Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trialBMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39094.648553.AE (Published 08 March 2007) Cite this as: BMJ 2007;334:517
- Nanette Mutrie, professor of exercise and sport psychology1,
- Anna M Campbell, research fellow1,
- Fiona Whyte, Macmillan cancer lecturer2,
- Alex McConnachie, senior analyst3,
- Carol Emslie, research scientist4,
- Laura Lee, research assistant1,
- Nora Kearney, professor of cancer care5,
- Andrew Walker, health economist3,
- Diana Ritchie, consultant oncologist6
- 1Department of Sport, Culture and the Arts, Strathclyde University, Glasgow G13 1PP
- 2Nursing and Midwifery School, University of Glasgow, Glasgow G12 8LW
- 3Robertson Centre for Biostatistics, University of Glasgow G12 8QQ
- 4MRC Social and Public Health Sciences Unit, Glasgow G12 8RZ
- 5Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA
- 6Beatson Oncology Centre, Glasgow G11 6NT
- Correspondence to: N Mutrie
- Accepted 26 December 2006
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.
Contributors: NM, AMC, NK, FW, and Gaye Patterson planned the project. All authors supervised the conduct of the study. AMC, Fiona Scott, and Claire Wilson taught the exercise classes. AMC, LL, Fiona Scott, Claire Wilson, and CE collected the data. FW, DR, and NK provided clinical expertise. CE was responsible for qualitative aspects. AMcC was responsible for data handling and analysis. Mary Smith, Janice Japp, and Linda Robb recruited the participants. NM and AMC wrote the first draft, and all authors contributed to the final paper and agreed revisions. NM is the guarantor.
Funding: Cancer Research UK. The funders were independent from the conduct and outcomes of this study. CE is funded by the UK Medical Research Council.
Competing interests: None declared.
Ethical approval: West ethics committee of Greater Glasgow Health Board (LREC Ref:03/22(2)).
- Accepted 26 December 2006