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Level of Exercise Influences the Severity of Fatigue, Energy Levels, and Sleep Disturbance in Oncology Outpatients Receiving Chemotherapy


Background – Fatigue and sleep disturbance are common co-occurring symptoms in patients receiving chemotherapy (CTX). While the results from the meta-analyses support the use of exercise to decrease the severity of these symptoms, information is needed on patients’ “real world experiences” with the use of exercise during CTX.

Objective – Determine the distribution of patients who did and did not exercise on a regular basis and evaluate for differences in demographic and clinical characteristics, as well as the severity of fatigue, decrements in energy, and sleep disturbance among the exercise groups.

Methods – Patients (n=1033) completed self-report questionnaires prior to their second or third cycle of CTX. Patients were categorized into 3 exercise (Ex) groups (i.e., NoEx, <150 minutes/week (LessEx), >150 minutes/week (RecEx). Differences among the groups were evaluated using parametric and nonparametric tests.

Results – Only 19.1% of the patients were in the RecEx group. Patients in the NoEx group (37.2%) were had fewer years of education, were more likely to be non-white and unemployed, had a higher BMI and a worse comorbidity profile. Patients in the NoEx group had higher levels of morning fatigue, lower levels of morning and evening energy, and higher levels of sleep disturbance.

Conclusions – Findings from this “real world” study suggest that lack of physical activity is associated with higher levels of fatigue and sleep disturbance.

Implications for Practice – Given that the most frequently used intervention in this study was walking, clinicians can recommend this inexpensive intervention to patients to manage fatigue and sleep disturbance.

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