Aim of the study: To evaluate the effects of an 8-week multimodal physical therapy program with multimedia support on cancer-related fatigue, cortisol and IgA salivary concentrations, alpha-amylase activity and neck-shoulder mobility, in breast cancer. Methods: This was a prospective randomised clinical trial using between-groups design. Seventy-eight breast cancer survivors during first year after treatment participated. Participants were assigned into 2 groups: CUIDATE group (multimodal program) or control group (usual care). CUIDATE program consisted of 24 h of individual physical training and 12 h of stretching and massage interventions. Measurements included the Piper Fatigue Scale, cortisol and IgA salivary levels, alpha-amylase activity and active cervical-shoulder range of motion. Results: Compared to the control group, CUIDATE group showed a estimated improvement for total fatigue score of -2.49 points immediately after treatment (between-group effect size 0.68; P < 0.001) and -1.43 at 6 month follow-up (between group effect size: 0.43; P < 0.01). CUIDATE group showed a decrease in alpha-amylase activity of -41.77 U/ml immediately after treatment compared to the control group (between-group effect size: 0.24; P = 0.046). Further, significant between-group improvements for shoulder flexion, horizontal abduction, cervical extension and lateral-flexion (between-group effect sizes ranging 0.30-0.75; all P < 0.05) after treatment were also found. Conclusions: An 8-week multimodal physical therapy program was effective at short and 6 month follow-up for decreasing fatigue in breast cancer survivors. The program was also effective in decreasing alpha-amylase activity and improving shoulder and cervical range of motion. (C) 2011 Elsevier GmbH. All rights reserved.
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