Skip to main content
SpringerLink
Log in

Fatigue mediates the effects of exercise on quality of life

Quality of Life Research Aims and scope Submit manuscript

Cite this article

Abstract

Purpose: Fatigue is a common side effect of cancer treatment that impacts quality of life. Exercise is one approach suggested to improve fatigue. The purpose of this study was to explore the relationship of exercise to fatigue and quality of life. Methods: Thirty-one subjects with breast cancer were enrolled prior to beginning chemotherapy and 27 completed the study. All baseline measures were obtained before the first chemotherapy treatment. Subjects were instructed on a home-based, 8-week exercise program. Results: Women who adopted the exercise program (60%) showed significant increases in functional ability and less weight gain. Exploratory, stepwise multiple regression analyses suggested that the maximum effect of exercise on quality of life outcomes may be mediated by fatigue. Conclusions: The low-to-moderate intensity, home-based exercise program was feasible for some women with breast cancer receiving chemotherapy. The results suggest that exercise may affect quality of life and that this effect may be mediated by the effects of exercise on fatigue. Better retention of functional ability and better weight control are additional possible benefits of exposing breast cancer patients to increased exercise. A randomized, controlled clinical trial is needed to establish confidence in these observed relationships.

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

References

  1. Irvine D, Vincent L, Graydon JE, Bubela N, Thompson L. The prevalence and correlates of fatigu in patients receiving treatment with chemotherapy and radiotherapy. Cancer Nursing 1994; 17: 367–378.

    PubMed  Google Scholar 

  2. Nail LM, Winningham ML. Fatigue and weakness in cancer patients: The symptom experience. Sem Oncol Nursing 1995; 11: 272–278.

    Google Scholar 

  3. Richardson A, Ream E, Wilson-Barnett J. Fatigue in patients receiving chemotherapy: Patterns of changes. Cancer Nursing 1998; 21: 17–30.

    PubMed  Google Scholar 

  4. Aistars J. Fatigue in the cancer patient: A conceptual approach to a clinical problem. Oncol Nursing Forum 1987; 12: 122–127.

    Google Scholar 

  5. Bruera E, MacDonald RN. Asthenia in patients with advanced cancer. J Symptom Manag 1988; 3: 9–14.

    Google Scholar 

  6. Piper BF, Lindsey AM, Dodd MJ. Fatigue mechanisms in cancer patients: Developing nursing theory. Oncol Nursing Forum 1987; 14: 17–23.

    Google Scholar 

  7. St. Pierre BA, Kasper CE, Lindsey AM. Fatigue mechanisms in patients with cancer: Effects of tumor necrosis factor and exercise on skeletal muscle. Oncol Nursing Forum 1992; 19: 419–425.

    Google Scholar 

  8. Smets EMA, Garssen B, Schuster-Utterhoeve ALJ, et al. Fatigue in cancer patients. British J Cancer 1993; 68: 220–224.

    Google Scholar 

  9. Winningham ML, Nail LM, Burke MB, Brophy L, Cimprich B, Jones LS, et al. Fatigue and the cancer experience: The state of the knowledge. Oncol Nursing Forum 1994; 21: 23–36.

    Google Scholar 

  10. Cimprich B. Attentional fatigue following breast cancer surgery. Res Nursing and Health 1992; 15: 199–207.

    Google Scholar 

  11. Pickard-Holley S. Fatigue in cancer patients. Cancer Nursing 1991; 14: 13–19.

    PubMed  Google Scholar 

  12. Post-White J, Schroeder L. Factors influencing breast cancer survivors' fatigue, emotional state and immune function and quality of life. Proceeds from the American Cancer Society National Conference on Cancer Nursing Research, Panama City, FL, January 1997.

  13. Rhodes VA, Watson PM, Hanson BM. Patient descriptors of the influence of tiredness and weakness on self-care. Cancer Nursing 1992; 11: 186–194.

    Google Scholar 

  14. Skalla KA, Lacasse C. Patient education for fatigue. Oncol Nursing Forum 1992; 19: 1537–1539.

    Google Scholar 

  15. Galantino ML. Performance status = Nutrition + Exercise. Nutritional Oncol 1995; 2: 1–12.

    Google Scholar 

  16. MacVicar MG, Winningham ML. Promoting the functional capacity of cancer patients. Cancer Bulletin 1986; 38: 235–239.

    Google Scholar 

  17. Dimeo F, Rumberger BG, Keul J. Aerobic exercise as therapy for cancer fatigue. Med Sci Sports and Exerc 1998; 30: 475–478.

    Google Scholar 

  18. Shangraw RE, Stuart CA, Prince MJ. Insulin responsiveness of protein metabolism in vivo following bed rest in humans. Am J Physiol 1988; 255: E548-E558.

    PubMed  Google Scholar 

  19. Stuart CS, Shangraw RE, Prince MJ. Bed-rest induced insulin resistance occurs primarily in muscle. Metabolism 1988; 37: 802–806.

    PubMed  Google Scholar 

  20. Mock V, Dow KH, Meares CJ, Grimm PM, Dienemann JA, Haisfield-Wolfe ME, et al. An exercise intervention for management of fatigue and emotional distress during radiotherapy treatment for breast cancer. Oncol Nursing Forum 1997; 24: 991–1000.

    Google Scholar 

  21. Dimeo FC, Tilmann MHM, Bertz H, Kanz L, Mertelsmann R, Keul J. Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous stem cell transplantation. Cancer 1997; 79: 1717–1722.

    PubMed  Google Scholar 

  22. Dimeo FC, Fetscher S, Lange W, Mertelsmann R, Keul J. Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood 1997; 90: 3390–3394.

    PubMed  Google Scholar 

  23. Young-McCaughan S, Séxton DL. A retrospective investigation of the relationship between aerobic exercise and quality of life in women with breast cancer. Oncol Nursing Forum 1991; 18: 751–757.

    Google Scholar 

  24. Cook TD, Campbell DT. Quasi-experimentation: Design and analysis issues for field settings. Boston: Houghton Mi.in Company, 1979: 50–55.

    Google Scholar 

  25. Cooper KH. A means of assessing maximal oxygen uptake. J Am Med Assoc 1968; 203: 133–138.

    Google Scholar 

  26. Steele B. Timed walking tests of exercise capacity in chronic cardiopulmonary illness. J Cardiopulmonary Rehab 1996; 16: 25–33.

    Google Scholar 

  27. Montoye HJ, Washburn R, Seavers S, Eritt A, Webster A, Nagle F. Estimation of energy expenditure by portable accelerometer. Med Sci Sports and Exerc 1983; 15: 899–907.

    Google Scholar 

  28. Sallis JF, Buono MJ, Roby JJ, Carlson D, Nelson JA. The Caltrac accelerometer as a physical activity monitor for school-age children. Med Sci Sports and Exerc 1990; 22: 698–703.

    Google Scholar 

  29. Washburn RA, LaPorte RE. Assessment of walking behavior: E.ect of speed and monitor position on two objective physical activity monitors. Res Quart Exerc and Sports 1988; 59: 83–85.

    Google Scholar 

  30. McNair DM, Lorr M, Droppleman LF. Profile of mood states manual. San Diego: Educational and Industrial Testing Service, 1992: 16–18.

    Google Scholar 

  31. Schwartz AL. Reliability and validity of the Schwartz Cancer Fatigue Scale. Oncol Nursing Forum 1998; 25: 711–717.

    Google Scholar 

  32. Schwartz AL, Meek P. Additional construct validity of the Schwartz Cancer Fatigue Scale. J Nursing Measur 1999; 7: 35–45.

    Google Scholar 

  33. Mock V, Burke MB, Sheehan P, Creaton EM, Winningham ML, McKenney-Tedder S, et al. A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncol Nursing Forum 1994; 21: 899–907.

    Google Scholar 

  34. PadillaGV, GrantMM.Quality of life asacancer nursing outcome variable. Adv Nursing Sci 1985; 8: 45–60.

  35. King KB, Nail LM, Kraemer K, Strohl R, Johnson J. Patients' descriptions of the experience of receiving radiation therapy. Oncol Nursing Forum 1985; 12: 55–61.

    Google Scholar 

  36. Nunnally JC, Bernstein IH. Psychometric Theory, 3rd ed. New York, NY: McGraw Hill, 1994.

    Google Scholar 

  37. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. J Personality and Social Psychol 1986; 51: 11731182.

    Google Scholar 

  38. Lindley P, Walker SN. Theoretical and methodological di.erentiation of moderation and meditation. Nursing Res 1993; 42: 276–279.

    Google Scholar 

  39. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. J Am Med Assoc 1995; 22: 402–407.

    Google Scholar 

  40. Dishman RK. Determinants of participation in physical activity. In: Bouchard C, Shepard RJ, Stephens T, Sutton JR, McPherson BD. Exercise, Fitness and Health: A consensus of current knowledge. Champaign, IL: Human Kinetics Publishers, 1990: 78–101.

    Google Scholar 

  41. King AC. Community and public health approaches to the promotion of physical activity. Med Sci Sport and Exerc 1991

  42. King AC, Young DR, Oka RK, Haskell WL. Effects of exercise format and intensity on two-year health outcomes in the aging adults (Abstract). The Gerontologist 1992; 32: 190.

    Google Scholar 

  43. News section. Tired out Patients find few easy answers for cancer-related fatigue. J Nat Cancer Inst 1998; Nov4: 1591.

  44. McAuley E, Courneya KS, Rudolph DL, Lox CLL. Enhancing exercise adherence in middle-aged males and females. Prev Med 1994; 23: 498–506.

    PubMed  Google Scholar 

  45. Christensen T, Stage JG, Glabo H, Christensen NJ, Kehlet H, et al. Fatigue and cardiac and endocrine metabolic response to exercise after abdominal surgery. Surgery 1989; 105: 46–50.

    PubMed  Google Scholar 

  46. Lorig KR, Sobel DS, Stewart AL, Brown BW, Bandura A, Ritter P, Gonzalez VM, Laurent DD, Holman HR. Evidence suggesting that a chronic disease selfmanagement program can improve health status while reducing hospitalization. A randomized trial. Med Care 1999; 37: 5–14.

    PubMed  Google Scholar 

  47. Schwartz AL. Patterns of exercise and fatigue in physically active cancer survivors. Oncol Nursing Forum 1998; 25: 485–491.

    Google Scholar 

  48. Pate PR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American college of Sports Medicine. JAMA 195; 273: 402–407.

  49. Eaton CB, Reynes J, Assaf AR, Feldman H, Lasater T, Carlton RA. Predicting physical activity change in men and women in two New England communities. Am J Prev Med 1993; 9: 209–219.

    PubMed  Google Scholar 

  50. Broadhead WE, Kaplan BH, James, et al. The epidemiologic evidence for a relationship between social support and health.AmJ Epidemiol 1983; 117: 521–537.

    Google Scholar 

  51. Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monogr 1974; 2: 354–386.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nursing, University of Washington, Box 357266, Seattle, WA, 98195-7266, USA

    Anna L. Schwartz

Authors
  1. Anna L. Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Schwartz, A.L. Fatigue mediates the effects of exercise on quality of life. Qual Life Res 8, 529–538 (1999). https://doi.org/10.1023/A:1008978611274

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008978611274

search

Navigation