Baruth, M., Wilcox, S., Der Ananian, C., & Heiney, S. (2013). Effects of home-based walking on quality of life and fatigue outcomes in early stage breast cancer survivors: A 12-week pilot study. Journal of Physical Activity and Health [Epub ahead of print].

Study Purpose

To examine the effects of a home-based walking program on quality of life and fatigue.

Intervention Characteristics/Basic Study Process

Women were randomized to the usual care, wait list control, or intervention groups. Those in the intervention group received a 30 minute in-person counseling session and follow-up telephone counseling calls in weeks 1, 2, 4, 7, and 10. Counseling calls applied constructs of social cognitive therapy, discussing specific behavior change principles that could be used to increase walking, using a semi-structured script. Walking plans were designed for gradual increases in frequency, duration, and intensity. Women in the usual care group were asked to maintain their usual activity levels. Those in the intervention group were asked to keep daily activity logs and were given pedometers.

Sample Characteristics

  • N = 32  
  • MEAN AGE = 55 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: All had breast cancer, stages I–III. All had completed adjuvant treatment within the last 12 months.


  • SITE: Single site  
  • SETTING TYPE: Home  
  • LOCATION: South Carolina

Phase of Care and Clinical Applications

  • PHASE OF CARE: Transition phase after active treatment

Study Design

  • RCT

Measurement Instruments/Methods

  • SF-36®
  • Physical activity logs
  • Pedometer
  • International Breast Cancer Study Group QOL Core Questionnaire
  • Functional Assessment of Cancer Therapy–Fatigue
  • Community Health Activities Model Program for Seniors (CHAMPS) questionnaire


Fatigue declined in all patients. There was a greater decline among the intervention group, but the difference was not significant. Estimated activity level of walking METs was not significantly different between groups at baseline, but levels post-intervention are not reported. Overall, participants in the intervention group completed 86% (range = 62%–100%) of prescribed walking sessions.


Findings suggest relatively good adherence to home-based walking prescriptions and suggest that this activity may improve fatigue symptoms.


  • Small sample (< 100)
  • Baseline sample/group differences of import
  • Risk of bias (no blinding)
  • Risk of bias (no appropriate attentional control condition)
  • Questionable protocol fidelity
  • Other limitations/explanation: No measures were taken to check phone follow-up fidelity. Fifty percent of patients in the control group were African American, compared to only 10% in the intervention group. The intervention group was almost twice as large as the control group.

Nursing Implications

Findings suggest that a prescription for a home-based walking program can be a practical way to improve or maintain physical activity among women with breast cancer after initial treatment, and that this activity can improve symptoms of fatigue. There were multiple limitations to this study; however, multiple studies have shown that exercise is effective to reduce fatigue. Previous findings regarding self-managed exercise programs have been mixed. This pilot study suggests that a prescription for exercise, patient counseling and follow-up contacts may facilitate performance of home-based exercise.