Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

Christina M Dieli-Conwright, Kerry S Courneya, Wendy Demark-Wahnefried, Nathalie Sami, Kyuwan Lee, Frank C Sweeney, Christina Stewart, Thomas A Buchanan, Darcy Spicer, Debu Tripathy, Leslie Bernstein, Joanne E Mortimer, Christina M Dieli-Conwright, Kerry S Courneya, Wendy Demark-Wahnefried, Nathalie Sami, Kyuwan Lee, Frank C Sweeney, Christina Stewart, Thomas A Buchanan, Darcy Spicer, Debu Tripathy, Leslie Bernstein, Joanne E Mortimer

Abstract

Background: Exercise is an effective strategy to improve quality of life and physical fitness in breast cancer survivors; however, few studies have focused on the early survivorship period, minorities, physically inactive and obese women, or tested a combined exercise program and measured bone health. Here, we report the effects of a 16-week aerobic and resistance exercise intervention on patient-reported outcomes, physical fitness, and bone health in ethnically diverse, physically inactive, overweight or obese breast cancer survivors.

Methods: One hundred breast cancer survivors within 6 months of completing adjuvant treatment were assessed at baseline, post-intervention, and 3-month follow-up (exercise group only) for physical fitness, bone mineral density, serum concentrations of bone biomarkers, and quality of life. The exercise intervention consisted of moderate-vigorous (65-85% heart rate maximum) aerobic and resistance exercise thrice weekly for 16 weeks. Differences in mean changes for outcomes were evaluated using mixed-model repeated measure analysis.

Results: At post-intervention, the exercise group was superior to usual care for quality of life (between group difference: 14.7, 95% CI: 18.2, 9.7; p < 0.001), fatigue (p < 0.001), depression (p < 0.001), estimated VO2max (p < 0.001), muscular strength (p < 0.001), osteocalcin (p = 0.01), and BSAP (p = 0.001). At 3-month follow-up, all patient-reported outcomes and physical fitness variables remained significantly improved compared to baseline in the exercise group (p < 0.01).

Conclusions: A 16-week combined aerobic and resistance exercise program designed to address metabolic syndrome in ethnically-diverse overweight or obese breast cancer survivors also significantly improved quality of life and physical fitness. Our findings further support the inclusion of supervised clinical exercise programs into breast cancer treatment and care.

Trial registration: This trial is registered on ClinicalTrials.gov: NCT01140282 as of June 9, 2010.

Keywords: Exercise; bone health; breast cancer; physical fitness; quality of life.

Conflict of interest statement

Ethics approval and consent to participate

The protocol and informed consent were approved (HS-12-00141) by the USC Institutional Review Board.

Consent for publication

A signed informed consent was obtained from each participant. The informed consent is available upon request.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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