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We investigated whether exercise training improves cognition in chemotherapy-exposed breast cancer patients 2\u20134\u00a0years after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Chemotherapy-exposed breast cancer patients, with both self-reported cognitive problems and lower than expected performance on neuropsychological tests, were randomized to an exercise or control group. The 6-month exercise intervention consisted of supervised aerobic and strength training (2\u00a0h\/week), and Nordic\/power walking (2\u00a0h\/week). Our primary outcome was memory functioning (Hopkins Verbal Learning Test-Revised; HVLT-R). Secondary outcomes included online neuropsychological tests (Amsterdam Cognition Scan; ACS), self-reported cognition (MD Anderson Symptom Inventory for multiple myeloma; MDASI-MM), physical fitness (relative maximum oxygen uptake; VO\n                      <jats:sub>2peak<\/jats:sub>\n                      ), fatigue (Multidimensional Fatigue Inventory), QoL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ C-30), depression (Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale; HADS), and anxiety (HADS). HVLT-R total recall was analyzed with a Fisher exact test for clinically relevant improvement (\u2265\u20095 words). Other outcomes were analyzed using multiple regression analyses adjusted for baseline and stratification factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We randomized 181 patients to the exercise (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200991) or control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200990). Two-third of the patients attended\u2009\u2265\u200980% of the exercise sessions, and physical fitness significantly improved compared to control patients (B VO\n                      <jats:sub>2peak<\/jats:sub>\n                      1.4\u00a0ml\/min\/kg, 95%CI:0.6;2.2). No difference in favor of the intervention group was seen on the primary outcome. Significant beneficial intervention effects were found for self-reported cognitive functioning [MDASI-MM severity (B-0.7, 95% CI \u2212\u20091.2; \u2212\u20090.1)], fatigue, QoL, and depression. A hypothesis-driven analysis in highly fatigued patients showed positive exercise effects on tested cognitive functioning [ACS Reaction Time (B-26.8, 95% CI \u2212\u200952.9; \u2212\u20090.6) and ACS Wordlist Learning (B4.4, 95% CI 0.5; 8.3)].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A 6-month exercise intervention improved self-reported cognitive functioning,\u00a0physical fitness, fatigue, QoL, and depression in chemotherapy-exposed breast cancer patients with cognitive problems. Tested cognitive functioning was not affected. However, subgroup analysis indicated a positive effect of exercise on tested cognitive functioning in highly fatigued patients.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial Registration Netherlands Trial Registry<\/jats:italic>\n                      : Trial NL5924 (NTR6104). Registered 24 October 2016,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.trialregister.nl\/trial\/5924\">https:\/\/www.trialregister.nl\/trial\/5924<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13058-022-01530-2","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T08:03:32Z","timestamp":1653552212000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":110,"title":["Effect of physical exercise on cognitive function after chemotherapy in patients with breast cancer: a randomized controlled trial (PAM study)"],"prefix":"10.1186","volume":"24","author":[{"given":"E. W.","family":"Koevoets","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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