Effects of a 12-week supervised resistance training program, combined with home-based physical activity, on physical fitness and quality of life in female breast cancer survivors: the EFICAN randomized controlled trial

Abstract

Purpose: This study assessed the effects of 12-week supervised resistance training combined with home-based physical activity on physical fitness, cancer-related fatigue, depressive symptoms, health-related quality of life (HRQoL), and life satisfaction in female breast cancer survivors.

Methods: A parallel-group, outcome assessor-blinded, randomized controlled trial included 60 female breast cancer survivors who had completed their core treatments within the previous 10 years. Through computer-generated simple randomization, participants were assigned to resistance training (RTG; two sessions/week for 12 weeks plus instructions to undertake ≥ 10,000 steps/d) or control (CG; ≥ 10,000 steps/d only). Outcomes were evaluated at baseline and week 12. Muscular strength was assessed with electromechanical dynamometry. A standardized full-body muscular strength score was the primary outcome. Secondary outcomes included cardiorespiratory fitness, shoulder mobility, cancer-related fatigue, depressive symptoms, HRQoL, and life satisfaction.

Results: Thirty-two participants were assigned to RTG (29 achieved ≥ 75% attendance) and 28 to CG (all completed the trial). Intention-to-treat analyses revealed that the standardized full-body muscular strength score increased significantly in the RTG compared to the CG (0.718; 95% CI 0.361-1.074, P < 0.001, Cohen's d = 1.04). This increase was consistent for the standardized scores of upper-body (0.727; 95% CI 0.294-1.160, P = 0.001, d = 0.87) and lower-body (0.709; 95% CI 0.324-1.094, P = 0.001, d = 0.96) strength. There was no effect on cardiorespiratory fitness, shoulder flexion, cancer-related fatigue, depressive symptoms, HRQoL, or life satisfaction. The sensitivity analyses confirmed these results.

Conclusion: and implication for cancer survivors. In female breast cancer survivors who had completed their core treatments within the past 10 years, adding two weekly sessions of supervised resistance training to a prescription of home-based physical activity for 12 weeks produced a large increase in upper-, lower-, and full-body muscular strength, while other fitness components and patient-reported outcomes did not improve.

Trial registration number: ISRCTN14601208.

Keywords: Breast cancer; Cancer-related fatigue; Health-related quality of life; Muscular strength; Resistance training.

Fig. 1

Graphical representation of the muscular strength assessment comprising the isometric mid-thigh pull test (A), the unilateral isometric knee extension in a closed kinetic chain at 90° (B), the bilateral isometric seated bench press (C), the unilateral isometric seated bench press (D), the bilateral isometric seated row (E), and the unilateral isometric seated row (F). Reprinted from Soriano-Maldonado et al. Medicine 2019;98:44(e17625), distributed under the terms of the Creative Commons CC-BY license (i.e. no permissions required)

Fig. 2

CONSORT flowchart of the study participants throughout the EFICAN randomized controlled trial

Fig. 3

Graphical representation of the effects of the resistance training intervention on the peak isometric muscular strength for the different tests at the individual level in breast cancer survivors. The dots represent the baseline levels, and the arrows represent the changes at 12-week follow-up