Examining cancer-related fatigue through FITT principles of exercise: a cross-sectional analysis of cancer wellness program baseline data

Abstract

Background: Cancer-related fatigue (CRF) is a distressing and prevalent symptom with limited treatment options. While exercise is the most effective treatment for CRF, more evidence is needed to recommend individualized prescription to meet the complex needs of those experiencing fatigue. Moreover, literature on CRF's subdomains is sparse, and no framework exists to target physical or cognitive dimensions. Therefore, the purpose of this study was to examine how exercise frequency, intensity, time, and type (FITT) are related to general, physical, and cognitive CRF. Methods: Retrospective, secondary analysis of baseline data from individuals with a cancer diagnosis enrolled in a clinical exercise program. Exercise was self-reported using the Godin-Leisure-Time Exercise Questionnaire. CRF was self-reported using the FACIT-F for general fatigue, and QLQ-FA12 for fatigue subdomains. Univariate associations between exercise volume, frequency, and time were assessed using Pearson correlations. Group mean differences were compared using two sample t-tests and supplemented with effect sizes. Post-hoc regression analyses were performed to control for exercise volume. Results: Higher reported exercise volume, time, and frequency were all significantly associated with lower general fatigue (p <0.05). Only exercise volume had a significant association with physical fatigue (p <.05); no significant associations were observed for cognitive fatigue. Those who reported moderate-to-vigorous intensity exercise reported lower fatigue across all measures when compared to those who reported light intensity only, but differences were not statistically significant. Those who reported combined aerobic and resistance training on average reported lower fatigue across all measures, but only differences in physical fatigue were significant. After controlling for volume, no significant differences in general fatigue or subdomains were found by exercise intensity or type. Conclusion: Individuals looking to reduce general and physical cancer-related fatigue may benefit from exercising according to preference, prioritizing a combination of FITT principles that promote greater volumes of exercise, as fatigue-specific benefits do not appear to differ across intensity and type. Prospective studies are needed to investigate the impact of specific FITT prescriptions on cognitive fatigue before exercise can be recommended as a viable treatment.