Impact of Six Months of Three Different Modalities of Exercise on Stress in Post-Treatment Breast Cancer Survivors


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Article

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Institute for Health Promotion Research, University of Texas Health—San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78229, USA

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Department of Health and Human Physiology, University of Iowa, 115 S. Grand Ave., 110 IBIF, Iowa City, IA 52245, USA

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Physical Therapy Program, Allen College UnityPoint Health, 1825 Logan Avenue, Waterloo, IA 50703, USA

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Integrative Medicine Program, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe, Houston, TX 77030, USA

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Exercise and Sport Science Department, St. Mary’s University, One Camino Santa Maria, San Antonio, TX 78228, USA

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Nydia’s Yoga Therapy & Open Hand Institute, 1403 Blue Crest Lane, San Antonio, TX 78232, USA

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Baylor College of Medicine, 1 Baylor Plz, Houston, TX 77030, USA

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Department of Population Health Sciences, Institute for Health Promotion Research, University of Texas Health—San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78229, USA

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Author to whom correspondence should be addressed.

Submission received: 19 July 2024
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Revised: 16 September 2024
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Accepted: 16 September 2024
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Published: 4 October 2024

Simple Summary

Research continues to show that exercising at recommended levels is associated with lower mortality rates and decreased risk of recurrence in breast cancer survivors (BCS). Moreover, those BCS exercising at levels meeting guidelines have higher self-reported health-related quality of life (HR-QOL) than those that do not. This includes lowered levels of perceived global stress. However, which modalities of exercise are most effective has yet to be determined. Our study investigates changes in stress experienced by breast cancer survivors participating in one of three different exercise modalities conducted over six months, as indicated by self-report and salivary cortisol measures. The revealed improvement in constructs of Health Related-Quality of Life (HR-QOL) suggest that engagement in exercise had a greater impact on outcomes than any particular modality.

Abstract

Abstract: Background/Objectives: Extensive evidence suggests that exercise is physically and mentally beneficial for cancer survivors. This study reports on changes in self-reported stress, physiological biomarkers for stress (salivary cortisol), and HR-QOL constructs for fifty breast cancer survivors participating in one of three different exercise programs over 6 months. Methods: Fifty post-treatment breast cancer survivors were randomized to either therapeutic yoga-based exercise (YE), comprehensive exercise (CE) (aerobic, resistance, flexibility), or choosing (C) their own exercise activities. Participants completed the Perceived Stress Scale (PSS), Medical Outcomes Short-Form 36® (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Five samples of salivary cortisol were collected on two consecutive days. The 10 samples were used to calculate the diurnal rhythm slope. Outcome measures were repeated after six months. Results: All groups improved in HR-QOL measures of PSS; PSQI sleep quality components of latency and daytime functioning; and five of the ten SF-36 scales (Mental Component Scale, Social Functioning subscale, Mental Health subscale, Physical Component Scale, Physical Functioning subscale). Although the CE group observed the most favorable change in cortisol (−0.183), where cortisol slope changes approached significance (p = 0.057), but no significant decrease in cortisol between groups were noted. Conclusion: Our results suggest that it is the engagement of, rather than the specific type of exercise, which is associated with improved HR-QOL. However, longer-term studies with better adherence monitoring and larger sample sizes are needed to better determine clinical impact.

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Daniel C. Hughes www.mdpi.com