WFU researchers link exercise to breast cancer survivors’ quality of life

The study, called EQUAL for Exercise and Quality of Life in Older Women with Breast Cancer, attempted to describe the psychological and physical characteristics of older women with breast cancer. Sixty women, ages 52-77, participated in the study. It was supported by a grant from the Office of Women’s Research from the National Institutes of Health and ran for nine months beginning in June 2000.

Shannon Mihalko, assistant professor of health and exercise science, and Paul Ribisl, chair of Wake Forest’s health and exercise science department, led the study on the Reynolda Campus.

Mihalko said that although exercise has been linked to positive self-esteem and quality of life, little has been done to examine the relationship between physical activity and psychological health in older women recently diagnosed with breast cancer. EQUAL found that exercise may have an important role in treatment of women diagnosed with the disease.

“Through this study we have now suggested the need for exercise in treatment plans for these women,” she said.

Mihalko and fellow researcher Gretchen Brenes, assistant professor of psychiatry and behavioral medicine at Wake Forest School of Medicine, presented the research in March at the national conference of the Society of Behavioral Medicine in Seattle.

“Working with survivors after surgery provides an ideal opportunity to influence their total health,” Mihalko said. “Not only are these women sedentary, but they are less fit than their otherwise healthy cohorts. It is an opportune time to intervene with physical activity because they are very receptive to anything that will restore their health and vitality.”

Women were referred to the study by their physicians at Wake Forest University Baptist Medical Center. Their recovery time ranged from one month to two years after surgery.

Each participant first completed a questionnaire measuring quality of life, self-esteem and confidence in their ability to participate in physical activity. Then, two physical testing sessions conducted one week apart evaluated percentage of body fat, muscular strength and flexibility. All sessions were conducted on Wake Forest’s Reynolda Campus.

In one session, a six-minute walk was followed by an evaluation of each woman’s confidence in her fitness condition. The women then completed 10 repetitions of the maximum weight they could lift on a variety of weight equipment. In another session, skin calipers estimated body composition and a series of exercises measured hip and shoulder flexibility. Each woman also tracked her average daily activity by wearing a pedometer.

A third meeting gave the researchers an opportunity to meet with each woman individually, discuss her results and make recommendations for diet and exercise. What Mihalko and her team learned was that having recently faced breast cancer, these women were physically and mentally more receptive to exercise intervention.

Encouraged by the results, the researchers will move to the next phase of the study where the findings are put into effect. In May, they will conduct an exercise intervention study on a similar group of women to find out how exercise influences their overall quality of life over time.

“This initial research shows that participation in physical activity and physical function is directly related to life satisfaction,” Mihalko said. “We now want to promote adherence to an exercise plan, but one that is tailored to the needs and wants of this group of women. We may then be able to find out how changes in function influence quality of living in older women with breast cancer.”

Mihalko and Ribisl worked with Wake Forest graduate students; Gary Miller, assistant professor of health and exercise science; and fellow researchers from the Wake Forest School of Medicine on the study. Researchers from the medical school included Brenes; Sally Shumaker, director of the Women’s Health Center of Excellence at Wake Forest University Baptist Medical Center and professor of public health sciences; and Roger Anderson, associate professor of public health sciences.