Effects of an 18-week exercise programme started early during breast cancer treatment: A randomised controlled trial

Noémie Travier, Miranda J. Velthuis, Charlotte N. Steins Bisschop, Bram van den Buijs, Evelyn M. Monninkhof, Frank Backx, Maartje Los, Frans Erdkamp, Haiko J. Bloemendal, Carla Rodenhuis, Marnix A J de Roos, Marlies Verhaar, Daan ten Bokkel Huinink, Elsken van der Wall, Petra H M Peeters, Anne M. May

Research output: Contribution to journalArticle

Abstract

Background: Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within 6 weeks after diagnosis, on preventing an increase in fatigue. Methods: This multi-centre controlled trial randomly assigned 204 breast cancer patients to usual care (n = 102) or supervised aerobic and resistance exercise (n = 102). By design, all patients received chemotherapy between baseline and 18 weeks. Fatigue (i.e., primary outcome at 18 weeks), quality of life, anxiety, depression, and physical fitness were measured at 18 and 36 weeks. Results: Intention-to-treat mixed linear model analyses showed that physical fatigue increased significantly less during cancer treatment in the intervention group compared to control (mean between-group differences at 18 weeks: -1.3; 95 % CI -2.5 to -0.1; effect size -0.30). Results for general fatigue were comparable but did not reach statistical significance (-1.0, 95%CI -2.1; 0.1; effect size -0.23). At 18 weeks, submaximal cardiorespiratory fitness and several muscle strength tests (leg extension and flexion) were significantly higher in the intervention group compared to control, whereas peak oxygen uptake did not differ between groups. At 36 weeks these differences were no longer statistically significant. Quality of life outcomes favoured the exercise group but were not significantly different between groups. Conclusions: A supervised 18-week exercise programme offered early in routine care during adjuvant breast cancer treatment showed positive effects on physical fatigue, submaximal cardiorespiratory fitness, and muscle strength. Exercise early during treatment of breast cancer can be recommended. At 36 weeks, these effects were no longer statistically significant. This might have been caused by the control participants' high physical activity levels during follow-up. Trial registration: Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on December 9th, 2009.

Original languageEnglish (US)
Article number121
JournalBMC Medicine
Volume13
Issue number1
DOIs
StatePublished - Jun 8 2015
Externally publishedYes

Fingerprint

Randomized Controlled Trials
Exercise
Breast Neoplasms
Fatigue
Muscle Strength
Therapeutics
Quality of Life
Physical Fitness
Linear Models
Neoplasms
Leg
Anxiety
Depression
Oxygen
Drug Therapy

Keywords

  • Breast cancer
  • Exercise therapy
  • Fatigue
  • Randomised controlled trial

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Travier, N., Velthuis, M. J., Steins Bisschop, C. N., van den Buijs, B., Monninkhof, E. M., Backx, F., ... May, A. M. (2015). Effects of an 18-week exercise programme started early during breast cancer treatment: A randomised controlled trial. BMC Medicine, 13(1), [121]. https://doi.org/10.1186/s12916-015-0362-z

Effects of an 18-week exercise programme started early during breast cancer treatment : A randomised controlled trial. / Travier, Noémie; Velthuis, Miranda J.; Steins Bisschop, Charlotte N.; van den Buijs, Bram; Monninkhof, Evelyn M.; Backx, Frank; Los, Maartje; Erdkamp, Frans; Bloemendal, Haiko J.; Rodenhuis, Carla; de Roos, Marnix A J; Verhaar, Marlies; ten Bokkel Huinink, Daan; van der Wall, Elsken; Peeters, Petra H M; May, Anne M.

In: BMC Medicine, Vol. 13, No. 1, 121, 08.06.2015.

Research output: Contribution to journalArticle

Travier, N, Velthuis, MJ, Steins Bisschop, CN, van den Buijs, B, Monninkhof, EM, Backx, F, Los, M, Erdkamp, F, Bloemendal, HJ, Rodenhuis, C, de Roos, MAJ, Verhaar, M, ten Bokkel Huinink, D, van der Wall, E, Peeters, PHM & May, AM 2015, 'Effects of an 18-week exercise programme started early during breast cancer treatment: A randomised controlled trial', BMC Medicine, vol. 13, no. 1, 121. https://doi.org/10.1186/s12916-015-0362-z
Travier N, Velthuis MJ, Steins Bisschop CN, van den Buijs B, Monninkhof EM, Backx F et al. Effects of an 18-week exercise programme started early during breast cancer treatment: A randomised controlled trial. BMC Medicine. 2015 Jun 8;13(1). 121. https://doi.org/10.1186/s12916-015-0362-z
Travier, Noémie ; Velthuis, Miranda J. ; Steins Bisschop, Charlotte N. ; van den Buijs, Bram ; Monninkhof, Evelyn M. ; Backx, Frank ; Los, Maartje ; Erdkamp, Frans ; Bloemendal, Haiko J. ; Rodenhuis, Carla ; de Roos, Marnix A J ; Verhaar, Marlies ; ten Bokkel Huinink, Daan ; van der Wall, Elsken ; Peeters, Petra H M ; May, Anne M. / Effects of an 18-week exercise programme started early during breast cancer treatment : A randomised controlled trial. In: BMC Medicine. 2015 ; Vol. 13, No. 1.
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T1 - Effects of an 18-week exercise programme started early during breast cancer treatment

T2 - A randomised controlled trial

AU - Travier, Noémie

AU - Velthuis, Miranda J.

AU - Steins Bisschop, Charlotte N.

AU - van den Buijs, Bram

AU - Monninkhof, Evelyn M.

AU - Backx, Frank

AU - Los, Maartje

AU - Erdkamp, Frans

AU - Bloemendal, Haiko J.

AU - Rodenhuis, Carla

AU - de Roos, Marnix A J

AU - Verhaar, Marlies

AU - ten Bokkel Huinink, Daan

AU - van der Wall, Elsken

AU - Peeters, Petra H M

AU - May, Anne M.

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N2 - Background: Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within 6 weeks after diagnosis, on preventing an increase in fatigue. Methods: This multi-centre controlled trial randomly assigned 204 breast cancer patients to usual care (n = 102) or supervised aerobic and resistance exercise (n = 102). By design, all patients received chemotherapy between baseline and 18 weeks. Fatigue (i.e., primary outcome at 18 weeks), quality of life, anxiety, depression, and physical fitness were measured at 18 and 36 weeks. Results: Intention-to-treat mixed linear model analyses showed that physical fatigue increased significantly less during cancer treatment in the intervention group compared to control (mean between-group differences at 18 weeks: -1.3; 95 % CI -2.5 to -0.1; effect size -0.30). Results for general fatigue were comparable but did not reach statistical significance (-1.0, 95%CI -2.1; 0.1; effect size -0.23). At 18 weeks, submaximal cardiorespiratory fitness and several muscle strength tests (leg extension and flexion) were significantly higher in the intervention group compared to control, whereas peak oxygen uptake did not differ between groups. At 36 weeks these differences were no longer statistically significant. Quality of life outcomes favoured the exercise group but were not significantly different between groups. Conclusions: A supervised 18-week exercise programme offered early in routine care during adjuvant breast cancer treatment showed positive effects on physical fatigue, submaximal cardiorespiratory fitness, and muscle strength. Exercise early during treatment of breast cancer can be recommended. At 36 weeks, these effects were no longer statistically significant. This might have been caused by the control participants' high physical activity levels during follow-up. Trial registration: Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on December 9th, 2009.

AB - Background: Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints. The Physical Activity during Cancer Treatment (PACT) study was designed to primarily examine the effects of an 18-week exercise intervention, offered in the daily clinical practice setting and starting within 6 weeks after diagnosis, on preventing an increase in fatigue. Methods: This multi-centre controlled trial randomly assigned 204 breast cancer patients to usual care (n = 102) or supervised aerobic and resistance exercise (n = 102). By design, all patients received chemotherapy between baseline and 18 weeks. Fatigue (i.e., primary outcome at 18 weeks), quality of life, anxiety, depression, and physical fitness were measured at 18 and 36 weeks. Results: Intention-to-treat mixed linear model analyses showed that physical fatigue increased significantly less during cancer treatment in the intervention group compared to control (mean between-group differences at 18 weeks: -1.3; 95 % CI -2.5 to -0.1; effect size -0.30). Results for general fatigue were comparable but did not reach statistical significance (-1.0, 95%CI -2.1; 0.1; effect size -0.23). At 18 weeks, submaximal cardiorespiratory fitness and several muscle strength tests (leg extension and flexion) were significantly higher in the intervention group compared to control, whereas peak oxygen uptake did not differ between groups. At 36 weeks these differences were no longer statistically significant. Quality of life outcomes favoured the exercise group but were not significantly different between groups. Conclusions: A supervised 18-week exercise programme offered early in routine care during adjuvant breast cancer treatment showed positive effects on physical fatigue, submaximal cardiorespiratory fitness, and muscle strength. Exercise early during treatment of breast cancer can be recommended. At 36 weeks, these effects were no longer statistically significant. This might have been caused by the control participants' high physical activity levels during follow-up. Trial registration: Current Controlled Trials ISRCTN43801571 , Dutch Trial Register NTR2138 . Trial registered on December 9th, 2009.

KW - Breast cancer

KW - Exercise therapy

KW - Fatigue

KW - Randomised controlled trial

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