Heim 2007.

Study characteristics
Methods	Study design: quasi‐RCT Number randomized: 63; 32 assigned to the exercise group and 31 to the control group Study start and stop dates: not reported Length of intervention: unclear Length of follow‐up: 3 months' postrehabilitation
Participants	Type cancer: breast cancer Time since cancer diagnosis: not reported Time beyond active treatment: not reported, but at least 6 weeks since surgery or chemotherapy Inclusion criteria: score of 4 or more on a linear analog scale evaluating fatigue ranging in value from 0 to 10 Eligibility criterion related to interest or ability to exercise, or both: not reported Exclusion criteria: psychiatric condition < 6 weeks since surgery or chemotherapy Gender: female Current age, n (%): exercise group: 31 to 50 years, 14 (44%); 51 to 70 years, 18 (56%) control group: 31 to 50 years, 18 (58%); 51 to 70 years, 13 (42%) Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level: not reported SES: not reported Employment status, n (%): exercise group: working, professional life, 19 (59%) control group: working, professional life, 23 (74%) Comorbidities: not reported Past exercise history (before disease), n (%): exercise group: no sports, 8 (25%); < 1 hour per week, 11 (34%); 1 to 2 hours per week, 11 (34%); ≥ 3 hours per week, 2 (6%) control group: no sports, 8 (26%); < 1 hour per week, 10 (32%); 1 to 2 hours per week, 10 (32%); ≥ 3 hours per week, 3 (10%) On hormone therapy: none
Interventions	32 participants assigned to the exercise intervention, including: educational program, physical therapy, group exercise, and psycho‐oncologic interventions brochure with instructions for 9 muscle strength and 9 stretching exercises for all large muscle groups, demonstrated by instructor instructions for aerobic exercises (walking program), coordination, and relaxation Type exercise (aerobic/anaerobic): aerobic Intensity of experimental exercise intervention: not reported Frequency: instructions were to complete strength training 3 times per week and aerobic exercise for 30 minutes twice per week Duration of exercise session: not reported Duration of exercise program: not reported Total number of exercise sessions: not reported Format: individual Facility: inpatient rehabilitation center, but exercises could also be completed at home Professionally led: initial instruction and printed brochures, but no further instruction Adherence: assessed as percentage (where adherence to program was equal to 100%), adherence to: muscle strength was 26% at end of rehabilitation and 37% at 3 months after rehabilitation stretching was 30% at end of rehabilitation and 42% at 3 months after rehabilitation aerobic exercises were 163% at end of rehabilitation and 192% at 3 months after rehabilitation 31 participants assigned to control group, including: educational program, physical therapy, group exercise, and psycho‐oncological interventions Contamination of control group: not reported, although this group received group exercises
Outcomes	Outcomes: QoL outcomes, including: FACIT HADS MFI questionnaire on physical activity and motivation to perform exercises and sport aerobic capacity, using Harvard step test muscular strength, using Digimax Multifunktionstest Outcomes were measured at baseline, after rehabilitation and at 3 months, 59 participants with complete data: exercise group: number at baseline not reported, n = 32 at 3 months control group: number at baseline not reported, n = 31 at 3 months total number of participants at 6 months = 59, not reported by group assignment Adverse events: not reported
Notes	Country: Germany Funding: German Fatigue Society
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	"according to their admission to hospital; depending on the alternating weeks they were allocated to the intervention group or the control group."
Allocation concealment (selection bias)	High risk	Because of alternation, the investigators were aware of the next treatment assignment
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	High risk	There were complete data packets for 59 participants, but no information on missing patients.  Also, "More patients in the control group (15) than in the training group (12) did not continue the study"
Selective reporting (reporting bias)	Low risk	There appears to be no selective reporting of outcomes
Other bias	Unclear risk	Poorly described study