Schmidt, T., Weisser, B., Jonat, W., Baumann, F. T., & Mundhenke, C. (2012). Gentle strength training in rehabilitation of breast cancer patients compared to conventional therapy. Anticancer Research, 32, 3229–3233.

Study Purpose

To evaluate the effect of gentle strength training on endurance and psychological outcomes in patients with breast cancer.

Intervention Characteristics/Basic Study Process

Patients were randomized to the intervention or control study groups. Patients in the control group participated weekly in gymnastic exercises, such as chair or floor exercises with various sports equipment. Those in the intervention group were trained with strength endurance training, according to individualized training plans based on a training load of 50% of one repetition maximum on a weekly basis. Both groups continued the weekly training program for six months. Data were collected at baseline, after three months, and after six months.

Sample Characteristics

  • Thirty-three participants (100% female) were included. 
  • Mean age was 56 years.
  • All participants had breast cancer and had completed initial antitumor treatments. 
  • Participants were an average of approximately nine months since diagnosis.


  • Single site 
  • Other setting
  • Germany

Phase of Care and Clinical Applications

Patients were undergoing the transition phase after active treatment.

Study Design

This was a randomized, two-group prospective study.

Measurement Instruments/Methods

  • Endurance test using a bicycle ergometer
  • European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-BR-23) module for quality of life (QOL) and fatigue
  • Body mass index (BMI)


There was a significant reduction in BMI in both groups. QOL and fatigue scores showed a significant improvement in both groups at three and six months (p < 0.01). There were no significant differences between groups. The pattern of fatigue change showed decline in both groups by three months. At the six-month time point, the intervention group continued to experience a decline, whereas those in the control group showed increased fatigue, although this level was still below that at baseline.


Both conventional gymnastic exercise and gentle strength training were associated with weight reduction and improvement in fatigue and QOL in women with breast cancer.


  • The study had a small sample size, with less than 100 participants.    
  • Baseline sample/group differences were of import.
  • The study had risks of bias due to no control group and no blinding.
  • Measurement validity/reliability was questionable.*
  • * Baseline QOL measures were higher in the intervention group.  There was no information provided regarding patient adherence to weekly sessions.  Fatigue was only measured with a single item from the instrument used.  It was not clear whether patients had relevant levels of fatigue at baseline or if all exercise was supervised or if individuals performed the sessions on their own.

Nursing Implications

Findings suggested that both types of exercise were beneficial to patients with breast cancer.  Further research in this area would be beneficial to determine those types of exercise and the timing of exercise related to cancer treatment that are most effective for the prevention and management of fatigue.