Level of exercise influences the severity of fatigue, energy levels, and sleep disturbance in oncology outpatients receiving chemotherapy

Sally Moy, Kord M. Kober, Carol Viele, Steven M. Paul, Marilyn Hammer, Michelle Melisko, Fay Wright, Yvette P. Conley, Jon D. Levine, Christine Miaskowski

Research output: Contribution to journalArticlepeer-review


Background: Fatigue and sleep disturbance are common co-occurring symptoms in patients receiving chemotherapy. While the results from meta-analyses support the use of exercise to decrease the severity of these symptoms, information is needed on patients’ “real world experiences” with the use of exercise. Objective: The aims of this study were to determine distribution of patients who did and did not exercise on a regular basis and evaluate for differences in demographic and clinical characteristics, as well as the severity of fatigue, decrements in energy, and sleep disturbance among the exercise groups. Methods: Patients (n = 1033) completed self-report questionnaires prior to their second or third cycle of chemotherapy. Patients were categorized into 3 exercise (Ex) groups (ie, NoEx, <150 min/wk [LessEx]; ≥150 min/wk [RecEx]). Differences among the groups were evaluated using parametric and nonparametric tests. Results: Only 19.1% of the patients were in the RecEx group. Patients in the NoEx group (37.2%) had fewer years of education, were more likely to be non-White and unemployed, had a higher body mass index, and a worse comorbidity profile. Patients in the NoEx group had higher levels of morning fatigue, lower levels of morning and evening energy, and higher levels of sleep disturbance. Conclusions: Findings from this real-world study suggest that lack of physical activity is associated with higher levels of fatigue and sleep disturbance. Implications for Practice: Given that the most frequently used intervention in this study was walking, clinicians can recommend this inexpensive intervention to patients to manage fatigue and sleep disturbance.

Original languageEnglish (US)
Pages (from-to)3-11
Number of pages9
JournalCancer Nursing
Issue number1
StatePublished - Dec 9 2021


  • Cancer
  • Chemotherapy
  • Decrements in energy
  • Exercise
  • Fatigue
  • Sleep disturbance
  • Fatigue/etiology
  • Humans
  • Outpatients
  • Sleep
  • Antineoplastic Agents/adverse effects
  • Neoplasms/complications
  • Sleep Wake Disorders/etiology

ASJC Scopus subject areas

  • Oncology(nursing)
  • Oncology


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