Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer

Abstract

Purposes/objectives: To test the hypothesis that women participating in a walking exercise program during radiation therapy treatment for breast cancer would demonstrate more adaptive responses as evidenced by higher levels of physical functioning and lower levels of symptom intensity than women who did not participate.

Design: Experimental, two-group pretest, post-test.

Setting: Two university teaching hospital outpatient radiation therapy departments.

Sample: 46 women beginning a six-week program of radiation therapy for early stage breast cancer.

Methods: Following random assignment, subjects in the exercise group maintained an individualized, self-paced, home-based walking exercise program throughout treatment. The control group received usual care. Dependent variables were measured prior to and at the end of radiation therapy. In addition, symptoms were assessed at the end of three weeks of treatment.

Main research variables: Participation in the walking exercise program, physical functioning fatigue, emotional distress, and difficulty sleeping.

Findings: Hypothesis testing by multivariate analysis of covariance, with pretest scores as covariates, indicated significant differences between groups on outcome measures (p < 0.001). The exercise group scored significantly higher than the usual care group on physical functioning (p = 0.003) and symptom intensity, particularly fatigue, anxiety, and difficulty sleeping. Fatigue was the most frequent and intense subjective symptom reported.

Conclusions: A self-paced, home-based walking exercise program can help manage symptoms and improve physical functioning during radiation therapy.

Implications for nursing practice: Nurse-prescribed and -monitored exercise is an effective, convenient, and low-cost self-care activity that reduces symptoms and facilitates adaptation to breast cancer diagnosis and treatment.