Exercise Intervention in Breast Cancer Patients with Treatment-Induced Arthralgia

Abstract

Aromatase inhibitors (AIs) are widely used as an adjuvant treatment in postmenopausal women with estrogen receptor-positive breast cancer. AIs arrest the final step in the synthesis of estrogen by blocking the activity of the enzyme aromatase. One of the most common side effects of AI treatment is joint pain, particularly in the hand and fingers. PURPOSE: To examine the effectiveness of an 8-week home-based exercise program in reducing joint pain and improving quality of life (QOL) and functional performance in breast cancer patients treated with AIs. METHODS: Participants underwent baseline measures of height, body mass, waist and hip circumference, and body composition. Functional performance was evaluated using grip strength, arm curl to exhaustion, and sit-to-stand. A 3-minute step test determined subject's cardiovascular endurance. Subjective measures of joint pain and QOL were conducted using self-administered surveys. Participants were instructed how to execute lower and upper body resistance exercises using Thera-BandR exercise bands and different hand exercises using an elastic band. A video was provided to each participant illustrating these exercises, as well as warm up, flexibility, and cool down. Participants were instructed how to monitor heart rate in order to pace aerobic activity. This was an 8 week, individualized, home-based program in which participants recorded daily activity on exercise logs and received interactive weekly phone calls to provide support. RESULTS: No significant pre-post changes were observed in the anthropometric measures (BMI, WHR, body composition). Grip strength, bicep curls to exhaustion and sit-to-stand improved significantly (8%, 45%, and 19%, respectively). HR recovery after the step test trended toward significance (5% reduction). Subjectively, participants reported an improvement in QOL, but no change in joint pain. CONCLUSIONS: An 8-week, home-based exercise program significantly improved functional performance and QOL in breast cancer patients suffering joint pain secondary to treatment with aromatase inhibitors. Supported by Susan G Komen for the Cure, WNY Affiliate.