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Impact of community-based exercise on fatigue in early breast cancer survivors: identifying potential determinants of change

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Abstract

Background

Exercise has been shown to reduce fatigue in early breast cancer survivors (EBCS), though it is unclear if these results translate to community-based exercise settings. Mechanisms that influence changes in fatigue seen after exercise are also poorly understood. This study sought to evaluate the impact of community-based exercise and identify associations of fatigue in EBCS.

Methods

Twenty-nine EBCS and 13 non-cancer controls (CON) enrolled. Pre/post-intervention measurements included measures of fitness/function, balance, and adherence/compliance as well as self-reported measures of fatigue, health-related quality of life (HRQOL), well-being, self-efficacy, and physical activity. Both groups participated in a supervised 16-week aerobic + resistance exercise intervention. A mixed model ANOVA and Cohen’s D effect size assessed fatigue changes, and univariable linear regressions identified fatigue associations.

Results

Fatigue improved for EBCS (– 2.6, Cohen’s D = 0.51) but not CON (0.0, Cohen’s D = 0.02); no interaction effect was observed. Post-intervention fatigue in EBCS was associated with better QOL (R2 = 0.387; p < 0.01), depression (R2 = 0.251; p < 0.01), self-efficacy, (R2 = 0.453; p < 0.01), outcome expectations from exercise (R2 = 0.254; p < 0.01), balance (R2 = 0.167; p < 0.05), and the 6-minute walk test (R2 = 0.193; p < 0.05). EBCS improvements in fatigue were associated with improvements in self-reported physical health (R2 = 0.425; p < 0.01), depression (R2 = 0.233; p < 0.01), pain (R2 = 0.157; p < 0.05), outcome expectations from exercise (R2 = 0.420; p < 0.01), and the 6-minute walk test (R2 = 0.172; p < 0.05). Less fatigue in the CON group was shown be associated with better sleep quality (R2 = 0.309; p < 0.05) and pain (R2 = 0.259; p < 0.05).

Conclusion

Community-based exercise appears beneficial for alleviating fatigue in EBCS. These improvements may be driven by parallel improvements in psychosocial outcomes and objectively measured functional outcomes.

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Acknowledgements

This work was supported by the Breast Cancer Research Foundation. We would like to acknowledge DJ Amatuli, Stephanie Sullivan, Lauren Bates, and Paige Harrel for their extensive contributions and efforts in the recruitment, data collection, and exercise training portions of this project. We are also very grateful for the voluntary participation of all the breast cancer patients in the Get REAL and Heel Breast Cancer Program as well those that volunteered their time to participate in the control group. ClinicalTrials.gov Number: NCT03760536.

Funding

Breast Cancer Research Foundation.

Author information

Authors and Affiliations

  1. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Chad W. Wagoner, Jordan T. Lee, Erik D. Hanson, Zachary Y. Kerr & Claudio L. Battaglini

  2. Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Chad W. Wagoner, Jordan T. Lee, Erik D. Hanson, Zachary Y. Kerr & Claudio L. Battaglini

  3. Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N IN4, Canada

    Chad W. Wagoner

  4. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Erik D. Hanson, Kirsten A. Nyrop, Hyman B. Muss & Claudio L. Battaglini

  5. Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Zachary Y. Kerr

  6. Division of Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kirsten A. Nyrop & Hyman B. Muss

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  1. Chad W. Wagoner
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Contributions

All authors contributed to the study conception and design. Chad Wagoner contributed to the conceptualization, project administration lead, and writing. Jordan Lee contributed to the project administration, editing, and critical appraisal of content; Erik Hanson, Zachary Kerr, Kirsten Nyrop, and Hyman Muss contributed to the conceptualization, project administration, editing, and critical appraisal of content. Claudio Battaglini contributed to the conceptualization, methodology, editing, and critical appraisal of content.

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Correspondence to Chad W. Wagoner.

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Wagoner, C.W., Lee, J.T., Hanson, E.D. et al. Impact of community-based exercise on fatigue in early breast cancer survivors: identifying potential determinants of change. Breast Cancer 29, 1001–1012 (2022). https://doi.org/10.1007/s12282-022-01380-y

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