Home-based Exercise, Health-related Fitness, Fatigue, Sleep, And HRQL Among Cancer Patients Undergoing Radiation

Abstract

Cancer treatments, such as radiation, often result in side effects that impair a patient's health-related quality of life (HRQL). Radiotherapy-induced fatigue is reported in 78–80% of irradiated patients, is associated with sleep disruptions, and has been shown to improve with exercise participation. However, relationships between fatigue, sleep, HRQL and health-related physical fitness (e.g., cardiorespiratory fitness [CF], muscular strength [MS], muscle mass [MM], and body fat [BF]) have not been fully elucidated among cancer patients currently undergoing radiotherapy. PURPOSE To conduct a pilot study comparing the influence of a low to moderate home-based walking and resistance training intervention (HBEX) to standard care (SC) on health-related fitness (CF, MS, MM, and BF), fatigue, sleep, and HRQL in a sample of breast (BC) and prostate cancer (PC) patients undergoing radiotherapy. METHODS BC and PC patients (N=14, mean age=58, 64% female) were randomized to a 4wk HBEX or SC condition, with 6-minute walk, handgrip dynamometry, bioelectrical impedance, fatigue, sleep, and HRQL assessments pre and post-intervention. RESULTS Raw change scores indicated improvements in the HBEX group on all of the following outcomes: CF (mean=85.88, SE=58.27), MS (mean=.29, SE=1.57), MM (mean=1.07, SE=.67), BF (mean=−1.27, SE=.68), fatigue (mean=−1.86, SE=2.04), sleep (mean=.33, SE=.56), and HRQL (mean=1.29, SE=4.80), while the SC group demonstrated declines in all of these outcomes: CF (mean=−149.68, SE=54.47), MS (mean=−.33, SE=1.49), MM (mean=−.34, SE=.26), BF (mean=.11, SE=.33), fatigue (mean=2.86, SE=1.51), sleep (mean=−3.00, SE=1.05), and HRQL (mean=−.94, SE=2.85). Paired sample t-tests indicated that HBEX participants (N=7) demonstrated a trend toward significant improvements in sleep (T13=1.91, p=.08), while SC participants declined, from baseline to wk 6. Additionally, fatigue was significantly correlated with HRQL (r=−.85, p<.05) in both conditions, and CF with MS (r=−.90, p<.05) and fatigue (r=−.92, p<.001) in the SC condition. CONCLUSIONS Despite a lack of statistical significance due to a small sample, these results suggest that participation in a low to moderate home-based exercise program is associated with improvements in CF, MS, MM, BF, fatigue, sleep, and HRQL, while SC is associated with declines in all of these areas among BC and PC patients during radiotherapy. Future randomized controlled trials are needed with larger samples to fully investigate the influence of HBEX on CF, MS, MM, BF, fatigue, sleep, and HRQL, with foci on elucidating the relationships among these clinical outcomes.