Mayo, N.E., Moriello, C., Scott, S.C., Dawes, D., Auais, M., & Chasen, M. (2014). Pedometer-facilitated walking intervention shows promising effectiveness for reducing cancer fatigue: A pilot randomized trial. Clinical Rehabilitation, 28, 1198–1209. 

DOI Link

Study Purpose

To contribute preliminary evidence for the feasibility and potential effectiveness of a structured walking intervention on reducing cancer-related fatigue in order to plan for a full-scale study of effectiveness

Intervention Characteristics/Basic Study Process

The study consisted of an eight-week program with three intervention groups: one with the STEPS (a walking program using a pedometer) during rehabilitation, one with STEPS after rehabilitation, and one group with only the rehabilitation program for people with advanced cancer and a > 4 fatigue level on a Visual Analog Scale (VAS).

Sample Characteristics

N = 26  
AGE RANGE = 34–88 years
MALES: 14 (54%), FEMALES: 12 (46%)
KEY DISEASE CHARACTERISTICS: Stages I-V; fatigue score > 4; medically accepted into the rehabilitation program
OTHER KEY SAMPLE CHARACTERISTICS: Thirteen cancer types represented including breast, colorectal, and head and neck


  • SITE: Single-site    
  • SETTING TYPE: Outpatient    
  • LOCATION: McGill University Health Centre, Montreal, Canada

Phase of Care and Clinical Applications

  • PHASE OF CARE: Late effects and survivorship

Study Design

A pilot randomized trial. The STEPS program was based on the participants’ current walking status and progressed according to fatigue level.

Measurement Instruments/Methods

Instruments chosen to measure fatigue and symptoms of anxiety and depression included the following.

  • Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System
  • Fatigue Symptom Inventory (FSI)/Two-Minute Walk Test (2MWT)
  • RAND-36 Survey
  • Community Healthy Activities Model Program for Seniors (CHAMPS)
  • EuroQol System
  • Functional Assessment of Cancer Therapy (FACT-G)
  • Hospital Anxiety and Depression Scale (HADS)
  • Pittsburgh Sleep Quality Index (PSQI)
  • Fatigue Visual Analogue Scale (VAS)


Results demonstrated that the pedometer-facilitated walking intervention adapted to fatigue levels (STEPS program) showed promise as an intervention to decrease cancer-related fatigue.


Compared to rehabilitation alone, the eight-week adaptive walking intervention reduced fatigue and improved physical function and well-being over a 16-week period and was sustained to six months.


  • Small sample (< 30)
  • Subject withdrawals ≥ 10%

Nursing Implications

Walking intervention is associated with a trend toward less fatigue; however, this study needs replication in the advanced cancer population. Effectiveness not established.