The effect of a structured exercise program on fatigue, strength, endurance, physical self -efficacy, and functional wellness in women with early stage breast cancer.

Abstract

Cancer treatment-related fatigue is a distressing effect of cancer therapy. Early efforts in describing the fatigue experience have progressed to the testing of potential interventions. This study built on the fatigue, functional capacity, and exercise activity of previous studies with women with early stage breast cancer. Strength training and the nature of the relationship of physical self-efficacy and performance to functional wellness, contribute new understanding to the area of fatigue and symptom management. The purpose of this thirteen-week study was to test the effectiveness of a structured exercise program in decreasing fatigue, increasing physical performance, increasing perceptions of attention performance and physical self-efficacy, and enhancing perceptions of functional wellness in women undergoing a specific type of adjuvant chemotherapy for early stage breast cancer. The study utilized a randomized, two-group, repeated measures experimental design. The sample consisted of 22 women (36--58 years) randomized to comparison (n = 9) and intervention (n = 13) groups. Both groups were tested at weeks 1 and 13 for physical performance (VO2max and 1-Repetition Maximum) and attention performance (Attention Functional Index). Measurement of fatigue (Revised Piper Fatigue Scale), physical self-efficacy (Physical Self-Efficacy Scales), and functional wellness (MOS SF-36, and Functional Wellness Questionnaire) occurred during weeks l, 7, and 13. Data analysis found significant differences between groups in VO2max from weeks 1 to 13. Significant differences in activity also existed between the two groups. Treatment-related fatigue increased over the study period for both groups, although the intervention group reported lower overall fatigue scores, as compared to the comparison group. Perceptions of physical self-efficacy declined in both groups over the study period with the peak fall at week 7, the midpoint of the study. Preliminary testing of the proposed conceptual model utilizing multiple regression, demonstrated support for relationships between dose, exercise program, performance, physical self-efficacy, functional wellness, and fatigue. Correlation coefficients strongly supported the associations between fatigue and vitality, physical self-efficacy with attention performance, attention performance with vitality, and physical self-efficacy and physical functioning. These findings, provide support to the positive role of exercise during a specific type of adjuvant chemotherapy for early stage breast cancer.Ph.D.Health and Environmental SciencesNursingPublic healthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/123815/2/3106039.pd