Impact of resistance training in cancer survivors: A meta-analysis

Medicine and Science in Sports and Exercise

Volumn 45, Issue 11, 2013, Pages 2080-2090

  Strasser, Barbara ^a   Steindorf, Karen ^b   Wiskemann, Joachim ^b,c   Ulrich, Cornelia M ^b,d,e  

^a UNIVERSITY FOR HEALTH SCIENCES   (Austria)

^b GERMAN CANCER RESEARCH CENTER DKFZ   (Germany)

^c UNIVERSITY HOSPITAL HEIDELBERG   (Germany)

^d Fred Hutchinson Cancer Research Center   (United States)

^e UNIVERSITY OF WASHINGTON   (United States)

Author keywords

Cancer; Exercise; Muscle Function; Quality Of Life; Strength Training; Systematic Review

Indexed keywords

ARM; ARTICLE; BODY COMPOSITION; FATIGUE; HUMAN; LEG; META ANALYSIS; METHODOLOGY; MUSCLE STRENGTH; NEOPLASM; PHYSIOLOGY; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESISTANCE TRAINING; SKELETAL MUSCLE;

BODY COMPOSITION; FATIGUE; HUMANS; LOWER EXTREMITY; MUSCLE STRENGTH; MUSCLE, SKELETAL; NEOPLASMS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RESISTANCE TRAINING; UPPER EXTREMITY;

EID: 84887073383     PISSN: 01959131     EISSN: 15300315     Source Type: Journal    
DOI: 10.1249/MSS.0b013e31829a3b63     Document Type: Article

References (116)

1. Abe T, DeHoyos DV, Pollock ML, Garzarella L. Time course of strength and muscle thickness changes following upper and lower body resistance training in men and women. Eur J Appl Physiol. 2000;81:174-80.
2. Ahmed RL, Thomas W, Yee D, Schmitz KH. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol. 2006;24:2765-72.
3. Atlantis E, Martin SA, Haren MT, Taylor AW, Wittert GA; Members of the Florey Adelaide Male Ageing Study. Inverse associations between muscle mass, strength, and the metabolic syndrome. Metabolism. 2009;58:1013-22.
4. Battaglini C, Bottaro M, Dennehy C, et al. The effects of resistance training on muscle strength and fatigue in breast cancer patients. Rev Bras Med Esporte. 2007;12:139e-44e.
5. Battaglini C, Bottaro M, Dennehy C, et al. The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment. Sao Paulo Med J. 2007; 125:22-8.
6. Brown JC, Huedo-Medina TB, Pescatello LS, Pescatello SM, Ferrer RA, Johnson BT. Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2011;20: 123-33.
7. Burd NA, West DW, Staples AW, et al. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. PLoS One. 2010;5:e12033.
8. Carrillo AE, Flynn MG, Pinkston C, et al. Impact of vitamin D supplementation during a resistance training intervention on body composition, muscle function, and glucose tolerance in overweight and obese adults. Clin Nutr. 2013;32:375-81.
9. Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE. Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage. 2002;24:547-61.
10. Cheema B, Gaul CA, Lane K, Fiatarone Singh MA. Progressive resistance training in breast cancer: a sytematic review of clinical trials. Breast Cancer Res Treat. 2008;109:9-26.
11. Cheville AL, Girardi J, Clark MM, et al. Therapeutic exercise during outpatient radiation therapy for advanced cancer. Am J Phys Med Rehabil. 2010;89:611-19.
12. Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396-404.
13. Cramp F, Byron D. Exercise for the management of cancerrelated fatigue in adults. Cochrane Database Syst Rev. 2012;11: CD006145.
14. Cramp F, Daniel J. Exercise for the management for cancerrelated fatigue in adults. Cochrane Database Syst Rev. 2008;2: CD006145.
15. Cramp F, James A, Lambert J. The effects of resistance training on quality of life in cancer: a systematic literature review and metaanalysis. Support Care Cancer. 2010;18:1367-76.
16. De Backer IC, Schep G, Backx FJ, Vreugdenhil G, Kuipers H. Resistance training in cancer survivors: a systematic review. Int J Sports Med. 2009;30:703-12.
17. Dimeo F. Effects of exercise on cancer-related fatigue. Cancer. 2001;92:1689-93.
18. Donnelly E, Jakicic M, Pronk NP. Is resistance exercise effective for weight management? Evid Based Prev Med. 2004;1:21-9.
19. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK; American College of Sports Medicine. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2): 459-71.
20. Doyle C, Kushi LH, Byers T, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006; 56:323-53.
21. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA. 1990;263:3029-34
22. Fong DY, Ho JW, Hui BP, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012; 344:e70.
23. 2max in older men. J Appl Physiol. 1990;68:329-33.
24. Galvao DA, Nosaka K, Taaffe DR, et al. Resistance training and reduction of treatment side effects in prostate cancer patients. Med Sci Sports Exerc. 2006;38(12):2045-52.
25. Henwood TR, Taaffe DR. Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training. Gerontology. 2005;51:108-15.
26. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-60.
27. Holick CN, Newcomb PA, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarker Prev. 2008;17:379-86.
28. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:1479-86.
29. Jackson AW, Lee DC, Sui X, et al. Muscular strength is inversely related to prevalence and incidence of obesity in adult men. Obesity. 2010;18:1988-95.
30. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1-12.
31. Kraemer WJ, Adams K, Cafarelli E, et al.; American College of Sports Medicine. American College of Sports Medicine Position Stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002;34(3):364-80.
32. Larew K, Hunter GR, Larson-Meyer DE, Newcomer BR, McCarthy JP, Weinsier RL. Muscle metabolic function, exercise performance, and weight gain. Med Sci Sports Exerc. 2003;35(2):230-6.
33. Marcell TJ. Sarcopenia: causes, consequences, and prevention. J Gerontol A Biol Sci Med Sci. 2003;58:M911-6.
34. McNeely ML, Parliament M, Courneya KS, et al. A pilot study of a randomized controlled trial to evaluate the effects of progressive resistance exercise training on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in head and neck cancer survivors. Head Neck. 2004;26:518-30.
35. McNeely ML, Parliament MB, Seikaly H, et al. Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors. A randomized controlled trial. Cancer. 2008;113: 214-22.
36. Narici MV, Hoppeler H, Kayser B, et al. Human quadriceps crosssectional area, torque and neural activation during 6 months strength training. Acta Physiol Scand. 1996;157:175-86.
37. National Comprehensive Cancer Network. Clinical practice guidelines in oncology. Cancer-related fatigue version 1 [Internet]. 2010 [cited 2010 August 10]. Available from: http://www.nccn.org.
38. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. JAMA. 1994;272:1909-14.
39. Newman AB, Kupelian V, Visser M, et al. Strength but not muscle mass, is associated with mortality in the health aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006; 61:72-7.
40. Ohira T, Schmitz KH, Ahmed RL, Yee D. Effects of weight training on quality of life in recent breast cancer survivors. Cancer. 2006;106:2076-83.
41. Peddle-McIntyre CJ, Bell G, Fenton D, McCargar L, Courneya KS. Feasibility and preliminary efficacy of progressive resistance exercise training in lung cancer survivors. Lung Cancer. 2012; 75:126-32.
42. Ahmed RL, Thomas W, Yee D, Schmitz KH. Randomized controlled trial of weight training and lymphedema in breast cancer survivors. J Clin Oncol. 2006;24:2765-72.
43. Atlantis E, Martin SA, Haren MT, Taylor AW, Wittert GA; Members of the Florey Adelaide Male Ageing Study. Inverse associations between muscle mass, strength, and the metabolic syndrome. Metabolism. 2009;58:1013-22.
44. Battaglini C, Bottaro M, Dennehy C, et al. The effects of resistance training on muscle strength and fatigue in breast cancer patients. Rev Bras Med Esporte. 2007;12:139e-44e.
45. Battaglini C, Bottaro M, Dennehy C, et al. The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment. Sao Paulo Med J. 2007; 125:22-8.
46. Brown JC, Huedo-Medina TB, Pescatello LS, Pescatello SM, Ferrer RA, Johnson BT. Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2011;20: 123-33.
47. Burd NA, West DW, Staples AW, et al. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. PLoS One. 2010;5:e12033.
48. Carrillo AE, Flynn MG, Pinkston C, et al. Impact of vitamin D supplementation during a resistance training intervention on body composition, muscle function, and glucose tolerance in overweight and obese adults. Clin Nutr. 2013;32:375-81.
49. Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE. Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage. 2002;24:547-61.
50. Cheema B, Gaul CA, Lane K, Fiatarone Singh MA. Progressive resistance training in breast cancer: a sytematic review of clinical trials. Breast Cancer Res Treat. 2008;109:9-26.
51. Cheville AL, Girardi J, Clark MM, et al. Therapeutic exercise during outpatient radiation therapy for advanced cancer. Am J Phys Med Rehabil. 2010;89:611-19.
52. Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396-404.
53. Cramp F, Byron D. Exercise for the management of cancerrelated fatigue in adults. Cochrane Database Syst Rev. 2012;11: CD006145.
54. Cramp F, Daniel J. Exercise for the management for cancerrelated fatigue in adults. Cochrane Database Syst Rev. 2008;2: CD006145.
55. Cramp F, James A, Lambert J. The effects of resistance training on quality of life in cancer: a systematic literature review and metaanalysis. Support Care Cancer. 2010;18:1367-76.
56. De Backer IC, Schep G, Backx FJ, Vreugdenhil G, Kuipers H. Resistance training in cancer survivors: a systematic review. Int J Sports Med. 2009;30:703-12.
57. Dimeo F. Effects of exercise on cancer-related fatigue. Cancer. 2001;92:1689-93.
58. Donnelly E, Jakicic M, Pronk NP. Is resistance exercise effective for weight management? Evid Based Prev Med. 2004;1:21-9.
59. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK; American College of Sports Medicine. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2): 459-71.
60. Doyle C, Kushi LH, Byers T, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006; 56:323-53.
61. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA. 1990;263:3029-34 22.
62. Fong DY, Ho JW, Hui BP, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012; 344:e70.
63. 2max in older men. J Appl Physiol. 1990;68:329-33.
64. Galvao DA, Nosaka K, Taaffe DR, et al. Resistance training and reduction of treatment side effects in prostate cancer patients. Med Sci Sports Exerc. 2006;38(12):2045-52.
65. Henwood TR, Taaffe DR. Improved physical performance in older adults undertaking a short-term programme of high-velocity resistance training. Gerontology. 2005;51:108-15.
66. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-60.
67. Holick CN, Newcomb PA, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarker Prev. 2008;17:379-86.
68. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:1479-86.
69. Jackson AW, Lee DC, Sui X, et al. Muscular strength is inversely related to prevalence and incidence of obesity in adult men. Obesity. 2010;18:1988-95.
70. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1-12.
71. Kraemer WJ, Adams K, Cafarelli E, et al.; American College of Sports Medicine. American College of Sports Medicine Position Stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002;34(3):364-80.
72. Larew K, Hunter GR, Larson-Meyer DE, Newcomer BR, McCarthy JP, Weinsier RL. Muscle metabolic function, exercise performance, and weight gain. Med Sci Sports Exerc. 2003;35(2):230-6.
73. Marcell TJ. Sarcopenia: causes, consequences, and prevention. J Gerontol A Biol Sci Med Sci. 2003;58:M911-6.
74. McNeely ML, Parliament M, Courneya KS, et al. A pilot study of a randomized controlled trial to evaluate the effects of progressive resistance exercise training on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in head and neck cancer survivors. Head Neck. 2004;26:518-30.
75. McNeely ML, Parliament MB, Seikaly H, et al. Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivors. A randomized controlled trial. Cancer. 2008;113: 214-22.
76. Narici MV, Hoppeler H, Kayser B, et al. Human quadriceps crosssectional area, torque and neural activation during 6 months strength training. Acta Physiol Scand. 1996;157:175-86.
77. National Comprehensive Cancer Network. Clinical practice guidelines in oncology. Cancer-related fatigue version 1 [Internet]. 2010 [cited 2010 August 10]. Available from: http://www.nccn.org.
78. Nelson ME, Fiatarone MA, Morganti CM, Trice I, Greenberg RA, Evans WJ. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. JAMA. 1994;272:1909-14.
79. Newman AB, Kupelian V, Visser M, et al. Strength but not muscle mass, is associated with mortality in the health aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006; 61:72-7.
80. Ohira T, Schmitz KH, Ahmed RL, Yee D. Effects of weight training on quality of life in recent breast cancer survivors. Cancer. 2006;106:2076-83.
81. Peddle-McIntyre CJ, Bell G, Fenton D, McCargar L, Courneya KS. Feasibility and preliminary efficacy of progressive resistance exercise training in lung cancer survivors. Lung Cancer. 2012; 75:126-32.
82. Peterson MD, Rhea MR, Sen A, Gordon PM. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev. 2010;9:226-37.
83. Peterson MD, Sen A, Gordon PM. Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc. 2011;43(2):249-58.
84. Phillips MD, Flynn MG, McFarlin BK, Stewart LK, Timmerman KL. Resistance training at eight-repetition maximum reduces the inflammatory milieu in elderly women. Med Sci Sports Exerc. 2010;42(2):314-25.
85. Phillips SM, Tipton KD, Aarsland A, Wolf SE, Wolfe RR. Mixed muscle protein synthesis and breakdown after resistance exercise in humans. Am J Physiol. 1997;273:E99-107.
86. Ruiz JR, Sui X, Lobelo F, et al. Muscular strength and adiposity as predictors of adulthood cancer mortality in men. Cancer Epidemiol Biomarkers Prev. 2009;18:1468-76.
87. Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR. Mechanisms of cancer related fatigue. Oncologist. 2007;12:22-34.
88. Schmidt T, Weisser B, Jonat W, Baumann FT, Mundhenke C. Gentle strength training in rehabilitation of breast cancer patients compared to conventional therapy. Anticancer Res. 2012;32: 3229-34.
89. Schmitz KH, Ahmed R, Hannan PJ, Yee D. Safety and efficacy of weight training in recent breast cancer survivors to alter body composition, insulin, and insulin-like growth factor axis proteins. Cancer Epidemiol Biomarkers Prev. 2005;14:1672-80.
90. Schmitz KH, Ahmed RL, Troxel AB, et al. Weight lifting for women at risk for breast cancer-related lymphedema. JAMA. 2010;304:2699-705.
91. Schmitz KH, Ahmed RL, Troxel AB, et al. Weight lifting in women with breast cancer-related lymphedema. N Engl J Med. 2009;361:664-73.
92. Schmitz KH, Courneya KS, Matthews C, et al.; American College of Sports Medicine. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409-26.
93. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995; 273:408-12.
94. Schwartz AL, Winters-Stone K, Gallucci B. Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum. 2007;34:627-33.
95. Schwartz AL, Winters-Stone KM. Effects of a 12-month randomized controlled trial of aerobic or resistance exercise during and following cancer treatment in women. Phys Sportsmed. 2009;37:62-7
96. Segal RJ, Reid RD, Courneya KS, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003;21:1653-59.
97. Segal RJ, Reid RD, Courneya KS, et al. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol. 2009;27:344-51.
98. Skipworth RJ, Stewart GD, Dejong CH, Preston T, Fearon KC. Pathophysiology of cancer cachexia: much more than host-tumor interaction? Clin Nutr. 2007;26:667-76.
99. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4:87-100.
100. Speck RM, Gross CR, Hormes JM, et al. Changes in the body image and relationship scale following a one-year strength training trial for breast cancer survivors with or at risk for lymphedema. Breast Cancer Res Treat. 2010;121:421-30.
101. Strasser B, Keinrad M, Haber P, Schobersberger W. Efficacy of systematic endurance and resistance training on muscle strength and endurance performance in elderly adults-a randomized controlled trial. Wien Klin Wochenschr. 2009;121:757-64.
102. Strasser B, Leeb G, Strehblow C, Schobersberger W, Haber P, Cauza E. The effects of strength and endurance training in patients with rheumatoid arthritis. Clin Rheumatol. 2011;30:623-32.
103. Strasser B, Siebert U, Schobersberger W. Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Sports Med. 2010;40:397-415.
104. Thompson SG. Why and how sources of heterogeneity should be investigated. In: Egger M, Smith GD, Altman DG, editors. Systematic Reviews in Health Care: Meta-Analysis in Context. London: BMJ Publishing Group; 2001. p. 157-75.
105. Tisdale MJ. Cachexia in cancer patients. Nat Rev Cancer. 2002;2: 862-71.
106. US Cancer Statistics Working Group. United States Cancer Statistics: 2004 Incidence and Mortality. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2007. p. 1-22.
107. Vance V, Mourtzakis M, McCargar L, Hanning R. Weight gain in breast cancer survivors: prevalence, pattern and Health consequences. Obes Rev. 2011;12:282-94.
108. Vincent HK, Bourguignon C, Vincent KR. Resistance training lowers exercise-induced oxidative stress and homocysteine levels in overweight and obese older adults. Obesity. 2006;14: 1921-30.
109. Waltman NL, Twiss JJ, Ott CD, et al. The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial. Osteoporos Int. 2010;21:1361-69.
110. Wernbom M, Augustsson J, Thomee' R. The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans. Sports Med. 2007; 37:225-64.
111. Westcott W. Strength training for frail older adults. J Active Aging. 2009;8:52-9.
112. Williams MA, Haskell WL, Ades PA, et al.; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2007; 166:572-84.
113. Winters-Stone KM, Dobek J, Bennett JA, Nail LM, Leo MC, Schwartz A. The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial. J Cancer Surviv. 2012;6: 189-99.
114. Winters-Stone KM, Dobek J, Nail L, et al. Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors. A randomized, controlled trial. Breast Cancer Res Treat. 2011;127:447-56.
115. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy measurement system. J Pain Symptom Manage. 1997;13:63-74.
116. Yuen HK, Sword D. Home-based exercise to alleviate fatigue and improve functional capacity among breast cancer survivors. J Allied Health. 2007;36:e257-75.