Feasibility and Effects of Home-based Physical Activity Intervention in Patients With Breast Cancer in Indonesia
Move to Improve: Investigating the Feasibility of Embedding Physical Activity Into Routine Breast Cancer Care in Indonesia
The goal of this clinical trial is to learn the impact and implementation of home-based aerobic and resistance training for patients with breast cancer in Indonesia. The main questions it aims to answer are:
- Does the home-based aerobic and resistance training improve physical fitness, fatigue, and quality of life of patients with breast cancer?
- Are the benefits of aerobic and resistance training mediated by inflammatory level changes?
- What are the barriers and facilitators in implementing the home-based aerobic and resistance training?
- Is the home-based aerobic and resistance training feasible to be implemented in Indonesia's setting?
To answer those questions, participants will:
- Conduct home-based aerobic and resistance training with supervision.
- Visit the hospital once every 4 weeks for their routine visits.
- Undergo physical fitness test before and after 12 weeks using treadmill test, as well as interviews to assess fatigue, quality of life, and intervention acceptability.
- Keep a diary to record the aerobic and resistance training at home.
- Undergo routine monitoring by phone every week with the research team.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Yogyakarta Special Region
-
Sleman, Yogyakarta Special Region, Indonesia, 55284
- Dr. Sardjito General Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with stage I-III hormone-receptor positive breast cancer
- Eastern Cooperative Oncology Group (ECOG) score ≤1
- Had completed primary treatment (e.g., surgery, chemotherapy, and radiotherapy), except for hormonal treatment
- Within 5 years of diagnosis
- Able to perform moderate-intensity physical activity as determined by their oncologist and care team
- Able to read and write in Indonesian
- Willing to provide written informed consent.
Exclusion Criteria:
- Had an ejection fraction of <50%
- Evidence of cardiac disease, severe musculoskeletal problems, or other contraindications for exercise.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Physical activity intervention
|
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Physical fitness
Time Frame: Baseline and post-intervention (12 weeks)
|
Physical fitness was measured using a submaximal treadmill test with the modified Bruce protocol.
Treadmill speed and inclination were automatically increased every 3 min (test stage).
The test was terminated when participants reached volitional fatigue.
Physical fitness was classified as low, fair, average, and good, based on patients' age, treadmill test duration, and predicted VO2peak.
|
Baseline and post-intervention (12 weeks)
|
|
Fatigue
Time Frame: Baseline and post-intervention (12 weeks)
|
Fatigue was assessed using the Indonesian version of Fatigue Severity Scale (FSS).
A higher score on the FSS indicated a more severe level of fatigue.
The FSS was also classified as no-to-mild fatigue (FSS <4.0) and severe fatigue (≥4.0).
|
Baseline and post-intervention (12 weeks)
|
|
Health-related quality of life
Time Frame: Baseline and post-intervention (12 weeks)
|
Health-related quality of life was assessed using the Indonesian version of the EORTC Quality of Life Questionnaire (QLQ-C30).
The EORTC QLQ-C30 consists of global health status, functional scales, and symptom scales.
A higher score indicates better health for global health status and functional scales, but represents a higher level of burden for symptom scales.
|
Baseline and post-intervention (12 weeks)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Inflammatory biomarkers
Time Frame: Baseline and post-intervention (12 weeks)
|
Venous blood (5 ml) was collected at baseline and post-intervention to measure the levels of inflammatory biomarkers, including CRP, IL-6, and IL-10.
The CRP levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) assay (Calbiotech, CR120C), while IL-6 and IL-10 were measured using a Luminex assay (eBioscience, PPX-02-MXYMMK2).
|
Baseline and post-intervention (12 weeks)
|
|
Intervention acceptability
Time Frame: Post-intervention (12 weeks)
|
Intervention acceptability was explored using semi-structured interviews using a research team-developed interview guide.
All interviews were individual and face-to-face, took place in a private room, and were audiotaped.
|
Post-intervention (12 weeks)
|
|
Intervention barriers and facilitators
Time Frame: Post-intervention (12 weeks)
|
Intervention barriers and facilitators were explored using semi-structured interviews using research team-developed interview guide.
All interviews were individual and face-to-face, took place in a private room, and audiotaped.
|
Post-intervention (12 weeks)
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intervention feasibility
Time Frame: During study period (baseline to 12 weeks)
|
Intervention feasibility was determined by (a) recruitment (ratio of the number of participants recruited to the number of eligible participants approached), (b) retention (ratio of the number of participants who completed the 12-week program to the total number of participants enrolled in the study), (c) adherence (the ratio of the number of participants meeting at least 70% of prescribed activities calculated using steps per day, resistance exercise frequency, duration, and intensity to the total number of participants completing the 12-week program).
The intervention was defined as feasible if those rates were above 75%.
|
During study period (baseline to 12 weeks)
|
|
Adverse events
Time Frame: During study period (baseline to 12 weeks)
|
Adverse events (e.g., dyspnea, tachycardia, nausea, pain, and myalgia) that were reported by participants.
|
During study period (baseline to 12 weeks)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Susanna H Hutajulu, MD, PhD, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
- Study Chair: Shaunna Burke, PhD, Faculty of Biological Sciences, School of Biomedical Sciences, University of Leeds
Publications and helpful links
General Publications
- McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ. 2006 Jul 4;175(1):34-41. doi: 10.1503/cmaj.051073.
- Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity for women with breast cancer after adjuvant therapy. Cochrane Database Syst Rev. 2018 Jan 29;1(1):CD011292. doi: 10.1002/14651858.CD011292.pub2.
- Leite VF, Cecatto RB, Battistella LR, de Brito CMM. Establishing a Cancer Rehabilitation Service in a Middle-Income Country: an Experience from Brazil. Curr Phys Med Rehabil Rep. 2022;10(4):339-344. doi: 10.1007/s40141-022-00373-4. Epub 2022 Nov 28.
- Batalik L, Winnige P, Dosbaba F, Vlazna D, Janikova A. Home-Based Aerobic and Resistance Exercise Interventions in Cancer Patients and Survivors: A Systematic Review. Cancers (Basel). 2021 Apr 15;13(8):1915. doi: 10.3390/cancers13081915.
- de Jesus Leite MAF, Puga GM, Arantes FJ, Oliveira CJF, Cunha LM, Bortolini MJS, Penha-Silva N. Effects of combined and resistance training on the inflammatory profile in breast cancer survivors: A systematic review. Complement Ther Med. 2018 Feb;36:73-81. doi: 10.1016/j.ctim.2017.11.023. Epub 2017 Dec 1.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 3550/UN1.P.III/DitLit/PT.01.05
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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