Structured exercise improves physical functioning in women with stages I and II breast cancer: Results of a randomized controlled trial

Purpose: Self-directed and supervised exercise were compared with usual car e in a clinical trial designed to evaluate the effect of structured exercis e on physical functioning and other dimensions of health-related quality of life in women with stages I and II bread cancer. Patients and Methods: One hundred twenty-three women with stages I and II b reast cancer completed baseline evaluations of generic and disease- and sit e-specific health-related quality of life, aerobic capacity, and body weigh t. Participants were randomly allocated to one of three intervention groups : usual care (control group), self-directed exercise, or supervised exercis e. Quality of life, aerobic capacity, and body weight measures were repeate d at 26 weeks. The primary outcome was the change in the Short Form-36 phys ical functioning scale between baseline and 26 weeks. Results: Physical functioning in the control group decreased by 4.1 points, whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups, respectively (P = .04). Post hoc analysis show ed a moderately large land clinically important) difference between the sel f-directed and control groups (9.8 points; P = .01)and a more modest differ ence between the supervised and control groups (6.3 points; P = .09). No si gnificant differences between groups were observed for changes in quality o f life scores. In a secondary analysis of participants stratified by type o f adjuvant therapy, supervised exercise improved aerobic capacity (+3.5 ml/ kg/min; P = .01) and reduced body weight (-4.8 kg; P < .05) compared with u sual care only in participants not receiving chemotherapy. Conclusion: Physical exercise can blunt some of the negative side effects o f breast cancer treatment, including reduced physical functioning. Self-dir ected exercise is an effective way to improve physical functioning compared with usual care. In participants not receiving chemotherapy, supervised ex ercise may increase aerobic capacity and reduce body weight compared with u sual care. (C) 2001 by American Society of Clinical Oncology.