Supportive Care in Cancer

, Volume 27, Issue 1, pp 109–122 | Cite as

The effect of training interventions on physical performance, quality of life, and fatigue in patients receiving breast cancer treatment: a systematic review

  • Nick GebruersEmail author
  • Melissa Camberlin
  • Fleur Theunissen
  • Wiebren Tjalma
  • Hanne Verbelen
  • Timia Van Soom
  • Eric van Breda
Review Article



The primary purpose of this systematic review is to structure the available evidence concerning physical exercise programs and their effects on (1) physical performance outcomes, (2) experienced fatigue, and (3) quality of life (QoL) in patients during the initial treatment for breast cancer.

Data sources

A systematic literature search, based upon the PRISMA guideline, up to January 1, 2018, was performed using four databases (Web of Science, Cochrane Library for Clinical Trials, PubMed, and Medline).

Study selection

Inclusion criteria were as follows: (1) adults > 18 years; (2) patients with breast cancer undergoing initial treatment; (3) interventions with the aim to influence the patient’s physical activity, QoL, or fatigue; (4) randomized controlled trials (RCTs) of all ages. The selected studies were scored for methodological quality, and data concerning physical performance, QoL, and fatigue were extracted. Twenty-eight RCTs were included.

Data extraction

Different treatment modalities during initial treatment were identified (radiation therapy, chemotherapy, and combination therapy), as well as different types of physical training interventions (cardiovascular endurance exercise, strengthening programs, or a combination of both). Therefore, the results were clustered with regard to the above-mentioned grouping; extracting every relevant outcome related to physical performance (6 MWT or VO2peak; grip/muscle strength), QoL (questionnaires), and fatigue (questionnaires).

Data synthesis

Different training programs (endurance, resistance, or a combination of both) were found. These programs were applied during different phases of initial treatment. Some programs were supervised while others were home based. Overall, most training interventions provided an improvement in physical performance and a decrease in perceived fatigue. QoL was the outcome variable least susceptible to improvement.


Different types of exercise programs are available for rehabilitation purposes of breast cancer patients during adjuvant therapy. Overall resistance training or resistance training in combination with CV endurance training provides the best results, especially on physical performance and perceived fatigue.


Breast cancer Breast neoplasm Physical activity QoL Fatigue Motor activity Benefit 



quality of life


6-min walking test

12 MWT

12-min walking test




radiation therapy


activities of daily living


peak oxygen uptake

1 RM

one repetition maximum





Funding was provided by University of Antwerp; no additional funding was requested. Prof. Gebruers received funding from IWT-TBM, grant IWT.150178. No further conflicts of interest to be declared by any of the authors.

The current review was registered on PROSPERO (; registration CRD42017071940 and used the PRISMA statement for reporting the results.

Compliance with ethical standards

Conflicts of interest

The authors did not receive any funding for any of the steps taken to write this systematic review.

None of the authors have any conflict of interest to declare.

The data table created for this systematic review is under the control of Prof. Dr. Nick Gebruers and is available on request.

Supplementary material

520_2018_4490_MOESM1_ESM.doc (64 kb)
ESM 1 (DOC 64 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Rehabilitation Sciences and Physiotherapy REVAKI-MOVANT Research Group, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  2. 2.Multidisciplinary Breast ClinicAntwerp University HospitalAntwerpBelgium
  3. 3.Multidisciplinary Edema ClinicAntwerp University HospitalAntwerpBelgium
  4. 4.Department of MedicineUniversity of AntwerpAntwerpBelgium

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