Slow Jogging for Breast Cancer Survivors

Background Breast cancer is the most common malignancy among women worldwide. Although advances in cancer treatment have substantially improved survival rates, many breast cancer survivors continue to experience persistent sleep disturbance, cancer-related fatigue, and impaired health-related quality of life after completing primary treatment. Exercise is recognized as an important component of cancer survivorship care; however, evidence regarding the effectiveness of slow jogging for improving these outcomes among breast cancer survivors remains limited. Slow jogging is a low-impact aerobic exercise performed at a comfortable pace and is considered safe and feasible for individuals with different levels of physical fitness. This study aims to evaluate the effectiveness of a structured slow jogging exercise program in improving sleep quality, reducing cancer-related fatigue, and enhancing health-related quality of life among breast cancer survivors.

Study Design

This is an investigator-initiated, single-center, parallel-group randomized controlled trial conducted at Mackay Memorial Hospital, Taiwan.

Eligible participants are women aged 20 years or older with histologically confirmed hormone receptor-positive breast cancer (Stage I-IV) who have completed primary cancer treatment (surgery, chemotherapy, or radiotherapy) within the previous 12 months. Participants receiving ongoing anti-human epidermal growth factor receptor 2 (HER2) targeted therapy and/or endocrine therapy are eligible. Additional eligibility criteria include the ability to independently operate a smartphone, willingness to use the study LINE official account, and self-reported sleep disturbance within the previous two weeks, defined as a Single-item Sleep Quality Scale (SQS) score of 6 or higher.

Participants will be randomly assigned to either the slow jogging intervention group or the usual care control group using permuted block randomization (block size = 6) with allocation concealment to ensure balanced group assignment throughout participant enrollment.

Intervention Participants assigned to the intervention group will receive a standardized 12-week slow jogging exercise program in addition to usual care. Before beginning the intervention, participants will receive face-to-face exercise instruction, an educational manual, demonstration videos, and standardized training to ensure correct performance of the exercise program. Participants will record each exercise session using exercise logs and receive regular reminders and follow-up through the official LINE account to enhance adherence.

Participants will perform slow jogging at least three times per week, with each exercise session lasting approximately 36 minutes, according to the prescribed exercise protocol throughout the 12-week intervention period.

Participants assigned to the control group will receive routine survivorship care, including standard health education and sleep education provided by the hospital, without participation in the structured slow jogging exercise program during the study period. After completion of the study, participants in the control group will receive the slow jogging educational materials.

Outcome Measures The primary outcome is the change in the Chinese Pittsburgh Sleep Quality Index (CPSQI) global score. Secondary outcomes include the change in the Taiwanese Brief Fatigue Inventory (BFI-T) total score and the change in the Functional Assessment of Cancer Therapy-Breast (FACT-B) total score. Outcome assessments will be conducted at baseline and at Weeks 4, 8, and 12.

Significance This study is expected to provide high-quality clinical evidence regarding the effectiveness of slow jogging as a supportive care intervention for breast cancer survivors. The findings may contribute to evidence-based exercise recommendations and facilitate the integration of structured exercise programs into routine breast cancer survivorship care, thereby improving sleep quality, reducing cancer-related fatigue, and enhancing health-related quality of life

Inclusion criteria

• Female breast cancer survivors aged 20 years or older.
• Histologically confirmed hormone receptor-positive breast cancer (Stage I-IV) and considered suitable for exercise intervention by the treating physician.
• Completed primary cancer treatment (surgery, chemotherapy, or radiotherapy) within the previous 12 months; participants receiving ongoing anti-HER2 targeted therapy and/or endocrine therapy are eligible.
• Able to independently operate a smartphone and willing to install and use the study application.
• Self-reported sleep disturbance within the previous two weeks, defined as a Single-item Sleep Quality Scale (SQS) score ≥ 6.
• Willing to participate and provide written informed consent.

Exclusion criteria

• History of cancer treatment-related cardiovascular complications or judged by the treating physician to be unsuitable for exercise.
• Musculoskeletal disorders affecting lower-extremity function (e.g., plantar fasciitis, knee osteoarthritis, ankle degenerative disease) that limit exercise participation.
• Currently participating in another structured moderate- or vigorous-intensity aerobic exercise program (≥3 sessions/week, ≥30 minutes/session for ≥3 consecutive weeks).
• Any other medical or psychological condition judged by the investigator to interfere with safe participation or completion of the study.