Abstract P2-14-03: Does the Mode of Delivering an Exercise Intervention Following Breast Cancer Influence Effect on Quality of Life? Results from a Randomized, Controlled Trial
Authors: Hayes SC , DiSipio T , Eakin E , Battistutta D. 
Published: April 2011

Abstract
Background: Participating in an exercise intervention during and following breast cancer has been associated with a range of physical and psychosocial benefits that ultimately improve quality of life. However, studies that have demonstrated such effects have largely assessed the effect of clinic-based interventions in well-controlled settings. Questions remain whether a more ‘pragmatic’ exercise intervention could influence quality of life and whether the manner by which the intervention is delivered would influence effect?
Methods: Exercise for Health is a randomized, controlled trial of an eight-month, exercise intervention delivered face-to-face or over the telephone, over 16 sessions with a qualified Exercise Physiologist. Women from urban areas of Queensland diagnosed with unilateral breast cancer in 2006/2007 were eligible to participate and were allocated to either the face-to-face group (FG; n=67), the telephone group (TG; n=67), or the usual-care group (UG; n=60). Quality of life was assessed using the Functional Assessment of Cancer Therapy-Breast questionnaire (FACT-B+4) at six weeks (pre-intervention), six months (mid-intervention) and 12 months (three months post-intervention) post-surgery. Repeated measures analysis of variance was used to assess time and group effects and the potential for an age by group interaction. Differences over time or between groups of at least eight points reflect a clinically meaningful difference and data was analyzed using intention-to-treat principles.
Results: Pre-, mid-and post-intervention, younger (&lt;50 years) breast cancer survivors reported lower QoL when compared with older women (50+ years), however differences were only clinically relevant pre-intervention (mean, 112.6 vs. 120.9). While all women experienced improvements in QoL overtime, only those in the FG and TG experienced improvements of clinical and statistical significance. For younger women, the mode of delivery did not influence effect of the intervention on QoL (mean QoL mid-intervention: 122.3 and 123.2 for FG and TG, respectively; mean QoL post-intervention: 127.9 and 128.9, respectively). However, there was preliminary evidence to suggest that older women responded better to exercise advice delivered over the phone with the TG reporting the highest levels of QoL mid-and post-intervention (128.7 and 130.2, respectively) compared with the FG (118.8 and 124.4, respectively). Discussion: This work demonstrates that an exercise intervention designed to be delivered in the real-world setting can optimize QoL during and following treatment for breast cancer. Results also suggest that the telephone may be an effective medium for delivering exercise counseling. This is particularly important for women living in more rural areas who may have limited access to specialist services and also has potential cost-benefits over face-to-face or clinic-based delivery modes.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-14-03.