Acute (Null) Effects of Relaxation Training and Aerobic Cycling on Executive Functioning among Breast Cancer Survivors

Authors: Cohen JD, Trinh L, Petruzzello S, Rogers WA, Mullen SP

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020

Abstract Body:
Purpose: Chemotherapy-based complaints reflecting deficits in executive functions (EF) are prevalent among breast cancer (BC) survivors. Exercise is an often used method for alleviating these symptoms. This randomized controlled trial explored the efficacy of three 90-minute intervention sessions, in a 7-day period for improving EF. Methods: Participants (N = 40) were female, middle-aged (Mage = 57.33), primarily Caucasian (95%), married (75%), a college graduate (82.50%) and employed full time (67.50%). Fifteen (37.50%) received alkylating agents, six (15%) received plant alkaloids, and nineteen (47.50%) received anti-tumor antibodies. Participants were randomized to an experimental multi-modal aerobic exercise and tech-based relaxation training (n=13), standalone aerobic (n=14), or relaxation training (n=13). Cognitive testing (NIH Toolbox) at the 1st and 3rd appointments (7-day difference) measured 3 EF tasks (working memory: Picture Sequence Task correct responses-PST, inhibitory control and attention: Flanker Task correct reaction time-FT, and cognitive flexibility: Dimensional Change Card Sort Task accuracy-DCCST). A repeated-measures 3 (group) X 3 (measures) X 2 (time) MANOVA adjusted via established covariates including baseline BMI, physical activity, age, anxiety, and depression was conducted. Results: Group showed no effect on PST: [p =.28, cp2=.08], FT: [p=.84, cp2=.01], or DCCST: [p =.15, cp2=.11]. Conclusions: Although our measures of EF did not show benefits of the acute intervention, cognitive improvements (non-EF; e.g., processing speed) have been demonstrated in similar interventions and populations, those particular components of cognitive functioning (or those specific tests) may have been more sensitive to change. Sample size and practice effects may have also challenged the sensitivity of tasks used in the present trial to capture group differences. These results inform the development of future research to assess more intensive interventions (e.g., frequency and duration), and a larger sample to determine if these methodological limitations masked the potential for improvement, as these areas are clinically relevant to neurophysiological components related to disease and treatment.

Keywords: Breast Cancer Survivors, Executive Function, Physical Activity, Relaxation