Cadmus 2009.

Study characteristics
Methods	Study design: RCT Number randomized: 75; 37 to the exercise group and 38 to the control group Study start and stop dates: March 2004 to July 2006 Length of intervention: 6 months Length of follow‐up: to end of the intervention
Participants	Type cancer: breast cancer, stage 0 to IIIA Time since cancer diagnosis, mean (SD) weeks: exercise group: 187.5 (114.2) weeks control group: 173.2 (135.2) weeks Time beyond active treatment: at least 12 months Inclusion criteria: cancer survivor 34 to 79 years old nondiabetic inactive (< 90 minutes per week of moderate to vigorous intensity recreational physical activity) postmenopausal Eligibility criteria related to interest or ability to exercise, or both: none reported Exclusion criteria: diagnosis of recurrent or other primary cancer event current smoker current or planned enrolment in a structured weight loss program premenopausal physically active diabetes mellitus Gender: female Current age, mean (SD) years: exercise group: 56.5 (9.5) years control group: 55.1 (7.7) years Age at cancer diagnosis: not reported Ethnicity/race: 84% non‐Hispanic white for both groups Education level: exercise group: college degree or higher, 60% control group: college degree or higher, 41% SES: not reported Employment status: not reported Comorbidities: none Past exercise history, mean (SD): exercise group: Physical Activity Questionnaire score, 13 (24) minutes per day of physical activity; pedometer, 5145 (2312) steps per day control group: Physical Activity Questionnaire score, 12 (20) minutes per day of physical activity; pedometer, 5342 (2744) steps per day On hormone therapy: exercise group, 57% control group, 70%
Interventions	37 participants assigned to the exercise intervention, including: home‐ and facility‐based supervised exercise program Type exercise (aerobic/anaerobic): aerobic Intensity of the experimental exercise intervention: Polar HR monitors to maintain the goal of 60% to 80% of predicted maximal HR Frequency: 5 days per week Duration of individual sessions: 30 minutes Duration of exercise program: 6 months Total number of exercise sessions: 120 Format: individual Facility: 2 days/week at home and 3 days/week at a facility (local health club) Professionally led: professionally led by an exercise physiologist Adherence: average 123 minutes/week (SD 52) of moderate to vigorous intensity sports/recreational activity (range: 0 to 637) 34% of participants met the study goal of 150 minutes/week 56% completed at least 120 minutes/week, or 80% of the study goal 67% attended supervised exercise sessions 96% reported exercising at least twice per week at home 38 participants assigned to control group, including: usual exercise Contamination of control group: not reported
Outcomes	Outcomes: QoL and physiologic outcomes, including: happiness, assessed using the 2‐item Fordyce Happiness Measure self‐esteem, assessed using the RSE Scale depression, assessed using the CES‐D anxiety, assessed using the STAI stress, assessed using the Cohen's 10‐item Perceived Stress Scale QoL, assessed using FACT‐B QoL, assessed using the MOS SF‐36 physical activity anthropometric measurements Outcomes were measured at baseline and 6 months: exercise group: n = 37 at baseline, n = 37 at 6 months control group: n = 38 at baseline, n = 37 at 6 months Adverse events: none reported
Notes	Country: US Funding: Lance Armstrong Foundation, American Cancer Society, Susan G. Komen. In part by the National Center of Research Resources (NIH)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer generated randomization code
Allocation concealment (selection bias)	Low risk	"The randomization code was obtained by the principal investigator (who was not involved in recruitment or data collection) only after baseline measures for that individual had been completed and staff conducting clinic visits did not have access to the randomization program"
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to blind the participants; however, it is unclear whether the outcome was influenced by a lack of masking
Blinding of outcome assessment (detection bias) All outcomes	High risk	Study personnel and outcome assessors were not masked or blinded to the study interventions
Incomplete outcome data (attrition bias) All outcomes	Low risk	ITT analysis performed
Selective reporting (reporting bias)	Low risk	There appears to be no selective reporting of outcomes
Other bias	Low risk	The trial appears to be free of other problems that could put it at a high risk of bias