Feasibility, acceptability, and preliminary effectiveness of implementing a 12-week home-based aerobic and resistance exercise program for breast cancer patients receiving endocrine treatment in Indonesia: A mixed methods study.
Yufi Kartika Astari, Susanna Hilda Hutajulu, Yayi Suryo Prabandari, Bagas Suryo Bintoro, Rakhmat Ari Wibowo, Mardiah Suci Hardianti, Anggoro Budi Hartopo, Katie M Di Sebastiano, Matthew John Allsop, Shaunna Burke
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Abstract
Objectives: To assess the feasibility, acceptability, and preliminary effectiveness of implementing a home-based aerobic and resistance exercise for patients with breast cancer receiving endocrine treatment in Indonesia.
Methods: This is a mixed methods study with concurrent design consisting of quantitative single-arm pre-post intervention and qualitative study. We recruited patients with breast cancer (N = 36) receiving endocrine treatment and assigned 12 weeks of home-based pedometer-driven walking and resistance exercises using therapeutic bands. Descriptive statistics were used to assess the feasibility (recruitment, retention, and adherence) and safety. The modified Bruce treadmill test was used to measure predicted aerobic capacity (V̇O2 peak). Quality of life and fatigue were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and fatigue severity scale. Measurements were performed at baseline and post-intervention and analyzed with the paired t-test or Wilcoxon test. Semi-structured interviews and thematic analysis were conducted post-intervention to explore patients' acceptability.
Results: The results showed a recruitment rate of 75%, retention rate of 89%, and adherence rates were 53% for aerobic and 78% for resistance exercise. No severe adverse events were reported. Post-intervention interviews identified positive attitudes toward the intervention, with low burden and high perceived benefit. Exercise duration and predicted V̇O2 peak increased significantly (+1.1 min, p = 0.001 and +2.3 ml/kg/min, p = 0.043), but no significant change was detected for Quality of Life (p > 0.050) or fatigue severity (p = 0.299).
Conclusions: A home-based aerobic and resistance exercise was feasible when implemented in the context of routine care in our study population, improving predicted aerobic capacity. Further research is required to understand limited changes to Quality of Life and fatigue and adaptations to support implementation in additional sites in Indonesia.
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