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      The effects of home-based exercise therapy for breast cancer-related fatigue induced by radical radiotherapy

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          Abstract

          Background

          Radiotherapy (RT) can lead to cancer-related fatigue (CRF) and decreased health-related quality of life (HRQoL) in breast cancer patients. The purpose of this trial was to examine the feasibility and efficacy of a home-based resistance and aerobic exercise intervention for reducing CRF and improving HRQoL in breast cancer patients during RT.

          Methods

          Women with breast cancer ( N = 106) commencing RT were randomized to 12 weeks of home-based resistance and aerobic exercise (EX) or usual care/control (CON). The primary endpoint was CRF, with secondary endpoints of HRQoL, sleep duration and quality, and physical activity. Measurements were undertaken prior to RT, at completion of RT (~ 6 weeks), at completion of the intervention (12 weeks), and 6 and 12 months after RT completion, while CRF was also measured weekly during RT.

          Results

          Eighty-nine women completed the study (EX = 43, CON = 46). Over the 12-week intervention, EX completed 1–2 resistance training sessions and accumulated 30–40 min of aerobic exercise weekly. For CRF, EX had a quicker recovery both during and post-RT compared to CON ( p < 0.05). Moreover, there was a significant difference in HRQoL between groups at RT completion, with HRQoL unchanged in CON and higher in EX ( p < 0.05). There was no change in sleep duration or quality for either group and there were no exercise-related adverse effects.

          Conclusions

          Home-based resistance and aerobic exercise during RT is safe, feasible, and effective in accelerating CRF recovery and improving HRQoL. Improvements in CRF and HRQoL for these patients can be achieved with smaller exercise dosages than stated in the generic recommendations for breast cancer.

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          Most cited references35

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            lmerTest Package: Tests in Linear Mixed Effects Models

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              Exercise Guidelines for Cancer Survivors

              The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue.
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                Author and article information

                Contributors
                r.newton@ecu.edu.au
                Journal
                Breast Cancer
                Breast Cancer
                Breast Cancer (Tokyo, Japan)
                Springer Nature Singapore (Singapore )
                1340-6868
                1880-4233
                14 October 2022
                14 October 2022
                2023
                : 30
                : 1
                : 139-150
                Affiliations
                [1 ]GRID grid.1038.a, ISNI 0000 0004 0389 4302, Exercise Medicine Research Institute, , Edith Cowan University, ; 270 Joondalup Drive, Joondalup, WA 6027 Australia
                [2 ]GRID grid.1038.a, ISNI 0000 0004 0389 4302, School of Medical and Health Sciences, , Edith Cowan University, ; Joondalup, Australia
                [3 ]GRID grid.1025.6, ISNI 0000 0004 0436 6763, Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Aging, Health Futures Institute, , Murdoch University, ; Perth, Australia
                [4 ]GRID grid.1025.6, ISNI 0000 0004 0436 6763, Discipline of Exercise Science, , Murdoch University, ; Perth, Australia
                [5 ]GRID grid.1055.1, ISNI 0000000403978434, Peter MacCallum Cancer Centre, ; Melbourne, Australia
                [6 ]Department of Radiation Oncology, Genesis Cancer Care, Perth, Australia
                [7 ]GRID grid.1003.2, ISNI 0000 0000 9320 7537, School of Human Movement and Nutrition Sciences, , University of Queensland, ; Brisbane, Australia
                Author information
                http://orcid.org/0000-0001-7753-5693
                http://orcid.org/0000-0003-0302-6129
                Article
                1408
                10.1007/s12282-022-01408-3
                9813229
                36239907
                f3a2657e-ce42-451e-a704-05efc5d9db9a
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 3 June 2022
                : 5 October 2022
                Funding
                Funded by: Edith Cowan University
                Categories
                Original Article
                Custom metadata
                © The Author(s), under exclusive licence to The Japanese Breast Cancer Society 2023

                Oncology & Radiotherapy
                radiotherapy,breast cancer,quality of life,behavior change,home-based exercise,cancer-related fatigue

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