The Effectiveness of a Deep Water Aquatic Exercise Program in Cancer-Related Fatigue in Breast Cancer Survivors: A Randomized Controlled Trial

Abstract Objective To investigate the effectiveness of an 8-week aquatic program on cancer-related fatigue, as well as physical and psychological outcomes in breast cancer survivors. Design A randomized controlled trial. Setting Outpatient clinic, urban, academic medical center, and a sport university swimming pool. Participants Breast cancer survivors (N=68) were randomly assigned to either an experimental (aquatic exercise group in deep water pool) group or a control (usual care) group. Interventions The intervention group attended aquatic exercise sessions 3 times per week for 8 weeks in a heated deep swimming pool. Sessions lasted 60 minutes in duration: 10 minutes of warm-up, 40 minutes of aerobic and endurance exercises, and 10 minutes of cool-down exercises. Patients allocated to the usual care group followed the oncologist’s recommendations in relation to a healthy lifestyle. Main Outcome Measures Values for fatigue (Piper Fatigue Scale), mood state (Profile of Mood States), and abdominal (trunk curl static endurance test) and leg (multiple sit-to-stand test) strength were collected at baseline, after the last treatment session, and at a 6-month follow-up. Results Immediately after discharge, the aquatic exercise group showed a large effect size in total fatigue score ( d =.87; 95% confidence interval, .48–1.26), trunk curl endurance ( d =.92; 95% confidence interval, 1.97–3.83), and leg strength ( d =1.10; .55–2.76), but negligible effects in vigor, confusion, and disturbance of mood ( d d> .90) and negligible effects for the fatigue-severity dimension and different scales of the Profile of Mood States ( d