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The role of physical activity and physical fitness in postcancer fatigue: a randomized controlled trial

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Abstract

Purpose

Patients suffering from postcancer fatigue have both an inferior physical activity and physical fitness compared to non-fatigued cancer survivors. The aims of this study were (1) to examine the effect of cognitive behavior therapy, an effective treatment for postcancer fatigue, on physical activity and physical fitness and (2) to examine whether the effect of cognitive behavior therapy on postcancer fatigue is mediated by physical activity and/or physical fitness.

Methods

Severely fatigued cancer survivors were randomly assigned to either the intervention (cognitive behavior therapy) or the waiting list condition. After assigning 23 patients in the intervention condition and 14 patients in the waiting list condition, they were assessed both at baseline and 6 months later. Physical activity was assessed via actigraphy and physical fitness was assessed by a maximal exercise test. A nonparametric bootstrap approach was used to test the statistical significance of the mediation effects.

Results

A significant increase in physical activity was observed in the intervention group from baseline to follow-up, whereas physical activity did not change from baseline to follow-up in the waiting list group. Physical fitness did not significantly change after cognitive behavior therapy or after 6 months of waiting for therapy. Fatigue decreased more significantly in the intervention group than in the waiting list group. The mediation hypotheses were rejected.

Conclusions

Cognitive behavior therapy effectively reduced postcancer fatigue and increased physical activity but did not change physical fitness. The effect of cognitive behavior therapy on postcancer fatigue is not mediated by a change in physical activity or physical fitness.

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Acknowledgments

We thank all patients for participating in this trial; all physicians for referring patients for cognitive behavior therapy; Lianne Vermeeren for assistance in data collection; José de la Fonteijne, Thea Berends, Hans Knoop, and Hein Voskamp for treating the patients with cognitive behavior therapy; and Bregina Hijmans-Kersten and Linda Pardoel for technical support and helpful advice during the maximal exercise tests. This work was supported by the Dutch Cancer Society [KUN 2008–4002], but it was not involved in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Conflict of interest statement

The corresponding author and the co-authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 8, 6525 GA, Nijmegen, the Netherlands

    H. Prinsen, L. Heijmen & H. W. M. van Laarhoven

  2. Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Toernooiveld 214, 6525 EC, Nijmegen, the Netherlands

    G. Bleijenberg

  3. Epilepsy Centre Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, the Netherlands

    M. J. Zwarts

  4. Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 32, 6525 GA, Nijmegen, the Netherlands

    J. W. H. Leer

  5. Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, the Netherlands

    A. Heerschap

  6. Department of Physiology, Radboud University Nijmegen Medical Centre, Philips van Leijdenlaan 15, 6525 EX, Nijmegen, the Netherlands

    M. T. E. Hopman

  7. Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands

    H. W. M. van Laarhoven

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  1. H. Prinsen
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  2. G. Bleijenberg
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  3. L. Heijmen
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  4. M. J. Zwarts
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  5. J. W. H. Leer
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  6. A. Heerschap
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  7. M. T. E. Hopman
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  8. H. W. M. van Laarhoven
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Corresponding author

Correspondence to H. Prinsen.

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Prinsen, H., Bleijenberg, G., Heijmen, L. et al. The role of physical activity and physical fitness in postcancer fatigue: a randomized controlled trial. Support Care Cancer 21, 2279–2288 (2013). https://doi.org/10.1007/s00520-013-1784-9

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  • DOI: https://doi.org/10.1007/s00520-013-1784-9

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