Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation Effects of Scheduled Exercise on Cancer-Related Fatigue in Women with Early Breast Cancer [Effects of a home-based exercise program for patients with stomach cancer receiving oral chemotherapy after surgery]. A Randomized Controlled Trial of Home-Based Exercise for Cancer-Related Fatigue in Women During and After Chemotherapy With or Without Radiation Therapy Strength and endurance training in the treatment of lung cancer patients in stages IIIA/IIIB/IV A randomized trial of the effect of a walking regimen on the functional status of 100 adult allogeneic donor hematopoietic cell transplant patients. A randomized pilot study with daily walking during adjuvant chemotherapy for patients with breast and colorectal cancer Effect of exercise on the caloric intake of breast cancer patients undergoing treatment. Modulation of blood flow, hypoxia, and vascular function in orthotopic prostate tumors during exercise. Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial. A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Effects of a home-based walking program on perceived symptom and mood status in postoperative breast cancer women receiving adjuvant chemotherapy. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial A pilot study of a supervised group exercise programme as a rehabilitation treatment for women with breast cancer receiving adjuvant treatment. Effects of exercise on fatigue, sleep, and performance: a randomized trial. Multimodal exercise training during myeloablative chemotherapy: a prospective randomized pilot trial A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial The effect of seated exercise on fatigue and quality of life in women with advanced breast cancer. Effects of Exercise on Biobehavioral Outcomes of Fatigue During Cancer Treatment [Effects of an exercise training program on the quality of life of women with breast cancer on chemotherapy]. Effects of self-directed stress management training and home-based exercise on stress management skills in cancer patients receiving chemotherapy. Effects of exercise vs bisphosphonates on bone mineral density in breast cancer patients receiving chemotherapy. Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. A controlled randomized study examining the effects of exercise therapy on patients undergoing haematopoietic stem cell transplantation Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Safety and efficacy of aerobic training in operable breast cancer patients receiving neoadjuvant chemotherapy: A phase II randomized trial
PURPOSE Self-directed and supervised exercise were compared with usual care in a clinical trial design ed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer . PATIENTS AND METHODS One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life , aerobic capacity , and body weight . Participants were r and omly allocated to one of three intervention groups : usual care ( control group ) , self-directed exercise , or supervised exercise .  Quality of life , aerobic capacity , and body weight measures were repeated at 26 weeks . The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks . RESULTS Physical functioning in the control group decreased by 4.1 points , whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups , respectively ( P = .04 ) . Post hoc analysis showed a moderately large ( and clinical ly important ) difference between the self-directed and control groups ( 9.8 points ; P = .01 ) and a more modest difference between the supervised and control groups ( 6.3 points ; P = .09 ) . No significant differences between groups were observed for changes in quality of life scores . In a secondary analysis of participants stratified by type of adjuvant therapy , supervised exercise improved aerobic capacity ( + 3.5 mL/kg/min ; P = .01 ) and reduced body weight ( -4.8 kg ; P < .05 ) compared with usual care only in participants not receiving chemotherapy . CONCLUSION Physical exercise can blunt some of the negative side effects of breast cancer treatment , including reduced physical functioning .  Self-directed exercise is an effective way to improve physical functioning compared with usual care . In participants not receiving chemotherapy  , supervised exercise may increase aerobic capacity and reduce body weight compared with usual care To evaluate the efficacy and economic efficiency of a multimedia , multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer . We conducted a r and omized trial with concurrent incremental cost-effectiveness analysis and blinded baseline , 3 , 6 and 12-month follow-up assessment s amongst women undergoing adjuvant therapy following surgery for breast cancer ( n = 89 ) . The intervention was a multimedia , multimodal exercise program comprising strength , balance and endurance training elements . The control was sham flexibility and relaxation program delivered using similar material s. The primary outcome was health-related quality of life ( EQ-5D & VAS , EORTC C30 , BR23 ) . Economic outcomes included direct health care costs and productivity gains and losses . Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [ mean ( sd ) EQ-5D VAS ( 0–100 ) baseline : 72.6 ( 15.6 ) , 3 month : 80.6 ( 11.6 ) ] when compared to control group participants [ baseline : 77.5 ( 13.5 ) , 3 month : 74.1 ( 20.6 ) , P = 0.006 ] and also improved more in terms of physical function [ mean ( sd ) EORTC C30 physical function scale intervention ( 0–100 ) baseline : 84.9 ( 14.8 ) , 3 month : 86.9 ( 10.7 ) , control baseline : 91.3 ( 9.6 ) , 3 month : 86.7 ( 14.9 ) , P = 0.02 ] . These improvements were not sustained beyond this point . Upper limb volumes were also lower amongst intervention group participants . However , there was low probability that the intervention would be both less costly and more effective than the control condition ( range probability = 0.05–50.02 % depending on approach ) . Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of question able economic efficiency While physical activity during cancer treatment is found beneficial for breast cancer patients , evidence indicates ambiguous findings concerning effects of scheduled exercise programs on treatment-related symptoms . This study investigated effects of a scheduled home-based exercise intervention in breast cancer patients during adjuvant chemotherapy  , on cancer-related fatigue , physical fitness , and activity level .  Sixty-seven women were r and omized to an exercise intervention group ( n = 33 , performed strength training 3x/week and 30 minutes brisk walking/day ) and a control group ( n = 34 , performed their regular physical activity level ) . Data collection was performed at baseline , at completion of chemotherapy ( Post1 ) , and 6-month postchemotherapy ( Post2 ) . Exercise levels were slightly higher in the scheduled exercise group than in the control group . In both groups , cancer-related fatigue increased at Post1 but returned to baseline at Post2 . Physical fitness and activity levels decreased at Post1 but were significantly improved at Post2 . Significant differences between intervention and control groups were not found . The findings suggest that generally recommended physical activity levels are enough to relief cancer-related fatigue and restore physical capacity in breast cancer patients during adjuvant chemotherapy , although one can not rule out that results reflect diminishing treatment side effects over time PURPOSE The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy . METHODS The home-based exercise program was developed from the study findings of Winningham ( 1990 ) and data from the Korea Athletic Promotion Association ( 2007 ) . The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy . Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul . Patients were r and omly assigned to either the experimental group ( 11 ) or control group ( 13 ) . The effects of the home-based exercise program were measured by level of cancer related fatigue , NK cell ratio , anxiety , and quality of life . Data were analyzed using SPSS/WIN 13.0 version . RESULTS The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group . The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased . CONCLUSION This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy Background : Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment . Objective : The purpose of this study was to evaluate the effectiveness of a home-based exercise training intervention , the Pro-self Fatigue Control Program on the management of cancer-related fatigue . Interventions / Methods : Participants ( N = 119 ) were r and omized into 1 of 3 groups : group 1 received the exercise prescription throughout the study ; group 2 received their exercise prescription after completing cancer treatment ; and group 3 received usual care . Patients completed the Piper Fatigue Scale , General Sleep Disturbance Scale , Center for Epidemiological Studies -Depression Scale , and Worst Pain Intensity Scale . Results : All groups reported mild fatigue levels , sleep disturbance , and mild pain , but not depression . Using multilevel regression analysis , significant linear and quadratic trends were found for change in fatigue and pain ( ie , scores increased , then decreased over time ) . No group differences were found in the changing scores over time . A significant quadratic effect for the trajectory of sleep disturbance was found , but no group differences were detected over time . No significant time or group effects were found for depression . Conclusions : Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment . The optimal timing of exercise remains to be determined . Implication s for Practice : Clinicians need to be aware that some physical activity is better than none , and there is no harm in exercise as tolerated during cancer treatment . Further analysis is needed to examine the adherence to exercise . More frequent assessment s of fatigue , sleep disturbance , depression , and pain may capture the effect of exercise Purpose This r and omized controlled trial tested the effects of a specially design ed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy . Methods Between August 2010 and December 2011 , 46 patients were r and omized into two groups receiving either conventional physiotherapy or special physiotherapeutic training . The Barthel Index served as primary endpoint . The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( EORTC QLQ C-30/LC-13 ) question naire , the 6-Minute Walk Test ( 6MWT ) , stair walking , the Modified Borg Scale , and muscle strength . Nonparametrical data were analyzed with the Wilcoxon and Mann – Whitney U test . For parametric , data student t tests were used . A p value of ≤.05 was accepted . Results Twenty-nine patients completed the trial ( Intervention group ( IG ) , n = 18 ; control group ( CG ) , n = 11 ) . Significant differences were detectable in the Barthel Index ( IGmean = 92.08 ; CGmean = 81.67 ; p = .041 ) , in single scores of the EORTC QLQ C-30/LC-13 question naire ( physical functioning , p = .025 ; hemoptysis , p = .019 ; pain in arms or shoulder , p = .048 ; peripheral neuropathy , p = .050 ; cognitive functioning , p = .050 ) , in the 6MWT , stair walking , strength capacity , and in the patient ’s dyspnoea perception during submaximal walking activities ( IG > CG ) . Conclusion According to these findings , lung cancer patients should receive enhanced physical activity intervention during palliative chemotherapy To investigate the impact of exercise on adult allogeneic hematopoietic cell transplant recipients , we r and omized 100 patients to either a  structured walking regimen  or to a  control group with no formal exercise program . Starting on the day of admission for transplant , patients in the exercise arm were asked to walk on a treadmill twice a day for 15 minutes while in the hospital . After discharge , they were asked to walk once a day for 30 minutes . The effect of the exercise program was primarily measured by the change in the Karnofsky score ( KPS ) from transplant admission to day 100 posttransplant , which was scored by the attending physician who was blinded to the assigned exercise regimen . The decline in KPS was smaller in the exercise group than in the control group : 10 points versus 20 points . This difference was not statistically significant in the total study population ( P=.21 ) but was statistically significant among the subset of older and less fit patients receiving nonmyeloablative pretransplant conditioning ( P=.04 ) . Sixty-four percent of patients on the exercise arm who had a baseline KPS<90 had a score > or=90 by day 100 compared to 18 % of the control arm ( P=.03 ) . Thirty-two percent of patients with a baseline score > or=90 had a score > or=90 by day 100 in both groups ( P=.99 ) . Analyses of patients ' self reported scores at the time of discharge for physical and emotional well-being showed that the exercise arm had better scores for physical well-being ( P<.01 ) . Among the subset of nonmyeloablative patients , scores for physical and emotional well-being were both higher in the exercise arm ( P=.02 ) . Length of hospitalization and survival were not different between the 2 study arms . We conclude that assignment of a structured walking regimen to patients can lead to better physical performance during the recovery period and by patient assessment , a better perceived physical and emotional state . In addition , exercise has a greater impact among patients who are less fit coming into transplant .  Structured exercise may have a positive impact on physical and emotional recovery following transplant therapy and may accelerate patients ' return to health and function Abstract Background . Physical activity during chemotherapy has been shown in several studies to reduce fatigue , improve symptoms and impact positively on health-related quality of life ( HRQoL ) . Challenges associated with intervention studies on physical activity during cancer treatment relate to consistent adherence . The primary objective was to study feasibility and adherence of physical activity intervention among patients with cancer during adjuvant chemotherapy treatment . The secondary objective was to investigate the effects of physical activity on health aspects , including HRQoL , symptoms and surrogate markers for cardiovascular disease . Material and methods . This r and omized controlled trial included patients with breast cancer ( BRCA ) and colorectal cancer ( CRC ) during adjuvant chemotherapy .  The intervention continued for 10 weeks and included daily walks of 10 000 steps and a weekly supervised group walk . Adherence was assessed by a pedometer and the number of participants who reported step counts every week and percentage of participants who achieved the target steps every week . Results . Adherence average reached 91 % during the intervention period ; in total 74 % completed the exercise intervention . The majority of the participants achieved an average of 83 % of the target of 10 000 steps per day for 10 weeks . There was a significant increase in daily physical activity ( p = 0.016 ) in the intervention group . Significant differences were also found for some breast cancer-specific symptoms [ swelling , mobility and pain ( p = 0.045 ) ] . The study showed a relatively small weight gain an average of 0.9 kg in the intervention group and 1.3 kg in the control group . Conclusion . Physical activity in the form of walking is feasible during adjuvant chemotherapy treatment despite increasing symptoms . The physical activity increased in the intervention group during the study time and had a positive impact on breast symptoms and the weight gain was lower in comparison to previous studies The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake ( TCI ) of breast cancer patients undergoing treatment . A secondary purpose was to determine whether or not a relationship existed between changes in TCI , body fat composition ( % BF ) , and fatigue during the study , which lasted 6 months . Twenty females recently diagnosed with breast cancer , scheduled to undergo chemotherapy or radiation , were assigned r and omly to an experimental ( N = 10 ) or control group ( N = 10 ) . Outcome measures included TCI ( 3-day food diary ) , % BF ( skinfolds ) , and fatigue ( revised Piper Fatigue Scale ) . Each exercise session was conducted as follows : initial cardiovascular activity ( 6 - 12 min ) , followed by stretching ( 5 - 10 min ) , resistance training ( 15 - 30 min ) , and a cool-down ( approximately 8 min ) . Significant changes in TCI were observed among groups ( F1,18 = 8.582 ; P = 0.009 ) , at treatments 2 and 3 , and at the end of the study [ experimental ( 1973 + /- 419 ) , control ( 1488 + /- 418 ) ; experimental ( 1946 + /- 437 ) , control ( 1436 + /- 429 ) ; experimental ( 2315 + /- 455 ) , control ( 1474 + /- 294 ) , respectively ] . A significant negative correlation was found ( Spearman rho(18 ) = -0.759 ; P < 0.001 ) between TCI and % BF and between TCI and fatigue levels ( Spearman rho(18 ) = -0.541 ; P = 0.014 ) at the end of the study . In conclusion , the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects , including decreased TCI , increased fatigue , and negative changes in body composition BACKGROUND Previous studies have hypothesized that tumor blood flow may be elevated or reduced during exercise , which could impact the tumor microenvironment . However , to date technical limitations have precluded the measurement of tumor blood flow during exercise . Using an orthotopic pre clinical model of prostate cancer , we tested the hypotheses that during exercise tumors would experience 1 ) diminished vascular resistance , 2 ) augmented blood flow , 3 ) increased numbers of perfused vessels , and 4 ) decreased tissue hypoxia and , furthermore , that the increased perfusion would be associated with diminished vasoconstriction in prostate tumor arterioles . METHODS  Dunning R-3327 MatLyLu tumor cells were injected into the ventral prostate of male Copenhagen rats aged 4 to 6 months r and omly assigned to tumor-bearing ( n = 42 ) or vehicle control ( n = 14 ) groups .  Prostate tumor blood flow , vascular resistance , patent vessel number , and hypoxia were measured in vivo in conscious rats at rest and during treadmill exercise , and vasoconstrictor responsiveness of resistance arterioles was investigated in vitro . RESULTS During exercise there was a statistically significant increase in tumor blood flow ( approximately 200 % ) and number of patent vessels ( rest mean ± st and ard deviation [ SD ] = 12.7±1.3 ; exercise mean ± SD = 14.3±0.6 vessels/field ; Student t test two-sided P = .02 ) and decreased hypoxia compared with measurements made at rest . In tumor arterioles , the maximal constriction elicited by norepinephrine was blunted by approximately 95 % vs control prostate vessels . CONCLUSIONS During exercise there is enhanced tumor perfusion and diminished tumor hypoxia due , in part , to a diminished vasoconstriction . The clinical relevance of these findings are that exercise may enhance the delivery of tumor-targeting drugs as well as attenuate the hypoxic microenvironment within a tumor and lead to a less aggressive phenotype Loss of physical performance is a universal problem of cancer patients undergoing chemotherapy .  We postulated that this impairment can be partially prevented by aerobic exercise . In a r and omized study , 33 cancer patients receiving high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation ( training group , T ) performed an exercise program consisting of biking on an ergometer in the supine position after an interval-training pattern for 30 minutes daily during hospitalization . Patients in the  control group ( C , n = 37 )  did not train . Maximal physical performance was assessed with a treadmill test by admission and discharge . Physical performance of the two groups was not different on admission . The decrement in performance during hospitalization was 27 % greater in the control group than in the training group ( P = .05 ) ; this result ed in a significantly higher maximal physical performance at discharge in the trained patients ( P = .04 ) . Duration of neutropenia ( P = .01 ) and thrombopenia ( P = .06 ) , severity of diarrhea ( P = .04 ) , severity of pain ( P = .01 ) , and duration of hospitalization ( P = . 03 ) were reduced in the training group . We conclude that aerobic exercise can be safely carried out immediately after high-dose chemotherapy and can partially prevent loss of physical performance . Based on the potential significance of the observed outcomes , further studies are warranted to confirm our results PURPOSE We evaluated the effectiveness of a low-intensity , home-based physical activity program ( Onco-Move ) and a moderate- to high-intensity , combined supervised resistance and aerobic exercise program ( OnTrack ) versus usual care ( UC ) in maintaining or enhancing physical fitness , minimizing fatigue , enhancing health-related quality of life , and optimizing chemotherapy completion rates in patients undergoing adjuvant chemotherapy for breast cancer . PATIENTS AND METHODS We r and omly assigned patients who were scheduled to undergo adjuvant chemotherapy ( N = 230 ) to Onco-Move , OnTrack , or UC .  Performance-based and self-reported outcomes were assessed before r and om assignment , at the end of chemotherapy , and at the 6-month follow-up . We used generalized estimating equations to compare the groups over time . RESULTS Onco-Move and OnTrack result ed in less decline in cardiorespiratory fitness ( P < .001 ) , better physical functioning ( P ≤ .001 ) , less nausea and vomiting ( P = .029 and .031 , respectively ) and less pain ( P = .003 and .011 , respectively ) compared with UC . OnTrack also result ed in better outcomes for muscle strength ( P = .002 ) and physical fatigue ( P < .001 ) . At the 6-month follow-up , most outcomes returned to baseline levels for all three groups . A smaller percentage of participants in OnTrack required chemotherapy dose adjustments than those in the UC or Onco-Move groups ( P = .002 ) . Both intervention groups returned earlier ( P = .012 ) , as well as for more hours per week ( P = .014 ) , to work than the control group . CONCLUSION A supervised , moderate- to high-intensity , combined resistance and aerobic exercise program is most effective for patients with breast cancer undergoing adjuvant chemotherapy . A home-based , low-intensity physical activity program represents a viable alternative for women who are unable or unwilling to follow the higher intensity program PURPOSE / OBJECTIVES To examine the effects of a comprehensive rehabilitation program on facilitating physical and psychosocial adaptation of women with breast cancer who are receiving adjuvant chemotherapy . DESIGN Experimental . SETTING Breast evaluation clinics of two New Engl and medical centers with comprehensive cancer treatment programs . SAMPLE 14 women ( mean age = 44 years ) receiving adjuvant chemotherapy for breast cancer ( 86 % stage II ) following surgical treatment . METHODS Subjects were assigned r and omly to the experimental group or the usual care group . Experimental group members began a structured exercise program of walking and attended support group meetings . All subjects were tested before beginning chemotherapy , during the course of chemotherapy , and one month following chemotherapy completion . MAIN RESEARCH VARIABLES Performance status , physical functioning , psychosocial adjustment , self-concept and body image , and 12 symptoms ( e.g. , fatigue , nausea , anxiety ) . FINDINGS Measures of physical performance , psychosocial adjustment , and symptom intensity revealed improved adaptation in subjects who completed the walking/support group program . CONCLUSIONS Physical and psychosocial benefits from a modest walking exercise program and a support group are possible for patients receiving adjuvant chemotherapy . IMPLICATION S FOR NURSING PRACTICE Although more detailed research is necessary to answer some of the questions raised by this study , implementing the walking program and forming a support group are achievable in an outpatient setting AIM This paper is a report of a study analysing the effect of a home-based walking exercise program on symptoms and mood distress among breast cancer women receiving chemotherapy postoperatively . BACKGROUND Treatment-related symptoms , mood distress and decline in physical activity have been identified as major complaints among cancer patients . Studies on the efficacy of home-based walking exercise for symptoms and mood did not fully describe the exercise prescriptions that could be safe and beneficial for women with breast cancer , especially these receiving adjuvant chemotherapy . METHOD This is a prospect i ve , r and omized clinical trial . In 2008 - 2009 , participants were recruited from the oncology outpatient clinic of a medical center in Taiwan , and were assigned to either the  exercise group ( n=19 ) or the  control group ( n=21 ) . Women in the exercise group participated in a moderate-intensity home-based walking program for 12 weeks during their chemotherapy treatments .  Symptoms , mood status and physical activity level were measured at baseline , 6- and 12-week follow-up . Data were analysed by two-way repeated- measures analysis of variance . RESULTS Women in the exercise group reported significantly lower symptom severity scores and mood disturbance compared with those in the control group throughout the study period . CONCLUSION Regular moderate-intensity exercise can play an important role in improving treatment-related symptoms and mood in women with breast cancer . A home-based walking exercise program can be easily incorporated into care for women with breast cancer undergoing chemotherapy PURPOSE Breast cancer chemotherapy  may cause unfavorable changes in physical functioning , body composition , psychosocial functioning , and quality of life ( QOL ) . We evaluated the relative merits of aerobic and resistance exercise in blunting these effects . PATIENTS AND METHODS We conducted a multicenter r and omized controlled trial in Canada between 2003 and 2005 that r and omly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care ( n = 82 ) , supervised resistance exercise  ( n = 82 ) , or supervised aerobic exercise  ( n = 78 ) for the duration of their chemotherapy ( median , 17 weeks ; 95 % CI , 9 to 24 weeks ) . Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy-Anemia scale . Secondary end points were fatigue , psychosocial functioning , physical fitness , body composition , chemotherapy completion rate , and lymphedema . RESULTS The follow-up assessment rate for our primary end point was 92.1 % , and adherence to the supervised exercise was 70.2 % . Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem ( P = .015 ) , aerobic fitness ( P = .006 ) , and percent body fat ( adjusted P = .076 ) . Resistance exercise was superior to usual care for improving self-esteem ( P = .018 ) , muscular strength ( P < .001 ) , lean body mass ( P = .015 ) , and chemotherapy completion rate ( P = .033 ) . Changes in cancer-specific QOL , fatigue , depression , and anxiety favored the exercise groups but did not reach statistical significance . Exercise did not cause lymphedema or adverse events . CONCLUSION Neither aerobic nor resistance exercise significantly improved cancer-specific QOL  in breast cancer patients receiving chemotherapy , but they did improve self-esteem , physical fitness , body composition , and chemotherapy completion rate without causing lymphedema or significant adverse events Objective To assess the effect of a multimodal group exercise intervention , as an adjunct to conventional care , on fatigue , physical capacity , general wellbeing , physical activity , and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease . Design R and omised controlled trial . Setting Two university hospitals in Copenhagen , Denmark . Participants 269 patients with cancer ; 73 men , 196 women , mean age 47 years ( range 20 - 65 ) representing 21 diagnoses . Main exclusion criteria were brain or bone metastases . 235 patients completed follow-up . Intervention Supervised exercise comprising high intensity cardiovascular and resistance training , relaxation and body awareness training , massage , nine hours weekly for six weeks in addition to conventional care , compared with conventional care . Main outcome measures European Organization for Research and Treatment of Cancer Quality of Life Question naire ( EORTC QLQ-C30 ) , Medical Outcomes Study Short Form ( MOS SF-36 ) , Leisure Time Physical Activity Question naire , muscular strength ( one repetition maximum ) , maximum oxygen consumption ( Vo2max ) . Statistical methods The general linear model was used for continuous outcome while analysis of associates between categorical outcomes was performed as analysis of marginal homogeneity in contingency tables . Results Adjusted for baseline score , disease , and demographic covariates , the intervention group showed an estimated improvement at six weeks for the primary outcome , fatigue , of −6.6 points ( 95 % confidence interval −12.3 to −0.9 , P=0.02 ; effect size=0.33 , 0.04 to 0.61 ) . Significant effects were seen on vitality ( effect size 0.55 , 95 % CI 0.27 to 0.82 ) , physical functioning ( 0.37 , 0.09 to 0.65 ) , role physical ( 0.37 , 0.10 to 0.64 ) , role emotional ( 0.32 , 0.05 to 0.59 ) , and mental health ( 0.28 , 0.02 to 0.56 ) scores . Improvement was noted in physical capacity : estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min ( 95 % CI 0.1 to 0.2 , P<0.0001 ) and for muscular strength ( leg press ) was 29.7 kg ( 23.4 to 34.9 , P<0.0001 ) . No significant effect was seen on global health status/ quality of life . Conclusion A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced disease . The intervention reduced fatigue and improved vitality , aerobic capacity , muscular strength , and physical and functional activity , and emotional wellbeing , but not quality of life . Trial registration Current Controlled trials IS RCT N05322922 Background Exercise started shortly after breast cancer diagnosis might prevent or diminish fatigue complaints . The Physical Activity during Cancer Treatment ( PACT ) study was design ed 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 r and omly 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 IS RCT N43801571 , Dutch Trial Register NTR2138 . Trial registered on December 9th , 2009 This pilot study examined whether exercise as an adjunctive rehabilitation therapy could benefit women who have early stage breast cancer and are currently receiving chemotherapy/radiotherapy . The study was design ed as a r and omised controlled trial ( RCT ) . Physical functioning , fatigue and Quality of Life ( QoL ) outcomes were evaluated pre and post a 12-week intervention . The results showed that after 12 weeks the women who participated in the exercise programme ( n = 12 ) displayed significantly higher levels of physical functioning and reported higher QoL scores than the controls ( n = 10 ) . Changes in fatigue and satisfaction with life favoured the intervention group but did not reach significance . These results are encouraging and suggest that a structured group exercise programme during adjuvant treatment is a safe , well tolerated and effective way of providing physical and psychological health benefits to women during treatment for early stage breast cancer . Since this was a pilot study the numbers did not allow appropriately powered analyses of some variables of interest and favoured relatively young and socio-economically advantaged women . Future studies need to address these issues and determine if these short-term benefits can be sustained PURPOSE / OBJECTIVES To compare usual care with a home-based individualized exercise program ( HBIEP ) in patients receiving intensive treatment for multiple myeloma ( MM ) and epoetin alfa therapy .  DESIGN R and omized trial with repeated measures of two groups ( one experimental and one control ) and an approximate 15-week experimental period . SETTING Outpatient setting of the Myeloma Institute for Research and Therapy at the Rockfellow Cancer Center at the University of Arkansas for Medical Sciences . SAMPLE 187 patients with newly diagnosed MM enrolled in a separate study evaluating effectiveness of the Total Therapy regimen , with or without thalidomide . METHODS Measurements included the Profile of Mood States fatigue scale , Functional Assessment of Cancer Therapy-Fatigue , ActiGraph ® recordings , 6-Minute Walk Test , and hemoglobin levels at baseline and before and after stem cell collection . Descriptive statistics were used to compare demographics and treatment effects , and repeated measures analysis of variance was used to determine effects of HBIEP . MAIN RESEARCH VARIABLES Fatigue , nighttime sleep , performance ( aerobic capacity ) as dependent or outcome measures , and HBIEP combining strength building and aerobic exercise as the independent variable . FINDINGS Both groups were equivalent for age , gender , race , receipt of thalidomide , hemoglobin levels , and type of treatment regimen for MM . No statistically significant differences existed among the experimental and control groups for fatigue , sleep , or performance ( aerobic capacity ) . Statistically significant differences ( p < 0.05 ) were found in each of the study outcomes for all patients as treatment progressed and patients experienced more fatigue and poorer nighttime sleep and performance ( aerobic capacity ) . CONCLUSIONS The effect of exercise seemed to be minimal on decreasing fatigue , improving sleep , and improving performance ( aerobic capacity ) . IMPLICATION S FOR NURSING Exercise is safe and has physiologic benefits for patients undergoing MM treatment ; exercise combined with epoetin alfa helped alleviate anemia Purpose Cancer and its treatment-related side effects induce loss of physical performance . This study evaluated the effects of multimodal aerobic and strength exercises on physical performance in hospitalized cancer patients while receiving myeloablative chemotherapy . Methods In this prospect i ve pilot study , 48 evaluable patients were r and omly assigned to a training ( TG , n = 24 ) or control ( CG , n = 24 ) group . The TG performed an individually supervised exercise program five times a week with ergometer training and strength exercises for 20 min each during the hospitalization period for chemotherapy . The CG received st and ard physiotherapy .  Physical performance was evaluated using spiroergometry , lung function , and muscle strength testing . Treatment-related side effects were assessed by daily interviews , quality of life by EORTC-QLQ-C30 , and fatigue using the Modified Fatigue Impact Scale ( MFIS ) question naire . Results Physical performance significantly increased in the TG ( 8.96 ± 24 W ) and decreased in the CG ( −7.24 ± 20 W , p = 0.02 ) . At 2-mmol/ml blood lactate concentration , the TG achieved significantly increased oxygen consumption ( p = 0.03 ) and expiratory minute ventilation ( p = 0.04 ) compared to the CG . Furthermore , physical functioning increased significantly in the TG ( p = 0.04 ) . Patients in the TG required less antiemetics ( p = 0.01 ) and experienced significantly less fatigue ( p = 0.04 ) , although MFIS analysis was not able to detect this beneficial effect . Patients of the CG displayed higher impairments of cognitive ( p = 0.02 ) and psychosocial function ( p = 0.03 ) after chemotherapy . No adverse events due to the study intervention were observed . Conclusions Multimodal exercise has beneficial effects on physical performance , physical functioning , and treatment-related symptoms even during myeloablative chemotherapy . We suggest an enhanced physical activity intervention program during hospitalization of cancer patients Objectives This study aim ed to determine the effect of a moderate , tailored exercise program on health-related quality of life , physical function , and arm volume in women receiving treatment for nonmetastatic breast cancer . Methods Women who were within 4–12 weeks of surgery for stage I – III breast cancer were r and omized to center-based exercise and lymphedema education intervention or patient education .  Functional Assessment of Cancer Therapy – Breast Cancer ( FACT-B ) , 6-min walk , and arm volume were performed at 3-month intervals through 18 months . Repeated measures analysis of covariance was used to model the total meters walked over time , FACT-B scores , and arm volume . Models were adjusted for baseline measurement , baseline affected arm volume , number of nodes removed , age , self-reported symptoms , baseline SF-12 mental and physical component scores , visit , and treatment group . Results Of the recruited 104 women , 82 completed all 18 months . Mean age ( range ) was 53.6 ( 32–82 ) years ; 88 % were Caucasian ; 45 % were employed full time ; 44 % were overweight ; and 28 % obese . Approximately , 46 % had breast-conserving surgery ; 79 % had axillary node dissection ; 59 % received chemotherapy ; and 64 % received radiation . The intervention result ed in an average increase of 34.3 ml ( SD = 12.8 ) versus patient education ( p = 0.01 ) . Changes in FACT-B scores and arm volumes were not significantly different . Conclusions With this early exercise intervention after breast cancer diagnosis , a significant improvement was achieved in physical function , with no decline in health-related quality of life or detrimental effect on arm volume . Implication s for cancer survivorsStarting a supervised exercise regimen that is tailored to an individual 's strength and stamina within 3 months following breast cancer surgery appears safe and may hasten improvements in physical functioning PURPOSE / OBJECTIVES To examine the effects of a seated exercise program on fatigue and quality of life ( QOL ) in women with metastatic breast cancer . DESIGN R and omized , controlled , longitudinal trial . SETTING Outpatient clinic of a comprehensive cancer center . SAMPLE Convenience sample of 38 women who were beginning outpatient chemotherapy . METHODS Subjects were r and omized to a control or intervention group ; the intervention was performance of a seated exercise program using home videotape three times per week for four cycles of chemotherapy . All subjects completed the Functional Assessment of Chronic Illness Therapy Fatigue Version IV ( FACIT F ) at baseline and at the time of the next three cycles . Subjects were asked to document the frequency , duration , and intensity of all exercise participation on monthly calendars . MAIN RESEARCH VARIABLES Exercise , fatigue , and QOL . FINDINGS 32 subjects , 16 per group , completed the study follow-up . With a mixed modeling approach , total FACIT F scores for the entire sample declined at a significant rate ( p = 0.003 ) beginning with cycle 3 but at a slower rate for the experimental group ( p = 0.02 ) . Fatigue scores indicated less increase and physical well-being subscale scores showed less decline for the experimental group ( p = 0.008 and p = 0.02 , respectively ) . CONCLUSIONS Women with advanced breast cancer r and omized to the seated exercise intervention had a slower decline in total and physical well-being and less increase in fatigue scores starting with the third cycle of chemotherapy . IMPLICATION S FOR NURSING Seated exercise may be a feasible exercise program for women with advanced cancer for controlling fatigue and improving physical well-being Cancer treatment is associated with decreased hemoglobin ( Hb ) concentration and aerobic fitness ( VO2 max ) , which may contribute to cancer-related fatigue ( CRF ) and decreased quality of life ( QoL ) .  Endurance exercise may attenuate CRF and improve QoL , but the mechanisms have not been thoroughly investigated . Objectives . To ( a ) determine the feasibility of conducting an exercise intervention among women receiving treatment for breast cancer ; ( b ) examine the effects of exercise on Hb and VO2 max and determine their association with changes in CRF and QoL ; and ( c ) investigate changes in selected inflammatory markers . Methods . Fourteen women receiving chemotherapy for Stages I – II breast cancer were r and omly assigned to exercise ( n = 7 ) or usual care ( n = 7 ) . Women in the exercise group performed supervised , individualized treadmill exercise 2–3 times/week for the duration of chemotherapy ( 9–12 weeks ) . Data were collected 4 times over 15–16 weeks . Results . Recruitment rate was 45.7 % . Sixteen women consented and 14 completed the trial , for a retention rate of 87.5 % . Adherence to exercise protocol was 95–97 % , and completion of data collection was 87.5–100 % . Exercise was well tolerated . VO2 max was maintained at prechemotherapy levels in exercisers but declined in the usual-care group ( p < .05 ) . Hb decreased ( p < .001 ) in all participants as they progressed through chemotherapy . Exercise did not have significant effects on CRF or QoL. Changes in inflammatory markers favored the exercise group . Conclusions . Exercise during chemotherapy may protect against chemotherapy-induced decline in VO2 max but not Hb concentration BACKGROUND Exercise may reduce anxiety and depression associated to the diagnosis and treatment of cancer . AIM To assess the effects of a physical training program during chemotherapy among women with breast cancer . PATIENTS AND METHODS Twenty two women aged 49 + /- 7 years with breast cancer voluntarily agreed to take part in the study , after surgical treatment . Functional capacity ( Karnofsky Performance Status ) , psychological status ( General Health Question naire , GHQ ) and quality of life ( EORTC QLQ-C30 ) were evaluated at baseline and at the end of the study . Before beginning with adjuvant chemotherapy , ten women were r and omly assigned to a program of physical exercise and seven to a control group . The program lasted 18 to 22 weeks , depending on the duration of chemotherapy . RESULTS Five women were lost from follow up . Before starting chemotherapy , 41 % of women were working and all had to kit . At baseline all had a normal Karnofski score and quality of life was compromised . At the end of the study , the intervention group had an improvement of their quality of life , compared to the control group that did not experience significant changes . CONCLUSIONS An exercise training program improves quality of life of women with breast cancer on chemotherapy Although exercise may be used by some to decrease distress , little is known about how it may contribute to stress management ( SM ) among patients receiving chemotherapy . We evaluated whether exercise separately or in combination with SM training is effective at increasing perceived ability to manage stress .  Patients receiving chemotherapy ( N = 391 ) were r and omized to receive usual care only ( UCO ) , SM , exercise ( EX ) , or stress management and exercise ( SMEX ) .  They completed the Measure of Current Status prior to receiving chemotherapy and 12 weeks after the first infusion . We hypothesized that participants r and omized to an intervention condition would report improvements in relaxation , awareness of tension , getting needs met and coping confidence compared with those receiving UCO . Results indicated significant group-by-time interactions for the following : relaxation ( UCO versus SM , p = 0.008 ) , awareness of tension ( UCO versus SMEX , p = 0.029 and UCO versus EX , p < 0.001 ) , getting needs met ( UCO versus SMEX , p = 0.020 ) and Measure of Current Status total score ( UCO versus SMEX , p = 0.007 and UCO versus EX , p = 0.016 ) . There were no group-by-time interactions for coping confidence ( p-values > 0.05 ) . This study provides support for including an exercise component in SM interventions for cancer patients receiving chemotherapy ( clinical trials.gov identifier : NCT00740038 ) Chemotherapy for breast cancer causes early-onset menopause for most women older than age 40 and is associated with accelerated bone loss . The primary objective of this study was to compare the effects of intravenous ( IV ) zoledronic acid versus prescribed physical activity ( PA ) on changes in bone mineral density ( BMD ) for women between the ages of 40 and 55 years receiving chemotherapy for breast cancer . A r and omized controlled trial of 62 patients with breast cancer during chemotherapy compared IV zoledronic acid and oral calcium/vitamin D ( ZO group ) versus a PA program and oral calcium/vitamin D ( PA group ) . ZO group participants received zoledronic acid IV every 3 months for 5 treatments . PA group participants were enrolled in a home-based exercise program and received motivational counseling , pedometers , and exercise tapes .  BMD measurements from dual-energy x-ray absorptiometry ( DEXA ) scanning were completed at baseline and at 12 months . BMD significantly decreased in the PA group but not in the ZO group . Although spine , total hip , and total body BMD increased in the ZO group by 1.6 % , 0.8 % , and 0.8 % , respectively , BMD decreased in the PA group by 6.0 % , 3.4 % , and 3.3 % , respectively ( P values < 0.0001 for all group comparisons ) . Zoledronic acid protected patients with breast cancer against bone loss during initial treatment , whereas home-based PA interventions were less effective in preventing bone loss PURPOSE Lymphoma patients commonly experience declines in physical functioning and quality of life ( QoL )  that may be reversed with exercise training . PATIENTS AND METHODS We conducted a r and omized controlled trial in Edmonton , Alberta , Canada , between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and r and omly assigned them to usual care ( UC ; n = 62 ) or 12 weeks of supervised aerobic exercise training ( AET ; n = 60 ) . Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia . Secondary end points were overall QoL , psychosocial functioning , cardiovascular fitness , and body composition . RESULTS Follow-up assessment for our primary end point was 96 % ( 117 of 122 ) at postintervention and 90 % ( 110 of 122 ) at 6-month follow-up . Median adherence to the supervised exercise program was 92 % . At postintervention , AET was superior to UC for patient-rated physical functioning ( mean group difference , + 9.0 ; 95 % CI , 2.0 to 16.0 ; P = .012 ) , overall QoL ( P = .021 ) , fatigue ( P = .013 ) , happiness ( P = .004 ) , depression ( P = .005 ) , general health ( P < .001 ) , cardiovascular fitness ( P < .001 ) , and lean body mass ( P = .008 ) . Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning . AET did not interfere with chemotherapy completion rate or treatment response . At 6-month follow-up , AET was still borderline or significantly superior to UC for overall QoL ( P = .054 ) , happiness ( P = .034 ) , and depression ( P = .009 ) without an increased risk of disease recurrence/progression . CONCLUSION AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response . Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients A haematopoietic SCT ( HSCT ) can cause severe side effects , which may have a profound impact on a patient 's life both physically and psychologically . Some studies have shown that physical activity has positive effects for in patients after an HSCT .  Therefore , the question arises whether a controlled exercise programme right from the beginning of the conditioning phase could help contribute to a patient 's physical and psychological recovery . To evaluate the different effects of specific , moderate physical activities on the physical and psychological condition of HSCT  patients we performed a controlled r and omized study with 64 in patients undergoing an allogeneic or autologous HSCT .  The patients were r and omly assigned to two groups . Although the training group took part in a specific programme of exercise therapy twice a day throughout the entire hospitalization phase , patients in the control group were offered the hospital 's st and ard mobilization programme . The results of this study showed significant differences in favour of the training group regarding strength , endurance , lung function and quality of life . However , further studies are needed to confirm these results Fatigue is a common and often severe problem in cancer patients undergoing chemotherapy .  The authors postulated that physical activity training can reduce the intensity of fatigue in this group of patients Fatigue is the most prevalent and debilitating symptom experienced by breast cancer patients receiving adjuvant chemotherapy or radiation therapy and few evidence -based treatments are available to manage this distressing side-effect . The purpose of this multi-institutional r and omized controlled trial was to determine the effects of exercise on fatigue levels during treatment for breast cancer . Sedentary women ( N=119 ) with Stage 0-III breast cancer receiving outpatient adjuvant chemotherapy or radiation therapy were r and omized to a home-based moderate-intensity walking exercise program or to usual care for the duration of their cancer treatment . Of participants r and omized to exercise , 72 % adhered to the exercise prescription ; 61 % of the usual care group adhered . The intention-to-treat analysis revealed no group differences in part because of a dilution of treatment effect as 39 % of the usual care group exercised and 28 % of the exercise group did not . When exercise participation was considered using the data analysis method of instrumental variables with principal stratification , a clinical ly important and statistically significant ( p=0.03 ) effect of exercise on pretest-to-posttest change in fatigue levels was demonstrated . Adherence to a home-based moderate-intensity walking exercise program may effectively mitigate the high levels of fatigue prevalent during cancer treatment UNLABELLED Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes ; however , no r and omized data are available . Here , we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training ( START ) . METHODS The START was a Canadian multicenter trial that r and omized 242 breast cancer patients between 2003 and 2005 to usual care ( n = 82 ) , supervised aerobic ( n = 78 ) , or resistance ( n = 82 ) exercise during chemotherapy .  The primary end point for this exploratory analysis was disease-free survival ( DFS ) . Secondary end points were overall survival , distant DFS , and recurrence-free interval . The two exercise arms were combined for analysis ( n = 160 ) , and selected subgroups were explored . RESULTS After a median follow-up of 89 months , there were 25/160 ( 15.6 % ) DFS events in the exercise groups and 18/82 ( 22.0 % ) in the control group . Eight-year DFS was 82.7 % for the exercise groups compared with 75.6 % for the control group ( HR , 0.68 ; 95 % confidence interval ( CI ) , 0.37 - 1.24 ; log-rank , P = 0.21 ) . Slightly stronger effects were observed for overall survival ( HR , 0.60 ; 95 % CI , 0.27 - 1.33 ; log-rank , P = 0.21 ) , distant DFS ( HR , 0.62 ; 95 % CI , 0.32 - 1.19 ; log-rank , P = 0.15 ) , and recurrence-free interval ( HR , 0.58 ; 95 % CI , 0.30 - 1.11 ; Gray test , P = 0.095 ) . Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese ( HR , 0.59 ; 95 % CI , 0.27 - 1.27 ) , had stage II/III cancer ( HR , 0.61 ; 95 % CI , 0.31 - 1.20 ) , estrogen receptor-positive tumors ( HR , 0.58 ; 95 % CI , 0.26 - 1.29 ) , human epidermal growth factor receptor 2-positive tumors ( HR , 0.21 ; 95 % CI , 0.04 - 1.02 ) , received taxane-based chemotherapies ( HR , 0.46 ; 95 % CI , 0.19 - 1.15 ) , and ≥85 % of their planned chemotherapy ( HR , 0.50 ; 95 % CI , 0.25 - 1.01 ) . CONCLUSIONS This exploratory follow-up of the START provides the first r and omized data to suggest that adding exercise to st and ard chemotherapy may improve breast cancer outcomes . A definitive phase III trial is warranted Abstract Background . To evaluate the safety and efficacy of moderate-to-high intensity aerobic training in breast cancer patients receiving neoadjuvant chemotherapy . Methods . Twenty patients with stage IIB – IIIC operable breast cancer were r and omly assigned to receive doxorubicin plus cyclophosphamide ( AC ) or AC in combination with aerobic training ( AC + AET ) ( n = 10/group ) for 12 weeks . The AC+ AET group performed three supervised aerobic cycle ergometry sessions per week at 60%–100 % of exercise capacity ( VO2peak ) . Safety outcomes included exercise testing as well as treatment- and exercise training-related adverse events ( AEs ) , whereas efficacy outcomes included cardiopulmonary function and patient-reported outcomes ( PROs ) as measured by a cardiopulmonary exercise test ( CPET ) and Functional Assessment of Cancer Therapy-Breast ( FACT-B ) scale . Results . Twelve non-significant ECG abnormalities and three non-life threatening events occurred during CPET procedures . One AE was reported during aerobic training . There were no significant between group differences for clinician-documented events ( e.g. pain , nausea ) or hematological parameters ( p 's > 0.05 ) . Attendance and adherence rates to aerobic training were 82 % and 66 % , respectively . Intention-to-treat analysis indicated that VO2peak increased by 2.6 ± 3.5 ml/kg/min ( + 13.3 % ) in the AC + AET group and decreased by 1.5 ± 2.2 ml/kg/min ( −8.6 % ) in the AC group ( between group difference , p = 0.001 ) . FACT-B increased 11.1 points in the AC + AET group compared to a 1.5 point decrease in the AC group ( between group difference , p = 0.685 ) . Conclusion . Moderate-to-high intensity aerobic training when conducted with one-on-one supervision is a safe adjunct therapy associated with improvements in cardiopulmonary function and select PROs during neoadjuvant chemotherapy
Purpose Aerobic exercise improves prognosis and quality of life ( QoL ) following completion of chemotherapy .
However , the safety and efficacy of aerobic exercise during chemotherapy is less certain .