Skip to main content

Advertisement

SpringerLink
Log in

Sustainable impact of an individualized exercise program on physical activity level and fatigue syndrome on breast cancer patients in two German rehabilitation centers

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Although physical activity has been demonstrated to increase cancer survival in epidemiological studies, breast cancer patients tend toward inactivity after treatment.

Methods

Breast cancer patients were quasi-randomly allocated to two different groups, intervention (IG) and control (CG) groups. The intervention group (n = 111) received an individual 3-week exercise program with two additional 1-week inpatient stays after 4 and 8 months. At the end of the rehabilitation, a home-based exercise program was designed. The control group (n = 83) received a 3-week rehabilitation program and did not obtain any follow-up care. Patients from both groups were measured using questionnaires on physical activity, fatigue, and quality of life (QoL) at five time points, 4 months (t1), 8 months (t2), 12 months (t3), 18 months (t4), and 24 months (t5) after the beginning of the rehabilitation.

Results

After 2 years, the level of physical activity (total metabolic rate) increased significantly from 2733.16 ± 2547.95 (t0) to 4169.71 ± 3492.27 (t5) metabolic equivalent (MET)-min/week in the intervention group, but just slightly changed from 2858.38 ± 2393.79 (t0) to 2875.74 ± 2590.15 (t5) MET-min/week in the control group (means ± standard deviation). Furthermore, the internal group comparison showed significant differences after 2 years as well. These results came along with a significantly reduced fatigue syndrome and an increased health-related quality of life.

Conclusions

The data indicate that an individual, according to their preferences, and physical-resource-adapted exercise program has a more sustainable impact on the physical activity level in breast cancer patients than the usual care. It is suggested that the rehabilitation program should be personalized for all breast cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Global Burden of Disease Cancer Collaboration (2015) The global burden of cancer 2013. JAMA Oncol 1:505–527. doi:10.1001/jamaoncol.2015.0735

    Article  PubMed Central  Google Scholar 

  2. Robert-Koch-Institut und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. (Hrsg.) (2015) Krebs in Deutschland 2011/2012. Berlin, Germany. doi:10.17886/rkipubl-2015-004

  3. Skarin A (2000) Diagnosis in oncology: side effects of chemotherapy. J Clin Oncol 18:693–698

    Article  Google Scholar 

  4. Hidding JT, Beurskens CH, van der Wees PJ, van Laarhoven HW, Nijhuis-van der Sanden MW (2014) Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One 9:e96748. doi:10.1371/journal.pone.0096748

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Burish TG, Tope DM (1992) Psychological techniques for controlling the adverse side effects of cancer chemotherapy: findings from a decade of research. J Pain Symptom Manag 7:287–301. doi:10.1016/0885-3924(92)90062-M

    Article  CAS  Google Scholar 

  6. Asher A (2011) Cognitive dysfunction among cancer survivors. American Journal of Physical Medicine & Rehabilitation/Association of Academic Physiatrists 90:16–26. doi:10.1097/PHM.0b013e31820be463

    Article  Google Scholar 

  7. Kwok C, White K (2014) Perceived information needs and social support of Chinese-Australian breast cancer survivors. Support Care Cancer 22:2651–2659. doi:10.1007/s00520-014-2252-x

    Article  CAS  PubMed  Google Scholar 

  8. Kayl AE, Meyers CA (2006) Side-effects of chemotherapy and quality of life in ovarian and breast cancer patients. Current Opinion in Obstetrics & Gynecology 18:24–28. doi:10.1097/01.gco.0000192996.20040.24

    Article  Google Scholar 

  9. Palmer BV, Walsh GA, McKinna JA, Greening WP (1980) Adjuvant chemotherapy for breast cancer: side effects and quality of life. BMJ 281:1594–1597. doi:10.1136/bmj.281.6255.1594

    Article  CAS  PubMed  Google Scholar 

  10. Velthuis MJ, Agasi-Idenburg SC, Aufdemkampe G, Wittink HM (2010) The effect of physical exercise on cancer related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. ClinOncol 22:208–221. doi:10.1016/j.clon.2009.12.005

    Article  CAS  Google Scholar 

  11. Robert JT, Holm M, Al-Adhami A (2014) Physical activity after cancer: an evidence review of the international literature. British Journal of Medical Practitioners 7(1):a708

    Google Scholar 

  12. Holmes MD, Chen WY, Feskanich, Kroenke CA, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486. doi:10.1001/jama.293.20.2479

    Article  CAS  Google Scholar 

  13. Irwin ML, Wilder Smith A, McTiernan A et al (2008) Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J ClinOncol 26:3958–3964. doi:10.1200/JCO.2007.15.9822

    Article  Google Scholar 

  14. Pinto BM, Rabin C, Papandomatos GD, Frierson GM, Trunzo JJ, Marcus BH (2008) Maintenance of effects of a home-based physical activity program among breast cancer survivors. Support Care Cancer 16(11):1279–1289. doi:10.1007/s00520-008-0434-0

    Article  PubMed  PubMed Central  Google Scholar 

  15. Huy C, Schmidt ME, Vrieling A, Chang-Claude J, Steindorf K (2012) Physical activity in a German breast cancer patient cohort: one-year trend and characteristics associated with change in activity level. Eur J Cancer 48:297–304. doi:10.1016/j.ejca.2011.08.005

    Article  PubMed  Google Scholar 

  16. Rogers LQ, Hopkins-Price P, Vicari S et al (2009) A randomized trial to increase physical activity in breast cancer. Med Sci Sports Exerc 41:935–946. doi:10.1249/MSS.0b013e31818e0e1b

    Article  PubMed  Google Scholar 

  17. Frey I, Berg A, Gratwohl D, Keul J (1999) Freiburger Fragebogen zur körperlichen Aktivität—entwicklung, prüfung und anwendung. Soz Praventivmed 44:55–64. doi:10.1007/BF01667127

    Article  CAS  PubMed  Google Scholar 

  18. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376. doi:10.1093/jnci/85.5.365

    Article  CAS  PubMed  Google Scholar 

  19. Smets EM, Garssen B, Bonke B, De Haes JC (1995) The Multidimensional Fatigue Inventory (MFI) psychometric qualities to assess fatigue. J Psychosom Res 39:315–325. doi:10.1016/0022-3999(94)00125-O

    Article  CAS  PubMed  Google Scholar 

  20. Smets EM, Garssen B, Cull A, De Haes JC (1996) Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br J Cancer 73:241–245

    Article  CAS  Google Scholar 

  21. Rosner B (2000) Fundamentals of biostatistics, 5th edn. Duxbury, Pacific Grove, p. 308

    Google Scholar 

  22. Hays WL (1994) Statistics, 5th edn. Holt, Rinehart and Winston, New York

    Google Scholar 

  23. Uitenbroek DG (1993) Seasonal variation in leisure time physical activity. Med Sci Sports Exerc 25:755–760

    Article  CAS  Google Scholar 

  24. Fong SSM, Ng SSM, Luk WS et al (2014) Effects of qigong exercise on upper limb lymphedema and blood flow in survivors of breast cancer: a pilot study. Integr Cancer Ther 13:54–61. doi:10.1177/1534735413490797

    Article  PubMed  Google Scholar 

  25. McKenzie DC, Kalda AL (2003) Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 21:463–466. doi:10.1200/JCO.2003.04.069

    Article  PubMed  Google Scholar 

  26. Mishra SI, Scherer RW, Snyder C et al (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 15:CD007566. doi:10.1002/14651858.CD007566.pub2

    Article  Google Scholar 

  27. Markes M, Brockow T, Resch KL (2006) Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 18:CD005001. doi:10.1002/14651858.CD005001.pub2

    Article  Google Scholar 

  28. Galvao DA, Newton RU (2005) Review of exercise intervention studies in cancer patients. J Clin Oncol 23:899–909. doi:10.1200/JCO.2005.06.085

    Article  PubMed  Google Scholar 

  29. Conn VS, Hafdahl AR, Porock DC et al (2007) A meta-analysis of exercise interventions among people treated for cancer. Support Care Cancer 14:699–712. doi:10.1007/s00520-005-0905-5

    Article  Google Scholar 

  30. McNeely ML, Campbell KL, Rowe BH et al (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175:34–41. doi:10.1503/cmaj.051073

    Article  PubMed  PubMed Central  Google Scholar 

  31. Schmitz KH, Holtzman J, Courneya KS et al (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev 14:1588–1595. doi:10.1158/1055-9965.EPI-04-0703

    Article  Google Scholar 

  32. Mehnert A, Veers S, Howaldt D et al (2011) Effects of a physical exercise rehabilitation group program an anxiety, depression, body image, and health related quality of life among breast cancer patients. Onkologie 34:248–253. doi:10.1159/000327813

    Article  PubMed  Google Scholar 

  33. Dimeo FC (2001) Effects of exercise on cancer-related fatigue. Am Cancer Soc 92:1689–1693

    CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank the “Deutsche Rentenversicherung Baden Württemberg” for the financial support to conduct this study.

Author information

Authors and Affiliations

  1. Department 1 of Internal Medicine, Center for Integrated Oncology Köln Bonn University Clinic of Cologne, Kerpenerstraße 62, 50937, Cologne, Germany

    Freerk T. Baumann

  2. Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany

    Oliver Bieck, Max Oberste, Eva Zopf, Wilhelm Bloch & Klaus Schüle

  3. Rehabilitation Center, “Klinik Am Kurpark”, Bad Kissingen, Germany

    Rafaela Kuhn, Joachim Schmitt & Steffen Wentrock

  4. Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia

    Eva Zopf

  5. Facharztpraxis am Rehabilitations- und Präventionszentrum, Bad Bocklet, Germany

    Monika Reuss-Borst

Authors
  1. Freerk T. Baumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oliver Bieck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Max Oberste
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rafaela Kuhn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joachim Schmitt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Steffen Wentrock
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eva Zopf
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Wilhelm Bloch
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Klaus Schüle
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Monika Reuss-Borst
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Freerk T. Baumann.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was in accordance with the Declaration of Helsinki and approved by the ethics committee of the German Sports University of Cologne. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baumann, F.T., Bieck, O., Oberste, M. et al. Sustainable impact of an individualized exercise program on physical activity level and fatigue syndrome on breast cancer patients in two German rehabilitation centers. Support Care Cancer 25, 1047–1054 (2017). https://doi.org/10.1007/s00520-016-3490-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3490-x

Keywords

Search

Navigation