***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Preliminary studies suggest that physical exercise interventions can improve physical fitness , fatigue and quality of life in cancer patients after completion of chemotherapy . Additional research is needed to rigorously test the effects of exercise programmes among cancer patients and to determine optimal training intensity accordingly . The present paper presents the design of a r and omized controlled trial evaluating the effectiveness and cost-effectiveness of a high intensity exercise programme compared to a low-to-moderate intensity exercise programme and a waiting list control group on physical fitness and fatigue as primary outcomes . Methods After baseline measurements , cancer patients who completed chemotherapy  are r and omly assigned to either a 12-week high intensity exercise programme or a low-to-moderate intensity exercise programme . Next , patients from both groups are r and omly assigned to immediate training or a waiting list ( i.e. waiting list control group ) . After 12 weeks , patients of the waiting list control group start with the exercise programme they have been allocated to . Both interventions consist of equal bouts of resistance and endurance interval exercises with the same frequency and duration , but differ in training intensity . Additionally , patients of both exercise programmes are counselled to improve compliance and achieve and maintain an active lifestyle , tailored to their individual preferences and capabilities . Measurements will be performed at baseline ( t = 0 ) , 12 weeks after r and omization ( t = 1 ) , and 64 weeks after r and omization ( t = 2 ) . The primary outcome measures are cardiorespiratory fitness and muscle strength assessed by means of objective performance indicators , and self-reported fatigue . Secondary outcome measures include health-related quality of life , self-reported physical activity , daily functioning , body composition , mood and sleep disturbances , and return to work . In addition , compliance and satisfaction with the interventions will be evaluated . Potential moderation by pre- and post-illness lifestyle , health and exercise-related attitudes , beliefs and motivation will also be assessed . Finally , the cost-effectiveness of both exercise interventions will be evaluated . Discussion This r and omized controlled trial will be a rigorous test of effects of exercise programmes for cancer patients after chemotherapy , aim ing to contribute to evidence -based practice in cancer rehabilitation programmes . Trial registration This study is registered at the Netherl and s Trial Register ( NTR2153 Background : Substantial numbers of cancer patients use complementary medicine therapies , even without a supportive evidence base . This study aim ed to evaluate in a r and omized controlled trial , the use of Medical Qigong ( MQ ) compared with usual care to improve the quality of life ( QOL ) of cancer patients . Patients and methods : One hundred and sixty-two patients with a range of cancers were recruited .  QOL and fatigue were measured by Functional Assessment of Cancer Therapy — General and Functional Assessment of Cancer Therapy — Fatigue , respectively , and mood status by Profile of Mood State . The inflammatory marker serum C-reactive protein ( CRP ) was monitored serially . Results : Regression analysis indicated that the MQ group significantly improved overall QOL ( t144 = −5.761 , P < 0.001 ) , fatigue ( t153 = −5.621 , P < 0.001 ) , mood disturbance ( t122 = 2.346 , P = 0.021 ) and inflammation ( CRP ) ( t99 = 2.042 , P < 0.044 ) compared with usual care after controlling for baseline variables . Conclusions : This study indicates that MQ can improve  cancer patients  ’ overall QOL and mood status and reduce specific side-effects of treatment . It may also produce physical benefits in the long term through reduced inflammation Introduction Numerous primary studies and several review papers have highlighted delayed physical and psychological recovery for survivors of critical illness , often beyond 6 months after discharge . This r and omized controlled trial with blinded assessment aims to test the effects of an 8-week , home-based , individually tailored physical rehabilitation programme on physical and psychological recovery for survivors of a critical illness after discharge from hospital . Method Participants are survivors of a critical illness discharged from nine intensive care units ( ICUs ) in Australia , who are aged 18 years or older , in an ICU longer than 48 hours , discharged home to self-care or carer ( non-institutional care ) , able to participate in physical rehabilitation , and within the hospitals ' local geographical areas for home visits . The study is based in participants ' home environments . Blinded assessment s at weeks 1 , 8 and 26 after hospital discharge examine physical functioning , exercise capacity , health-related quality of life and psychological well being . The intervention is grade d , individualized endurance and strength training prescribed by a pulmonary rehabilitation physiotherapist over an 8-week period , with three home visits , five follow-up phone calls , and a printed exercise manual supporting the training . Initial focus is on lower limb exercises and walking , with warm-up stretches , and progresses to the addition of core stabilization and upper limb exercises . Results The burden of a critical illness is well documented . This novel study will determine whether a home-based physical rehabilitation programme improves the recovery trajectory for survivors of critical illness . The projected sample size of 200 patients aims to detect a clinical ly important 10 % improvement in physical functioning . The study will also examine whether other important physical and psychological measures are improved . Conclusion This multicentre , r and omized controlled trial will examine outcomes that are meaningful to patients , their family and society , namely functional ability and well being . The study will also target a health problem that is likely to increase as the population ages . If the programme is effective , it will provide a model that can be easily adapted and adopted by existing primary care or community services to improve the recovery of individuals following critical illness BACKGROUND Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity , increased fatigue , and lower quality of life ( QoL ) . Erythropoiesis-stimulating agents ( ESAs ) have been shown to improve these outcomes ; however , it is unknown if additional benefits can be achieved with aerobic exercise training . METHODS We conducted a single-center , prospect i ve , r and omized , controlled trial in 55 mild-to-moderately anemic patients with solid tumors . Patients were r and omized to either darbepoetin alfa alone ( DAL , n = 29 ) or darbepoetin alfa plus aerobic exercise training ( DEX ; n = 26 ) . The DEX group performed aerobic exercise training three times per week at 60%-100 % of baseline exercise capacity for 12 weeks . The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale . Secondary endpoints were fatigue , cardiorespiratory fitness ( VO(2peak ) ) , hemoglobin ( Hb ) response , and darbepoetin alfa dosing . RESULTS Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences . The DEX group had a significantly greater VO(2peak ) than the DAL group ( mean group difference , + 3.0 ml/kg per minute ; 95 % confidence interval , 1.2 - 4.7 ; p = .001 ) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing . CONCLUSIONS Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements . Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs Background : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors Background The Exercise Intensity Trial ( EXcITe ) is a r and omized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training , relative to attention control , on aerobic capacity , physiologic mechanisms , patient-reported outcomes , and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy . Methods / Design Using a single-center , r and omized design , 174 postmenopausal women ( 58 patients / study arm ) with histologically confirmed , operable breast cancer presenting to Duke University Medical Center ( DUMC ) will be enrolled in this trial following completion of primary therapy ( including surgery , radiation therapy , and chemotherapy ) . After baseline assessment s , eligible participants will be r and omized to one of two supervised aerobic training interventions ( moderate-intensity or moderate/high-intensity aerobic training ) or an attention-control group ( progressive stretching ) . The aerobic training interventions will include 150 mins.wk-1 of supervised treadmill walking per week at an intensity of 60%-70 % ( moderate-intensity ) or 60 % to 100 % ( moderate to high-intensity ) of the individually determined peak oxygen consumption ( VO2peak ) between 20 - 45 minutes/session for 16 weeks . The progressive stretching program will be consistent with the exercise interventions in terms of program length ( 16 weeks ) , social interaction ( participants will receive one-on-one instruction ) , and duration ( 20 - 45 mins/session ) . The primary study endpoint is VO2peak , as measured by an incremental cardiopulmonary exercise test . Secondary endpoints include physiologic determinants that govern VO2peak , patient-reported outcomes , and biomarkers associated with breast cancer recurrence/mortality . All endpoints will be assessed at baseline and after the intervention ( 16 weeks ) . Discussion EXCITE is design ed to investigate the intensity of aerobic training required to induce optimal improvements in VO2peak and other pertinent outcomes in women who have completed definitive adjuvant therapy for operable breast cancer . Overall , this trial will inform and refine exercise guidelines to optimize recovery in breast and other cancer survivors following the completion of primary cytotoxic therapy . Trial Registration Background Colorectal cancer ( CRC ) diagnosis and the ensuing treatments can have a substantial impact on the physical and psychological health of survivors . As the number of CRC survivors increases , so too does the need to develop viable rehabilitation programs to help these survivors return to good health as quickly as possible . Exercise has the potential to address many of the adverse effects of CRC treatment ; however , to date , the role of exercise in the rehabilitation of cancer patients immediately after the completion of treatment has received limited research attention . This paper presents the design of a r and omised controlled trial which will evaluate the feasibility and efficacy of a 12-week supervised aerobic exercise program ( ImPACT Program ) on the physiological and psychological markers of rehabilitation , in addition to biomarkers of st and ard haematological outcomes and the IGF axis . Methods / Design Forty CRC patients will be recruited through oncology clinics and r and omised to an exercise group or a usual care control group .  Baseline assessment will take place within 4 weeks of the patient completing adjuvant chemotherapy treatment . The exercise program for patients in the intervention group will commence a week after the baseline assessment . The program consists of three supervised moderate-intensity aerobic exercise sessions per week for 12 weeks . All participants will have assessment s at baseline ( 0 wks ) , mid-intervention ( 6 wks ) , post-intervention ( 12 wks ) and at a 6-week follow-up ( 18 wks ) . Outcome measures include cardio-respiratory fitness , biomarkers associated with health and survival , and indices of fatigue and quality of life . Process measures are participants ' acceptability of , adherence to , and compliance with the exercise program , in addition to the safety of the program . Discussion The results of this study will provide valuable insight into the role of supervised exercise in improving life after CRC . Additionally , process analyses will inform the feasibility of implementing the program in a population of CRC patients immediately after completing chemotherapy . Trial registration PURPOSE / OBJECTIVES To evaluate the effects of 10 weeks of aerobic exercise on depressive and anxiety symptoms and self-esteem of breast cancer survivors . DESIGN 
    Output:
    
HRQoL and its domains were measured using a wide range of measures .The results suggested that exercise compared with control has a positive impact on HRQoL and certain HRQoL domains .
No conclusions can be drawn regarding the effects of exercise interventions on HRQoL domains of cognitive function , physical functioning , general health perspective , role function , and spirituality .
This systematic review indicates that exercise may have beneficial effects on HRQoL and certain HRQoL domains including cancer-specific concerns ( e.g. breast cancer ) , body image/self-esteem , emotional well-being , sexuality , sleep disturbance , social functioning , anxiety , fatigue , and pain at varying follow-up periods .