Abstract
Goals of work
This pilot project explored the feasibility, safety, and effectiveness of a self-administered exercise and stress management intervention for cancer patients receiving chemotherapy.
Patients and methods
Thirty-nine of 56 eligible patients (acceptance =69%) with a variety of solid tumors volunteered for the study. Participants were advised to exercise 20–40 min at 50–75% estimated heart rate reserve 3–5 times per week. In addition, patients were provided with instruction and written materials regarding stress management techniques. Follow-up data were collected during regularly scheduled outpatient visits at the start of the second, third, and fourth chemotherapy cycles using diary entries and the same questionnaires previously administered at baseline.
Main results
Twenty-four of 39 patients (62%) completed all study requirements. These participants completed 438 of the 678 exercise sessions assigned (adherence =62%). Of the stress management techniques, positive thinking most practiced most frequently (48%), followed by deep breathing (38%) and active relaxation (37%). Paired t tests, comparing baseline values with final recorded values, indicated a significant improvement over time in bodily pain (p<0.03) and mental health (p<0.04) subscale scores. Participants’ evaluations of the combined intervention were favorable: 90% felt it was helpful to them and 100% would recommend it to another patient.
Conclusions
A self-administered intervention combining aerobic exercise and stress management was acceptable and safe for cancer patients receiving chemotherapy. Preliminary data demonstrating intervention efficacy should be confirmed in subsequent randomized clinical trials.
Similar content being viewed by others
References
American College of Sports Medicine (1990) Position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc 22:256–274
Blumenthal JA, Jiang W, Babyak MA, Krantz DS, Frid DJ, Coleman RE, Waugh R, Hanson M, Appelbaum M, O’Connor C, Morris JJ (1997) Stress management and exercise training in cardiac patients with myocardial ischemia. Effects on prognosis and evaluation of mechanisms. Arch Intern Med 157:2213–2223
Burish TG, Lyles JN (1981) Effectiveness of relaxation training in reducing adverse reactions to cancer chemotherapy. J Behav Med 4:65–78
Burish TG, Carey MP, Krozely MG, Greco FA (1987) Conditioned side effects induced by cancer chemotherapy:Prevention through behavioral treatment. J Consult Clin Psychol 55:42–48
Burish TG, Snyder SL, Jenkins RA (1991) Preparing patients for cancer chemotherapy:effect of coping preparation and relaxation interventions. J Consult Clin Psychol 59:518–525
Burish TG, Jenkins RA (1992) Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy. Health Psychol 11:17–23
Carey MP, Burish TG (1987) Providing relaxation training to cancer chemotherapy patients:a comparison of three delivery techniques. J Consult Clin Psychol 55:732–737
Carlson CR, Hoyle RH (1993) Efficacy of abbreviated progressive muscle relaxation training:a quantitative review of behavioral medicine research. J Consult Clin Psychol 61:1059–1067
Courneya KS, Mackey JR, Quinney HA (2002) Neoplasms. In Myers J, Herbert W, Humphrey R (eds) American college of sports medicine’s resources for clinical exercise physiology: musculoskeletal, neuromuscular, neoplastic, immunologic, and hematologic conditions. Lippincott, New York, NY, pp 179–191
Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS (2003) Randomized controlled trial of exercise training in postmenopausal breast cancer survivors:cardiopulmonary and quality of life outcomes. J Clin Oncol 21:1660–1668
Fried R (2000) Breathing as a clinical tool. In Mostofsky DI, Barlow DH (eds) The management of stress and anxiety in medical disorders. Allyn & Bacon, Boston, MA pp 100–118
Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC (2002) Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol 20:2851–2862
Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G (2005) Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 23:3830–3842
Luebbert K, Dahme B, Hasenbring M (2001) The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non-surgical cancer treatment:a meta-analytical review. Psychooncology 10:490–502
Lyles JN, Burish TG, Krozely MG, Oldham RK (1982) Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy. J Consult Clin Psychol 50:509–524
MacVicar MG, Winningham ML, Nickel JL (1989) Effects of aerobic interval training on cancer patients’ functional capacity. Nurs Res 38:348–351
Meichenbaum D, Novaco R (1985) Stress inoculation:a preventative approach. Issues Ment Health Nurs 7:419–435
Mock V, Burke MB, Sheehan PK, Creaton EM, Winningham ML, McKenney-Tedder S, Schwager LP, Liebman M (1994) A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum 21:899–907
Mock V, Pickett M, Ropka ME, Lin EM, Stewart KJ, Rhodes VA, McDaniel R, Grimm PM, Krumm S, McCorkle R (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 9:119–127
Mock V, Frangakis C, Davidson NE, Ropka ME, Pickett M, Poniatowski B, Stewart KJ, Cameron L, Zawacki K, Podewils LJ, Cohen G, McCorkle R (2005) Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology 14:464–477
Morrow GR (1984) Appropriateness of taped versus live relaxation in the systematic desensitization of anticipatory nausea and vomiting in cancer patients. J Consult Clin Psychol 52:1098–1099
Morrow GR (1986) Effect of the cognitive hierarchy in the systematic desensitization treatment of anticipatory nausea in cancer patients: a component comparison with relaxation only, counseling, and no treatment. Cogn Ther Res 10:421–446
Mundy E, DuHamel K, Montgomery G (2003) The efficacy of behavioral interventions for cancer treatment-related side effects. Semin Clin Neuropsychiatry 8:253–275
Schwartz AL (2000) Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Pract 8:231–237
Segal R, Evans W, Johnson D, et al (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer:results of a randomized controlled trial. J Clin Oncol 19:657–665
Turk DC, Meichenbaum D, Genest M (1993) Pain and behavioral medicine: a cognitive–behavioral perspective. Guilford Press, New York
Ware JE (1993) SF-36 Health survey:manual and interpretation guide. The Health Institute, New England Medical Center, Boston
Ware JE (1994) SF-36 Physical and mental health summary scales: a user’s manual. The Health Institute, New England Medical Center, Boston
Winningham ML, MacVicar MG (1988) The effect of aerobic exercise on patient reports of nausea. Oncol Nurs Forum 15:447–450
Winningham ML, MacVicar MG, Bondoc M, Anderson JI, Minton JP (1989) Effect of aerobic exercise on body weight and composition in patients with breast cancer on adjuvant chemotherapy. Oncol Nurs Forum 16:683–689
Author information
Authors and Affiliations
Corresponding author
Additional information
This project was reviewed and approved by the Protocol Monitoring and Review Committee, H. Lee Moffitt Cancer Center and Research Institute and by the Institutional Review Board (Biomedical), University of South Florida.
Rights and permissions
About this article
Cite this article
Wilson, R.W., Taliaferro, L.A. & Jacobsen, P.B. Pilot study of a self-administered stress management and exercise intervention during chemotherapy for cancer. Support Care Cancer 14, 928–935 (2006). https://doi.org/10.1007/s00520-006-0021-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-006-0021-1