS: Patients were within one year of breast cancer diagnosis, were aged 25–65 years, and post-cancer treatment within past six months.
  • OTHER KEY SAMPLE CHARACTERISTICS: Patients were excluded if they had a fear of aquatic exercise.

Setting

  • SITE: Multi-site  
  • SETTING TYPE: Outpatient  
  • LOCATION: Two primary care centers in Andalusia, Spain

Phase of Care and Clinical Applications

  • PHASE OF CARE: Transition phase after active treatment

Study Design

  • Non-randomized study with a wait-list control group 
  • Outcomes were measured/evaluated by one assessor who was blinded to participant group allocation.

Measurement Instruments/Methods

  • Piper Fatigue Scale–Revised
  • SF-12 Health Survey
  • European Quality of Life (five dimensions)
  • European Visual Analog Scale

Results

Statistically significant differences in fatigue were found between groups after eight weeks, with the intervention group reporting greater improvement in behavioral severity, affective/meaning, and sensory fatigue.

Conclusions

Demonstrated positive effects of exercise on cancer-related fatigue. Supports prior studies that demonstrated greater improvement combining educational and exercise programs

Limitations

  • Small sample (< 100)
  • Risk of bias (no random assignment)
  • Intervention expensive, impractical, or training needs existed
  • No long-term follow-up

Nursing Implications

This is a difficult program to replicate, but it appears that it is likely to be effective in reducing cancer-related fatigue.