NCT01843608

Brief Summary

Breast cancer survival it is affected by the side effects related to the illness, the treatments or even the behavioral factors (e.g. inadequate diet, sedentary behavior) that create in this women an important quantity of psychological and physical disorders. Prior systematic reviews and meta-analyses have demonstrate that supervised aerobic training is a safe, feasible, and effective adjunct therapy to improve a broad range of physiological and psychological outcomes in women with early breast cancer. However the vast majority of studies to date have focused on the efficacy of exercise to improve symptom control outcomes in breast cancer patients either during or following the completion of adjuvant therapy. Most relevant consequences are found in women that have to undergo surgery as 16% to 43% of women with breast cancer suffer functional limitation in the shoulder, inflammation, pain or strength and flexibility reduction in upper body limbs one year after surgery with a high prevalence which is rising. Weight gain is associated with decreased quality of life and increased risk for several comorbid conditions, such as cardiovascular disease and diabetes. The most of the cardiopulmonary problems are induced by chemotherapy or radiotherapy, because of the treatments effect in the heart and its consequences in cardiorespiratory fitness of these women. These side effects become in important limitations to allow women return their normal life style. These limitations have a severe effect in decreasing of physical activity practice, which have visible consequences in increasing general fatigue and calcium deficiency in bones due to the age and some adjuvant treatments. Previous studies found that patients with breast cancer who gained modest amounts of weight were significantly more likely to experience disease recurrence and die from breast cancer and other causes that those who were weight stable. In addition, two thirds of the studies that have assessed body composition change in relation to weight gain in this patient population observe no net gain in muscle mass or loss in muscle mass as body weight and adipose tissue increase. These changes are defined as sarcopenic obesity. This kind of obesity is characterized by weight gain in the presence of lean tissue loss or absence of lean tissue gain. In addition fat tissue gain is related with other health disorders such as diabetes, functional limitations and poor survival levels. Treatment for this unique pattern of weight gain is an exercise intervention, especially strength training. Psychological effects have to be took account as cancer produce important aftermath. Large scientific evidence shows the psycho-emotional alterations in women diagnosed with breast cancer at some point in their life. World Health Organization (WHO) defines quality of life as "individuals perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment." Following this definition numbered of researches have been developed, presenting interest in both physiological and psychological changes and improvements, as show different studies. HYPOTHESIS The primary hypothesis of this study is that group exercise intervention, combining aerobic and strength training, will reduce lean mass and body fat tissue in breast cancer post treatment survival. Secondary hypothesis of this clinical trial are follows:

  1. 1.Combined exercise intervention will increase maximal strength level of chest press and leg press.
  2. 2.Combined exercise intervention will increase maximal cardiopulmonary capacity, assessed by Peak Oxygen Consumption(VO2peak), which has been confirmed as an important value in survivals. In addition, ACSM propose this value as the Gold Standard to assess fitness level.
  3. 3.Combined exercise intervention will increase global Isometric Strength Index, assessed by Grip Strength Dynamometer.
  4. 4.Combined exercise intervention will improve range motion in upper-limbs.
  5. 5.Patients Reported Outcomes (PROs), such as quality of life (QoL), Health perception and depression.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
90

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Feb 2013

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2013

Completed
3 months until next milestone

First Submitted

Initial submission to the registry

April 26, 2013

Completed
4 days until next milestone

First Posted

Study publicly available on registry

April 30, 2013

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2014

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2014

Completed
Last Updated

November 25, 2013

Status Verified

November 1, 2013

Enrollment Period

1.3 years

First QC Date

April 26, 2013

Last Update Submit

November 22, 2013

Conditions

Keywords

Physical treatmentExercise prescription to breast cancer survivalSide cancer effect treatment

Outcome Measures

Primary Outcomes (2)

  • Lean mass percentage

    Lean body mass percentage in each participant before and after intervention in intervention group and three months after in control group, assessed by bioimpedance.

    3 months

  • Maximal Strength

    Maximal strength in upper limbs and in legs assessed by 8 RM protocol. Maxima resistance strength.

    3 months

Secondary Outcomes (7)

  • Fat body mass

    3 months

  • Cardiovascular capacity

    3 months

  • Quality of Life

    3 moths

  • Fatigue

    3 months

  • Health Perception

    3 months

  • +2 more secondary outcomes

Study Arms (2)

Control Group

NO INTERVENTION

Patients in this group will be asked to maintain the same activity level until the baseline assessments. They cannot change physical activity and nutritional habits.

Physical Intervention Group

EXPERIMENTAL

They have to perform two days per week of guide and planned exercise during three months. All classes are composed by different parts: aerobic exercise, to improve cardiovascular capacity, strength, to work muscle mass and flexibility to increase joint movements. They have to present an attendance above or equal to 80%.

Other: Physical Intervention

Interventions

The exercise program will be designed and conducted by qualified in Physical Activity and Sport Sciences. The exercise program will consist in a combined two days per week of supervised training program and one day per week of briskly walking by themselves, following a document, designed by the specialist trainer, which will be given at the beginning of the program. The intervention will have a duration of 12 consecutive weeks. The intensity will be increasing progressively from 65% to 85% of heart rate. The intensity will be controlled by heart rate monitor trademark POLAR FT7 in aerobic exercise and with the number of repetitions (from 8 to 15) and sets (from 2 to 3) in strength exercises. Prescription intensity will be done using Karvonen equation, recommended method to work with risk population.

Also known as: Women In Motion
Physical Intervention Group

Eligibility Criteria

Age18 Years - 75 Years
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Breast cancer diagnosed confirmed stage I-IIIA.
  • Randomized disposition.
  • Minimum of forty-five days and maximum of thirty-six months after finishing treatments (chemotherapy and radiotherapy).
  • in Eastern Cooperative Oncology Group (ECOG) scale (present the ability to walk briskly)
  • Oncologist approval.
  • Informed Consent signed.
  • Community of Madrid inhabitant.

You may not qualify if:

  • Metastasis presence
  • Serious medical risk such as unstable cardiac condition or severe pulmonary disease and anticoagulants treatments.
  • ECOG \> 1
  • Pregnant

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Physical Activity and Sport Science Faculty

Madrid, Madrid, 28040, Spain

RECRUITING

Related Publications (26)

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    PMID: 20052559BACKGROUND
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    PMID: 22392097BACKGROUND
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    PMID: 19863217BACKGROUND
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    PMID: 11844838BACKGROUND
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    PMID: 22907032BACKGROUND
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    PMID: 22614980BACKGROUND
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    PMID: 12655532BACKGROUND
  • Riggs BL, Khosla S, Melton LJ 3rd. A unitary model for involutional osteoporosis: estrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res. 1998 May;13(5):763-73. doi: 10.1359/jbmr.1998.13.5.763.

    PMID: 9610739BACKGROUND
  • Winer EP, Hudis C, Burstein HJ, Wolff AC, Pritchard KI, Ingle JN, Chlebowski RT, Gelber R, Edge SB, Gralow J, Cobleigh MA, Mamounas EP, Goldstein LJ, Whelan TJ, Powles TJ, Bryant J, Perkins C, Perotti J, Braun S, Langer AS, Browman GP, Somerfield MR. American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol. 2005 Jan 20;23(3):619-29. doi: 10.1200/JCO.2005.09.121. Epub 2004 Nov 15.

    PMID: 15545664BACKGROUND
  • Kroenke CH, Chen WY, Rosner B, Holmes MD. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol. 2005 Mar 1;23(7):1370-8. doi: 10.1200/JCO.2005.01.079. Epub 2005 Jan 31.

    PMID: 15684320BACKGROUND
  • Aslani A, Smith RC, Allen BJ, Pavlakis N, Levi JA. Changes in body composition during breast cancer chemotherapy with the CMF-regimen. Breast Cancer Res Treat. 1999 Oct;57(3):285-90. doi: 10.1023/a:1006220510597.

    PMID: 10617305BACKGROUND
  • Ingram C, Brown JK. Patterns of weight and body composition change in premenopausal women with early stage breast cancer: has weight gain been overestimated? Cancer Nurs. 2004 Nov-Dec;27(6):483-90. doi: 10.1097/00002820-200411000-00008.

    PMID: 15632788BACKGROUND
  • Cheney CL, Mahloch J, Freeny P. Computerized tomography assessment of women with weight changes associated with adjuvant treatment for breast cancer. Am J Clin Nutr. 1997 Jul;66(1):141-6. doi: 10.1093/ajcn/66.1.141.

    PMID: 9209182BACKGROUND
  • Demark-Wahnefried W, Peterson BL, Winer EP, Marks L, Aziz N, Marcom PK, Blackwell K, Rimer BK. Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2001 May 1;19(9):2381-9. doi: 10.1200/JCO.2001.19.9.2381.

    PMID: 11331316BACKGROUND
  • Demark-Wahnefried W, Hars V, Conaway MR, Havlin K, Rimer BK, McElveen G, Winer EP. Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. Am J Clin Nutr. 1997 May;65(5):1495-501. doi: 10.1093/ajcn/65.5.1495.

    PMID: 9129482BACKGROUND
  • Ligibel JA, Campbell N, Partridge A, Chen WY, Salinardi T, Chen H, Adloff K, Keshaviah A, Winer EP. Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. J Clin Oncol. 2008 Feb 20;26(6):907-12. doi: 10.1200/JCO.2007.12.7357.

    PMID: 18281663BACKGROUND
  • Heber D, Ingles S, Ashley JM, Maxwell MH, Lyons RF, Elashoff RM. Clinical detection of sarcopenic obesity by bioelectrical impedance analysis. Am J Clin Nutr. 1996 Sep;64(3 Suppl):472S-477S. doi: 10.1093/ajcn/64.3.472S.

    PMID: 8780366BACKGROUND
  • Irwin ML. Physical activity interventions for cancer survivors. Br J Sports Med. 2009 Jan;43(1):32-8. doi: 10.1136/bjsm.2008.053843. Epub 2008 Oct 23.

    PMID: 18948351BACKGROUND
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    PMID: 16818906BACKGROUND
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    PMID: 11157015BACKGROUND
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    PMID: 20645033BACKGROUND

MeSH Terms

Conditions

FatigueDepression

Interventions

Motion

Condition Hierarchy (Ancestors)

Signs and SymptomsPathological Conditions, Signs and SymptomsBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

Physical Phenomena

Study Officials

  • Javier Sampedro, Professor

    Universidad Politecnica de Madrid

    STUDY DIRECTOR

Central Study Contacts

Soraya Casla, PhD Student

CONTACT

Ruben O Barakat, Profesor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD Student

Study Record Dates

First Submitted

April 26, 2013

First Posted

April 30, 2013

Study Start

February 1, 2013

Primary Completion

June 1, 2014

Study Completion

September 1, 2014

Last Updated

November 25, 2013

Record last verified: 2013-11

Locations