Courneya, K.S., Segal, R.J., Gelmon, K., Reid, R.D., Mackey, J.R., Friedenreich, C.M., . . . McKenzie, D.C. (2007). Six-month follow-up of patient-rated outcomes in a randomized controlled trial of exercise training during breast cancer chemotherapy. Cancer Epidemiology, Biomarkers and Prevention, 16, 2572–2578.doi: 10.1158/1055-9965.EPI-07-0413
Primary aim: To determine if prior research findings of improvement in patient outcomes with exercise during adjuvant chemotherapy would be maintained at six-month follow-up
Secondary aim: To determine if patients who reported regular exercise during the follow-up period would report better outcomes at six-month follow-up
Participants who had initially been in a three-armed randomized controlled trial were recruited to participate in this study. Prior study groups were aerobic exercise, resistance exercise, and control. Exercise groups were supervised. Participants were mailed questionnaires to determine the frequency of exercise and to rate their quality of life, self-esteem, fatigue, anxiety, and depression. Participants were asked to recall their exercise of the past six months using a questionnaire, and were then categorized into meeting or not meeting current guidelines for aerobic exercise (>/= 60 minutes of vigorous or 150 minutes of moderate exercise per week).
Patients were undergoing the transition phase of care after initial treatment.
This was a descriptive study for follow-up from a previous randomized controlled trial.
Of the sample, 20.9% reported meeting both aerobic and resistance exercise guidelines, 8% reported meeting only resistance exercise guidelines, 28.9% reported meeting only aerobic guidelines, and 42.3% reported not meeting any exercise guidelines. Those who originally were in a group given supervised aerobic exercise training (AET) had fewer reporting that they met exercise guidelines during follow-up (p = 0.034). Those who had received resistance exercise training (RET) reported higher self-esteem at six months (p = 0.032). The AET group reported significantly lower anxiety at six months than either the control or RET group members (p = 0.049). All other changes in self-reported outcomes at six months favored the exercise groups, but were not statistically significant. Those who reported that they met exercise guidelines reported higher quality of life (p = 0.025) and less fatigue (p = 0.013). They also reported less anxiety, but this difference was not significant. At six months, those in the AET group reported that anxiety was lower by 4.7 points and depression was reduced by 2.7 points.
Exercise training during chemotherapy treatment may have longer-term effects on anxiety and self-esteem. Consistent exercise meeting recommended guidelines appears to benefit patients in terms of a positive effect on symptoms of fatigue and general quality of life.
Findings suggest that ongoing exercise according to guidelines appears to have positive effects on patients’ quality of life, fatigue, anxiety, and self-esteem. Nurses can educate patients about these potential benefits.