Dodd, M. J., Cho, M. H., Miaskowski, C., Painter, P. L., Paul, S. M., Cooper, B. A., . . . Bank, K. A. (2010). A randomized controlled trial of home-based exercise for cancer-related fatigue in women during and after chemotherapy with or without radiation therapy. Cancer Nursing, 33, 245–257.

The primary aim was to evaluate the effectiveness of a home-based exercise training intervention called the Pro-self:  Fatigue Control Program on the management of cancer-related fatigue (CRF). The secondary aim was to study the effects of the intervention on sleep disturbance, depression, and pain.

Patients were randomized to one of three groups. Two groups received a home-based prescription for exercise called the Pro-self:  Fatigue Control Program (during and after cancer treatment). One of these groups had follow-up. The third group received usual care. All patients completed four valid and reliable tools at baseline, the week before the second chemotherapy treatment, at the end of cancer treatment, and at the end of the study (about one year after the start of the study). The tools measured fatigue, sleep disturbance, depression, and pain and were analyzed to compare how fatigue and other study variables had changed over time and by groups. It was a randomized, single-blind, three-arm, controlled trial design.

• The sample was comprised of 119 women.
• Patients had to be 18 years or older to enroll.
• Mean age was 50.5 years.
• Patients had colon (n = 1), ovarian (n = 6), and breast (n = 112) cancer.
• Patients had a mean education of 16.1 years. 
• Mean Karnofsky Performance Status (KPS) was 87.63. 
• A mean of 94 patients were employed.

• Setting Type1:  Multisite
• Setting Type2:  Outpatient setting
• San Francisco Bay Area

The study was a randomized, controlled trial (RCT).

• Piper Fatigue Scale (PFS) (α range .96–.97)
• General Sleep Disturbance Scale (GSDS) (α range .83–.86)
• Center for Epidemiologic Studies Depression Inventory (CESD) (α range .80–.89)
• Worst of Pain Intensity Scale
• KPS
• Intervention Framework:  Pro-self:  Fatigue Control Program based on self-care and adult learning theory
• Data Analysis used SPSS version 15, two-tailed tests and multilevel regression analysis. 

Change in fatigue did not change over time. No significant change in fatigue occurred among groups.

The home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment. The optimal timing of exercise remains to be determined.

When the study was conducted, the benefits of exercise were being reported in the literature and patients could not be asked to stop their regular exercise. The PFS was administered only three times a year, which might not be frequent enough to capture the true effect of exercise on CRF. The self-report of exercise behaviors was obtained with no objective measures.

CRF is a common problem. Some physical activity is better than none, and there is no harm in exercise as tolerated during cancer treatment. More frequent assessments of fatigue, sleep disturbance, depression, and pain may capture the effect of exercise.