LymphedemaV1, Main, Exploration, bibRecord, 002D13

Biobehavioral Factors Mediate Exercise Effects on Fatigue in Breast Cancer Survivors

Identifieur interne : 002D13 ( Main/Exploration ); précédent : 002D12; suivant : 002D14

Biobehavioral Factors Mediate Exercise Effects on Fatigue in Breast Cancer Survivors

Auteurs : Laura Q. Rogers [États-Unis] ; Sandra Vicari [États-Unis] ; Rita Trammell [États-Unis] ; Patricia Hopkins-Price [États-Unis] ; Amanda Fogleman [États-Unis] ; Allison Spenner [États-Unis] ; Krishna Rao [États-Unis] ; Kerry S. Courneya [Canada] ; Karen S. Hoelzer [États-Unis] ; Randall Robbs [États-Unis] ; Steven Verhulst [États-Unis]

Source :

Medicine and science in sports and exercise [ 0195-9131 ] ; 2014.

RBID : PMC:4435796

Abstract

Purpose

Examine mediators of fatigue response to an exercise intervention for breast cancer survivors (BCS) in a pilot randomized controlled trial.

Methods

Postmenopausal BCS (n=46; ≤ Stage II), off primary treatment, and reporting fatigue and/or sleep dysfunction were randomized to a 3-month exercise intervention (160 minutes/week of moderate intensity aerobic walking, twice weekly resistance training with resistance bands) or control group. Six discussion group sessions provided behavioral support to improve adherence. Fatigue, serum cytokines, accelerometer physical activity, cardiorespiratory fitness, sleep dysfunction, and psychosocial factors were assessed at baseline and 3 months.

Results

Exercise intervention effect sizes for fatigue were: fatigue intensity d=0.30 (p=.34), interference d=−0.38 (p=.22), and general fatigue d=−0.49 (p=.13). Using Freedman-Schatzkin difference-in-coefficients tests, increase in fatigue intensity was significantly mediated by interleukin (IL)-6 (82%), IL-10 (94%), IL-6:IL-10 (49%), and tumor necrosis factor (TNF)-alpha:IL-10 (78%) with reduced sleep dysfunction increasing the relationship between intervention and fatigue intensity rather than mediating intervention effects (−88%). Decrease in fatigue interference was mediated by sleep dysfunction (35%) while IL-10 and pro:anti-inflammatory cytokine ratios increased the relationship between intervention and interference (−25% to −40%). The reduction in general fatigue was significantly mediated by minutes of physical activity (76%), sleep dysfunction (45%), and physical activity enjoyment (40%) with IL-10 (−40%) and IL-6:IL-10 (−11%) increasing the intervention-fatigue relationship. In the intervention group, higher baseline fatigue, anxiety, depression, and perceived exercise barriers interference predicted a greater decline in fatigue interference and/or general fatigue during the intervention.

Conclusions

Biobehavioral factors mediated and enhanced intervention effects on fatigue while psychosocial factors predicted fatigue response. Further study is warranted to confirm our results and improve understanding of relationships that mediate and strengthen the intervention-fatigue association.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435796

DOI: 10.1249/MSS.0000000000000210
PubMed: 24212124
PubMed Central: 4435796

Affiliations:

Canada, États-Unis
Alabama, Illinois

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">Examine mediators of fatigue response to an exercise intervention for breast cancer survivors (BCS) in a pilot randomized controlled trial.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Postmenopausal BCS (n=46; ≤ Stage II), off primary treatment, and reporting fatigue and/or sleep dysfunction were randomized to a 3-month exercise intervention (160 minutes/week of moderate intensity aerobic walking, twice weekly resistance training with resistance bands) or control group. Six discussion group sessions provided behavioral support to improve adherence. Fatigue, serum cytokines, accelerometer physical activity, cardiorespiratory fitness, sleep dysfunction, and psychosocial factors were assessed at baseline and 3 months.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Exercise intervention effect sizes for fatigue were: fatigue intensity <italic>d</italic>
=0.30 (p=.34), interference <italic>d</italic>
=−0.38 (p=.22), and general fatigue <italic>d</italic>
=−0.49 (p=.13). Using Freedman-Schatzkin difference-in-coefficients tests, increase in fatigue intensity was significantly mediated by interleukin (IL)-6 (82%), IL-10 (94%), IL-6:IL-10 (49%), and tumor necrosis factor (TNF)-alpha:IL-10 (78%) with reduced sleep dysfunction increasing the relationship between intervention and fatigue intensity rather than mediating intervention effects (−88%). Decrease in fatigue interference was mediated by sleep dysfunction (35%) while IL-10 and pro:anti-inflammatory cytokine ratios increased the relationship between intervention and interference (−25% to −40%). The reduction in general fatigue was significantly mediated by minutes of physical activity (76%), sleep dysfunction (45%), and physical activity enjoyment (40%) with IL-10 (−40%) and IL-6:IL-10 (−11%) increasing the intervention-fatigue relationship. In the intervention group, higher baseline fatigue, anxiety, depression, and perceived exercise barriers interference predicted a greater decline in fatigue interference and/or general fatigue during the intervention.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Biobehavioral factors mediated and enhanced intervention effects on fatigue while psychosocial factors predicted fatigue response. Further study is warranted to confirm our results and improve understanding of relationships that mediate and strengthen the intervention-fatigue association.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>Canada</li>
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<tree><country name="États-Unis"><region name="Alabama"><name sortKey="Rogers, Laura Q" sort="Rogers, Laura Q" uniqKey="Rogers L" first="Laura Q" last="Rogers">Laura Q. Rogers</name>
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<name sortKey="Fogleman, Amanda" sort="Fogleman, Amanda" uniqKey="Fogleman A" first="Amanda" last="Fogleman">Amanda Fogleman</name>
<name sortKey="Hoelzer, Karen S" sort="Hoelzer, Karen S" uniqKey="Hoelzer K" first="Karen S" last="Hoelzer">Karen S. Hoelzer</name>
<name sortKey="Hopkins Price, Patricia" sort="Hopkins Price, Patricia" uniqKey="Hopkins Price P" first="Patricia" last="Hopkins-Price">Patricia Hopkins-Price</name>
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<name sortKey="Spenner, Allison" sort="Spenner, Allison" uniqKey="Spenner A" first="Allison" last="Spenner">Allison Spenner</name>
<name sortKey="Trammell, Rita" sort="Trammell, Rita" uniqKey="Trammell R" first="Rita" last="Trammell">Rita Trammell</name>
<name sortKey="Verhulst, Steven" sort="Verhulst, Steven" uniqKey="Verhulst S" first="Steven" last="Verhulst">Steven Verhulst</name>
<name sortKey="Vicari, Sandra" sort="Vicari, Sandra" uniqKey="Vicari S" first="Sandra" last="Vicari">Sandra Vicari</name>
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<country name="Canada"><noRegion><name sortKey="Courneya, Kerry S" sort="Courneya, Kerry S" uniqKey="Courneya K" first="Kerry S" last="Courneya">Kerry S. Courneya</name>
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Biobehavioral Factors Mediate Exercise Effects on Fatigue in Breast Cancer Survivors

Biobehavioral Factors Mediate Exercise Effects on Fatigue in Breast Cancer Survivors

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Abstract

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