Exercise as it relates to Disease/Physical activity interventions to improve fitness and psychological well-being in breast cancer patients

This wiki fact sheet is based on the journal article "Home-Based Physical Activity Intervention for Breast Cancer Patients".

Background
This research was conducted to evaluate whether or not home-based physical activity interventions could prove to be beneficial in stage 0 to 2 breast cancer patients. Previous research has shown that certain treatments for breast cancer patients have consequently led to them developing more medical issues and several diseases. As a result of the treatment and all the health complications that arise with it, data indicates that physical activity in this population is often neglected. Furthermore, breast cancer survivors have displayed difficulties with sleeping and weight gain etc., all of which researchers believe can be fixed through implementing something as simple as physical activity interventions. This research looked to compare the outcome of the breast cancer patients who engaged in the physical activity interventions, against the control group who did not.

Where the research was conducted
The study was carried out by researchers in the United States within the Centres for Behavioural and Preventative Medicine at Miriam Hospital, Brown Medical School, and also Bryant College, RI. It was published on the 18th of March 2005, by the American Society of Clinical Oncology.

Type of research
The study conducted a randomized controlled trial with 86 female participants being recruited via letters from their personal oncologist, in-person at hospitalized practices, and also by mail. To be eligible to partake in the study, they had to meet the following criteria:
 * ≥18 years of age
 * Sedentary on a daily basis or exercising very little
 * Diagnosed with stage 0 to 2 breast cancer within the last 5 years
 * Undergone surgery, chemotherapy, and/or radiation
 * Must be ambulatory

What the research involved
The participants were equally divided and randomly assigned to either a control group, or a physical activity (PA) group. Tests were conducted at baseline, following the treatment, and twice more as part of a follow-up routine at 6 and 9 months. The control group were asked to keep their current level of physical activity unchanged and the PA group received home-based physical activity instructions. These instructions consisted of how to: To allow the researchers to monitor the PA group, the participants received weekly phone calls, were given home logs, and were also given a pedometer to wear during bouts of exercise. To start off, the PA group were instructed to not do too much and to progressively increase exercise frequency and duration. By week 12, they were exercising for 30 minutes at least 5 days/week.
 * Appropriately warm up prior to physical activity
 * Exercise at a moderate-intensity
 * Precisely observe heart rate, and
 * Correctly cool down after physical activity

In order for the PA group to monitor their progress, they received a physical activity and cancer survivor tip sheet every fortnight for the duration of the course. Of the 43 participants in the PA group there was a total of 4 dropouts, and within the control group there were no dropouts.

Results
The results showed that the PA group engaged in higher levels of moderate-intensity physical activity and had greater weekly energy expenditure when compared to the control group. They also performed better in the one-mile walk test in that they were able to complete the test much faster than the control group. In addition, the mean amount of steps achieved by the PA group at the week-twelve mark was much higher than they achieved in week one. All of these findings indicate that the PA intervention has allowed for physical fitness improvements in the PA group.

The Chi square analyses illustrated that the PA group were more likely than the control group to adopt a weekly physical activity routine of a certain duration and intensity. The data also showed that the motivational state of readiness values were higher and increasing within the PA group. In contrast, approximately half the participants in the control group’s values remained unchanged. Statistics also showed that the PA group had decreased mood disturbance and fatigue, as well as better scores on the Body Esteem Scale when compared to that of the control group.

The results also demonstrated that the PA group were more likely than the control group to meet the moderate-intensity CDC/ACSM guidelines. The results of another study found that women diagnosed with breast cancer who followed US physical activity guidelines, may increase their chances of survival. It also found that regular physical activity significantly improved quality of life. A more recent study further highlights the importance of physical activity, as it found that engaging in exercise of ≥2.8 METs/hour/week showed a 35-49% decreased mortality rate in breast cancer patients. All of these results justify the importance of this study surrounding the home-based interventions.

How did the researchers interpret the results?
The researchers concluded that, promoting physical activity in breast cancer patients through home-based interventions provides both physical and psychological benefits. Increases in motivational readiness, being more likely to meet CDC/ACSM guidelines, and the fitness improvements observed, all contribute to the strength of the intervention.

Conclusion
The home-based physical activity intervention has shown to be significantly beneficial to breast cancer patients in both a physical and psychological sense. The negative effects of cancer treatment can be improved through simply engaging in physical activity. And as a result of these improvements, supporting research has shown quality of life to drastically increase, and survival rates with a potential to increase.

Implications
This research and supporting literature undeniably suggest that a positive relationship between physical activity and breast cancer patients exists. Due to the health complications that arise from cancer treatment, physical activity is often neglected. To further underline the benefits seen with physical activity, future research has the potential to change the way physical activity is viewed for the respective population. Lastly, this intervention was effectively monitored through brief weekly phone calls. Which suggests that more complex on-site interventions are not necessary for breast cancer patients to increase their levels of physical activity. This provides important implications for future research, with regards to the types of interventions that should be recommended for breast cancer patients.