Chen, H.M., Tsai, C.M., Wu, Y.C., Lin, K.C., & Lin, C.C. (2016). Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: A randomised controlled trial. British Journal of Cancer, 115, 1304–1312.
To assess the effects of a 12-week walking program on improving subjective and objective sleep quality and rest-activity rhythms in patients with lung cancer
Home-based walking exercise at moderate intensity and weekly exercise counseling were provided. Participants were given detailed instruction according to a manual for the exercise program, including determination of intensity, pulse monitoring, rating perceived exertion, prevention of injury, and conditions requiring termination of the exercise program. Weekly exercise-related phone counseling was provided to reinforce teaching and encourage continued participation. The usual care control group was given typical services and asked to maintain normal activity and not perform additional exercise. Exercise counseling was offered to the usual care group at the end of the study. An actigraph was worn by patients to collect data continuously for 72 hours.
PHASE OF CARE: Multiple phases of care
Randomized, controlled trial
Overall participants completed 58.2% of all planned exercise sessions. The usual care group showed a higher mean amount of moderate physical activity at all time points when measured (37–46 minutes per day compared to 38–10 minutes per day at three and six months). No significant difference over time was reported between groups. The walking exercise group had improved PSQI scores over time compared to the usual care group (p = 0.001). No differences between groups in objective measures of sleep quality existed, except that total sleep time at six months was higher in the exercise group (p = 0.023).
Sleep quality measures showed improvement in the study group compared to the controls; however, given that the average amount of moderate intensity exercise was higher in the control group, the impact of walking exercise versus counseling is unclear.
The effect of exercise on sleep quality in patients with insomnia remains unclear from this study. Although measures showed improvement in the walking exercise group compared to the controls, the amount of moderate intensity exercise was actually higher in the control group. This does not point to the impact of exercise on differences seen in this study.