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While exercise has been shown to effectively reduce CRF, the underlying mechanisms are not fully clear. Therefore, the aim of this study was to explore the effects of a 4-month walking exercise program on fatigue severity and to explore potential underlying physiological, behavioral, and psychological mechanisms of action.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We included 27 cancer survivors (59\u2009\u00b1\u200915\u00a0years, 37% female) with variable cancer diagnoses who were at least moderately fatigued and finished treatment between 6 and 36\u00a0months ago. This study with a quasi-experimental interrupted time-series design compared a 4-month walking intervention period with a 4-month control period. Measurements of fatigue and physiological, behavioral, and psychological factors were performed, supplemented with participants\u2019 perceptions on how exercise influenced their fatigue.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A significant and clinically relevant decrease in fatigue severity was found over time (\u03b2\u2009=\u2009\u2009\u2212\u20098.1, 95% CI\u2009=\u2009\u2009\u2212\u200912.1;\u2009\u2212\u20094.2), but could not be attributed directly to the walking exercise intervention. Increases in muscle strength (\u03b2\u2009=\u2009\u2009\u2212\u20090.07, 95% CI\u2009=\u2009\u2009\u2212\u20090.12;\u2009\u2212\u20090.02), physical activity (\u03b2\u2009=\u2009\u2009\u2212\u20090.1, 95% CI\u2009=\u2009\u2009\u2212\u20090.2;\u2009\u2212\u20090.04), and sleep quality (\u03b2\u2009=\u20091.1, 95% CI\u2009=\u20090.3; 1.9), as well as decreases in muscle relaxation times (\u03b2\u2009=\u20090.09, 95% CI\u2009=\u20090.02; 0.16) and psychological distress (\u03b2\u2009=\u20091.1, 95% CI\u2009=\u20090.8; 1.3) were associated with reductions in fatigue severity. Resilience and physical well-being were perceived as most important constructs explaining the walking exercise effects on fatigue.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our findings reveal potential physiological, behavioral, and psychological mechanisms underlying the multidimensional effects of exercise on fatigue severity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Implications for Cancer Survivors.<\/jats:title>\n            <jats:p>Incorporating resistance exercise and addressing resilience and physical well-being might improve the efficacy of exercise interventions for cancer survivors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11764-024-01537-y","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T17:01:40Z","timestamp":1706720500000},"page":"1132-1142","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Potential mechanisms underlying the effect of walking exercise on cancer-related fatigue in cancer survivors"],"prefix":"10.1007","volume":"19","author":[{"given":"Isa Hiske","family":"Mast","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coen C. 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