Abstract

This study aimed to determine the effectiveness of therapeutic exercise plus patient therapeutic education on perceived fatigue, functional capacity and pain in breast cancer survivors with cancer-related fatigue. A randomised, single-blind, clinical trial was conducted with a total of 80 breast cancer survivors who presented cancer-related fatigue. Women were randomised into a supervised therapeutic exercise group (STE-G) (n = 40) or an unsupervised exercise group (UE-G) (n = 40). Both interventions included patient therapeutic education and were delivered in three sessions per week over eight weeks. The main outcome was perceived fatigue as assessed by the Spanish version of the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F). Other evaluated outcomes were pain measured on a visual analogue scale, and distance measured using the 6-Minute Walk Test. Data were collected at baseline, immediately post-intervention, and at three and six months after baseline. Significantly greater improvements across all variables were observed in the STE-G throughout the entire follow-up period with the exception of pain. Conclusions: A supervised therapeutic exercise program plus patient therapeutic education significantly reduce perceived fatigue and increase functional capacity in breast cancer survivors suffering from cancer-related fatigue compared to an unsupervised physical exercise program based on individual preferences with patient therapeutic education.

Highlights

  • Cancer and its treatments are usually accompanied by symptoms that affect body function and health-related quality of life, such as fatigue, pain, depression, or insomnia [1,2]

  • Significant intergroup differences were found in the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F) scores (p < 0.001) and minimum clinically important difference (MCID) at all post-treatment visits (V1, V2, and V3)

  • The women in this study showed high therain breast cancer (BC) survivors suffering from Cancer-related fatigue (CRF)

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Summary

Introduction

Cancer and its treatments are usually accompanied by symptoms that affect body function and health-related quality of life, such as fatigue, pain, depression, or insomnia [1,2]. Cancer-related fatigue (CRF) is one of the side effects associated with poorer healthrelated quality of life outcomes in cancer survivors [3,4] and entails a negative impact on socioeconomic status, greater healthcare utilisation, and reduced survival rates [2,5]. Complex multifactorial processes have been associated with the development of CRF, including physiological (adaptive responses to inflammation, dysregulation of the hypothalamicpituitary-adrenal axis, or reduced energy metabolism), clinical (direct or secondary effects of cancer treatments and contributions from comorbidities), and psychological (depression, catastrophising, or fear of recurrence) components [2]. Severe fatigue is found in 20–40% of breast cancer (BC) survivors [7], of which around 30% report significant CRF ten years after treatment [8]. CRF is seldom addressed in therapeutic plans for cancer survivors [9]

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