Exercise is more effective than health education in reducing fatigue in fatigued cancer survivors
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ORIGINAL ARTICLE
Exercise is more effective than health education in reducing fatigue in fatigued cancer survivors Patricia Sheehan 1 & Suzanne Denieffe 2 & Niamh M. Murphy 1 & Michael Harrison 1 Received: 29 May 2019 / Accepted: 27 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Cancer-related fatigue is a most debilitating side effect reported by survivors, often lasting years following treatment. Purpose To determine the effects of a 10-week exercise intervention compared with a health education intervention on fatigue, quality of life outcomes and functional fitness in cancer survivors with documented fatigue. Methods This quasi-experimental study allocated 37 post-treatment fatigued cancer survivors (33 female, 30 breast cancer, aged 55 ± 2 years, time since treatment 2.3 ± 0.3 years; mean ± SEM) to an exercise group (EX, n = 19) or health education comparison group (HE, n = 18). The EX intervention emphasised brisk walking with progressive increments, stretching, exercise education and self-efficacy enhancement. The HE intervention emphasised sleep management, nutrition and cognitive behavioural therapy. All participants were evaluated at pre- and post-intervention with EX followed up at 26 W. Results The intervention effect on fatigue (FACT-F) in EX was greater (p < 0.05) than that in HE, the difference being 4 times the recognised clinically important difference. The intervention also increased (p < 0.05) cognitive function, global quality of life and functional fitness scores. It reduced (p < 0.05) insomnia and fear of physical activity. All intervention effects were maintained to 26 W. The intervention effect on fatigue in EX was largely achieved by week 4. There was 100% retention rate at 10 W and no adverse events reported. Conclusions There is a reduction of considerable magnitude in cancer fatigue from group-based exercise training, that is sustainable and attributable to exercise per se. Implications for cancer survivors Exercise training is feasible for fatigued cancer survivors and should form part of tailored rehabilitation programmes. Keywords Cancer-related fatigue . Physical activity . Quality of life . Exercise rehabilitation
Introduction With an increase in cancer survivorship, there is a corresponding rise in rehabilitation and symptom management needs. One of the most common and debilitating side effects of cancer and its treatment is cancer-related fatigue (CrF) [1]. CrF is a distressing, persistent, subjective sense of physical, emotional and/or cognitive tiredness related to cancer or cancer treatment, that is not proportional to recent activity and that interferes with usual functioning [2]. This fatigue can have a severe * Michael Harrison [email protected] 1
Department of Sport and Exercise Science, Waterford Institute of Technology, Cork Road, Waterford, Ireland
2
School of Humanities, Waterford Institute of Technology, Cork Road, Waterford, Ireland
impact on many aspects of health, functioning and quality of life (QOL). It can pe
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