Article

Research suggests that cancer rehabilitation reduces fatigue in
survivors of cancer. To date, it is unclear what type of rehabilitation is most
beneficial. This randomized controlled trial compared the effect on
cancer-related fatigue of physical training combined with cognitive behavioral
therapy with physical training alone and with no intervention. DESIGN: In this
multicenter randomized controlled trial, 147 survivors of cancer were randomly
assigned to a group that received physical training combined with
cognitive-behavioral therapy (PT+CBT group, n=76) or to a group that received
physical training alone (PT group, n=71). In addition, a nonintervention control
group (WLC group) consisting of 62 survivors of cancer who were on the waiting
lists of rehabilitation centers elsewhere was included. SETTING: The study was
conducted at 4 rehabilitation centers in the Netherlands. PATIENTS: All patients
were survivors of cancer. INTERVENTION: Physical training consisting of 2 hours
of individual training and group sports took place twice weekly, and
cognitive-behavioral therapy took place once weekly for 2 hours. MEASUREMENTS:
Fatigue was assessed with the Multidimensional Fatigue Inventory before and
immediately after intervention (12 weeks after enrollment). The WLC group
completed questionnaires at the same time points. RESULTS: Baseline fatigue did
not differ significantly among the 3 groups. Over time, levels of fatigue
significantly decreased in all domains in all groups, except in mental fatigue in
the WLC group. Analyses of variance of postintervention fatigue showed
statistically significant group effects on general fatigue, on physical and
mental fatigue, and on reduced activation but not on reduced motivation. Compared
with the WLC group, the PT group reported significantly greater decline in 4
domains of fatigue, whereas the PT+CBT group reported significantly greater
decline in physical fatigue only. No significant differences in decline in
fatigue were found between the PT+CBT and PT groups. CONCLUSIONS: Physical
training combined with cognitive-behavioral therapy and physical training alone
had significant and beneficial effects on fatigue compared with no intervention.
Physical training was equally effective as or more effective than physical
training combined with cognitive-behavioral therapy in reducing cancer-related
fatigue, suggesting that cognitive-behavioral therapy did not have additional
beneficial effects beyond the benefits of physical training.

Langue : ANGLAIS