Concurrent Exercise Interventions in Breast Cancer Survivors with Cancer-related Fatigue

Abstract

This study compared the effects of two supervised concurrent training interventions in breast cancer survivors with cancer-related fatigue at baseline. Twenty-three female breast cancer survivors (50±8 years) were randomized to a high- (n=13) or a moderate-intensity (n=10) training program. Both interventions lasted 16 weeks and included the same resistance exercises, but the aerobic component was supervised and more intense in the former (i.e., rating of perceived exertion of 7–8 vs. 6 on a 1–10 scale for the high and moderate-intensity intervention, respectively). The primary endpoint was fatigue perception. Endpoints were assessed at baseline and after 16 weeks. The p-value for statistical significance was set at 0.004 after Bonferroni correction for multiple comparisons. The high-intensity training program increased lower-limb muscle strength significantly (p=0.002) and tended to improve fatigue perception (p=0.006), waist circumference (p=0.013), neutrophil-to-lymphocyte ratio (p=0.028) and some quality of life items (p=0.011). Although the moderate-intensity training program did not provide such benefits in general (i.e., higher p-values for pre vs post-intervention comparisons), no significant differences were found between interventions (all p>0.004). Further research is needed to elucidate if the benefits provided by high-intensity concurrent training are superior to those elicited by moderate-intensity training in breast cancer survivors.

Including people with fatigue: a systematic review and meta-analysis of physical activity after cancer treatment

“…From the 3743 records ( Supplementary File 3), we evaluated 67 full texts. Five studies met the eligibility criteria and were included in this systematic review [5,7,26,31,32]. One study required adjudication with a third reviewer [33].…”

“…Therefore, a total of 19 studies were eligible for this review and were included ( Figure 1). Of these 19 studies, 12 were described by the authors as pilot studies or as assessing feasibility [25,31,[34][35][36][37][38][39][40][41][42].…”

“…A total of 1035 participants were randomized across 19 studies, and the pooled loss to attrition was 17 ± 3% (mean ± SD). Of 19 studies, 12 [25,26,31,32,[37][38][39][40][41][42][43][44] were conducted in people with breast cancer, and four [5,7,45,46] included >1 type but were conducted primarily in people diagnosed with breast cancer. One study included people with gynaecological cancer [36], and one did not report the cancer type [34].…”

“…Five studies did not specify a primary outcome in the paper (Table 1). Only two studies used the same tool for both the screening for and measurement of fatigue [31,59]. Three studies used more than one fatigue scale to measure fatigue as an outcome [36,37,44].…”

“…Six studies specified the minimal clinically important difference (MCID) in fatigue in the methods [7,31,34,36,38,59], though only of these four reported on this in the results/discussion [7,31,36,59]. Three further studies considered the MCID [35,37,44], and the remainder (n=10), did not (Table 1).…”