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Faculty Advisor(s)

Mary I. Fisher, PT, PhD

Description

Purpose/Hypothesis: Cancer-related fatigue (CRF) is common in women treated for breast cancer. Exercise can reduce CRF, yet the impact of an eHealth exercise program on physical performance (PP) is rarely described. While the primary aim was to reduce CRF, this ongoing study reports on the effect of an 8-week multidisciplinary physical (PT) and occupational therapy (OT) eHealth program on measures of PP.

Materials and Methods: Participants ages 18-69 diagnosed with breast cancer in the last 5 years, who rated fatigue ≥4/10 on 0-10 scale and had completed primary cancer treatment, were randomized to intervention (EX) or control (CON) groups. Using individualized websites and web conferencing, EX met weekly with PT and OT for aerobic/resistance exercise instruction and progression, activity performance problem-solving, and completed exercise 3x/week. CON continued usual activities. Measures taken at baseline, 4 and 8 weeks included patient demographics, PP measured by step counts, minutes of moderate-vigorous activity (MVPA) (55-75% of heart rate max), 6-minute walk test (6MWT) and 30 second sit to stand (30STS). Valid activity tracker data were based on minimum wear time of 600 minutes 3x/week. An intention-to-treat analysis was performed; descriptives and independent samples t-tests were used to analyze demographics; a repeated measures ANOVA was used to analyze PP. Significance was alpha 0.05 a priori.

Results: Data from 22 women were available for analysis (Excluded: drop out (3); invalid tracker data (6)). Groups were not different at baseline for age (EX 47 (10) years, CON 51 (12), p =.477) and BMI (26.5(5.2) and 34.4(10.6, p=.054)). Most were white (86%), married (86%), college- educated (100%), and working >30 hours/week (71%). Most were stage 1-2 BC (90%), had mastectomy (52%), chemo (71%) and/or radiation (81%). PP measures were not significantly different within or between groups except for 6MWT from baseline (463 m (92.45)) to 8 weeks (539.6 m (96.81)) (p=.011, Cohen’s d=-.819).

Conclusions: A multidisciplinary PT-OT eHealth intervention 3x weekly for 8 weeks resulted in improved 6MWT distance compared to a control group. Given that CRF is a multidimensional construct, it is possible that outcomes used may not accurately capture PP except for the 6MWT, which can be considered an endurance test. The 30STS may have a ceiling effect. Step counts and time spent in MVPA may not capture PP in the same way. Wearing fitness trackers is known to improve steps counts via the Hawthorne effect and may not be the best way to capture PP. Limitations include sample size as it was powered for the primary fatigue measure, and incomplete data collection.

Clinical Relevance: Multidisciplinary PT-OT eHealth rehabilitation can result in improved walk distances which has been correlated with improved health outcomes in a variety of chronic disease populations. The 6MWT may be a better PP functional measure because it requires endurance similar to daily activity in comparison to step counts and time in MVPA.

Publication Date

5-8-2025

Disciplines

Physical Therapy | Rehabilitation and Therapy

Comments

Presented on February 13, 2025 at APTA Combined Sections Meeting

Effects of an eHealth Program on Physical Performance in Women With Cancer-Related Fatigue and Breast Cancer

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