Society for Women’s Health Research
Cancer-related fatigue is the most commonly reported side effect of cancer treatment, affecting 70-100% of patients and current literature suggests exercise is an important component of managing this side effect. The specific objective of this project was to evaluate the effectiveness of a 12-week evidence-based cancer exercise and education intervention on outcomes of fatigue, pain, depression, sleep disturbance and quality of life for women with cancer; the intervention was delivered by an interprofessional team in a medically-based wellness center.
The team was led by a physical therapist and included medical and radiation oncologists, general surgeons, nurses and cancer survivors, who developed the structure, content and format of this 12-week community-based intervention. The intervention consisted of group exercise sessions and education. Women with any type of cancer were eligible to enroll regardless of whether or not they were on active cancer treatment. Women were not eligible to enroll if they had any contraindication to exercise. Groups of no more than 15, completed hour-long supervised group exercise sessions twice weekly that were led by a physical therapist or exercise specialist. These sessions included resistance training, aerobic, flexibility, balance, aquatic or yoga exercises. The weekly education sessions included topics such as nutrition, sleep disturbance, depression, coping, lymphedema, exercise habits, healing arts, women’s health, spirituality, and stress management. This intervention was offered at no cost to participants, with funding provided by the hospital foundation. Participants reported their pre- and post-intervention perceptions of fatigue, pain, depression, sleep disturbance and quality of life on a 0 -10 point Likert scale (0 = none, 10 = worst). We used the related-sample Wilcoxon Signed Rank test to compare pre- and post- intervention scores and independent sample Mann-Whitney U test to compare change scores between those on and off treatment.
Approximately 80% (n=139) of the women having a mean age of 53.6 years (SD=11.8; range 23-87) completed the 12-week intervention. Upon completion, we found significant decreases in the perceptions of self-reported fatigue (-5.5, p<.001), pain (-0.5, p=.017), depression (-1.0, p<.001), sleep disturbance
(-0.5, p<.001), and quality of life (-1.4, p<.001). However, a subgroup analysis revealed that the impact of the intervention varied according to treatment status. Specifically, perceptions of fatigue decreased significantly for the 49 women who were on treatment (-1.4 vs. -0.03 p=.007) as compared to the 90 women who had completed treatment. Women on active treatment reported significantly higher levels of fatigue at the start of the intervention than did the women who had completed treatment (6.4 vs. 5.0, p<.0001). Our findings indicate that implementation of an evidence-based exercise and education intervention in a medically-based wellness center is effective in improving self-reported outcomes for women with cancer. The most significant impact of the intervention appeared to be in decreasing fatigue for women on active cancer treatment.
Becker, Betsy J.; Jones, Katherine J.; Hageman, Patricia A.; and VanGerpen, Ruth, "Integrating Best Evidence into Practice: Outcomes of a Community-Based 12-week Exercise and Education Intervention in Women with Cancer" (2013). Posters and Presentations: Physical Therapy. 4.