Reis, D., Walsh, M.E., Young-McCaughan, S., & Jones, T. (2013). Effects of Nia exercise in women receiving radiation therapy for breast cancer [Online exclusive]. Oncology Nursing Forum, 40, E374–E381. 

DOI Link

Study Purpose

To compare a 12-week Nia-based exercise program to usual care on cancer-related fatigue, quality of life, aerobic capacity, and shoulder flexibility in women receiving radiation therapy for breast cancer

Intervention Characteristics/Basic Study Process

Participants randomized to the intervention were instructed in Nia techniques as well as given a DVD for home use. They were instructed to perform the exercises for 20–60 minutes at least three times a week and maintain a log. The control group were instructed to maintain their usual exercise regime and maintain a log. The principle investigator met individually with both groups at the beginning and at 6 and 12 weeks. At the end of the 12 weeks, control group participants were given the opportunity to take part in a Nia group.

Sample Characteristics

  • N = 41  
  • MEAN AGE = 56 (range = 34–85)
  • KEY DISEASE CHARACTERISTICS: Patients with breast cancer receiving radiation therapy


  • SITE: Single site  
  • SETTING TYPE: Outpatient    
  • LOCATION: Northern Ohio

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active anti-tumor treatment

Study Design

  • Randomized, controlled study stratified by stage or disease and age

Measurement Instruments/Methods

  • Fatigue and quality of fife were measured by the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F).
  • Aerobic capacity measured by a six-minute walk test
  • Shoulder flexibility assessed using a goniometer


Both groups reported increased fatigue at week 6 (completing therapy) with improvement at week 12. Repeated measures of covariance noted statistically significant differences in the Nia and control groups between weeks 6 and 12; the Nia group had a greater increase in FACIT-F scores (p = 0.05).


Sample size and study limitations make it difficult to draw conclusions; however, Nia exercise can be beneficial to women with breast cancer receiving radiation therapy to reduce cancer-related fatigue.


  • Small sample (< 100)
  • Baseline sample/group differences of import
  • Risk of bias (no blinding)
  • Risk of bias(sample characteristics)
  • Selective outcomes reporting
  • Findings were not generalizable
  • Intervention expensive, impractical, or training needs
  • Questionable protocol fidelity
  • Subject withdrawals ≥ 10% 
  • Other limitations/explanation: Control group had less fatigue at baseline; both groups reported that keeping a diary reminded them to exercise

Nursing Implications

Nia exercise can be beneficial to women with breast cancer receiving radiation therapy, particularly those who favor a holistic or complementary approach.