Rabin, C., Pinto, B., Dunsiger, S., Nash, J., & Trask, P. (2009). Exercise and relaxation intervention for breast cancer survivors: feasibility, acceptability and effects. Psycho-Oncology, 18, 258–266.

To assess the feasibility, acceptability, and preliminary effects of a 12-week combined physical activity and relaxation intervention for sedentary, early stage breast cancer survivors after completing all primary treatment.

Early stage breast cancer survivors participated in a 12-week combined physical activity (PA) and relaxation intervention, with baseline and 12- and 24-week assessments. Participants received a theoretically grounded intervention modeled after on the “Moving Forward” intervention based on the principles of the transtheoretical model (TTM) and the social cognitive theory (SCT). Participants were instructed to do moderate-intensity level exercise with pre-/post stretching. The goal was to walk 30 minutes five times a week by the twelfth week of the intervention. The relaxation component included instruction on progressive muscle relaxation (PMR); a CD with PMR instructions was included. Participants were telephoned weekly to provide counseling, a review of their practice activities, reinforcement, identification of barriers, and negation of the next week's goals.

• The sample was comprised of 23 women.
• Mean age was 52.5 years (standard deviation = 8.4 years).
• Most participants were diagnosed with stage I or II, nearly two years prior.
• The majority were partnered, white, and non-Hispanic.
• The sample was relatively well-educated, with most participants receiving at least some college education.

• Multisite
• Outpatient oncology clinics
• East coast, United States

• Patients were undergoing the long-term follow-up phase of care.
• The study has clinical applicability for late effects and survivorship.

The study used a prospective, single-arm, repeated measures design.

• Medical and demographic information obtained from self-report and medical record abstraction
• Seven-Day Physical Activity Recall (7-Day PAR)    
• Pittsburgh Sleep Quality Index (PSQI)
• Stage of Motivational Readiness for PA
• IM Systems-3 dimensional accelerometers (Biotrainer-Pro)
• Profile of Mood States (POMS)
• Intervention feasibility and acceptability assessed via a single item, 1–5 Likert score of satisfaction with the exercise portion of the program; or relaxation component

Participant evaluations of the intervention indicated that it was feasible and acceptable (e.g., 100% would recommend it to others); objective data further supported its feasibility (e.g., 83% completed the trial, and 91% of the intervention calls were received). In addition, when comparing 12- and 24-week follow-up data to baseline data, participants demonstrated significantly increased PA, improved mood and sleep quality, and reduced fatigue (p < 0.05).

The pilot study suggested that the intervention is feasible, acceptable, and produces promising effects on mood, sleep, and fatigue.

• The study had a small sample size, with less than 30 participants.
• The study lacked a control group.
• The sample was racially and socioeconomically homogenous.
• The eligibility criteria were conservative.  

Multibehavior interventions, such as exercise and relaxation, hold promise for cancer survivors and may improve quality of life (i.e., fatigue, sleep, mood, and disturbance).