Effects Of EXCAP©® Exercise Intervention On Fatigue, Activities Of Daily Living And Work: A Randomized Controlled Trial With Breast Cancer Patients

Although exercise is a recommended therapy for the treatment of fatigue in patients with breast cancer, it is unclear if improvement in fatigue due to exercise results in subsequent improvements in activities of daily living (ADLs) and work. PURPOSE: The purpose of our study was to investigate the effects of exercise on fatigue and its interference with ADLs and work in patients with breast cancer receiving treatment. METHODS: We conducted a phase II Randomized Controlled Trial (RCT) in patients with breast cancer receiving radiation therapy (RT) and hormone therapy (HT). This study evaluated the effects of a 6-week home-based exercise prescription compared to standard care on fatigue and its interference with ADLs and work. The exercise regimen called Exercise for Cancer Patients (EXCAP©®) is a moderate intensity daily exercise prescription which increases weekly steps walked by 5-20% and includes resistance band exercises of 5 to 15 repetitions with resistance being increased to optimally challenge the patient. Fatigue was assessed using the fatigue sub-scale of FACIT-F, and its interference with ADLs and work were measured using a symptom inventory at baseline, post-intervention and 3-months later. RESULTS: 90 women with breast cancer (55.5 ± 9.6 years, 88% white, 47% receiving RT, 46% receiving HT) were consented. ANCOVAs showed significant differences between exercisers and standard care participants in fatigue (3.98 ±1.82) and its interference with ADLs (-0.94±.44) and work (-0.89±.42; all p< 0.05). Exercisers reported significant decreases in fatigue (5.98 ± 1.37, p < 0.05) and its interference with ADLs (-0.85 ± 0.35; p< 0.05) and work (-0.78 ± 0.35; p< 0.05). Standard care participants demonstrated no significant improvements in fatigue or its interference with ADLs and work. Pearson correlations showed a strong positive correlation between decreases in fatigue, its interference with ADLs and its interference with work (ADLs r= -0.64; Work r= -0.73). CONCLUSIONS: Our results suggest that exercise may improve fatigue as well as its interference with ADLs and work in patients undergoing treatment for breast cancer. Future phase III RCTs are needed to confirm these results. NCI K07CA120025