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Erschienen in: Supportive Care in Cancer 3/2018

01.03.2018 | Original Article

Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial

verfasst von: Kerri M. Winters-Stone, Esther L. Moe, Cynthia K. Perry, Mary Medysky, Rodney Pommier, John Vetto, Arpana Naik

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2018

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Abstract

Purpose

Fatigue is a troublesome symptom for breast cancer patients, which might be mitigated with exercise. Cancer patients often prefer their oncologist recommend an exercise program, yet a recommendation alone may not be enough to change behavior. Our study determined whether adding an exercise DVD to an oncologist’s recommendation to exercise led to better outcomes than a recommendation alone.

Methods

Ninety breast cancer patients, at varying phases of treatment and stages of disease, were randomized to receive the following: an oncologist verbal recommendation to exercise (REC; n = 43) or REC plus a cancer-specific yoga DVD (REC + DVD; n = 47). Fatigue, vigor, and depression subscales of the Profile of Mood States, and physical activity levels (MET-min/week), exercise readiness, and self-efficacy were assessed at baseline, 4, and 8 weeks. Analyses controlled for age, time since diagnosis, and metastatic disease.

Results

Over 8 weeks, women in REC + DVD used the DVD an average of twice per week. The REC + DVD group had greater reductions in fatigue (− 1.9 ± 5.0 vs. − 1.0 ± 3.5, p = 0.02), maintained exercise readiness (− 0.1 ± 1.1 vs. − 0.3 ± 1.3; p = 0.03), and reported less of a decrease in physical activity (− 420 ± 3075 vs. − 427 ± 5060 MET-min/week, p = 0.06) compared to REC only.

Conclusions

A low-cost, easily distributed, and scalable yoga-based DVD could be a simple booster to an oncologist’s advice that motivates breast cancer patients, even those with advanced disease and/or in treatment, to engage in self-care, e.g., exercise, to manage fatigue.

Trial registration

ClinicalTrials.gov Identifier: NCT03120819
Literatur
2.
Zurück zum Zitat McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175(1):34–41CrossRefPubMedPubMedCentral McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175(1):34–41CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM et al (2007) Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 25(28):4396–4404CrossRefPubMed Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM et al (2007) Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 25(28):4396–4404CrossRefPubMed
4.
Zurück zum Zitat Brown JC, Huedo-Medina TB, Pescatello LS, Pescatello SM, Ferrer RA, Johnson BT (2011) Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomark Prev 20(1):123–133CrossRef Brown JC, Huedo-Medina TB, Pescatello LS, Pescatello SM, Ferrer RA, Johnson BT (2011) Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomark Prev 20(1):123–133CrossRef
5.
Zurück zum Zitat McNeely ML, Courneya KS (2010) Exercise programs for cancer-related fatigue: evidence and clinical guidelines. J Natl Compr Cancer Netw 8(8):945–953CrossRef McNeely ML, Courneya KS (2010) Exercise programs for cancer-related fatigue: evidence and clinical guidelines. J Natl Compr Cancer Netw 8(8):945–953CrossRef
6.
Zurück zum Zitat Mason C, Alfano CM, Smith AW, Wang CY, Neuhouser ML, Duggan C et al (2013) Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomark Prev 22(6):1153–1161CrossRef Mason C, Alfano CM, Smith AW, Wang CY, Neuhouser ML, Duggan C et al (2013) Long-term physical activity trends in breast cancer survivors. Cancer Epidemiol Biomark Prev 22(6):1153–1161CrossRef
7.
Zurück zum Zitat Underwood JM, Townsend JS, Stewart SL, Buchannan N, Ekwueme DU, Hawkins NA et al (2012) Surveillance of demographic characteristics and health behaviors among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR Surveill Summ 61(1):1–23PubMed Underwood JM, Townsend JS, Stewart SL, Buchannan N, Ekwueme DU, Hawkins NA et al (2012) Surveillance of demographic characteristics and health behaviors among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR Surveill Summ 61(1):1–23PubMed
8.
Zurück zum Zitat Husson O, Mols F, van de Poll-Franse LV (2011) The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 22(4):761–772CrossRefPubMed Husson O, Mols F, van de Poll-Franse LV (2011) The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 22(4):761–772CrossRefPubMed
9.
Zurück zum Zitat Jones LW, Courneya KS, Peddle C, Mackey JR (2005) Oncologists’ opinions towards recommending exercise to patients with cancer: a Canadian national survey. Support Care Cancer 13(11):929–937CrossRefPubMed Jones LW, Courneya KS, Peddle C, Mackey JR (2005) Oncologists’ opinions towards recommending exercise to patients with cancer: a Canadian national survey. Support Care Cancer 13(11):929–937CrossRefPubMed
10.
11.
Zurück zum Zitat Jones SB, Thomas GA, Hesselsweet SD, Alvarez-Reeves M, Yu H, Irwin ML (2013) Effect of exercise on markers of inflammation in breast cancer survivors: the Yale exercise and survivorship study. Cancer Prev Res (Phila Pa) 6(2):109–118CrossRef Jones SB, Thomas GA, Hesselsweet SD, Alvarez-Reeves M, Yu H, Irwin ML (2013) Effect of exercise on markers of inflammation in breast cancer survivors: the Yale exercise and survivorship study. Cancer Prev Res (Phila Pa) 6(2):109–118CrossRef
12.
Zurück zum Zitat Rutten LJ, Arora NK, Bakos AD, Aziz N, Rowland J (2005) Information needs and sources of information among cancer patients: a systematic review of research (1980-2003). Patient Educ Couns 57(3):250–261CrossRefPubMed Rutten LJ, Arora NK, Bakos AD, Aziz N, Rowland J (2005) Information needs and sources of information among cancer patients: a systematic review of research (1980-2003). Patient Educ Couns 57(3):250–261CrossRefPubMed
13.
Zurück zum Zitat Jones LW, Courneya KS, Fairey AS, Mackey JR (2004) Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med 28(2):105–113CrossRefPubMed Jones LW, Courneya KS, Fairey AS, Mackey JR (2004) Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med 28(2):105–113CrossRefPubMed
14.
Zurück zum Zitat Jones L, Courneya K, Peddle C, Mackey J (2005) Oncologists’ opinions towards recommending exercise to patients with cancer: a Canadian national survey. Support Care Cancer 13(11):929–937CrossRefPubMed Jones L, Courneya K, Peddle C, Mackey J (2005) Oncologists’ opinions towards recommending exercise to patients with cancer: a Canadian national survey. Support Care Cancer 13(11):929–937CrossRefPubMed
15.
Zurück zum Zitat Park J-H, Lee J, Oh M, Park H, Chae J, Kim D-I et al (2015) The effect of oncologists’ exercise recommendations on the level of exercise and quality of life in survivors of breast and colorectal cancer: a randomized controlled trial. Cancer 121(16):2740–2748CrossRefPubMedPubMedCentral Park J-H, Lee J, Oh M, Park H, Chae J, Kim D-I et al (2015) The effect of oncologists’ exercise recommendations on the level of exercise and quality of life in survivors of breast and colorectal cancer: a randomized controlled trial. Cancer 121(16):2740–2748CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Buffart LM, Galvao DA, Brug J, Chinapaw MJ, Newton RU (2014) Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 40(2):327–340CrossRefPubMed Buffart LM, Galvao DA, Brug J, Chinapaw MJ, Newton RU (2014) Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 40(2):327–340CrossRefPubMed
17.
Zurück zum Zitat Elme A, Utriainen M, Kellokumpu-Lehtinen P, Palva T, Luoto R, Nikander R et al (2013) Obesity and physical inactivity are related to impaired physical health of breast cancer survivors. Anticancer Res 33(4):1595–1602PubMed Elme A, Utriainen M, Kellokumpu-Lehtinen P, Palva T, Luoto R, Nikander R et al (2013) Obesity and physical inactivity are related to impaired physical health of breast cancer survivors. Anticancer Res 33(4):1595–1602PubMed
18.
Zurück zum Zitat Jones LW, Alfano CM (2013) Exercise-oncology research: past, present, and future. Acta Oncol 52(2):195–215CrossRefPubMed Jones LW, Alfano CM (2013) Exercise-oncology research: past, present, and future. Acta Oncol 52(2):195–215CrossRefPubMed
19.
Zurück zum Zitat Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G (2005) Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 23(16):3830–3842CrossRefPubMed Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G (2005) Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 23(16):3830–3842CrossRefPubMed
20.
21.
Zurück zum Zitat Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4(2):87–100CrossRefPubMed Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4(2):87–100CrossRefPubMed
22.
Zurück zum Zitat Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM et al (2010) American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426CrossRefPubMed Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM et al (2010) American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426CrossRefPubMed
23.
Zurück zum Zitat Brown JK, Byers T, Doyle C, Coumeya KS, Demark-Wahnefried W, Kushi LH et al (2003) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 53(5):268–291CrossRefPubMed Brown JK, Byers T, Doyle C, Coumeya KS, Demark-Wahnefried W, Kushi LH et al (2003) Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin 53(5):268–291CrossRefPubMed
26.
Zurück zum Zitat McNair DM, Lorr, M., Droppleman, L.F. Revised manual for the Profile of Mood States. San Diego, CA: educational and industrial testing services.; 1992 McNair DM, Lorr, M., Droppleman, L.F. Revised manual for the Profile of Mood States. San Diego, CA: educational and industrial testing services.; 1992
27.
Zurück zum Zitat Meek PM, Nail LM, Barsevick A, Schwartz AL, Stephen S, Whitmer K et al (2000) Psychometric testing of fatigue instruments for use with cancer patients. Nurs Res 49(4):181–190CrossRefPubMed Meek PM, Nail LM, Barsevick A, Schwartz AL, Stephen S, Whitmer K et al (2000) Psychometric testing of fatigue instruments for use with cancer patients. Nurs Res 49(4):181–190CrossRefPubMed
28.
Zurück zum Zitat Edelman S, Bell DR, Kidman AD (1999) A group cognitive behaviour therapy programme with metastatic breast cancer patients. Psychooncology 8(4):295–305CrossRefPubMed Edelman S, Bell DR, Kidman AD (1999) A group cognitive behaviour therapy programme with metastatic breast cancer patients. Psychooncology 8(4):295–305CrossRefPubMed
30.
Zurück zum Zitat Prochaska JO, DiClemente CC (1982) Transtheoretical therapy: toward a more integrative model of change. Psychol Psychother 19(3):276–288 Prochaska JO, DiClemente CC (1982) Transtheoretical therapy: toward a more integrative model of change. Psychol Psychother 19(3):276–288
31.
Zurück zum Zitat Bennett JA, Lyons KS, Winters-Stone K, Nail LM, Scherer J (2007) Motivational interviewing to increase physical activity in long-term cancer survivors: a randomized controlled trial. Nurs Res 56(1):18–27CrossRefPubMed Bennett JA, Lyons KS, Winters-Stone K, Nail LM, Scherer J (2007) Motivational interviewing to increase physical activity in long-term cancer survivors: a randomized controlled trial. Nurs Res 56(1):18–27CrossRefPubMed
32.
Zurück zum Zitat Bandura A (1977) Self-efficacy: toward the unifying theory of behavioral change. Psychol Rev 84(2):191–215CrossRefPubMed Bandura A (1977) Self-efficacy: toward the unifying theory of behavioral change. Psychol Rev 84(2):191–215CrossRefPubMed
33.
Zurück zum Zitat Marcus BH, Selby VC, Niaura RS, Rossi JS (1992) Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport 63(1):60–66CrossRefPubMed Marcus BH, Selby VC, Niaura RS, Rossi JS (1992) Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport 63(1):60–66CrossRefPubMed
34.
Zurück zum Zitat McAuley E (1993) Self-efficacy and the maintenance of exercise participation in older adults. J Behav Med 16(1):103–113CrossRefPubMed McAuley E (1993) Self-efficacy and the maintenance of exercise participation in older adults. J Behav Med 16(1):103–113CrossRefPubMed
35.
Zurück zum Zitat Johnson-Kozlow M, Sallis JF, Gilpin EA, Rock CL, Pierce JP (2006) Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer. Int J Behav Nutr Phys Act 3:7CrossRefPubMedPubMedCentral Johnson-Kozlow M, Sallis JF, Gilpin EA, Rock CL, Pierce JP (2006) Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer. Int J Behav Nutr Phys Act 3:7CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395CrossRefPubMed
37.
Zurück zum Zitat Hintze J. PASS 6.0 Power Analysis and Sample Size for Windows. Keysville, Utah: NCSS; 1996 Hintze J. PASS 6.0 Power Analysis and Sample Size for Windows. Keysville, Utah: NCSS; 1996
38.
Zurück zum Zitat Hefferon K, Murphy H, McLeod J, Mutrie N, Campbell A (2013) Understanding barriers to exercise implementation 5-year post-breast cancer diagnosis: a large-scale qualitative study. Health Educ Res 28(5):843–856CrossRefPubMed Hefferon K, Murphy H, McLeod J, Mutrie N, Campbell A (2013) Understanding barriers to exercise implementation 5-year post-breast cancer diagnosis: a large-scale qualitative study. Health Educ Res 28(5):843–856CrossRefPubMed
39.
Zurück zum Zitat Olson EA, Mullen SP, Rogers LQ, Courneya KS, Verhulst S, McAuley E (2014) Meeting physical activity guidelines in rural breast cancer survivors. Am J Health Behav 38(6):890–899CrossRefPubMedPubMedCentral Olson EA, Mullen SP, Rogers LQ, Courneya KS, Verhulst S, McAuley E (2014) Meeting physical activity guidelines in rural breast cancer survivors. Am J Health Behav 38(6):890–899CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Nordin Å, Taft C, Lundgren-Nilsson Å, Dencker A (2016) Minimal important differences for fatigue patient reported outcome measures—a systematic review. BMC Med Res Methodol 16:62CrossRefPubMedPubMedCentral Nordin Å, Taft C, Lundgren-Nilsson Å, Dencker A (2016) Minimal important differences for fatigue patient reported outcome measures—a systematic review. BMC Med Res Methodol 16:62CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Schwartz AL, Nail LM, Chen S, Meek P, Barsevick AM, King ME et al (2000) Fatigue patterns observed in patients receiving chemotherapy and radiotherapy. Cancer Investig 18(1):11–19CrossRef Schwartz AL, Nail LM, Chen S, Meek P, Barsevick AM, King ME et al (2000) Fatigue patterns observed in patients receiving chemotherapy and radiotherapy. Cancer Investig 18(1):11–19CrossRef
42.
Zurück zum Zitat Lee PH, MacFarlane DJ, Lam TH, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115CrossRefPubMedPubMedCentral Lee PH, MacFarlane DJ, Lam TH, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Jones JM, Olson K, Catton P, Catton CN, Fleshner NE, Krzyzanowska MK et al (2016) Cancer-related fatigue and associated disability in post-treatment cancer survivors. J Cancer Surviv 10(1):51–61CrossRefPubMed Jones JM, Olson K, Catton P, Catton CN, Fleshner NE, Krzyzanowska MK et al (2016) Cancer-related fatigue and associated disability in post-treatment cancer survivors. J Cancer Surviv 10(1):51–61CrossRefPubMed
44.
Zurück zum Zitat Galiano-Castillo N, Ariza-García A, Cantarero-Villanueva I, Fernández-Lao C, Díaz-Rodríguez L, Arroyo-Morales M Depressed mood in breast cancer survivors: associations with physical activity, cancer-related fatigue, quality of life, and fitness level. Eur J Oncol Nursing 18(2):206–210 Galiano-Castillo N, Ariza-García A, Cantarero-Villanueva I, Fernández-Lao C, Díaz-Rodríguez L, Arroyo-Morales M Depressed mood in breast cancer survivors: associations with physical activity, cancer-related fatigue, quality of life, and fitness level. Eur J Oncol Nursing 18(2):206–210
45.
Zurück zum Zitat Sabatino SA, Coates RJ, Uhler RJ, Pollack LA, Alley LG, Zauderer LJ (2007) Provider counseling about health behaviors among cancer survivors in the United States. J Clin Oncol 25(15):2100–2106CrossRefPubMed Sabatino SA, Coates RJ, Uhler RJ, Pollack LA, Alley LG, Zauderer LJ (2007) Provider counseling about health behaviors among cancer survivors in the United States. J Clin Oncol 25(15):2100–2106CrossRefPubMed
Metadaten
Titel
Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial
verfasst von
Kerri M. Winters-Stone
Esther L. Moe
Cynthia K. Perry
Mary Medysky
Rodney Pommier
John Vetto
Arpana Naik
Publikationsdatum
01.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 3/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3909-z

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