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A 12-Week Exercise and Stress Management Pilot Program From Theory Through Implementation and Assessment

Packel, Lora, PT, PhD, CCS1; Fang, Carolyn Y., PhD2; Handorf, Elizabeth, PhD3; Rodoletz, Michelle, PhD4

doi: 10.1097/01.REO.0000000000000079

Purpose: To assess the response of a 12-week exercise, education, and stress management program on the fatigue levels of a heterogeneous group of fatigued cancer survivors in a community setting.

Methods: Peer-reviewed evidence was translated into a community-based exercise and stress management program for cancer-related fatigue. Inclusion criteria were adult with a cancer diagnosis, a score of 4 or more on a 0-10 fatigue scale, and the ability to walk for 10 continuous minutes. The 12-week program included 10 weeks of supervised moderate-intensity aerobic and strength training combined with 2 unsupervised weeks. During the 10 supervised sessions, participants also received education on nutrition, stress management, and sleep.

Outcome Measures: Functional Assessment of Chronic Illness Therapy–Fatigue, Hospital Anxiety and Depression Scale (HADS), National Comprehensive Cancer Network Distress Thermometer, Six-Minute Walk Test (6MWT), and Sit-to-Stand Test.

Results: Sixteen cancer survivors completed the program (mean age = 68.5 years). Sixty-two percent were female, and 24% had breast cancer. Significant improvements were noted in fatigue (P = .008), physical well-being (P = .004), and in the anxiety subscale scores of the HADS (P = .047). Increases in 6MWT distance (P = .002) and Sit-to-Stand Test score (P = .018) were also observed. Significant reductions in psychological distress were found (P = .003); however, no significant changes were observed in emotional well-being ( P = .855), social well-being (P = .327), or depression (P = .221).

Limitations: Because of attrition, this pilot study had a modest sample size. Study findings require replication with larger sample sizes.

Conclusions: A 12-week exercise, stress management, and education program may be effective in reducing fatigue in a heterogeneous group of cancer survivors in a community setting.

1Board Certified Cardiovascular and Pulmonary Specialist Chair & Associate Professor, Department of Physical Therapy, University of the Sciences, Philadelphia, PA

2Professor and Co-Leader of Cancer Prevention and Control, Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA

3Department of Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA

4Clinical Psychologist, Department of Medicine Section of Psychiatry, Fox Chase Cancer Center, Philadelphia, PA

Correspondence: Lora Packel, PT, PhD, CCS, Department of Physical Therapy, University of the Sciences, 600 S. 43rd St, Philadelphia, PA 19104 (

Grant Support: This study was partially funded by a Genesis Cares grant of $3000.

The authors declare no conflicts of interest.

©2017 (C) Academy of Oncologic Physical Therapy, APTA
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