Influence of Multimodal Treatment on Rest/Activity and Autonomic Regulation in Breast Cancer Patients with Cancer-Related Fatigue: Results of a Tri-Centre Trial with a Comprehensive Cohort Design

Abstract

<b><i>Introduction:</i></b> Breast cancer patients with cancer-related fatigue (BC-CRF) often have lower physical activity. To investigate how this could be improved, we evaluated a multimodal treatment (MT) and a combination of MT with aerobic training (CT) and compared these with aerobic training (AT) regarding rest/activity rhythm and state autonomic regulation (State aR). <b><i>Methods:</i></b> In this pragmatic comprehensive cohort design study, the explorative analysis focused on actigraphy and State aR including the rest/activity regulation subscale (State aR-R/A) which were assessed at baseline (T0), after 10 weeks of intervention (T1), and State aR additionally 6 months later (T2). Statistics: General linear modelling including propensity scores. <b><i>Results:</i></b> 65 BC-CRF were randomized, and 61 were allocated by preference to the treatment arms. 105 patients started the intervention. At T1, State aR-R/A improved the most in MT (+3.49, CI [2.42; 4.55]) compared to AT (+1.59, CI [0.13; 3.06]) and CT (+1.68, CI [0.83; 2.52]), showing superiority of MT to AT (<i>p</i> = 0.048). At T2 MT was sustainably superior to AT regarding State aR-R/A (+3.61, CI [2.38; 4.83] <i>p</i> &#x3c; 0.01) and State aR also showed superiority of MT to AT (<i>p</i> = 0.006). AT T1 24-h activity was higher in MT compared to AT (<i>p</i> = 0.029). <b><i>Conclusions:</i></b> MT was superior to AT regarding State aR total score after 6 months, State aR-R/A after 10 weeks, and after 6 months. Actigraphically measured total activity also improved after 10 weeks.