A physical activity program for women living with metastatic breast cancer

INTERVENTION: The intervention comprised an 8‐week program of 16 exercise sessions conducted in the participant’s home or a local park, supervised by an exercise specialist. An unsupervised walking program was also prescribed for the duration of the 8‐week intervention. Each supervised session consisted of a 10‐15 min brisk walk followed by 30‐40 min of resistance training. The short walk was monitored via a pedometer and Borg’s rating of perceived exertion (RPE), with a target zone of 11‐13 to reflect a moderate intensity. The resistance exercises included chest press, horizontal row, upright row, bicep curl, calf raises, lunges and either sit‐to‐stands or squats. Each exercise was individualised based on training experience and baseline strength. Upper body exercises were delivered using a Smart Stickâ„¢ and Smart Toner® and the lower body exercises used body weight resistance, with the addition of hand weights as required. Each resistance exercise involved 2 sets of 10‐12 repetitions, with one‐minute recovery between each set. Resistance training was performed at a moderate intensity. The volume and intensity of each exercise was recorded in an exercise diary by the trainer at each session. The unsupervised walking program was conducted in the same manner as the supervised walk, with steps counted using a pedometer and a target RPE of 11‐13. Women were asked to walk on days they were not seeing their trainer and encouraged to increase the number of steps taken each week by 10%. The number of steps taken during each walk was recorded in a diary maintained by the participant. CONDITION: Cancer ‐ Breast Metastatic breast cancer; ; Metastatic breast cancer Physical Medicine / Rehabilitation ‐ Other physical medicine / rehabilitation PRIMARY OUTCOME: Adherence calculated by the number of attended sessions divided by the number of expected sessions[Last patient last visit] Recruitment rate determined by the percentage of eligible patients who enrolled[Last patient first visit] Retention calculated as the percentage of participants who completed the final study visit (16 weeks after commencing the intervention)[Last patient last visit] INCLUSION CRITERIA: i. stage IV breast cancer ii. living in the community iii. mentally competent to follow instructions iv. Eastern Cooperative Oncology Group (ECOG) performance status of 0‐3 v. oncologist‐expected survival of at least 4 months SECONDARY OUTCOME: Cardiovascular fitness assessed using Modified Canadian Aerobic Fitness Test (mCAFT) [Baseline, 8 weeks and 16 weeks after the commencement of intervention] Daily physical activity energy expenditure assessed using ActiHeart[Baseline, 8 weeks and 16 weeks after the commencement of intervention] Fatigue assessed using FACIT‐Fatigue[Baseline, 8 weeks and 16 weeks after the commencement of intervention] Lower limb strength assessed using back‐leg dynamometry[Baseline, 8 weeks and 16 weeks after the commencement of intervention] Physical activity assessed using International Physical Activity Questionnaire [Baseline, 8 weeks and 16 weeks after the commencement of intervention] Quality of Life assessed using EORTC‐QLQ C30[Baseline, 8 weeks and 16 weeks after the commencement of intervention] Upper strength assessed using hand dynamometry[Baseline, 8 weeks and 16 weeks after the commencement of intervention]