TABLE 1.
Characteristics of randomized controlled trials evaluating the effects of home-based PA on fatigue.
| Study | Sample Size | Age (yr), % Female, % Caucasian, % Higher Education | Diagnosis (%) | Treatment (%) | Time Since Diagnosisa or Treatmentb | Inclusion and Exclusion Criteria | Intervention and Control | Primary Outcomes | Fatigue Instrument |
|---|---|---|---|---|---|---|---|---|---|
| Baruth et al. (32) | n = 32 (I:20, C: 12) | 56.46 (6.25), 100% female, 75% Caucasian, 91% higher education | Breast cancer | Surgery 91% Chemo 72% Radiation 78% Hormone 66% |
5. 1 (4.1) monthsb | Inclusion: 1) diagnosed with stage I–III cancer, 2) completed adjuvant treatment within the last 12 months, 3) postmenopausal, 4) free of cardiovascular disease and major orthopedic limitations, 5) not regularly active (<5 d·wk−1) Exclusion: — |
I: Home-based walking + counseling Duration: 12 wk Intensity: moderate intensity of RPE 10–11 (at weeks 1–8) and moderate to vigorous intensity of RPE 12–15 (at weeks 8–12) Frequency: from 3 d·wk−1 for 20 min (weeks 1–8) to 5 d·wk−1 for 30 to 40 min (weeks 8–12) Counseling: One in-person counseling session of 30 min (baseline) and five telephone counseling calls of 10–15 min (weeks 1, 2, 4, 7, and 10) provided by public health doctoral students Counseling was based on the social cognitive theory and focused on goal setting and exercise safety Materials: 1) pedometer and 2) activity logs. C: Wait-list control. Asked to remain usual PA levels and received the intervention upon completion of the study |
1) Quality of life (SF-36 and IBCSG-QLC) and 2) fatigue (FACT-F) | FACT-F |
| Pinto et al. (33) | n = 46 (I:20, C: 26) | 57.3 (9.7); 56% female, 98% Caucasian, 76% higher education |
Colon cancer (57%) and rectal cancer (43%) | Surgery 100% Chemo 83% Radiation 43% |
3.0 (1.6) yra | Inclusion: 1) age ≥18 yr, 2) completed primary and adjuvant treatments for colon or rectal cancer, 3) ≤5 yr since treatment completion, 4) able to read and speak English, 5) consent for medical chart review, 6) able to walk unassisted, 7) sedentary (exercising <60 min·wk−1 at moderate intensity or <20 min·wk−1 of vigorous intensity over the past 6 months), 8) access to a telephone Exclusion: 1) history of cancer or 2) a medical or current psychiatric illness |
I: Home-based PA + counseling Duration: 12 wk Intensity: moderate intensity at 64%–76% of HRM Frequency: first few weeks at least 10 min on at least 2 d·wk−1 Gradually increase to 30 min on 5 d·wk−1 Counseling: weekly telephone calls provided by research staff to monitor PA participation, identify relevant health problems, problem solve any barriers to PA, and reinforce participants for their efforts. Counseling was based on the transtheoretical model, the social cognitive theory, and motivational interviewing. Materials: 1) pedometer, 2) activity log, and 3) cancer survivorship tip sheets. C: Attentional control. Received weekly calls to monitor problems and cancer survivorship tip sheets |
1) Self-reported PA (7-d PAR), 2) submaximal fitness (treadwalk test) | FACT-F |
| Pinto et al. (34) | n = 192 (I:106, C: 86) | 60.0 (9.9); 100% female, 94% Caucasian, 76% higher education |
Breast cancer | Surgery 74%–100% Chemo 60% Radiation 72% Hormone 77% |
2.9 (2.1) yra | Inclusion: 1) female age > = 18 yr, 2) completed primary and adjuvant treatment for breast cancer (patients on hormone treatment such as tamoxifen were eligible), 3) = < 5 yr since treatment completion, 4) able to read and speak English, 5) provided consent for medical chart review, 6) able to walk unassisted, 7) relatively inactive (<30 min·wk−1 of vigorous intensity or <90 min·wk−1 of moderate intensity exercise), and 8) had access to a telephone. Exclusion: 1) a history of cancer or 2) a medical or current psychiatric illness |
I: Home-based PA + counseling Duration: 12 wk Intensity: low to moderate intensity at 55%–65% of HRM Frequency: First few weeks: at least 10 min on at least 2 d·wk−1. Gradually increase of goals to 30 min on at least 5 d·wk−1 Counseling: at baseline brief PA advice (<5 min) about PA benefits and recommendation of 30 min of moderate-intensity PA on most days of the week. Counseling was provided by research staff through weekly telephone calls at weeks 1–4, and biweekly calls at weeks 5–12. Counseling was based on the transtheoretical model, the social cognitive theory, and motivational interviewing, and focused on strengthening self-efficacy for PA, self-monitoring of PA, setting PA goals, and planning for exercise. Materials: 1) pedometer, 2) activity log, 3) PA and cancer survivorship tip sheet (weekly), and 4) feedback letter with participant’s progress (weeks 2, 4, 8, 12) C: Attentional control. Received brief PA advice (<5 min) about PA benefits and recommendation of 30 min of moderate-intensity PA on most days of the week, weekly calls during which the Symptom Questionnaire was administered to monitor problems and cancer survivorship tip sheets |
Self-reported PA (7-d PAR) | FACT-F |
| Vallance et al. (35) | n = 377 (PM: 94, PED: 94, COM: 93, C: 96) | 58 (range: 30–90); 100% female, 65% Caucasian, 30% higher education |
Breast cancer | Surgery 100% Chemo 54% Radiation 69% Hormone 67% Hormone current 59% |
3.25 (0.94) yra | Inclusion: 1) histologically confirmed stage I to IIIa breast cancer, 2) physician approval, 3) free of chronic medical and orthopedic conditions that would preclude PA, 4) English language, 5) completion of adjuvant therapy except hormone therapy, and 6) absence of current breast cancer Exclusion: — |
I: Home-based use of exercise materials Duration: 12 wk Intensity/frequency: standard recommendation to perform 30 min of moderate/vigorous PA on 5 d of the week Materials: PM group: exercise guide PED group: 1) pedometer and 2) 12-wk step calendar COM group: 1) pedometer and 2) 12-wk step calendar, and 3) exercise guide C: Usual care. Standard recommendation to perform 30 min of moderate/vigorous PA on 5 d of the week |
Self-reported PA (GLTEQ) | FACT-F |
| Zhou et al. (36) | n = 144 (I:74, C: 70) | 57.3 (8.6); 100% female, 95% Caucasian, 56% higher education |
Ovarian cancer | Chemo 93.1% | 1.7 (1.0) yra | Inclusion: 1) English speaking, 2) age between 18 and 75 yr, 3) diagnosed with ovarian cancer within the past 4 yr, 4) completion of chemotherapy at least 1 month before random assignment, 5) exercising fewer than 90 min· wk−1, and 6) physician consent to start an exercise program Exclusion: — |
I: Home-based PA + counseling Duration: 6 months Intensity: moderate Frequency: 150 min· wk−1 Counseling: weekly telephone counseling provided by a trainer to motivate participants to exercise, and to discuss topics related to exercise and to ovarian cancer survivorship Materials: 1) heart rate monitor and 2) daily activity log C: Attentional control. Received weekly phone calls and a 26-chapter book that contained ovarian cancer survivorship–related information |
1) Quality of life (SF-36) and 2) fatigue (FACT-F) | FACT-F |
| Bennett et al. (37) | n = 56 (I:28, C: 28) | 57.8 (10.0), 89% female, 98% Caucasian, 73% higher education | Breast cancer (77%) and other (25%) | NA | 5.9 (4.68) yra 3.5 (3.64) yrb |
Inclusion: 1) 18 yr or older, 2) completed treatment at least 6 months before enrollment, 3) fatigued or underactive (engaged in planned exercise fewer than 3 d·wk−1 for 20 min), 4) willing to try to increase PA Exclusion: 1) prior transplant treatment for cancer, 2) current immunosuppressive therapy, 3) medical conditions that contraindicated moderate exercise, 4) cognitive difficulties, and 5) psychiatric disorders |
I: Home-based PA + counseling Duration: 6 months Intensity: moderate Frequency: 30 min on most days of the week Counseling: Counseling was provided by a PA counselor, with the first counseling session in person of 30 min, and three telephone calls of 20 min at 2 wk, 2 months, and 4.5 months. Counseling was based on motivational interviewing, with motivational strategies directed at problem solving, offering encouragement, and reformulating goals. Materials: pedometer C: Attentional control. Asked to maintain their current levels of PA and received two telephone calls without motivational interviewing content (at 2 and 4.5 months) |
Self-reported PA (CHAMPS) | SCFS |
| Nyrop et al. (38) | n = 62 (I:31, C: 31) | 63.8 (8.3); 100% female, 74% Caucasian, 77% higher education |
Breast cancer | Surgery: 84%–100% Radiation 74% Chemo 65% Hormone 29% Hormone currently 53%–100% |
2.8 (2.5) yra | Inclusion: 1) adherent to AI prescription for at least 4 wk; 2) age 21 yr or older; 3) not undergoing chemotherapy or radiation treatment during the study period; 4) score of 3 out of 5 on a scale about joint pain, stiffness, or achiness intensity; 5) exercising less than 150 min· wk−1 Exclusion: — |
I: Home-based walking Duration: 6 wk Intensity: NA Frequency: 150 min· wk−1 Materials: 1) daily activity log, 2) workbook with strategies for starting and sustaining a daily walking program, and 3) brochure with topics related to walking, joint pain and treatment, and experiences of women who had completed the walking program before C: Wait-list control. Asked to await further contact from the research team and received intervention after 6 wk |
1) Self-reported walking (minutes per week), 2) joint pain/symptoms (WOMAC, VAS pain, VAS fatigue, VAS stiffness, pain points total), and 3) adherence to AI therapy | VAS fatigue |
| Pinto et al. (39) | n = 86 (I:43, C: 43) | 53.14 (9.76), 100% female, 95% Caucasian, 81% higher education |
Breast cancer | Surgery 49%–93% Chemo 56% Radiation 69% Hormone 62% |
1.84 (1.43) yra | Inclusion: 1) 18 yr or older; 2) sedentary (exercised < one time per week for 20 min at vigorous intensity or < two times per week for 30 min at moderate intensity for the past 6 months); 3) diagnosed with stage 0 to II breast cancer over the last 5 yr; 4) completed surgery, chemotherapy and/or radiation; 5) ambulatory; and 6) willing to be randomized Exclusion: 1) history of cancer (exception: nonmelanoma skin cancer), 2) medical or current psychiatric illness that could make compliance with the study protocol difficult or dangerous |
I: Home-based PA + counseling Duration: 12 wk Intensity: low to moderate intensity at 55%–65% of HRM Frequency: first few weeks at least 10 min on at least 2 d·wk−1. Gradually increase to 30 min on at least 5 d·wk−1 Counseling: During intervention weekly, telephone calls from research staff to monitor PA participation, identify relevant health problems, problem solve any barriers to PA, and reinforce participants for their efforts. Counseling was based on the transtheoretical model. After intervention, monthly calls for 3 months to prompt and reinforce regular PA. Materials: 1) pedometer, 2) activity log, 3) PA and cancer survivorship tip sheet (weekly), and 4) feedback letter with participant’s progress (weeks 2, 4, 8, 12) C: Attentional control. Asked not to change current level of PA and received weekly phone calls and cancer survivorship tip sheet |
1) BMI, 2) self-reported PA (7-d PAR), 3) Rockport 1-mile walk test, 4) PA monitoring (accelerometer), 5) stage of motivational readiness for PA, 6) POMS, 7) fatigue (VAS), 8) body esteem scale | VAS fatigue |
| Pinto et al. (40) | n = 86 (I:43, C: 43) | See Pinto et al. (40) | See Pinto et al. (40) | See Pinto et al. (40) | See Pinto et al. (40) | See Pinto et al. (40) | See Pinto et al. (38) | Self-reported PA (7-d PAR) | See Pinto et al. (40) |
aTime since diagnosis.
bTime since treatment.
7-d PAR, 7-d Physical Activity Recall; AI, aromatase inhibitors; BMI, body mass index; C, control; CHAMPS, Community Health Activities Model Program for Seniors; COM, combined group; FACT-F, Functional Assessment of Cancer Therapy—Fatigue; GLTEQ, Godin Leisure-Time Exercise Questionnaire; HRM, maximum heart rate; I, intervention; IBCSG-QLC, International Breast Cancer Study Group QOL Core Questionnaire; NA, not available; PA, physical activity; PED, pedometer group; PM, print material group; RPE, rating of perceived exertion; SF-36, Short Form Health Survey 36; SCFS, Schwartz Cancer Fatigue Scale; POMS, Profile Of Mood States; VAS, visual analog scale; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.