Effects of BEAT Cancer randomized physical activity trial on subjective memory impairments in breast cancer survivors.
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ABSTRACT:
SUBMITTER: Ehlers DK
PROVIDER: S-EPMC5643210 | biostudies-literature | 2018 Feb
REPOSITORIES: biostudies-literature
Publications
Effects of BEAT Cancer randomized physical activity trial on subjective memory impairments in breast cancer survivors.
Ehlers Diane K DK Rogers Laura Q LQ Courneya Kerry S KS Robbs Randall S RS McAuley Edward E
Psycho-oncology 20170511 2
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Project description:ObjectiveAlthough studies have shown that physical activity (PA) can reduce some treatment-related side effects of breast cancer, there is a need to offer PA programs outside of research settings to reach more cancer survivors. We partnered with the American Cancer Society's Reach to Recovery (RTR) program to train their volunteers (breast cancer survivors) to deliver a 12-week PA intervention to other breast cancer survivors.MethodWe conducted a randomized controlled trial to compare the PA intervention delivered by RTR volunteers (PA plus RTR) with contact control (RTR control). Eighteen RTR volunteers/coaches (Mage = 54.9 years; Mtime since diagnosis = 7.0 years) delivered the contact control condition or the PA intervention. Seventy-six breast cancer survivors in New England (Mage = 55.6 years; Mtime since diagnosis = 1.1 years) were randomized to 1 of the 2 groups. At baseline, 12 weeks (postintervention), and at 24 weeks, participants wore an accelerometer for 7 days, were interviewed about their PA, and reported their motivational readiness for PA.ResultsAdjusted, mixed-effects longitudinal regression models showed significant group differences favoring the PA plus RTR group in minutes of moderate to vigorous PA at 12 weeks (Mdifference = 103 min/week, p < .001) and at 24 weeks (Mdifference = 34.7 min/week, p = .03). Results were corroborated with significant group differences in accelerometer data favoring the PA plus RTR group at both time points.ConclusionPeer volunteers were able to significantly increase PA among cancer survivors relative to contact control. Partnerships with existing volunteer programs can help to widen the reach of behavioral interventions among cancer survivors. (PsycINFO Database Record
| S-EPMC4441331 | biostudies-literature
Project description:PurposeData from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post-primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post-primary treatment breast cancer survivors.MethodsPost-primary treatment breast cancer survivors (n = 222) were randomized to a 3-month physical activity behavior change intervention (Better Exercise Adherence after Treatment for Cancer [BEAT Cancer]) or usual care. Self-report (Pittsburgh Sleep Quality Index [PSQI]) and actigraphy (latency and efficiency) sleep outcomes were measured at baseline, 3 months (M3), and 6 months (M6).ResultsAfter adjusting for covariates, BEAT Cancer significantly improved PSQI global sleep quality when compared with usual care at M3 (mean between-group difference [M] = -1.4, 95% confidence interval [CI] = -2.1 to -0.7, P < 0.001) and M6 (M = -1.0, 95% CI = -1.7 to -0.2, P = 0.01). BEAT Cancer improved several PSQI subscales at M3 (sleep quality M = -0.3, 95% CI = -0.4 to -0.1, P = 0.002; sleep disturbances M = -0.2, 95% CI = -0.3 to -0.03, P = 0.016; daytime dysfunction M = -0.2, 95% CI = -0.4 to -0.02, P = 0.027) but not M6. A nonsignificant increase in percent of participants classified as good sleepers occurred. No significant between-group difference was noted for accelerometer latency or efficiency.ConclusionA physical activity intervention significantly reduced perceived global sleep dysfunction at 3 and 6 months, primarily because of improvements in sleep quality aspects not detected with accelerometer.
| S-EPMC5600650 | biostudies-literature
Project description:BackgroundPeer support can extend the reach of physical activity (PA) interventions. In previous studies, peer support via weekly counseling calls increased PA at 3 and 6 months among breast cancer survivors, compared to contact control. However, effects were attenuated at 6 months. Interventions targeting PA maintenance among cancer survivors are limited. Hence, we extended prior work to identify effective PA maintenance interventions.PurposeFollowing a 3-month PA intervention, the study compared the effects of three 6-month interventions on PA at 12 months.MethodsOne hundred and sixty-one inactive breast cancer survivors participated in a 12-month randomized controlled trial. Intervention delivery was uniform for the first 3-months: all participants received a weekly call with their peer coach to encourage PA. Following month 3, participants self-monitored PA and received feedback reports (Reach Plus) or additionally received, a monthly phone call (Reach Plus Phone), or weekly text message (Reach Plus Message). Moderate-to-vigorous PA (MVPA) was measured using self-report (7 Day PAR) and accelerometry at baseline, 3, 6, 9, and 12 months.ResultsAt 3 months, there were significant within group increases in self-reported and objectively measured MVPA with no between-group differences (ps > .05). At 6 months, adjusted longitudinal models showed that Reach Plus Message reported an additional 23.83 (SD = 6.33, f2 = .12) min/week of MVPA and Reach Plus Phone reported an additional 18.14 min/week (SD = 5.15, f2 =.16) versus Reach Plus. Results were similar at 9 months. At 12 months, Reach Plus Message and Reach Plus Phone both out-performed Reach Plus (ps = .04 and .05 respectively and effect sizes f2 = .11 and f2 = .21 respectively). Accelerometer data showed similar patterns: Reach Plus Message and Reach Plus Phone out-performed Reach Plus at 6 (f2 = .20) and 9 months (f2 = .09).ConclusionPhone calls from peer mentors and text messaging can support PA maintenance among breast cancer survivors.Clinical trial informationClinicalTrials.Gov NCT02694640.
| S-EPMC9345185 | biostudies-literature
Project description:BackgroundIncreasing physical activity can improve cognition in healthy and cognitively impaired adults; however, the benefits for cancer survivors are unknown. The current study examined a 12-week physical activity intervention, compared with a control condition, on objective and self-reported cognition among breast cancer survivors.MethodsSedentary breast cancer survivors were randomized to an exercise arm (n = 43) or a control arm (n = 44). At baseline and at 12 weeks, objective cognition was measured with the National Institutes of Health Cognitive Toolbox, and self-reported cognition using the Patient-Reported Outcomes Measurement Information System scales. Linear mixed-effects regression models tested intervention effects for changes in cognition scores.ResultsOn average, participants (n = 87) were aged 57 years (standard deviation, 10.4 years) and were 2.5 years (standard deviation, 1.3 years) post surgery. Scores on the Oral Symbol Digit subscale (a measure of processing speed) evidenced differential improvement in the exercise arm versus the control arm (b = 2.01; P < .05). The between-group differences in improvement on self-reported cognition were not statistically significant but were suggestive of potential group differences. Time since surgery moderated the correlation, and participants who were ≤2 years post surgery had a significantly greater improvement in Oral Symbol Digit score (exercise vs control (b = 4.00; P < .01), but no significant improvement was observed in patients who were >2 years postsurgery (b = -1.19; P = .40). A significant dose response was observed with greater increased physical activity associated with objective and self-reported cognition in the exercise arm.ConclusionsThe exercise intervention significantly improved processing speed, but only among those who had been diagnosed with breast cancer within the past 2 years. Slowed processing speed can have substantial implications for independent functioning, supporting the potential importance of early implementation of an exercise intervention among patients with breast cancer. Cancer 2018;124:192-202. © 2017 American Cancer Society.
| S-EPMC5735009 | biostudies-literature
Project description:Increased survival rates among breast cancer patients have drawn significant attention to consequences of both the presence of cancer, and the subsequent treatment-related impact on the brain. The incidence of breast cancer and the effects of treatment often result in alterations in the microstructure of white matter and impaired cognitive functioning. However, physical activity is proving to be a successful modifiable lifestyle factor in many studies that could prove beneficial to breast cancer survivors. This study investigates the link between white matter lesion volume, moderate physical activity, and cognition in breast cancer survivors following treatment compared to non-cancer age-matched controls. Results revealed that brain structure significantly predicted cognitive function via mediation of physical activity in breast cancer survivors. Overall, the study provided preliminary evidence suggesting moderate physical activity may help reduce the treatment related risks associated with breast cancer, including changes to WM integrity and cognitive impairment.
| S-EPMC4767728 | biostudies-literature
Project description:ObjectiveBreast cancer survivors (BCS) experience many issues of rehabilitative concern due to the treatments they have undergone. Given the chronicity of these outcomes, the increasing number of survivors, and the positive results obtained by supervised exercise, professionals should consider offering self-managed physical activity (PA) programs to this population. Our aim was to map the currently available evidence about self-care rehabilitation for BCS.MethodsMedline, CINAHL, and Cochrane databases were searched for primary literature. Scoping review methodological frameworks were used to tackle the heterogeneity of the topic. Studies investigating self-managed PA interventions prescribed to adult BCS were included.ResultsOne hundred-eight studies were included, with sample sizes ranging from 6 to 692 patients. Information was systematically collected in tables displaying study design, type of PA, duration and recommended frequency, professional leading the study, type of supervision, initial training, strategies used to help patients integrate self-care into their daily lives, and self-managed PA efficacy. Tables were produced for every oncological side effect that BCS might experience: lymphedema, arthralgia, cancer-related fatigue, a decline in physical parameters, treatment-related cardiotoxicity, peripheral neurotoxicity, and a possible decline in the quality of life.ConclusionsSelf-managed PA has the potential to improve BCS oncological issues. Professionals can adopt many strategies to support patients and empower them with long-lasting self-care competencies. This scoping review provided a comprehensive and easy-to-consult overview of self-managed PA interventions for BCS. We also provided recommendations for future primary studies and secondary synthesis.
| S-EPMC10124851 | biostudies-literature
Project description:BackgroundEmerging research suggests that increasing physical activity can help improve cognition among breast cancer survivors. However, little is known about the mechanism through which physical activity impacts cancer survivors' cognition.ObjectiveThe objective of this secondary analysis examined physical and psychological function potentially linking physical activity with changes in cognition among breast cancer survivors in a randomized controlled trial where the exercise arm had greater improvements in cognition than the control arm.MethodsA total of 87 sedentary breast cancer survivors were randomized to a 12-week physical activity intervention (n=43) or control condition (n=44). Objectively measured processing speed (National Institutes of Health Toolbox Oral Symbol Digit), self-reported cognition (patient-reported outcomes measurement information system [PROMIS] cognitive abilities), PROMIS measures of physical and psychological function (depression, anxiety, fatigue, and physical functioning), and plasma biomarkers (brain-derived neurotrophic factor, homeostatic model assessment 2 of insulin resistance, and C-reactive protein [CRP]) were collected at baseline and 12 weeks. Linear mixed-effects models tested intervention effects on changes in physical and psychological function variables and biomarkers. Bootstrapping was used to assess mediation. Exploratory analyses examined self-reported cognitive abilities and processing speed as mediators of the intervention effect on physical functioning.ResultsParticipants in the exercise arm had significantly greater improvements in physical functioning (beta=1.23; 95% CI 2.42 to 0.03; P=.049) and reductions in anxiety (beta=-1.50; 95% CI -0.07 to -2.94; P=.04) than those in the control arm. Anxiety significantly mediated the intervention effect on cognitive abilities (bootstrap 95% CI -1.96 to -0.06), whereas physical functioning did not (bootstrap 95% CI -1.12 to 0.10). Neither anxiety (bootstrap 95% CI -1.18 to 0.74) nor physical functioning (bootstrap 95% CI -2.34 to 0.15) mediated the intervention effect on processing speed. Of the biomarkers, only CRP had greater changes in the exercise arm than the control arm (beta=.253; 95% CI -0.04 to 0.57; P=.09), but CRP was not associated with cognition; therefore, none of the biomarker measures mediated the intervention effect on cognition. Neither cognitive abilities (bootstrap 95% CI -0.06 to 0.68) nor processing speed (bootstrap 95% CI -0.15 to 0.63) mediated the intervention effect on physical function.ConclusionsPhysical activity interventions may improve self-reported cognition by decreasing anxiety. If supported by larger studies, reducing anxiety may be an important target for improving self-reported cognition among cancer survivors.Trial registrationClinicalTrials.gov NCT02332876; https://clinicaltrials.gov/ct2/show/NCT02332876.
| S-EPMC6914286 | biostudies-literature
Project description:PurposeTo describe physical activity (PA) trajectories across 10 years post-breast cancer diagnosis and examine their association with quality of life (QoL).MethodsParticipants from the longitudinal Study of Women's Health Across the Nation who developed incident breast cancer completed the Quality of Life in Adult Cancer Survivors scale (QLACS) which has 12 domains. Breast cancer survivors (BCS) with at least one post-diagnosis measure of the Kaiser Physical Activity Survey (PA) were included (n = 96). We estimated metabolic equivalents of task minutes per week (MET-min/week) for the two most frequent sport/exercise activities. Group-based trajectory modeling determined PA trajectories over 10 years post-diagnosis. Analysis of covariance assessed associations between PA trajectory group and the three QLACS domains with the worst scores (fatigue, pain, and recurrence-related distress), adjusted for PA and other relevant covariates.ResultsThere were four post-diagnosis PA trajectories: consistently very low/no PA ("inactive," 11.5%); consistently some, but below aerobic PA guideline ("below guideline," 48.9%); generally met aerobic PA guideline with a slight decline ("met guideline," 22.2%); and exceeded aerobic PA guideline ("exceeded guideline," 18.8%). In adjusted models, the below guideline group reported more fatigue than the met or exceeded groups and more pain than the met guideline group, but there were no group differences in recurrence-related distress.ConclusionThe majority of BCS did not meet the aerobic PA guideline over 10 years post diagnosis. BCS who met the aerobic PA guideline reported less fatigue and pain compared to those who did not meet the guideline in adjusted analyses, suggesting a negative association between PA and QoL.
| S-EPMC11735529 | biostudies-literature
Project description: Not available
| S-EPMC9672970 | biostudies-literature
Project description:BackgroundHealthy lifestyle choices, including participation in regular physical activity, may improve health outcomes in survivors of childhood cancer. We aimed to evaluate the efficacy of a web-delivered physical activity intervention among adolescent survivors to increase moderate to vigorous physical activity (MVPA) and improve fitness and neurocognitive and health-related quality of life (HRQoL) over 24 weeks.ProcedureThis randomized controlled trial was conducted among survivors (aged ≥11 to <15 years) treated at a single institution. Participants were randomized to either a physical activity intervention delivered over the internet or a control group. The intervention group received educational materials, an activity monitor, and access to an interactive website designed to motivate increased physical activity via rewards; the control group received an activity monitor and educational materials. Physical activity, fitness, and neurocognitive and HRQoL outcomes were assessed at baseline and at 24 weeks. Mean changes were compared between groups using paired t-tests.ResultsOf the 97 survivors enrolled, 78 completed the study; the mean age was 12.7 (standard deviation 1.1), 80% were White, and 55.1% were female. Fifty-three survivors were assigned to the intervention and 25 to the control group. While survivors in the intervention group increased, and those in the control group decreased (4.7 ± 119.9 vs. -24.3 ± 89.7 min) weekly MVPA, this difference was not significant (P = 0.30). However, hand grip strength, number of sit-ups and pushups, neurocognitive function, and HRQoL outcomes improved in the intervention, but not in the control group.ConclusionsAn interactive, rewards-based intervention designed to increase MVPA is feasible in adolescent survivors of childhood cancer.
| S-EPMC6019155 | biostudies-literature