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Review
. 2012 Aug 15;2012(8):CD007566.
doi: 10.1002/14651858.CD007566.pub2.

Exercise interventions on health-related quality of life for cancer survivors

Shiraz I Mishra  1 , Roberta W Scherer, Paula M Geigle, Debra R Berlanstein, Ozlem Topaloglu, Carolyn C Gotay, Claire Snyder
Affiliations
Review

Exercise interventions on health-related quality of life for cancer survivors

Shiraz I Mishra et al. Cochrane Database Syst Rev. .

Abstract

Background: Cancer survivors experience numerous disease and treatment-related adverse outcomes and poorer health-related quality of life (HRQoL). Exercise interventions are hypothesized to alleviate these adverse outcomes. HRQoL and its domains are important measures for cancer survivorship.

Objectives: To evaluate the effectiveness of exercise on overall HRQoL and HRQoL domains among adult post-treatment cancer survivors.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, PEDRO, LILACS, SIGLE, SportDiscus, OTSeeker, and Sociological Abstracts from inception to October 2011 with no language or date restrictions. We also searched citations through Web of Science and Scopus, PubMed's related article feature, and several websites. We reviewed reference lists of included trials and other reviews in the field.

Selection criteria: We included all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing exercise interventions with usual care or other nonexercise intervention to assess overall HRQoL or at least one HRQoL domain in adults. Included trials tested exercise interventions that were initiated after completion of active cancer treatment. We excluded trials including people who were terminally ill, or receiving hospice care, or both, and where the majority of trial participants were undergoing active treatment for either the primary or recurrent cancer.

Data collection and analysis: Five paired review authors independently extracted information on characteristics of included trials, data on effects of the intervention, and assessed risk of bias based on predefined criteria. Where possible, meta-analyses results were performed for HRQoL and HRQoL domains for the reported difference between baseline values and follow-up values using standardized mean differences (SMD) and a random-effects model by length of follow-up. We also reported the SMDs between mean follow-up values of exercise and control group. Because investigators used many different HRQoL and HRQoL domain instruments and often more than one for the same domain, we selected the more commonly used instrument to include in the SMD meta-analyses. We also report the mean difference for each type of instrument separately.

Main results: We included 40 trials with 3694 participants randomized to an exercise (n = 1927) or comparison (n = 1764) group. Cancer diagnoses in study participants included breast, colorectal, head and neck, lymphoma, and other. Thirty trials were conducted among participants who had completed active treatment for their primary or recurrent cancer and 10 trials included participants both during and post cancer treatment. Mode of the exercise intervention included strength training, resistance training, walking, cycling, yoga, Qigong, or Tai Chi. HRQoL and its domains were measured using a wide range of measures.The results suggested that exercise compared with control has a positive impact on HRQoL and certain HRQoL domains. Exercise resulted in improvement in: global HRQoL at 12 weeks' (SMD 0.48; 95% confidence interval (CI) 0.16 to 0.81) and 6 months' (0.46; 95% CI 0.09 to 0.84) follow-up, breast cancer concerns between 12 weeks' and 6 months' follow-up (SMD 0.99; 95% CI 0.41 to 1.57), body image/self-esteem when assessed using the Rosenberg Self-Esteem scale at 12 weeks (MD 4.50; 95% CI 3.40 to 5.60) and between 12 weeks' and 6 months' (mean difference (MD) 2.70; 95% CI 0.73 to 4.67) follow-up, emotional well-being at 12 weeks' follow-up (SMD 0.33; 95% CI 0.05 to 0.61), sexuality at 6 months' follow-up (SMD 0.40; 95% CI 0.11 to 0.68), sleep disturbance when comparing follow-up values by comparison group at 12 weeks' follow-up (SMD -0.46; 95% CI -0.72 to -0.20), and social functioning at 12 weeks' (SMD 0.45; 95% CI 0.02 to 0.87) and 6 months' (SMD 0.49; 95% CI 0.11 to 0.87) follow-up. Further, exercise interventions resulted in decreased anxiety at 12 weeks' follow-up (SMD -0.26; 95% CI -0.07 to -0.44), fatigue at 12 weeks' (SMD -0.82; 95% CI -1.50 to -0.14) and between 12 weeks' and 6 months' (SMD -0.42; 95% CI -0.02 to -0.83) follow-up, and pain at 12 weeks' follow-up (SMD -0.29; 95% CI -0.55 to -0.04) when comparing follow-up values by comparison group.Positive trends and impact of exercise intervention existed for depression and body image (when analyzing combined instruments); however, because few studies measured these outcomes the robustness of findings is uncertain.No conclusions can be drawn regarding the effects of exercise interventions on HRQoL domains of cognitive function, physical functioning, general health perspective, role function, and spirituality.Results of the review need to be interpreted cautiously owing to the risk of bias. All the trials reviewed were at high risk for performance bias. In addition, the majority of trials were at high risk for detection, attrition, and selection bias.

Authors' conclusions: This systematic review indicates that exercise may have beneficial effects on HRQoL and certain HRQoL domains including cancer-specific concerns (e.g. breast cancer), body image/self-esteem, emotional well-being, sexuality, sleep disturbance, social functioning, anxiety, fatigue, and pain at varying follow-up periods. The positive results must be interpreted cautiously due to the heterogeneity of exercise programs tested and measures used to assess HRQoL and HRQoL domains, and the risk of bias in many trials. Further research is required to investigate how to sustain positive effects of exercise over time and to determine essential attributes of exercise (mode, intensity, frequency, duration, timing) by cancer type and cancer treatment for optimal effects on HRQoL and its domains.

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Conflict of interest statement

The authors declare no conflict of interest.

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  • doi: 10.1002/14651858.CD007566

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References

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Demark‐Wahnefried 2006 {published data only}
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Demark‐Wahnefried 2007 {published data only}
    1. Demark-Wahnefried W, Clipp EC, Lipkus IM, Lobach D, Snyder DC, Sloane R, et al. Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. Journal of Clinical Oncology 2007;25(19):2709-18. - PubMed
Dincer 2007 {published data only}
    1. Dincer U, Kaya E, Cakar E, Kiralp MZ, Dursun H. Effectiveness of comprehensive rehabilitation program and home-based exercise in middle and long term mastectomy related disability. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 2007;53(4):138-43.
Dong 2006 {published data only}
    1. Dong H-Y, Wang Z-F, Cai L. Correlation between quality of life and rehabilitative guidance education in the postoperative patients with breast cancer. Chinese Journal of Clinical Rehabilitation 2006;10(42):28-30.
Duijts 2009 {published data only}
    1. Duijts SF, Oldenburg HS, Beurden M, Aaronson NK. Cognitive behavioral therapy and physical exercise for climacteric symptoms in breast cancer patients experiencing treatment-induced menopause: design of a multicenter trial. BMC Women's Health 2009;9:15. - PMC - PubMed
Elkin 1998 {published data only}
    1. Elkin TD, Tyc VL, Hudson M, Crom D. Participation in sports by long-term survivors of childhood cancer. Journal of Psychosocial Oncology 1998;16(1):63-73.
Elliott 2006 {published data only}
    1. Elliott D, McKinley S, Alison JA, Aitken LM, King MT. Study protocol: home-based physical rehabilitation for survivors of a critical illness [ACTRN12605000166673]. Critical Care 2006;10(3):R90. - PMC - PubMed
Emslie 2007 {published data only}
    1. Emslie C, Whyte F, Campbell A, Nutrie N, Lee L, Ritchie D, Kearney N. 'I wouldn't have been interested in just sitting round a table talking about cancer'; exploring the experiences of women with breast cancer in a group exercise trial. Health Education Research 2007;22(6):827-838. - PubMed
Fairey 2005 {published data only}
    1. Fairey AS, Courneya KS, Field C J, Bell GJ, Jones LW, Mackey JR. Randomized controlled trial of exercise and blood immune function in postmenopausal breast cancer survivors. Journal of Applied Physiology 2005;98(4):1534-40. - PubMed
Fairey 2005a {published data only}
    1. Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Martin BS, et al. Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: a randomized controlled trial. Brain, Behavior, and Immunity 2005;19(5):381-8. - PubMed
Filocamo 2005 {published data only}
    1. Filocamo M T, Li Marzi V, Del Popolo G, Cecconi F, Marzocco M, Tosto A, et al. Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. European Urology 2005;48(5):734-8. - PubMed
Gordon 2005 {published data only}
    1. Gordon L G, Battistutta D, Scuffham P, Tweeddale M, Newman B. The impact of rehabilitation support services on health-related quality of life for women with breast cancer. Breast Cancer Research and Treatment 2005;93(3):217-26. - PubMed
Griffith 2009 {published data only}
    1. Griffith K, Wenzel J, Shang J, Thompson C, Stewart K, Mock V. Impact of a walking intervention on cardiorespiratory fitness, self-reported physical function, and pain in patients undergoing treatment for solid tumors. Cancer 2009;115(20):4874-84. - PMC - PubMed
Hayes 2004 {published data only}
    1. Hayes S, Davies PS, Parker T, Bashford J, Newman B. Quality of life changes following peripheral blood stem cell transplantation and participation in a mixed-type, moderate-intensity, exercise program. Bone Marrow Transplant 2004;33(5):553-8. - PubMed
Houborg 2006 {published data only}
    1. Houborg KB, Jensen MB, Rasmussen P, Gandrup P, Schroll M, Laurberg S. Postoperative physical training following colorectal surgery: a randomised, placebo-controlled study. Scandinavian Journal of Surgery 2006;95(1):17-22. - PubMed
Hughes 2004 {published data only}
    1. Hughes DC. Physical activity and stress in Hispanic breast cancer survivors. Dissertation Abstracts International: Section B: The Sciences and Engineering 2004;65((10-B)).
Hughes 2008 {published data only}
    1. Hughes DC, Leung P, Naus MJ. Using single-system analyses to assess the effectiveness of an exercise intervention on quality of life for Hispanic breast cancer survivors: a pilot study. Social Work in Health Care 2008;47(1):73-91. - PubMed
Jarden 2009 {published data only}
    1. Jarden M, Baadsgaard MT, Hovgaard DJ, Boesen E, Adamsen L. A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT. Bone Marrow Transplantation 2009;43(9):725-37. - PubMed
Jones 2004a {published data only}
    1. Jones LW, Courneya KS, Fairey AS, Mackey JR. Effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Annals of Behavioral Medicine 2004;28(2):105-13. - PubMed
Jones 2008 {published data only}
    1. Jones LW, Eves ND, Peterson BL, Garst J, Crawford J, West MJ, et al. Safety and feasibility of aerobic training on cardiopulmonary function and quality of life in postsurgical nonsmall cell lung cancer patients: a pilot study. Cancer 2008;113(12):3430-9. - PubMed
Kilbreath 2006 {published data only}
    1. Kilbreath SL, Refshauge KM, Beith JM, Ward LC, Simpson JM, Hansen RD. Progressive resistance training and stretching following surgery for breast cancer: study protocol for a randomised controlled trial. BMC Cancer 2006;6:273. - PMC - PubMed
Kim 2010 {published data only}
    1. Kim do S, Sim Y J, Jeong HJ, Kim GC. Effect of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2010;91(12):1844-8. - PubMed
Kim 2011 {published data only}
    1. Kim SH, Shin MS, Lee HS, Lee ES, Ro JS, Kang HS, et al. Randomized pilot test of a simultaneous stage-matched exercise and diet intervention for breast cancer survivors. Oncology Nursing Forum 2011;38(2):E97-106. - PubMed
Kolden 2002 {published data only}
    1. Kolden GG, Strauman TJ, Ward A, Kuta J, Woods TE, Schneider KL, et al. A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psychooncology 2002;11(5):447-56. - PubMed
Korstjens 2008 {published data only}
    1. Korstjens I, May AM, Weert E, Mesters I, Tan F, Ros WJ, et al. Quality of life after self-management cancer rehabilitation: a randomized controlled trial comparing physical and cognitive-behavioral training versus physical training. Psychosomatic Medicine 2008;70(4):422-9. - PubMed
Lazowski 1999 {published data only}
    1. Lazowski DA, Ecclestone NA, Myers AM, Paterson DH, Tudor-Locke C, Fitzgerald C, et al. A randomized outcome evaluation of group exercise programs in long-term care institutions. Journal of Gerontology 1999;54(12):M621-8. - PubMed
Ligibel 2008 {published data only}
    1. Ligibel JA, Campbell N, Partridge A, Chen WY, Salinardi T, Chen H, et al. Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. Journal of Clinical Oncology 2008;26(6):907-12. - PubMed
Livingston 2011 {published data only}
    1. Livingston PM, Salmon J, Courneya KS, Gaskin CJ, Craike M, Botti M, et al. Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE]: rationale and design for a cluster randomised controlled trial. BMC Cancer 2011;11:237. - PMC - PubMed
Mansky 2006 {published data only}
    1. Mansky P, Sannes T, Wallerstedt D, Ge A, Ryan M, Johnson LL, et al. Tai chi chuan: mind-body practice or exercise intervention? Studying the benefit for cancer survivors. Integrative Cancer Therapies 2006;5(3):192-201. - PubMed
Mathewson‐Chapman 1997 {published data only}
    1. Mathewson-Chapman M. Pelvic muscle exercise/biofeedback for urinary incontinence after prostatectomy: an education program. Journal of Cancer Education 1997;12(4):218-23. - PubMed
Matthews 2007 {published data only}
    1. Matthews CE, Wilcox S, Hanby CL, Der Ananian C, Heiney SP, Gebretsadik T, et al. Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Supportive Care in Cancer 2007;15(2):203-11. - PubMed
May 2008 {published data only}
    1. May A M, Van Weert E, Korstjens I, Hoekstra-Weebers J E, Van Der Schans C P, Zonderland M L, et al. Improved physical fitness of cancer survivors: a randomised controlled trial comparing physical training with physical and cognitive-behavioural training. Acta Oncologica 2008;47(5):825-34. - PubMed
McClure 2010 {published data only}
    1. McClure MK, McClure RJ, Day R, Brufsky AM. Randomized controlled trial of the Breast Cancer Recovery Program for women with breast cancer-related lymphedema. American Journal of Occupational Therapy 2010;64(1):59-72. - PubMed
McKenzie 2003 {published data only}
    1. McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. Journal of Clinical Oncology 2003;21(3):463-6. - PubMed
McNeely 2004 {published data only}
    1. McNeely ML, Parliament M, Courneya KS, Seikaly H, Jha N, Scrimger R, et al. A pilot study of a randomized controlled trial to evaluate the effects of progressive resistance exercise training on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in head and neck cancer survivors. Head & Neck 2004;26(6):518-30. - PubMed
Midtgaard 2006 {published data only}
    1. Midtgaard J, Rorth M, Stelter R, Adamsen L. The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment. European Journal of Cancer Care 2006;15(1):25-33. - PubMed
Milne 2008 {published data only}
    1. Milne HM, Wallman KE, Gordon S, Courneya KS. Impact of a combined resistance and aerobic exercise program on motivational variables in breast cancer survivors: a randomized controlled trial. Annals of Behavioral Medicine 2008;36(2):158-66. - PubMed
Morey 2009 {published data only}
    1. Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. Journal of the American Medical Association 2009;301(18):1883-91. - PMC - PubMed
Mustian 2006 {published data only}
    1. Mustian KM, Katula JA, Zhao H. A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors. Journal of Supportive Oncology 2006;4(3):139-45. - PubMed
Mutrie 2007 {published data only}
    1. Mutrie N, Campbell AM, Whyte F, McConnachie A, Emslie C, Lee L, et al. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. British Medical Journal 2007;334(7592):517. - PMC - PubMed
Nikander 2007 {published data only}
    1. Nikander R, Sievanen H, Ojala K, Oivanen T, Kellokumpu-Lehtinen PL, Saarto T. Effect of a vigorous aerobic regimen on physical performance in breast cancer patients - a randomized controlled pilot trial. Acta Oncologica 2007;46(2):181-6. - PubMed
Osei‐Tutu 2005 {published data only}
    1. Osei-Tutu KB, Campagna PD. The effects of short- vs. long-bout exercise on mood, VO2max, and percent body fat. Preventive Medicine 2005;40(1):92-8. - PubMed
Pinto 2009 {published data only}
    1. Pinto BM, Rabin C, Dunsiger S. Home-based exercise among cancer survivors: adherence and its predictors. Psychooncology 2009;18(4):369-76. - PMC - PubMed
Poorkiani 2010 {published data only}
    1. Poorkiani M, Abbaszadeh A, Hazrati M, Jafari P, Sadeghi M, Mohammadianpanah M. The effect of rehabilitation on quality of life in female breast cancer survivors in Iran. Indian Journal of Medical and Paediatric Oncology 2010;31(4):105-9. - PMC - PubMed
Rabin 2006 {published data only}
    1. Rabin CS, Pinto BM, Trunzo JJ, Frierson GM, Bucknam LM. Physical activity among breast cancer survivors: regular exercisers vs participants in a physical activity intervention. Psychooncology 2006;15(4):344-54. - PubMed
Sandel 2005 {published data only}
    1. Sandel SL, Judge JO, Landry N, Faria L, Ouellette R, Majczak M. Dance and movement program improves quality-of-life measures in breast cancer survivors. Cancer Nursing 2005;28(4):301-9. - PubMed
Schneider 2007 {published data only}
    1. Schneider C M, Hsieh C C, Sprod L K, Carter S D, Hayward R. Exercise training manages cardiopulmonary function and fatigue during and following cancer treatment in male cancer survivors. Integrative Cancer Therapies 2007;6(3):235-41. - PubMed
Segal 2001 {published data only}
    1. Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J, et al. Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. Journal of Clinical Oncology 2001;19(3):657-65. - PubMed
Segal 2003 {published data only}
    1. Segal RJ, Reid RD, Courneya KS, Malone SC, Parliament MB, Scott CG, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Journal of Clinical Oncology 2003;21(9):1653-9. - PubMed
Snyder 2009 {published data only}
    1. Snyder DC, Morey MC, Sloane R, Stull V, Cohen H J, Peterson B, et al. Reach out to ENhancE Wellness in Older Cancer Survivors (RENEW): design, methods and recruitment challenges of a home-based exercise and diet intervention to improve physical function among long-term survivors of breast, prostate, and colorectal cancer. Psychooncology 2009;18(4):429-39. - PMC - PubMed
Sprod 2005 {published data only}
    1. Sprod LK, Drum SN, Bentz AT, Carter SD, Schneider CM. The effects of walking poles on shoulder function in breast cancer survivors. Integrative Cancer Therapies 2005;4(4):287-93. - PubMed
Twiss 2009 {published data only}
    1. Twiss JJ, Waltman NL, Berg K, Ott CD, Gross GJ, Lindsey AM. An exercise intervention for breast cancer survivors with bone loss. Journal of Nursing Scholarship 2009;41(1):20-7. - PubMed
Vallance 2007 {published data only}
    1. Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. Journal of Clinical Oncology 2007;25(17):2352-9. - PubMed
Vallance 2007a {published data only}
    1. Vallance JK. Promoting physical activity in breast cancer survivors: a randomized controlled trial. Dissertation Abstracts International Section A: Humanities and Social Sciences 2007;68(7-A).
Vallance 2008 {published data only}
    1. Vallance JK, Courneya KS, Plotnikoff RC, Dinu I, Mackey JR. Maintenance of physical activity in breast cancer survivors after a randomized trial. Medicine and Science in Sports and Exercise 2008;40(1):173-80. - PubMed
Vallance 2008a {published data only}
    1. Vallance JK, Courneya KS, Plotnikoff RC, Mackey JR. Analyzing theoretical mechanisms of physical activity behavior change in breast cancer survivors: results from the activity promotion (ACTION) trial. Annals of Behavioral Medicine 2008;35(2):150-8. - PubMed
van Weert 2005 {published data only}
    1. Weert E, Hoekstra-Weebers J, Grol B, Otter R, Arendzen HJ, Postema K, et al. A multidimensional cancer rehabilitation program for cancer survivors: effectiveness on health-related quality of life. Journal of Psychosomatic Research 2005;58(6):485-96. - PubMed
van Weert 2010 {published data only}
    1. Weert E, May AM, Korstjens I, Post WJ, Schans CP, den Borne B, et al. Cancer-related fatigue and rehabilitation: a randomized controlled multicenter trial comparing physical training combined with cognitive-behavioral therapy with physical training only and with no intervention. Physical Therapy 2010;90(10):1413-25. - PubMed
von Gruenigen 2009 {published data only}
    1. Gruenigen VE, Gibbons HE, Kavanagh MB, Janata JW, Lerner E, Courneya KS. A randomized trial of a lifestyle intervention in obese endometrial cancer survivors: quality of life outcomes and mediators of behavior change. Health and Quality of Life Outcomes 2009;7:17. - PMC - PubMed
Wall 2000 {published data only}
    1. Wall LM. Changes in hope and power in lung cancer patients who exercise. Nursing Science Quarterly 2000;13(3):234-42. - PubMed
Yeh 2011 {published data only}
    1. Yeh CH, Man Wai JP, Lin US, Chiang YC. A pilot study to examine the feasibility and effects of a home-based aerobic program on reducing fatigue in children with acute lymphoblastic leukemia. Cancer Nursing 2011;34(1):3-12. - PubMed
Zhang 2006 {published data only}
    1. Zhang AY, Strauss GJ, Siminoff LA. Intervention of urinary incontinence and quality of life outcome in prostate cancer patients. Journal of Psychosocial Oncology 2006;24(2):17-30. - PubMed

References to studies awaiting assessment

Utz‐Billing 2010 {published data only}
    1. Utz-Billing I, Rosemeyer M. Yoga supports physical and mental well-being after breast cancer surgery. Journal of Psychosomatic Obstetrics and Gynecology 2010;31(Suppl. 1):125.

References to ongoing studies

Devonish 2007 {published data only}
    1. Devonish J-A, Culos-Reed N, Keats MR, Stephensopn LE. Physical activity for cancer survivors: fitness and quality of life results from a 16-week intervention. Journal of Sport & Exercise Psychology 2007;29:S157.
Galvao 2009 {published data only}
    1. Galvao DA, Spry N, Taaffe DR, Denham J, Joseph D, Lamb DS, et al. A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial. BMC Cancer 2009;9:419. - PMC - PubMed
Hayes 2011 {published data only}
    1. Hayes S, Rye S, Battistutta D, Yates P, Pyke C, Bashford J, et al. Design and implementation of the Exercise for Health trial -- a pragmatic exercise intervention for women with breast cancer. Contemporary Clinical Trials 2011;32(4):577-85. - PubMed
Jones 2010 {published data only}
    1. Jones LW, Douglas PS, Eves ND, Marcom PK, Kraus WE, Herndon JE 2nd, et al. Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer. BMC Cancer 2010;10:531. - PMC - PubMed
Jones 2010a {published data only}
    1. Jones LW, Eves ND, Kraus WE, Potti A, Crawford J, Blumenthal JA, et al. The lung cancer exercise training study: a randomized trial of aerobic training, resistance training, or both in postsurgical lung cancer patients: rationale and design. BMC Cancer 2010;10:155. - PMC - PubMed
Kampshoff 2010 {published data only}
    1. Kampshoff CS, Buffart LM, Schep G, Mechelen W, Brug J, Chinapaw MJ. Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue. BMC Cancer 2010;10:658. - PMC - PubMed
Persoon 2010 {published data only}
    1. Persoon S, Kersten MJ, Chinapaw MJ, Buffart LM, Burghout H, Schep G, et al. Design of the EXercise Intervention after Stem cell Transplantation (EXIST) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of an individualized high intensity physical exercise program on fitness and fatigue in patients with multiple myeloma or (non-) Hodgkin's lymphoma treated with high dose chemotherapy and autologous stem cell transplantation. BMC Cancer 2010;10:671. - PMC - PubMed
Saxton 2006 {published data only}
    1. Saxton J M, Daley A, Woodroofe N, Coleman R, Powers H, Mutrie N, et al. Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment [ISRCTN08045231]. BMC Cancer 2006;6:35. - PMC - PubMed
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    1. Sekse RJT, Hausmann F, Iversen V, Ncsheim-Bjorkvik G, Tengesdal E, Bjerke A, et al. Rehabilitation of women following treatment for gynaecological cancer: a randomized, controlled study-a description of a multicenter study and experiences so far. Psychooncology 2011;20(Suppl 2):236-7.
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Vardy 2010 {published data only}
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Walsh 2010 {published data only}
    1. Walsh JM, Hussey J, Guinan E, O'Donnell D. 'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': a feasibility study PEACH trial: prescribed exercise after chemotherapy. BMC Cancer 2010;10:42. - PMC - PubMed

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