Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: A randomized controlled trial Randomized controlled trial of the effects of high intensity and low-to-moderate intensity exercise on physical fitness and fatigue in cancer survivors: results of the Resistance and Endurance exercise After ChemoTherapy (REACT) study Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors. Motivational Interviewing to Increase Physical Activity in Long-Term Cancer Survivors: A Randomized Controlled Trial Quality of life and physical performance and activity of breast cancer patients after adjuvant treatments. Exercise Training Manages Cardiopulmonary Function and Fatigue During and Following Cancer Treatment in Male Cancer Survivors Physical Activity during Cancer Treatment (PACT) Study: design of a randomised clinical trial Impact of a home-based walking intervention on outcomes of sleep quality, emotional distress, and fatigue in patients undergoing treatment for solid tumors. Association between exercise and quality of life in multiple myeloma cancer survivors Three versus six months of exercise training in breast cancer survivors Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong Do Yoga and Aerobic Exercise Training Have Impact on Functional Capacity, Fatigue, Peripheral Muscle Strength, and Quality of Life in Breast Cancer Survivors? Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study. Effectiveness of a 12-month exercise program on physical performance and quality of life of breast cancer survivors. Effects of supervised exercise training on cardiopulmonary function and fatigue in breast cancer survivors during and after treatment The association between physical activity and health-related quality of life among breast cancer survivors Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial. Optimal Mode for Maximal Aerobic Exercise Testing in Breast Cancer Survivors Effects of a supervised exercise intervention on recovery from treatment regimens in breast cancer survivors. Home-based exercise to alleviate fatigue and improve functional capacity among breast cancer survivors. Telehealth system (e-CUIDATE) to improve quality of life in breast cancer survivors: rationale and study protocol for a randomized clinical trial Feasibility and efficacy of a supervised exercise intervention in de-conditioned cancer survivors during the early survivorship phase: the PEACH trial
OBJECTIVE To improve mechanistic underst and ing , this pilot r and omized controlled trial examined mediators of an exercise intervention effects on sleep in breast cancer survivors ( BCS ) . METHODS Forty-six postmenopausal BCS ( ≤Stage II , off primary treatment ) were r and omized to a 3-month exercise intervention or control group . Intervention included 160 min/week of moderate intensity aerobic walking , twice weekly resistance training ( resistance b and s ) , and six discussion groups ( to improve adherence ) . Blinded assessment s at baseline and post-intervention included sleep disturbance ( PSQI and PROMIS ® ) , objective sleep quality ( accelerometer ) , serum cytokines , accelerometer physical activity , cardiorespiratory fitness , body composition , fatigue , and psychosocial factors . Mediation was tested using Freedman-Schatzkin difference-in-coefficients tests . RESULTS When compared with control , the intervention group demonstrated a significant increase in PSQI sleep duration ( i.e. , fewer hours of sleep/night ) ( d = 0.73 , p = .03 ) . Medium to large but non-significant st and ardized effect sizes were noted for PSQI daytime somnolence ( d = -0.63 , p = .05 ) and accelerometer latency ( d = -0.49 , p = .14 ) . No statistically significant mediators were detected for PSQI sleep duration score or accelerometer latency . Daytime somnolence was mediated by tumor necrosis factor-alpha ( mediated 23 % of intervention effect , p < .05 ) , interleukin (IL)-6:IL-10 ( 16 % , p < .01 ) , IL-8:IL-10 ( 26 % , p < .01 ) , and fatigue ( 38 % , p < .05 ) . Mediating or enhancing relationships for several of the sleep outcomes were noted for accelerometer physical activity , PROMIS ® fatigue , exercise social support , and /or physical activity enjoyment . CONCLUSIONS Inflammation and psychosocial factors may mediate or enhance sleep response to our exercise intervention . Further study is warranted to confirm our results and translate our findings into more effective interventions aim ed at improving sleep quality in BCS BACKGROUND Yoga is a popular mind-body therapy that has demonstrated beneficial effects on psychological , behavioral , and functional outcomes . However , few studies have investigated effects on inflammatory processes . This study tested the hypothesis that an Iyengar yoga intervention specifically design ed for fatigued breast cancer survivors would lead to decreases in inflammation-related gene expression and circulating markers of proinflammatory cytokine activity . METHODS Breast cancer survivors with persistent cancer-related fatigue were r and omized to a 12-week Iyengar yoga intervention  ( n=16 ) or a 12-week health education control condition  ( n=15 ) . Blood sample s were collected at baseline , post-intervention , and at a 3-month follow-up for genome-wide transcriptional profiling and bioinformatic analyses . Plasma inflammatory markers and salivary cortisol were also assessed . RESULTS In promoter-based bioinformatics analyses , the yoga group showed reduced activity of the pro-inflammatory transcription factor nuclear factor kappa B ( NF-κB ) , increased activity of the anti-inflammatory glucocorticoid receptor , and reduced activity of cAMP response element-binding protein ( CREB ) family transcription factors relative to controls ( all ps<.05 ) . There was also a significant intervention effect on the soluble tumor necrosis factor receptor type II ( sTNF-RII ) , a marker of TNF activity ; plasma levels of sTNF-RII remained stable in the yoga group , whereas levels of this marker increased in the health education group ( p=.028 ) . A similar , non-significant trend was observed for the interleukin 1 receptor antagonist ( p=.16 ) . No significant changes in C reactive protein ( CRP ) , interleukin 6 ( IL-6 ) , or diurnal cortisol measures were observed . CONCLUSIONS A 12-week restorative Iyengar yoga intervention reduced inflammation-related gene expression in breast cancer survivors with persistent fatigue . These findings suggest that a targeted yoga program may have beneficial effects on inflammatory activity in this patient population , with potential relevance for behavioral and physical health Background International evidence -based guidelines recommend physical exercise to form part of st and ard care for all cancer survivors . However , at present , the optimum exercise intensity is unclear . Therefore , we aim ed to evaluate the effectiveness of a high intensity ( HI ) and low-to-moderate intensity ( LMI ) resistance and endurance exercise program compared with a wait list control ( WLC ) group on physical fitness and fatigue in a mixed group of cancer survivors who completed primary cancer treatment , including chemotherapy . Methods Overall , 277 cancer survivors were r and omized to 12 weeks of  HI exercise ( n = 91 ) , LMI exercise ( n = 95 ) , or WLC ( n = 91 ) . Both interventions were identical with respect to exercise type , duration and frequency , and only differed in intensity . Measurements were performed at baseline ( 4–6 weeks after primary treatment ) and post-intervention . The primary outcomes were cardiorespiratory fitness ( peakVO2 ) , muscle strength ( grip strength and 30-second chair-st and test ) , and self-reported fatigue ( Multidimensional Fatigue Inventory ; MFI ) . Secondary outcomes included health-related quality of life , physical activity , daily functioning , body composition , mood , and sleep disturbances . Multilevel linear regression analyses were performed to estimate intervention effects using an intention-to-treat principle . Results In the HI and LMI groups , 74 % and 70 % of the participants attended more than 80 % of the prescribed exercise sessions , respectively ( P = 0.53 ) . HI ( β = 2.2 ; 95 % CI , 1.2–3.1 ) and LMI ( β = 1.3 ; 95 % CI , 0.3–2.3 ) exercise showed significantly larger improvements in peakVO2 compared to WLC . Improvements in peakVO2 were larger for HI than LMI exercise ( β = 0.9 ; 95 % CI , −0.1 to 1.9 ) , but the difference was not statistically significant ( P = 0.08 ) . No intervention effects were found for grip strength and the 30-second chair-st and test . HI and LMI exercise significantly reduced general and physical fatigue and reduced activity ( MFI subscales ) compared to WLC , with no significant differences between both interventions . Finally , compared to WLC , we found benefits in global quality of life and anxiety after HI exercise , improved physical functioning after HI and LMI exercise , and less problems at work after LMI exercise . Conclusions Shortly after completion of cancer treatment , both HI and LMI exercise were safe and effective . There may be a dose – response relationship between exercise intensity and peakVO2 , favoring HI exercise . HI and LMI exercise were equally effective in reducing general and physical fatigue . Trial registration This study was registered at the Netherl and s Trial Register [ NTR2153 ] on the 5th of January 2010 PURPOSE This study aim ed to examine mediators of fatigue response to an exercise intervention for breast cancer survivors in a pilot r and omized controlled trial . METHODS Postmenopausal breast cancer survivors ( n = 46 ; ≤stage 2 ) , off primary treatment , and reporting fatigue and /or sleep dysfunction were r and omized to a 3-month exercise intervention ( 160 min·wk of moderate-intensity aerobic walking , twice weekly resistance training with resistance b and s ) or control group . Six discussion group sessions provided behavioral support to improve adherence . Fatigue , serum cytokines , accelerometer physical activity , cardiorespiratory fitness , sleep dysfunction , and psychosocial factors were assessed at baseline and 3 months . RESULTS The exercise intervention effect sizes for fatigue were as follows : fatigue intensity d = 0.30 ( P = 0.34 ) , interference d = -0.38 ( P = 0.22 ) , and general fatigue d = -0.49 ( P = 0.13 ) . Using the Freedman-Schatzkin difference-in-coefficients tests , increase in fatigue intensity was significantly mediated by interleukin 6 ( IL-6 ) ( 82 % ) , IL-10 ( 94 % ) , IL-6/IL-10 ( 49 % ) , and tumor necrosis factor-α (TNF-α):IL-10 ( 78 % ) with reduced sleep dysfunction increasing the relationship between intervention and fatigue intensity rather than mediating intervention effects ( -88 % ) . Decrease in fatigue interference was mediated by sleep dysfunction ( 35 % ) , whereas IL-10 and pro-anti-inflammatory cytokine ratios increased the relationship between intervention and interference ( -25 % to -40 % ) . The reduction in general fatigue was significantly mediated by minutes of physical activity ( 76 % ) , sleep dysfunction ( 45 % ) , and physical activity enjoyment ( 40 % ) , with IL-10 ( -40 % ) and IL-6/IL-10 ( -11 % ) increasing the intervention-fatigue relationship . In the intervention group , higher baseline fatigue , anxiety , depression , and perceived exercise barrier interference predicted a greater decline in fatigue interference and /or general fatigue during the intervention . CONCLUSIONS Biobehavioral factors mediated and enhanced intervention effects on fatigue , whereas psychosocial factors predicted fatigue response . Further study is warranted to confirm our results and to improve underst and ing of relationships that mediate and strengthen the intervention-fatigue association Background : Physical activity can confer many benefits on cancer survivors , including relief of persistent symptoms related to cancer treatment . Objectives : To evaluate the effect of a motivational interviewing ( MI ) intervention on increasing physical activity ( Community Healthy Activities Model Program for Seniors question naire ) and improving aerobic fitness ( 6-minute walk ) , health ( Medical Outcomes Study Short-Form 36 ) , and fatigue ( Schwartz Cancer Fatigue Scale ) in cancer survivors . A secondary purpose was to evaluate whether the effect of MI on physical activities depended on self-efficacy . Methods : Fifty-six physically inactive adult cancer survivors ( mean = 42 months since completion of treatment ) were assigned r and omly to intervention and control groups . The MI intervention consisted of one in-person counseling session followed by two MI telephone calls over 6 months . Control group participants received two telephone calls without MI content . Outcomes were measured at baseline , 3 months , and 6 months , and were analyzed using multilevel modeling . Results : The results of the MI intervention explained significant group differences in regular physical activities ( measured in caloric expenditure per week ) , controlling for time since completion of cancer treatment ( p < .05 ) . Aerobic fitness , physical and mental health , and fatigue were not different between groups . In the intervention group , individuals with high self-efficacy for exercise at baseline increased their physical activity more than those with low self-efficacy ( p < .05 ) . In the control group , increases in physical activity did not depend on self-efficacy . Discussion : Use of MI may increase physical activity in long-term cancer survivors , especially in persons with high self-efficacy for exercise . Multilevel modeling analysis revealed individual changes that would not have been shown by analysis of group means . Future studies with larger sample s or more intense MI interventions may show changes in aerobic fitness , physical and mental health , and fatigue OBJECTIVE The study aim ed at investigating the quality of life ( QoL ) and physical performance and activity , and their interrelations , in Finnish female breast cancer patients shortly after adjuvant treatments . METHODS A total of 537 disease-free breast cancer survivors aged 35 - 68 years were surveyed at the beginning of a one year r and omized exercise intervention . The patients were interviewed using EORTC QLQ-C30 , FACIT-F , RBDI , and WHQ ( for vasomotor symptoms ) question naires . Physical performance  was tested by a 2 km walking test . Physical activity was measured by a question naire and a prospect i ve two-week diary . Multivariate analysis was used to study the factors associated with QoL. RESULTS About 26 % of the patients were rated as depressed , 20.4 % as fatigued , and 82 % suffered from menopausal symptoms . The global QoL was lower than in general population ( 69.4 vs 74.7 , p<0.001 ) . About 62 % of the walking test results were below the population average . Fatigue ( p<0.001 ) , depression ( p<0.001 ) , body mass index ( p = 0.016 ) and comorbidity ( p = 0.032 ) impaired , and physical activity ( p = 0.003 ) improved QoL. Physical activity level correlated positively to physical performance ( r = -0.274 , p<0.0001 ) . CONCLUSIONS The QoL of the patients shortly after adjuvant treatments was impaired and the physical performance poor as compared to general population . In particular , depression and fatigue were related to impaired QoL. Physical performance and activity level were the only factors that correlated positively to QoL. Thus , physical exercise could be useful in rehabilitation of cancer survivors , especially for depressed and fatigued patients This investigation determined the cardiopulmonary function and fatigue alterations in male cancer survivors during treatment as well as following treatment utilizing similar exercise assessment protocol s and individualized , prescriptive exercise interventions . The study included 45 male cancer survivors that were referred by local oncologists . Following a comprehensive screening and physical examination , cardiovascular endurance , pulmonary function , and fatigue were assessed leading to the development of 12-week individualized exercise prescriptions and exercise interventions . The cancer survivors were divided into during treatment ( DTm ) and following treatment ( FTm ) groups . Repeated- measures analysis of variance and analyses of covariance were used to compare pre- versus postintervention and between groups . Cardiopulmonary function was maintained in the DTm , whereas the FTm showed significant reductions in resting heart rate ( P < .05 ) with concurrent increases in predicted VO2max and time on treadmill ( P < .05 ) postexercise intervention . Fatigue levels did not increase in the DTm group , whereas the FTm group showed significant reductions in behavioral fatigue , affective fatigue , sensory fatigue , cognitive/mood fatigue , and total fatigue ( P < .05 ) after the exercise intervention . The results of the current study suggest that moderate intensity , individualized , prescriptive exercise intervention maintains or improves cardiovascular and pulmonary function with concomitant reductions in fatigue in cancer survivors during and following cancer treatment . Exercise appears to be a safe , efficacious strategy for improving physical fitness in cancer survivors during and following treatment Background Fatigue is a major problem of cancer patients . Thirty percent of cancer survivors report serious fatigue three years after finishing treatment . There is evidence that physical exercise during cancer treatment reduces fatigue . This may also lead to an improvement of quality of life . Such findings may result in a decrease of healthcare related expenditures and societal costs due to sick leave . However , no studies are known that investigated these hypotheses . Therefore , the primary aim of our study is to assess the effect of exercise during cancer treatment on reducing complaints of fatigue and on reducing health service utilisation and sick leave . Methods / Design The Physical Activity during Cancer Treatment study is a multicentre r and omised controlled trial in 150 breast and 150 colon cancer patients undergoing cancer treatment . Participants will be r and omised to an  exercise or a control group .  In addition to the usual care , the exercise group will participate in an 18-week supervised group exercise programme . The control group will be asked to maintain their habitual physical activity pattern . Study endpoints will be assessed after 18 weeks ( short term ) and after 9 months ( long term ) . Vali date d question naires will be used . Primary outcome : fatigue ( Multidimensional Fatigue Inventory and Fatigue Quality List ) and cost-effectiveness , health service utilisation and sick leave . Secondary outcome : health related quality of life ( European Organisation Research and Treatment of Cancer- Quality of Life question naire-C30 , Short Form 36 healthy survey ) , impact on functioning and autonomy ( Impact on functioning and autonomy question naire ) , anxiety and depression ( Hospital Anxiety and Depression Scale ) , physical fitness ( aerobic peak capacity , muscle strength ) , body composition and cognitive-behavioural aspects . To register health service utilisation and sick leave , participants will keep diaries including the EuroQuol-5D . Physical activity level will be measured using the Short Question naire to Assess Health-Enhancing Physical Activity and will be monitored with an exercise log and a pedometer . Discussion This study investigates the (cost)-effectiveness of exercise during adjuvant treatment of patients with breast or colon cancer . If early physical exercise proves to be ( cost ) effective , establishing st and ardised physical exercise programmes during cancer treatment will be planned . Trial registration Current Controlled trials IS RCT N43801571 , Dutch Trial Register Exercise use among patients with cancer has been shown to have many benefits and few notable risks . The purpose of this study was to evaluate the impact of a home-based walking intervention during cancer treatment on sleep quality , emotional distress , and fatigue . Methods . A total of 138 patients with prostate ( 55.6 % ) , breast ( 32.5 % ) , and other solid tumors ( 11.9 % ) were r and omized to a  home-based walking intervention or usual care . Exercise dose was assessed using a five-item subscale of the Cooper Aerobics Center Longitudinal Study Physical Activity Question naire . Primary outcomes of sleep quality , distress , and fatigue were compared between the two study arms . Results . The exercise group ( n = 68 ) reported more vigor ( p = .03 ) than control group participants ( n = 58 ) . In dose response models , greater participation in aerobic exercise was associated with 11 % less fatigue ( p < .001 ) , 7.5 % more vigor ( p = .001 ) , and 3 % less emotional distress ( p = .03 ) , after controlling for intervention group assignment , age , and baseline exercise and fatigue levels . Conclusion . Patients who exercised during cancer treatment experienced less emotional distress than those who were less active . Increasing exercise was also associated with less fatigue and more vigor .  Home-based walking is a simple , sustainable strategy that may be helpful in improving a number of symptoms encountered by patients undergoing active treatment for cancer Goals of the workThe goal of this study was to examine the association between  exercise  and quality of life ( QOL ) in multiple myeloma cancer survivors . Patients and methods Using a retrospective design , 156 multiple myeloma cancer survivors were mailed a question naire that assessed self-reported exercise behavior over three periods ( prediagnosis , active treatment , and off-treatment ) and QOL.Main results The response rate was 56 % ( 88/156 ) . Descriptive analyses indicated that 6.8 % and 20.4 % of survivors met national exercise guidelines during active and off-treatment periods , respectively . Exercise during active treatment and off-treatment were positively associated with overall QOL and all subdomains of QOL ( all P<0.05 ) except physical wellbeing . Conclusions A low percentage of multiple myeloma cancer survivors are exercising regularly either during active or off-treatment periods . Survivors who report more exercise during these periods also report higher QOL . These findings suggest that a r and omized controlled trial is warranted Breast cancer is the most prevalent type of cancer in American women .  Exercise appears to diminish many of the side effects result ing from breast cancer and its treatment . Very little research , however , has compared the outcomes of varying lengths of combined aerobic and resistance training exercise interventions on physiological and psychological parameters in breast cancer survivors . The purpose of this study was to compare the physiological and psychological outcomes following 3 and 6 months of exercise in breast cancer survivors . Breast cancer survivors ( N = 114 ) participated in either 3 months of prescriptive , individualized exercise ( 3 M ; n = 29 ) , 6 months of prescriptive , individualized exercise ( 6 M ; n = 68 ) , or served as sedentary controls  ( C ; n = 17 ) . Cancer survivors completed a medical evaluation and assessment at baseline followed by a predetermined 3- or 6-month exercise intervention .  Cancer survivors in the control group performed no exercise between the initial assessment and 6-month re assessment . Cardiovascular endurance , pulmonary function , muscular endurance , fatigue , and symptoms of depression were assessed at baseline and post intervention . Repeated measures ANCOVA revealed improvements ( P < 0.05 ) in cardiovascular endurance , fatigue , and symptoms of depression in breast cancer survivors undergoing 3- and 6-month individualized exercise interventions . Breast cancer survivors exercising for 6 months showed additional improvements ( P < 0.05 ) in pulmonary function and muscular endurance . Cancer survivors in the control group did not improve in cardiovascular endurance , pulmonary function , muscular endurance , or fatigue . Three months of individualized , prescriptive exercise leads to improved cardiovascular endurance , fatigue , and symptoms of depression in breast cancer survivors . Additional benefits are seen if exercise is continued for a total of 6 months Purpose Fatigue is a commonly reported symptom by prostate cancer survivors and is associated with significant distress and declines in quality of life . Qigong is a mind – body activity that consists of both physical activity and meditative aspects . This 12-week r and omized controlled trial examined the feasibility and efficacy of a Qigong intervention for improving older prostate cancer survivors '  levels of fatigue and distress . Methods Forty older ( median age = 72 , range = 58–93 ) , fatigued ( cut-off value of ≥1 on the CTCAEv4.0 , > 20 on a fatigue grading scale ) , and sedentary ( < 150 min of moderate exercise/week ) prostate cancer survivors were r and omized to 12 weeks of Qigong or stretching classes . Primary outcomes were feasibility ( i.e. , retention and class attendance rates ) and fatigue [ Functional Assessment of Chronic Illness Therapy — Fatigue ( FACIT-Fatigue ) ] , and secondary outcome was distress [ Brief Symptom Inventory-18 ( BSI-18 ) ] . Results Study retention rates did not significantly differ between study groups ( Qigong = 80 % , stretching = 65 % , p = 0.48 ) . The Qigong group had significantly higher class attendance than the stretching group ( p = 0.04 ) . The Qigong group had significantly greater improvements in the FACIT-Fatigue ( p = 0.02 ) and distress ( i.e. , BSI-18 Somatization , Anxiety , & Global Severity Index , p 's < 0.05 ) , than the Stretching group . Conclusions This 12-week Qigong intervention was feasible and potentially efficacious in improving  senior prostate cancer survivors ' levels of fatigue and distress levels . Future , larger definitive r and omized controlled trials are needed to confirm these benefits in older prostate cancer survivors and in racially and ethnically diverse population s. Implication s for cancer survivorsQigong may be an effective nonpharmacological intervention for the management of senior prostate cancer survivors ' fatigue and distress Aim . The aim of the study was to compare the effects of aerobic exercise training and yoga on the functional capacity , peripheral muscle strength , quality of life ( QOL ) , and fatigue in breast cancer survivors . Material and methods . A total of 52 patients with a diagnosis of breast cancer were included in the study . The patients were r and omly assigned to 2 groups : aerobic exercise ( n = 28 ) and yoga added to aerobic exercise ( n = 24 ) . Both groups participated in submaximal exercise 30 minutes/d , 3 d/wk for 6 weeks . The second group participated in a 1-hour yoga program in addition to aerobic exercise training .  Functional capacity was assessed by the 6-Minute Walk Test ( 6MWT ) . Peripheral muscle strength was evaluated with a h and -held dynamometer . The fatigue severity level was assessed with the Fatigue Severity Scale ( FSS ) . The QOL was determined by the European Organisation for Research and Treatment of Cancer Quality of Life Question naire . Results . There were statistically significant increases in peripheral muscle strength , the 6MWT distance , and the perception of QOL in both groups ( P < .05 ) . Additionally , the group with aerobic exercise and yoga showed marked improvement compared with the aerobic exercise group in fatigue perception ( P < .05 ) . Conclusion . According to the data from this study , aerobic exercise training and yoga improved the functional capacity and QOL of breast cancer patients .  Aerobic exercise programs can be supported by body mind techniques , such as yoga , in the rehabilitation of cancer patients for improving functional recovery and psychosocial wellness BACKGROUND During radiotherapy ( RT ) , prostate cancer ( PCa ) patients may report cancer related fatigue ( CRF ) , which impairs functional capacity , psychological status , and quality of life ( QoL ) . RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation . While it is known that physical exercise plays an important anti-inflammatory role in healthy adults , its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined . AIM Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness , muscle strength , and QoL , however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients . Therefore , the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers , as well as the relationship of these parameters with functional capacity , fatigue , and QoL in high-risk PCa patients undergoing RT .  DESIGN This was a prospect i ve , two-arm r and omized controlled clinical trial . SETTING The study was performed in our out patients center . POPULATION Fifty-four high-risk PCa men were r and omly allocated to two groups prior to undergoing RT . METHODS Twenty-seven patients performed supervised , moderate-intensity physical exercise ( exercise group ; EG )  and the other 27 formed a control group that carried out normal daily physical activity ( usual group ; UG ) . The following parameters were assessed before and after RT : functional capacity , changes in blood count variables and production of pro-inflammatory cytokines ( interleukin [IL]-1β , IL-6 , tumor necrosis factor [TNF]-α ) , fatigue , and QoL ( using FACT-F score and EORTC question naires ) . RESULTS No significant differences existed between the study groups at baseline assessment . After RT , there was a significant improvement in functional capacity ( P<0.05 ) and a decrease in pro-inflammatory cytokine levels ( P>0.05 ) and fatigue ( P<0.05 ) in the EG compared to the UG . Fatigue level was significantly higher in the UG ( F[2.126 ] ; P<0.05 ) after RT than before . Physical exercise had no effect on the correlation between inflammatory blood markers and functional capacity and fatigue scores provided by study participants . CONCLUSIONS Regular , moderate-intensity physical exercise improves functional capacity , decreases the production of inflammatory markers and fatigue , and has a positive influence on QoL in high-risk PCa patients during RT . CLINICAL REHABILITATION IMPACT This is one of the first studies to examine the effects of supervised exercise training on pro-inflammatory cytokine levels during RT in PCa patients by measuring functional capacity , fatigue , and AIM The study aim ed at determining whether physical exercise training improves the quality of life ( QoL ) and physical fitness of breast cancer survivors . PATIENTS AND METHODS A total of 573 breast cancer survivors were r and omized into an exercise or a control group , 12-months after adjuvant treatments . EORTC QLQ-C30 and BR-23 question naires were used for evaluation of QoL , FACIT-F for fatigue and the Finnish modified version of Beck 's 13-item depression scale ( RBDI ) for depression . Physical fitness was assessed by a 2-km walking test , and a figure-8 running test and physical activity ( PA )  by metabolic equivalent ( MET ) hours per week ( MET-h/wk ) . RESULTS Figure-8 running time improved significantly among the patients of the intervention group compared with the controls ( p<0.001 ) . No significant between-group differences were observed in 2-km walking time , in PA , EORTC-QLQ-C30 , BR-23 , FACIT-F or BDI . However , there was a linear relationship between increased PA and improved QoL ( p=0.006 ) , irrespective of the intervention . CONCLUSION Increase in physical activity was associated with improved QoL , but no effect of the exercise intervention was observed Cancer treatments have serious physiological and psychological side effects in cancer survivors . This investigation examined cardiopulmonary function and fatigue in breast cancer survivors during and after treatment by using similar exercise assessment s , prescriptions , individualized interventions , and re assessment Background The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy . The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life ( HRQOL ) in breast cancer survivors . Methods We conducted a cross-sectional study of breast cancer survivors . A total of 231 women aged 21–78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study . We asked participants about their HRQOL and engagement in physical activity using structured question naires . We examined the association between HRQOL levels and physical activity using a generalized linear model . Results Breast cancer survivors in the high physical activity group ( 3rd tertile ) were more likely to have lower scores for fatigue ( p for trend = 0.001 ) and pain ( p for trend = 0.02 ) and higher scores for sexual function ( p for trend = 0.007 ) than those in the low physical activity group ( 1st tertile ) . When we stratified participants by stage , we found increasing scores for physical functioning ( p for trend = 0.01 ) and decreasing scores for fatigue ( p for trend = 0.02 ) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer . In survivors with stages II and III , we found statistically significant associations with fatigue ( p for trend = 0.02 ) and sexual functioning ( p for trend = 0.001 ) . Conclusions In conclusion , engagement in physical activity was related to better health-related quality of life among breast cancer survivors . Our findings may warrant further prospect i ve and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors OBJECTIVES Cancer survivors often report cognitive problems . Furthermore , decreases in physical activity typically occur over the course of cancer treatment . Although physical activity benefits cognitive function in noncancer population s , evidence linking physical activity to cognitive function in cancer survivors is limited . In our recent r and omized controlled trial , breast cancer survivors who received a yoga intervention  had lower fatigue and inflammation following the trial compared with a wait list control group . This secondary analysis of the parent trial addressed yoga 's impact on cognitive complaints . METHODS Posttreatment stage 0-IIIA breast cancer survivors ( n = 200 ) were r and omized to a 12-week , twice-weekly Hatha yoga intervention or a wait list control group . Participants reported cognitive complaints using the Breast Cancer Prevention Trial Cognitive Problems Scale at baseline , immediately postintervention , and 3-month follow-up . RESULTS Cognitive complaints did not differ significantly between groups immediately postintervention ( p = 0.250 ) . However , at 3-month follow-up , yoga participants ' Breast Cancer Prevention Trial Cognitive Problems Scale scores were an average of 23 % lower than wait list participants ' scores ( p = 0.003 ) . These group differences in cognitive complaints remained after controlling for psychological distress , fatigue , and sleep quality . Consistent with the primary results , those who practice d yoga more frequently reported significantly fewer cognitive problems at 3-month follow-up than those who practice d less frequently ( p < 0.001 ) . CONCLUSIONS These findings suggest that yoga can effectively reduce breast cancer survivors ' cognitive complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems Purpose . To determine which mode of exercise is preferred by breast cancer survivors and to evaluate this response between grade d exercise testing on a treadmill and on a cycle ergometer . Methods . Twelve breast cancer survivors completed 2 maximal aerobic stress tests on separate days . The women completed a ramp protocol on an electronically braked cycle ergometer and an incremental step protocol on a treadmill to volitional fatigue . Test order was r and omized . Expired gases were collected for the determination of peak aerobic capacity ( Vo2peak ) . Results . Exercise mode had a significant effect on the grade d exercise response in breast cancer survivors , P = .003 . Treadmill Vo2peak was significantly greater than bike Vo2peak ( 28.7 ± 4.7 vs 23.9 ± 4.7 mL/min/kg , respectively , P = .003 ) and VEmax was equivalent between exercise modes ( P = .731 ) . Maximal heart rate was significantly higher by 11 bpm during the treadmill protocol ( P = .004 ) , and Ve/VCo2 exhibited possible mode dependency ( P = .018 ) . Conclusion . This patient population felt more comfortable and produced significantly greater Vo2peak values using the treadmill protocol . These results discuss the potential implication s concerning the design and interpretation of exercise interventions for breast cancer survivors PURPOSE / OBJECTIVES To investigate the effects of supervised exercise training on cardiopulmonary function and fatigue in cancer survivors undergoing various clinical treatments . DESIGN Pretest and post-test quasiexperimental . SETTING Outpatient oncology rehabilitation center . SAMPLE 96 breast cancer survivors undergoing various clinical treatments . METHODS Subjects were divided into four groups based on the specific type of clinical treatment : surgery alone ( n = 22 ) ; surgery and chemotherapy ( n = 30 ) ; surgery and radiation ( n = 17 ) ; and surgery , chemotherapy , and radiation ( n = 27 ) . Following a comprehensive screening and medical examination , cardiovascular endurance , pulmonary function , and fatigue were assessed , leading to the development of an individualized exercise prescription and a six-month exercise intervention . Repeated- measures analysis of variance and covariance were used to compare the effectiveness of the intervention and differences among treatment groups . MAIN RESEARCH VARIABLES Systolic and diastolic blood pressure , resting heart rate , forced vital capacity , forced expiratory volume , predicted oxygen consumption , time on treadmill , and fatigue . FINDINGS Cardiopulmonary function ( predicted maximal oxygen consumption and time on treadmill ) significantly increased in all groups after exercise training . In addition , resting heart rate and forced vital capacity significantly improved in those receiving surgery , chemotherapy , and radiation . Psychologically , the exercise intervention result ed in significant reductions in behavioral , affective , sensory , cognitive and mood , and total fatigue scale scores in all three groups who received treatment with surgery . The breast cancer survivors in the surgery-alone group showed significant reductions in behavioral , affective , and total fatigue scale scores but not in sensory and cognitive and mood fatigue scale scores . CONCLUSIONS The results suggest that moderate intensity , individualized , prescriptive exercise maintains or improves cardiopulmonary function with concomitant reductions in fatigue regardless of treatment type . Moreover , cancer survivors receiving combination chemotherapy and radiotherapy following surgery appear to benefit to a greater extent as a result of an individualized exercise intervention . IMPLICATION S FOR NURSING Clinicians need to be aware of adjuvant therapies such as moderate exercise that attenuate negative side effects of cancer treatments . Symptom management recommendations should be given to cancer survivors concerning the effectiveness of exercise throughout the cancer continuum and the importance of participating in a cancer rehabilitation exercise program This pilot study examined the efficacy of two home-based exercise programs on alleviating fatigue and improving functional capacity in breast cancer survivors . Participants were r and omly assigned into one of three groups : aerobic exercise ( AE ) , resistance exercise ( RE ) , or usual care control ( CON ) . After receiving individualized instruction and training , participants assigned to the AE and RE groups were asked to perform the prescribed exercise(s ) 3 times per week for 12 weeks at home . Both groups were instructed to keep their perceived exercise intensity in the " fairly light " to " somewhat hard " range using the Borg Perceived Exertion Scale . All participants completed the revised Piper Fatigue Scale ( PFS ) and the 6-minute walk test ( 6MWT ) at baseline and 12-week post-exercise program . Analysis of pre- and post-training data revealed a significant reduction in fatigue levels on the PFS among participants in the AE group ( Z=2.521 , one-tailed P=0.006 ) , and a significant improvement in the distance of the 6MWT for the RE group ( Z=2.366 , one-tailed P=0.009 ) at the end of 12-week study period . No significant changes in fatigue or functional status were observed in the CON group . Findings provide preliminary support for RE as a viable strategy for improving functional capacity in breast cancer survivors , while AE may be more effective in attenuating cancer-related fatigue . Incorporating RE training for future research may help advance the growing body of knowledge in symptom management for breast cancer survivors Background Breast cancer survivors suffer physical impairment after oncology treatment . This impairment reduces quality of life ( QoL ) and increase the prevalence of h and icaps associated to unhealthy lifestyle ( for example , decreased aerobic capacity and strength , weight gain , and fatigue ) . Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival . Nowadays , technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional . It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective re source to improve fitness and reduce musculoskeletal disorders of these women . Methods / Design This study will use a two-arm , assessor blinded , parallel r and omized controlled trial design . People will be eligible if : their diagnosis is of stages I , II , or IIIA breast cancer ; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program ; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge ; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence ; and they have an interest in improving lifestyle . Participants will be r and omized into e-CUI DATE or usual care groups . E-CUI DATE give participants access to a range of contents : planning exercise arranged in series with breathing exercises , mobility , strength , and stretching . All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs . The control group will be asked to maintain their usual routine . Study endpoints will be assessed after 8 weeks ( immediate effects ) and after 6 months . The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life question naire . The secondary outcomes : pain ( algometry , Visual Analogue Scale , Brief Pain Inventory short form ) ; body composition ; physical measurement ( abdominal test , h and grip strength , back muscle strength , and multiple sit-to-st and test ) ; cardiorespiratory fitness ( International Fitness Scale , 6-minute walk test , International Physical Activity Question naire-Short Form ) ; fatigue ( Piper Fatigue Scale and Borg Fatigue Scale ) ; anxiety and depression ( Hospital Anxiety and Depression Scale ) ; cognitive function ( Trail Making Test and Auditory Consonant Trigram ) ; accelerometry ; lymphedema ; and anthropometric perimeters . Discussion This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer . If this treatment option is effective , telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase . Trial registration Clinical Trials.gov Identifier : Purpose This study aims to evaluate the feasibility and efficacy of an 8-week supervised exercise program in de-conditioned cancer survivors within 2–6 months of chemotherapy completion . Methods Participants were r and omly assigned to an 8-week , twice-weekly , supervised aerobic exercise training regime ( n = 23 ) or a usual care group ( n = 20 ) .  Feasibility was assessed by recruitment rate , program adherence and participant feedback . The primary outcome was aerobic fitness assessed by the Modified Bruce fitness test at baseline ( 0 weeks ) , post-intervention ( 8 weeks ) and at 3-month follow-up . Secondary outcomes included physical activity , waist circumference , fatigue and quality of life . Results The recruitment rate was 81 % and adherence to the supervised exercise was 78.3 % . Meaningful differences in aerobic fitness between the exercise and usual care groups at both the 8-week [ mean 3.0 mL kg−1 min−1 ( 95 % CI −1.1–7.0 ) ] and 3-month follow-up [ 2.1 mL kg−1 min−1 ( −2.3–6.6 ) ] were found , although these differences did not achieve statistical significance ( p values > 0.14 ) . Self-reported physical activity increased in the exercise group ( EG ) compared to the usual care group at both 8-week ( p = 0.01 ) and 3-month follow-up ( p = 0.03 ) and significant differences in favour of the EG were found for physical well-being at both the 8-week ( p = 0.03 ) and 3-month follow-up ( p = 0.04 ) . Improvements in fatigue ( p = 0.01 ) , total quality of life plus fatigue ( p = 0.04 ) , and a composite physical functioning score ( p = 0.01 ) at the 3-month follow-up were also found . Conclusion The PEACH trial suggests that 8 weeks of supervised aerobic exercise training was feasible and may improve aerobic fitness , fatigue and quality of life in de-conditioned cancer survivors during the early survivorship phase . Implication s for Cancer SurvivorsExercise interventions commenced in the early survivorship phase appear safe , feasible and may lead to improvements in QOL and fatigue
A significant negative association was found between aerobic exercise intensity and fatigue reduction .
A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance .
No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes .
Rates of adherence were typically high and few adverse events were reported .
Exercise is safe , reduces fatigue and increases endurance in cancer survivors .
QUESTION Is there a dose-response effect of exercise on inflammation , fatigue and activity in cancer survivors ?