title: Home-based exercise to alleviate fatigue and improve functional capacity among breast cancer survivors. The Timed Get-up-and-Go test revisited: measurement of the component tasks. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Greater rate of decline in maximal aerobic capacity with age in physically active vs. sedentary healthy women. Effectiveness of Core Stability Exercises and Recovery Myofascial Release Massage on Fatigue in Breast Cancer Survivors: A Randomized Controlled Clinical Trial Normal values of balance tests in women aged 20-80. Peak Oxygen Consumption as a Predictor of Death in Patients With Heart Failure Receiving β-Blockers A prospective study of cardiorespiratory fitness and breast cancer mortality. Optimal Mode for Maximal Aerobic Exercise Testing in Breast Cancer Survivors The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study
abstract: This pilot study examined the efficacy of two home-based exercise programs on alleviating fatigue and improving functional capacity in breast cancer survivors . Participants were r and omly assigned into one of three groups : aerobic exercise ( AE ) , resistance exercise ( RE ) , or usual care control ( CON ) . After receiving individualized instruction and training , participants assigned to the AE and RE groups were asked to perform the prescribed exercise(s ) 3 times per week for 12 weeks at home . Both groups were instructed to keep their perceived exercise intensity in the " fairly light " to " somewhat hard " range using the Borg Perceived Exertion Scale . All participants completed the revised Piper Fatigue Scale ( PFS ) and the 6-minute walk test ( 6MWT ) at baseline and 12-week post-exercise program . Analysis of pre- and post-training data revealed a significant reduction in fatigue levels on the PFS among participants in the AE group ( Z=2.521 , one-tailed P=0.006 ) , and a significant improvement in the distance of the 6MWT for the RE group ( Z=2.366 , one-tailed P=0.009 ) at the end of 12-week study period . No significant changes in fatigue or functional status were observed in the CON group . Findings provide preliminary support for RE as a viable strategy for improving functional capacity in breast cancer survivors , while AE may be more effective in attenuating cancer-related fatigue . Incorporating RE training for future research may help advance the growing body of knowledge in symptom management for breast cancer survivors The " Timed Get-up- and -Go " ( TGUG ) test measures the overall time to complete a series of functionally important tasks . In the " Exp and ed Timed Get-up- and -Go " ( ETGUG ) test , times for the component tasks are measured using a multimemory stopwatch . Results from the ETGUG test were compared to those from the TGUG test on three groups of subjects : nonimpaired young , nonimpaired elderly , and elderly subjects at risk of falling . Significant differences were found between the two control groups and the at-risk group for all components of the test . Walking speed was the only measurement found to be significantly different between the young and elderly controls . The ETGUG test is a sensitive and objective assessment of function that requires minimal equipment , training , or expense . It better isolates functional deficits , thereby aiding the clinician in devising prevention strategies and guiding both treatment and further testing BACKGROUND AND PURPOSE The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities . The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults . SUBJECTS Ninety-six community-dwelling elderly people ( 61 - 89 years of age ) with independent functioning performed 4 clinical tests . METHODS Data were collected on the  Six-Minute Walk Test ( 6MW ) , Berg Balance Scale ( BBS ) , and Timed Up & Go Test ( TUG ) and during comfortable- and fast-speed walking ( CGS and FGS ) . Intraclass correlation coefficients ( ICCs ) were used to determine the test-retest reliability for the 6MW , TUG , CGS , and FGS measurements . Data were analyzed by gender and age ( 60 - 69 , 70 - 79 , and 80 - 89 years ) cohorts , similar to previous studies . Means , st and ard deviations , and 95 % confidence intervals for each measurement were calculated for each cohort . RESULTS The 6MW , TUG , CGS , and FGS measurements showed high test-retest reliability ( ICC [2,1]=.95-.97 ) . Mean test scores showed a trend of age-related declines for the 6MW , BBS , TUG , CGS , and FGS for both male and female subjects . DISCUSSION AND CONCLUSION Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW , BBS , TUG , CGS and FGS . Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons PURPOSE Breast cancer chemotherapy  may cause unfavorable changes in physical functioning , body composition , psychosocial functioning , and quality of life ( QOL ) . We evaluated the relative merits of aerobic and resistance exercise in blunting these effects . PATIENTS AND METHODS We conducted a multicenter r and omized controlled trial in Canada between 2003 and 2005 that r and omly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care ( n = 82 ) , supervised resistance exercise  ( n = 82 ) , or supervised aerobic exercise  ( n = 78 ) for the duration of their chemotherapy ( median , 17 weeks ; 95 % CI , 9 to 24 weeks ) . Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy-Anemia scale . Secondary end points were fatigue , psychosocial functioning , physical fitness , body composition , chemotherapy completion rate , and lymphedema . RESULTS The follow-up assessment rate for our primary end point was 92.1 % , and adherence to the supervised exercise was 70.2 % . Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem ( P = .015 ) , aerobic fitness ( P = .006 ) , and percent body fat ( adjusted P = .076 ) . Resistance exercise was superior to usual care for improving self-esteem ( P = .018 ) , muscular strength ( P < .001 ) , lean body mass ( P = .015 ) , and chemotherapy completion rate ( P = .033 ) . Changes in cancer-specific QOL , fatigue , depression , and anxiety favored the exercise groups but did not reach statistical significance . Exercise did not cause lymphedema or adverse events . CONCLUSION Neither aerobic nor resistance exercise significantly improved cancer-specific QOL  in breast cancer patients receiving chemotherapy , but they did improve self-esteem , physical fitness , body composition , and chemotherapy completion rate without causing lymphedema or significant adverse events Using a meta-analytic approach , we recently reported that the rate of decline in maximal oxygen uptake ( VO2 max ) with age in healthy women is greatest in the most physically active and smallest in the least active when expressed in milliliters per kilogram per minute per decade . We tested this hypothesis prospect ively under well-controlled laboratory conditions by study ing 156 healthy , nonobese women ( age 20 - 75 yr ) : 84 endurance-trained runners ( ET ) and 72 sedentary subjects ( S ) . ET were matched across the age range for age-adjusted 10-km running performance . Body mass was positively related with age in S but not in ET . Fat-free mass was not different with age in ET or S. Maximal respiratory exchange ratio and rating of perceived exertion were similar across age in ET and S , suggesting equivalent voluntary maximal efforts . There was a significant but modest decline in running mileage , frequency , and speed with advancing age in ET . VO2 max ( ml . kg-1 . min-1 ) was inversely related to age ( P < 0.001 ) in ET ( r = -0.82 ) and S ( r = -0.71 ) and was higher at any age in ET . Consistent with our meta-analysic findings , the absolute rate of decline in VO2 max was greater in ET ( -5.7 ml . kg-1 . min-1 . decade-1 ) compared with S ( -3.2 ml . kg-1 . min-1 . decade-1 ; P < 0 . 01 ) , but the relative ( % ) rate of decline was similar ( -9.7 vs -9 . 1%/decade ; not significant ) . The greater absolute rate of decline in VO2 max in ET compared with S was not associated with a greater rate of decline in maximal heart rate ( -5.6 vs. -6.2 beats . min-1 . decade-1 ) , nor was it related to training factors . The present cross-sectional findings provide additional evidence that the absolute , but not the relative , rate of decline in maximal aerobic capacity with age may be greater in highly physically active women compared with their sedentary healthy peers . This difference does not appear to be related to age-associated changes in maximal heart rate , body composition , or training factors The purpose of the present paper was to evaluate the effects of an 8-week multimodal program focused on core stability exercises and recovery massage with DVD support for a 6-month period in physical and psychological outcomes in breast cancer survivors . A r and omized controlled clinical trial was performed . Seventy-eight ( n = 78 ) breast cancer survivors were assigned to experimental ( core stability exercises plus massage-myofascial release ) and control ( usual health care ) groups . The intervention period was 8 weeks . Mood state , fatigue , trunk curl endurance , and leg strength were determined at baseline , after the last treatment session , and at 6 months of followup . Immediately after treatment and at 6 months , fatigue , mood state , trunk curl endurance , and leg strength exhibited greater improvement within the experimental group compared to placebo group . This paper showed that a multimodal program focused on core stability exercises and massage  reduced fatigue , tension , depression , and improved vigor and muscle strength after intervention and 6 months after discharge OBJECTIVES To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging . DESIGN A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts . SETTING The Betty Byrne-Henderson Center for Women and Aging , Royal Womens ' Hospital , Brisbane , Australia . PARTICIPANTS Four hundred fifty-six community-dwelling , independently ambulant women with no obvious neurological or musculoskeletal-related disability , aged 20 to 80 , were r and omly recruited from a large metropolitan region . MEASUREMENTS The clinical balance measures /tests were the  Timed Up and Go test , step test , Functional Reach test , and lateral reach test .  Multivariate analysis was used to test the effect for age , height , and activity level . RESULTS Normal data were produced for each test across each decade cohort . Gradual decline in balance performance was confirmed , with significant effect for age demonstrated . CONCLUSION New normative data across the adult age decades are available for these clinical tests . Use of clinical balance tests could complement other balance tests and be used to screen women aged 40 to 60 whose performance is outside the normal values for age and to decrease later falls risk Background —Peak oxygen uptake ( peak & OV0312;o2 ) is a strong predictor of mortality and is commonly used in the evaluation of patients for cardiac transplantation .  β-Blockers reduce mortality in patients with heart failure , without influencing peak & OV0312;o2 , raising the possibility that peak & OV0312;o2 is no longer suitable as an indicator of prognosis in these patients . Methods and Results —We analyzed prospect ively gathered data on 2105 patients referred for cardiopulmonary testing for all-cause mortality and for occurrence of death or transplantation . Patients receiving β-blockers were younger , more likely to have coronary disease , and had a greater mean ejection fraction but had a similar peak & OV0312;o2 . There were 555 deaths ( 26 % ) and 194 ( 9 % ) transplants during a median follow-up of 3.5 years . Peak & OV0312;o2 was a predictor of mortality irrespective of β-blocker use ; a decrease of 1 mL · kg−1 · min−1 result ed in an adjusted hazard ratio ( HR ) of 1.13 ( 95 % CI 1.09 to 1.17 , P<0.0001 ) in patients not receiving β-blockers and 1.27 ( 95 % CI 1.18 to 1.36 , P<0.0001 ) in patients receiving β-blockers . Similar findings were noted when considering death or transplantation as an end point . β-Blocker use was associated with better outcomes until peak & OV0312;o2 values became very low ( ≈10 mL · kg−1 · min−1 ) , at which level survival rates were equally poor . Conclusion —Peak & OV0312;o2 is a determinant of survival in patients in heart failure even in the setting of β-blockade . Because of improved survival in patients treated with  β-blockers , the cut point value of 14 mg · kg−1 · min−1 for referral for cardiac transplantation in these patients requires reevaluation , and a lower cut point may be more appropriate PURPOSE Physical activity may protect against  breast cancer . Few prospect i ve studies have evaluated breast cancer mortality in relation to cardiorespiratory fitness ( CRF ) , an objective marker of physiologic response to physical activity habits . METHODS We examined the association between CRF and risk of death from breast cancer  in the Aerobics Center Longitudinal Study . Women ( N = 14,811 ) , aged 20 to 83 yr with no prior breast cancer history , received a preventive medical examination at the Cooper Clinic in Dallas , Texas , between 1970 and 2001 . Mortality surveillance was completed through December 31 , 2003 . CRF was quantified as maximal treadmill exercise test duration and was categorized for analysis as low ( lowest 20 % of exercise duration ) , moderate ( middle 40 % ) , and high ( upper 40 % ) . At baseline , all participants were able to complete the exercise test to at least 85 % of their age-predicted maximal heart rate . RESULTS A total of 68 breast cancer deaths occurred during follow-up ( mean = 16 yr ) . Age-adjusted breast cancer mortality rates per 10,000 woman-years were 4.4 , 3.2 , and 1.8 for low , moderate , and high CRF groups , respectively ( trend P = 0.008 ) . After further controlling for body mass index , smoking , drinking , chronic conditions , abnormal exercise ECG responses , family history of breast cancer , oral contraceptive use , and estrogen use , hazard ratios ( 95 % CI ) for breast cancer mortality across incremental CRF categories were 1.00 ( referent ) , 0.67 ( 0.35 - 1.26 ) , and 0.45 ( 0.22 - 0.95 ) ( trend P = 0.04 ) . CONCLUSIONS These results indicate that CRF is associated with a reduced risk of dying from breast cancer in women Purpose . To determine which mode of exercise is preferred by breast cancer survivors and to evaluate this response between grade d exercise testing on a treadmill and on a cycle ergometer . Methods . Twelve breast cancer survivors completed 2 maximal aerobic stress tests on separate days . The women completed a ramp protocol on an electronically braked cycle ergometer and an incremental step protocol on a treadmill to volitional fatigue . Test order was r and omized . Expired gases were collected for the determination of peak aerobic capacity ( Vo2peak ) . Results . Exercise mode had a significant effect on the grade d exercise response in breast cancer survivors , P = .003 . Treadmill Vo2peak was significantly greater than bike Vo2peak ( 28.7 ± 4.7 vs 23.9 ± 4.7 mL/min/kg , respectively , P = .003 ) and VEmax was equivalent between exercise modes ( P = .731 ) . Maximal heart rate was significantly higher by 11 bpm during the treadmill protocol ( P = .004 ) , and Ve/VCo2 exhibited possible mode dependency ( P = .018 ) . Conclusion . This patient population felt more comfortable and produced significantly greater Vo2peak values using the treadmill protocol . These results discuss the potential implication s concerning the design and interpretation of exercise interventions for breast cancer survivors Background Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection .  Physiotherapy has been clinical ly observed to improve treatment of these patients . However , it is not a st and ard treatment regime . The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function , pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection . Methods Thirty patients following breast cancer surgery and axillary lymph node dissection were included in a r and omised controlled study . Assessment s were made at baseline and after three and six months . The treatment group received st and ardised physiotherapy treatment of advice and exercises for the arm and shoulder for three months ; the control group received a leaflet containing advice and exercises . If necessary soft tissue massage to the surgical scar was applied . Primary outcome variables were amount of pain in the shoulder/arm recorded on the Visual Analogue Scale , and shoulder mobility ( flexion , abduction ) measured using a digital inclinometer under st and ardized conditions . Secondary outcome measures were shoulder disabilities during daily activities , edema , grip strength of both h and s and quality of life . The research er was blinded to treatment allocation . Results All thirty patients completed the trial . After three and six months the treatment group showed a significant improvement in shoulder mobility and had significantly less pain than the control group . Quality of life improved significantly , however , h and grip strength and arm volume did not alter significantly . Conclusion Physiotherapy reduces pain and improves shoulder function and quality of life following axillary dissection after breast cancer . Trial registration IS RCT
target: Aerobic fitness values were generally below average , although 6-minute walk time was closer to population norms .
  Upper and lower extremity strength was lower than population norms for women who were currently receiving cancer treatment .
  Lower extremity strength was above population norms for women who had completed treatment .
  Aerobic capacity and upper extremity strength in women diagnosed with breast cancer are generally lower than population norms .
background: QUESTION What are typical values of physical function for women diagnosed with breast cancer and how do these compare to normative data ?