Do, J., Cho, Y., & Jeon, J. (2015). Effects of a 4-week multimodal rehabilitation program on quality of life, cardiopulmonary function, and fatigue in breast cancer patients. Journal of Breast Cancer, 18, 87–96. 

DOI Link

Study Purpose

To examine effects of a rehabilitation program

Intervention Characteristics/Basic Study Process

Patients were randomly assigned to an early exercise group or a delayed exercise group. Participants attended rehabilitation sessions five times per week for four weeks. Sessions involved the use of upper and lower extremity stretching, aerobic, and strengthening exercises. During weeks 1–4, the early exercise group participated, and during weeks 4–8, the delayed group participated. Patients were evaluated at baseline and at two, four, six, and eight weeks.

Sample Characteristics

  • N = 62  
  • MEAN AGE = 46.1 years (SD = 8.5 years)
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Breast cancer; 53% had a lumpectomy; and all completed initial cancer treatment


  • SITE: Single site  
  • SETTING TYPE: Outpatient  
  • LOCATION: South Korea

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, parallel group trial with repeated measures

Measurement Instruments/Methods

  • European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30)
  • Cycle test for cardiorespiratory function
  • Fatigue Severity Scale (FSS)
  • Muscle strength measurements


Patients in both groups showed significant improvements in all measures except body image (p < 0.001). The greatest improvements were shown during the period of time that individuals were participating in the exercise sessions in both groups. There was no significant difference between groups.


The exercise combinations used here were effective in reducing fatigue and improving quality of life among participants


  • Small sample (< 100)
  • Risk of bias (no blinding)
  • Other limitations/explanation: Out of the 212 people who initially consented, only 62 actually participated in the study. This suggests that the program may not be acceptable to the majority of patients. There is a possible testing effect with repeated measures over a short period of time. No information is provided regarding adherence to exercise sessions.

Nursing Implications

The findings of this study add to the already extensive body of evidence that various forms of exercise are beneficial to reduce fatigue in patients with cancer. This study showed effects specifically during the time in which participants were exercising, suggesting the need for ongoing involvement in activity to maintain effectiveness