BMJ  2007;334:517 (10 March), doi:10.1136/bmj.39094.648553.AE (published 16 February 2007)

Research

Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial

¹ Department of Sport, Culture and the Arts, Strathclyde University, Glasgow G13 1PP, ² Nursing and Midwifery School, University of Glasgow, Glasgow G12 8LW, ³ Robertson Centre for Biostatistics, University of Glasgow G12 8QQ, ⁴ MRC Social and Public Health Sciences Unit, Glasgow G12 8RZ, ⁵ Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA, ⁶ Beatson Oncology Centre, Glasgow G11 6NT

Objectives To determine functional and psychological benefits of a 12 week supervised group exercise programme during treatment for early stage breast cancer, with six month follow-up.

Design Pragmatic randomised controlled prospective open trial.

Setting Three National Health Service oncology clinics in Scotland and community exercise facilities.

Participants 203 women entered the study; 177 completed the six month follow-up.

Interventions Supervised 12 week group exercise programme in addition to usual care, compared with usual care.

Main outcome measures Functional assessment of cancer therapy (FACT) questionnaire, Beck depression inventory, positive and negative affect scale, body mass index, seven day recall of physical activity, 12 minute walk test, and assessment of shoulder mobility.

Results Mixed effects models with adjustment for baseline values, study site, treatment at baseline, and age gave intervention effect estimates (intervention minus control) at 12 weeks of 129 (95% confidence interval 83 to 176) for metres walked in 12 minutes, 182 (75 to 289) for minutes of moderate intensity activity reported in a week, 2.6 (1.6 to 3.7) for shoulder mobility, 2.5 (1.0 to 3.9) for breast cancer specific subscale of quality of life, and 4.0 (1.8 to 6.3) for positive mood. No significant effect was seen for general quality of life (FACT-G), which was the primary outcome. At the six month follow-up, most of these effects were maintained and an intervention effect for breast cancer specific quality of life emerged. No adverse effects were noted.

Conclusion Supervised group exercise provided functional and psychological benefit after a 12 week intervention and six months later. Clinicians should encourage activity for their patients. Policy makers should consider the inclusion of exercise opportunities in cancer rehabilitation services.

Trial registration Current controlled trials ISRCTN12587864 [controlled-trials.com] .

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Find additional patient-related information at:

Workouts Boost Well-Being of Breast Cancer Patients

Related external webpages:

Student BMJ: Critical appraisal

This article has been cited by other articles:

• Oh, B., Butow, P., Mullan, B., Clarke, S., Beale, P., Pavlakis, N., Kothe, E., Lam, L., Rosenthal, D. (2009). Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol 0: mdp479v1-mdp479 [Abstract] [Full text]  
• Adamsen, L., Quist, M., Andersen, C., Moller, T., Herrstedt, J., Kronborg, D., Baadsgaard, M. T, Vistisen, K., Midtgaard, J., Christiansen, B., Stage, M., Kronborg, M. T, Rorth, M. (2009). Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ 339: b3410-b3410 [Abstract] [Full text]  
• Chen, X., Zheng, Y., Zheng, W., Gu, K., Chen, Z., Lu, W., Shu, X. O. (2009). The Effect of Regular Exercise on Quality of Life Among Breast Cancer Survivors. Am J Epidemiol 170: 854-862 [Abstract] [Full text]  
• Evans, E. S., Battaglini, C. L., Groff, D. G., Hackney, A.C. (2009). Aerobic Exercise Intensity in Breast Cancer Patients: A Preliminary Investigation. Integr Cancer Ther 8: 139-147 [Abstract]  
• Kim, C.-J., Kang, D.-H., Park, J.-W. (2009). A Meta-Analysis of Aerobic Exercise Interventions for Women With Breast Cancer. West J Nurs Res 31: 437-461 [Abstract]  
• Al-Majid, S., Gray, D. P. (2009). A Biobehavioral Model for the Study of Exercise Interventions in Cancer-related Fatigue. Biol Res Nurs 10: 381-391 [Abstract]  
• Zwarenstein, M., Treweek, S., Gagnier, J. J, Altman, D. G, Tunis, S., Haynes, B., Oxman, A. D, Moher, D., for the CONSORT and Pragmatic Trials in Healthcare, (2008). Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ 337: a2390-a2390 [Abstract] [Full text]  
• Courneya, K. S., Jones, L. W., Peddle, C. J., Sellar, C. M., Reiman, T., Joy, A. A., Chua, N., Tkachuk, L., Mackey, J. R. (2008). Effects of Aerobic Exercise Training in Anemic Cancer Patients Receiving Darbepoetin Alfa: A Randomized Controlled Trial. The Oncologist 13: 1012-1020 [Abstract] [Full text]  
• Holick, C. N., Newcomb, P. A., Trentham-Dietz, A., Titus-Ernstoff, L., Bersch, A. J., Stampfer, M. J., Baron, J. A., Egan, K. M., Willett, W. C. (2008). Physical Activity and Survival after Diagnosis of Invasive Breast Cancer. Cancer Epidemiol. Biomarkers Prev. 17: 379-386 [Abstract] [Full text]  
• Courneya, K. S., Segal, R. J., Gelmon, K., Reid, R. D., Mackey, J. R., Friedenreich, C. M., Proulx, C., Lane, K., Ladha, A. B., Vallance, J. K., Liu, Q., Yasui, Y., 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 Epidemiol. Biomarkers Prev. 16: 2572-2578 [Abstract] [Full text]  
• (2007). Benefits of Group Exercise During Breast Cancer Treatment. JWatch General 2007: 2-2 [Full text]  
• (2007). Working Out During Breast Cancer Treatment. JWatch Women's Health 2007: 1-1 [Full text]  
• Silver, J. K (2007). Exercise in survivors of cancer. BMJ 334: 484-485 [Full text]  

Rapid Responses:

Read all Rapid Responses

Breast Cancer Care on BMJ exercise study

Christine Fogg
bmj.com, 17 Feb 2007 [Full text]

Exercise Works but How?

Robert S. Brown
bmj.com, 9 Mar 2007 [Full text]

Online poll

Find out more on doc2doc >>