Abstract

Fatigue is regarded as a universal and unavoidable side effects of chemotherapy. Most of patients in chemotherapy prefer resting and reducing their level of activity, but reduced physical activity can actually decrease physical strength and functional status to produce secondary fatigue. The purpose of this study was to determine the effects of rhythmic walking exercise on physical strength, fatigue, and functional status of breast cancer patients in adjutant chemotherapy. A matched control group pretest-pottiest design was used. Seventeen subjects of the experimental group were taught the rhythmic walking exercise(Winningham etal, 1990) on their first visiting day and encouraged to practice it at home throughout that treatment cycle(four weeks). Participants kept an everyday exercise diary that included pulse rates, exercise time and subjective data. The rhythmic walking exercise consists of approximately 30-minute walking, everyday if possible for 4 weeks. Outcomes were measured by each instrument :1) physical strength by the treadmill test estimated the walking ability. The subject is instructed to walk as long as possible to the level of their tolerance ;2)functional status by the Inventory of Functional Status-Cancer(Tollman et al, 1991) ; and 3)fatigue was measured by the Piper Fatigue Scale in both groups at five different times-before beginning chemotherapy(pretest) and one time per week for 4 weeks. Data were analyzed with mean, standard deviation, X2-test, t-test, repeated measure MANOVA using SPSSWIN program. Results were obtained as follows :1)The physical strength of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise(t=3.92, p<.001). 2)The fatigue scores of the experimental group measured at the end of each week were significantly lower than those of the control group following the rhythmic walking exercise (1st week ; F=6.51, p<.016, after 1st week ; 863, p<.0001, after 2nd week ; F=46.754, p<.0001, after 3rd week ; F=60. 183, p<.0001, after 4th week). 3)The functional status of the experimental group was significantly higher than that of the control group following the rhythmic walking exercise (t=13.20, p<.0001). The results suggest that the appropriate rhythmic walking exercise for the breast cancer patients in adjutant chemotherapy can improve physical strength and functional status, and ultimately decrease the secondary fatigue.