Naraphong, W., Lane, A., Schafer, J., Whitmer, K., & Wilson, B.R. (2015). Exercise intervention for fatigue‐related symptoms in Thai women with breast cancer: A pilot study. Nursing and Health Sciences, 17, 33–41.

DOI Link

Study Purpose

To test the feasibility and provide a preliminary evaluation of the effects of an exercise program for fatigue, sleep disturbance, mood, and symptoms in patients with cancer

Intervention Characteristics/Basic Study Process

Participants randomly were assigned to the treatment or control group. Patients in the control group received usual care, an educational booklet and DVD, and weekly telephone calls. Patients in the experimental group received initial one-on-one training sessions and were given exercise program kits containing written instructions, a pedometer, and an exercise log. Patients were to choose activities that provided low to moderate intensity exercise and perform these daily for at least 20 minutes. Participants also were asked to walk three to five days per week. Weekly phone calls to the experimental group were made to monitor participation and make adjustments to the walking prescription as needed. The program was planned for 12 weeks.

Sample Characteristics

  • N = 23
  • MEAN AGE = 46.78 years (range = 31–59 years)
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: All patients had breast cancer (mostly stage II). Patients were recruited during chemotherapy given postoperatively.


  • SITE: Single-site  
  • SETTING TYPE: Outpatient  
  • LOCATION: Thailand

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, controlled trial

Measurement Instruments/Methods

  • Piper Fatigue Scale (PFS)
  • General Sleep Disturbance Scale (GSDS)
  • Profile of Mood States–Short Form (POMS-SF)
  • Memorial Symptom Assessment Scale (MSAS)


Patients in the experimental group demonstrated a nonsignificant improvement in fatigue (d = -0.48). There were no significant group by time effects for other measures. Data were not collected after week 10 because of loss of subject follow-up.


The findings of this study support the known effect of exercise on cancer-related fatigue; however, the small sample in this study limits the strength of these findings.


  • Small sample (< 30)
  • Small sample (< 100)
  • Baseline sample/group differences of import
  • Risk of bias (no blinding)
  • Subject withdrawals ≥ 10%
  • Other limitations/explanation: Patients in the control group reported higher fatigue levels at baseline.

Nursing Implications

This study provides minimal additional support for the benefits of exercise among women with breast cancer during active treatment. Exercise has been shown to be effective in reducing multiple symptoms, and nurses should encourage patients to be active.