Chad W Wagoner, Jordan T Lee, Erik D Hanson, Zachary Y Kerr, Kirsten A Nyrop, Hyman B Muss, Claudio L Battaglini
{"title":"社区运动对早期乳腺癌幸存者疲劳的影响:确定改变的潜在决定因素。","authors":"Chad W Wagoner, Jordan T Lee, Erik D Hanson, Zachary Y Kerr, Kirsten A Nyrop, Hyman B Muss, Claudio L Battaglini","doi":"10.1007/s12282-022-01380-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (R<sup>2</sup> = 0.387; p < 0.01), depression (R<sup>2</sup> = 0.251; p < 0.01), self-efficacy, (R<sup>2</sup> = 0.453; p < 0.01), outcome expectations from exercise (R<sup>2</sup> = 0.254; p < 0.01), balance (R<sup>2</sup> = 0.167; p < 0.05), and the 6-minute walk test (R<sup>2</sup> = 0.193; p < 0.05). EBCS improvements in fatigue were associated with improvements in self-reported physical health (R<sup>2</sup> = 0.425; p < 0.01), depression (R<sup>2</sup> = 0.233; p < 0.01), pain (R<sup>2</sup> = 0.157; p < 0.05), outcome expectations from exercise (R<sup>2</sup> = 0.420; p < 0.01), and the 6-minute walk test (R<sup>2</sup> = 0.172; p < 0.05). Less fatigue in the CON group was shown be associated with better sleep quality (R<sup>2</sup> = 0.309; p < 0.05) and pain (R<sup>2</sup> = 0.259; p < 0.05).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1001-1012"},"PeriodicalIF":2.9000,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of community-based exercise on fatigue in early breast cancer survivors: identifying potential determinants of change.\",\"authors\":\"Chad W Wagoner, Jordan T Lee, Erik D Hanson, Zachary Y Kerr, Kirsten A Nyrop, Hyman B Muss, Claudio L Battaglini\",\"doi\":\"10.1007/s12282-022-01380-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (R<sup>2</sup> = 0.387; p < 0.01), depression (R<sup>2</sup> = 0.251; p < 0.01), self-efficacy, (R<sup>2</sup> = 0.453; p < 0.01), outcome expectations from exercise (R<sup>2</sup> = 0.254; p < 0.01), balance (R<sup>2</sup> = 0.167; p < 0.05), and the 6-minute walk test (R<sup>2</sup> = 0.193; p < 0.05). EBCS improvements in fatigue were associated with improvements in self-reported physical health (R<sup>2</sup> = 0.425; p < 0.01), depression (R<sup>2</sup> = 0.233; p < 0.01), pain (R<sup>2</sup> = 0.157; p < 0.05), outcome expectations from exercise (R<sup>2</sup> = 0.420; p < 0.01), and the 6-minute walk test (R<sup>2</sup> = 0.172; p < 0.05). Less fatigue in the CON group was shown be associated with better sleep quality (R<sup>2</sup> = 0.309; p < 0.05) and pain (R<sup>2</sup> = 0.259; p < 0.05).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":520574,\"journal\":{\"name\":\"Breast cancer (Tokyo, Japan)\",\"volume\":\" \",\"pages\":\"1001-1012\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2022-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast cancer (Tokyo, Japan)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12282-022-01380-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/6/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast cancer (Tokyo, Japan)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12282-022-01380-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/6/24 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Impact of community-based exercise on fatigue in early breast cancer survivors: identifying potential determinants of change.
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.