The Effect of a Combined Exercise Program on the Fatigue Severity of Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Clinical Trial Study

Elahe Darvishi, Amir Musarezaie, Masoud Bahrami, Jahangir Karimian

Abstract


Abstract

Background: Breast Cancer (BC) is one of the most common cancers in the world, including in Iran. Chemotherapy as one of the basic treatments for BC leads to many side effects such as fatigue. This study aimed to examine the effect of a combined exercise program on the intensity of fatigue in patients with BC undergoing chemotherapy.

Materials and Methods: This clinical trial study was conducted on 64 patients with BC undergoing chemotherapy referring to the Seyyed al‑Shoada and the Al‑Zahra clinics from January to April 2022. Eligible patients who met inclusion criteria were recruited by the convenience sampling and then assigned randomly to intervention and control groups. The combined exercise program in the intervention group was done for 8 weeks as three sessions a week (34 sessions) each for 35–40 min. Piper’s Fatigue Scale was completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods.

Results: The results showed that the mean score of fatigue intensity in both control and intervention groups had a statistically significant difference after the intervention (p = 0.004). The mean fatigue intensity score in the intervention group decreased significantly from mean (SD) 8.17 (1.88) to 5.56 (1.74).

Conclusions: Based on the results, a combined exercise program can reduce fatigue in patients with BC. Therefore, nurses can utilize exercise programs and practices as a subset of complementary medicine alongside other treatment methods, which can effectively promote cancer patients’ quality of life by reducing their fatigue.



Keywords


Breast neoplasms, drug therapy, exercise, fatigue, nursing

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References


Available from: https://www.cancer.org/cancer/breast-cancer/ about/how-common-is-breast-cancer.html. [Last accessed on 2023 Feb 08].

Shiravand F, Nourollahi Z, Valipour Dehnou V. The effect of 8 weeks of HICT training on serum levels of BDNF and TNFα and aerobic power in breast cancer survivors: Randomized clinical trial. IJBD 2020;13:55 6. [Persian].

Firouzi R, Tizdast T, Khalatbari J, Ghorban Shiroudi Sh. [Relationship between stress coping strategies and difficulties in emotion regulation mediated by marital life quality in married women with breast cancer (Persian)]. J Arak Univ Med Sci (JAMS). 2020;23:34 47. [Persian].

Imanian M, Imanian M, Karimyar M. Sleep quality and fatigue among breast cancer patients undergoing chemotherapy. Int J Hematol Oncol Stem Cell Res 2019;13:196 200.

Hojjati H, Hekmati Pour N, Khandousti S, Mirzaali J, Akhondzadeh G, Kolangi F, et al. An investigation into the dimensions of prayer in cancer patients. JRH 2015;3:65 72. [Persian].

Khosravi N, Hanson E, Farajivafa V, Agha Alinejad H, Haghighat S, Molanouri Shamsi M, et al. Changes in monocyte populations following acute aerobic exercise in breast cancer survivors. Iran J Breast Dis 2018;11:7 16. [Persian].

Hurria A, Soto-Perez-de-Celis E, Allred J, Jay Cohen H, Arsenyan A, Ballman K, et al. Functional decline and resilience in older women receiving adjuvant chemotherapy for breast cancer. J Am Geriatr Soc 2019;67:920 7.

Yarbro CH, Frogge MH, Wick D, Gobel BH. Cancer Nursing. 8th ed. New York: Jones and Bartlett Publishers; 2016. p. 738 50.

Gonzalez VJ, Tofthagen CS, Chen X, Pedro E, Saligan LN. Differences in fatigue severity in a sample of adult cancer patients. JCN 2018;27:3345 54.

Yeh MH, Chao CH, Koo M, Chen CY, Yeh CH, Li TM. Association of traditional Chinese medicine body constitution and moderate to severe cancer related fatigue in cancer patients. Complementary Ther Med 2019;43:44–8.

Nunes AF, Bezerra CO, Custódio JDS, Friedrich CF, Oliveira IS, Lunardi AC. Clinimetric properties of the brief fatigue inventory applied to oncological patients hospitalized for chemotherapy. J Pain Symptom Manage 2019;57:297 303.

Liu Y, Hung T, Mudiyanselage K, Wang C, Lin M. Beneficial exercises for cancer related fatigue among women with breast cancer: A systematic review and network meta analysis. Women’s Health and Aging 2023;15:151 8.

Nguyen LT, Alexander K, Yates P. Psychoeducational intervention for symptom management of fatigue, pain, and sleep disturbance cluster among cancer patients: A pilot quasi experimental study. J Pain Symptom Manage 2018;55:1459 72.

Rad M, Borzoee F, Mohebbi M. The effect of humor therapy on fatigueseverity and quality of life in breastcancer patients undergoing external radiation therapy. ZUMS J 2016;24:102 14. [Persian.

O’Neill M, Samaroo D, Lopez C, Tomlinson G Santa Mina D, Sabiston C, Culos Reed N, et al. The effect of yoga interventions on cancer related fatigue and quality of life for women with breast cancer: A systematic review and meta analysis of randomized controlled trials. Integr Cancer Ther 2020;19:1 10.

Lee A, Mavaddat N, Wilcox AN, Cunningham AP, Carver T, Hartley S, et al. BOADICEA: A comprehensive breast cancer risk prediction model incorporating genetic and nongenetic risk factors. Genet Med 2019;21:1708 18.

Abrahams HJG, Gielissen MFM, Verhagen CAHHVM, Knoop H. The relationship of fatigue in breast cancer survivors with quality of life and factors to address in psychological interventions: A systematic review. Clin Psychol Rev 2018;63:1–11.

Crnkovic I, Brumini I, Racz A. Incidence of symptoms of fatigue, pain and sleep disorders in patients with a malignant disease who are actively involved in the rehabilitation process. Med Jad 2019;49:39 44.

Ozer ZC, Boz I, Kavradim T, Teskereci G. European Union Project ‘BestCARE’: Improving nursing care with best complementary therapy strategies. Int Nurs Rev 2019;66:112 21.

Erickson JM, Spurlock LK, Centini Kramer J, Davis MA. Self care strategies to relieve fatigue in patients receiving radiation therapy. Clin J Oncol Nurs 2013;17:319 24.

Maria S, Ruth L. Translated by Babaie E, Khorami Rad A, Ghaedi F, Kohan Sh, Movahedian A. Complementary Medicine and Alternative Therapies in Nursing, Tehran: Ebne sina Publication; 2013.

Smith MC. Nursing Theories and Nursing Practice. 5th ed. F.A. Davis Company; 2019.

Nurhidayah I, Pahria T, Hidayati NO, Nuraeni, A. The application of Levine’s conservation model on nursing care of children with cancer experiencing chemotherapy induced mucositis in Indonesia. KnE Life Sci 2019;4:448–62.

Jiang M, Ma Y, Yun B, Wang Q, Huang C, Han L. Exercise for fatigue in breast cancer patients: An umbrella review of systematic reviews. Int J Nurs Sci 2020;7:248 54.

Husebø AML, Dyrstad SM, Mjaaland I, Søreide JA, Bru E. Effects of scheduled exercise on cancer related fatigue in women with early breast cancer. ScientificWorldJournal 2014;2014:271828.

Coleman EA, Goodwin JA, Kennedy R, Coon SK, Richards K, Enderlin C, et al. Effects of exercise on fatigue, sleep, and performance: A randomized trial. Oncol Nurs Forum 2012;39:468 77.

Tsianakas V, Harris J, Ream E, Van Hemelrijck M, Purushotham A, Mucci L, et al. A feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer. BMJ 2017;7:2 8.

Kuehr L, Wiskemann J, Abel U, Ulrich CM, Hummler S, Thomas M. Exercise in patients with non small cell lung cancer. Med. Sci. Sports Exerc 2014;46:656–63.

Chiarotto JA, Akbarali R, Bellotti L, Dranitsaris G. A structured group exercise program for patients with metastatic cancer receiving chemotherapy and CTNNB1 (β catenin) as a biomarker of exercise efficacy. Cancer Manag Res 2017;9:495 501.

Guarda Korelo IR, Siega J, Carolina Cordeiro Woloschen A,Maryelle M. Brazilian version of cancer fatigue scale: Validation of the Brazilian version of cancer fatigue scale in patients with breast cancer. J Pain Symptom Manage 2019;57:1130 6.

Izadpanah A, Sahbaei F, Shojaei F, Fesharaki M. Effect of foot reflexology on fatigue in women admitted to Rama spa massage service center. J Health Care 2013;14:35 43.

Sheikh Taheri A, Norouzi E, Sadoughi F. Developing a mobile based self care application for patients with breast cancer undergoing chemotherapy. J Health Adm 2019;22:35 49.

Sung H, Ferlay J, Siegel L, Laversanne M, Soerjomataram I, Jemal A, et al. GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2020;71;209 49.

Berek JS. Berek & Novak’s Gynecology. 16th ed. Golban Medical Publication; 2019.

Schmidt ME, Wiskemann J, Armbrust P, Schneeweiss A, Ulrich CM, Steindorf K. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: A randomized controlled trial. Int J Cancer 2015;137:471 80.

Andersen C, Rørth M, Ejlertsen B, Stage M, Møller T, Midtgaard J, et al. The effects of a six week supervised multimodal exercise intervention during chemotherapy on cancer related fatigue. Eur J Oncol Nurs 2013;17:331 9.

An KY, Morielli AR, Kang DW, Friedenreich CM, McKenzie DC, Gelmon K, et al. Effects of exercise dose and type during breast cancer chemotherapy on longer term patient reported outcomes and health related fitness: A randomized controlled trial. Int J Cancer 2020;146;150–60.

Schuler MK, Hentschel L, Kisel W, Kramer M, Lenz F, Hornemann B, et al. Impact of different exercise programs on severe fatigue in patients undergoing anticancer treatentd a randomized controlled trial. J Pain Symptom Manage 2017;53:57 66.


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