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The search strategy, using different electronic databases, identified a total of 330 articles. These articles were obtained after searching on the terms breast cancer, physical activity and quality of life. These terms were adapted in each database according to the mesh-terms. After selecting on title and content of abstract, the double articles were excluded. This selection leads to an exclusion of 312 articles. Articles were excluded because they had no quality of life as main outcome, the intervention was no physical activity and if it wasn't a RCT or a pilot RCT.
The included articles were not all full text available. After writing to the authors 13 articles were included and the other five articles excluded.
The included articles were scored with the Pedro score. All articles were included with a Pedro score ≤ 4. Final included articles were 13.
The main content and methodological details from the relevant literature were extracted into a table (Table 1), which organized the information under the headings of: author and year, study design, sample size an population, measurements, exercise intervention, control intervention, main outcome.
Out of the 13 articles, six articles looked at quality of life after treatment, six articles investigated quality of life during treatment and one articles looked at both conditions.
Intervention during treatment
First an overview will be given about the articles where they investigated quality of life during treatment. In this condition the breast cancer patients are treated for breast cancer with chemotherapy and/or radiotherapy and/or hormone therapy. In these RCTs they were randomized into a group with the usual care or in the group with exercise training. In two studies they had three groups. In the study Courneya et al (2007), they randomized the patients in a group with aerobic training, a group with exercise training and a group with usual care. In the study of Segal et al. (2001), they randomized their patients in a group with supervised training, a group with home based training and a group with usual care.
The exercise intervention was more or less the same in the articles, but there were some changes. All articles exercised in a range of 50%-80% of max HR or VO2max. The intervention had strength and/or aerobic exercises. The duration of the training differed from five weeks till six months. There was also a difference in intensity of the training per week, there was a range between one time a week till five times a week.
Quality of life
Of the studies that reported on PA during treatment included in this review three out of six articles reported a positive effect on QoL (Campbell 2004, Courneya 2007, Hwang 2007). In the article of Mutri et al (2007), they found some positive effects on QoL after six months, but also no effects on QoL. The two other studies (Segal et al. 2001, Cadmus 2009) remained consistent over time.
Intervention after treatment
In these studies the breast cancer patients were treated for breast cancer in the past. After they completed their treatment of chemotherapy and/or radiotherapy and/or hormone therapy they were included in these studies. In these RCTs they were randomized into a group with the usual care after treatment or in the group with an exercise intervention.
The exercise intervention differed in some stages. Three articles exercised in a range of 60%-85% of max HR or VO2max. The three other articles didn't focus on percentages of max. HR or VO2max. In all interventions strength and/or aerobic exercises were used. The duration of the training differed from eight weeks till six months. There was also a difference in intensity of the training per week, there was a range between two times a week till five times a week.
Quality of life
Of the studies that reported on PA after treatment included in this review three found a positive effect on QoL as a result of PA (Milne 2008, Daley 2007, Herrero 2005). Ohira et al (2006) found a small effect. Two out of three items of the SF questionnaire were significant. Rogers et al. (2009) found only a small effect of PA 6 months after the intervention.