Lisa A. Cadmus Bertram, Gina Chung, Herbert Yu, Peter Salovey and Melinda Irwin
The purpose of this study was to determine the feasibility of using a tumor registry to recruit newly diagnosed survivors into a randomized controlled exercise trial and to discuss issues related to this recruitment strategy.
A tumor registry-based rapid ascertainment system was used to recruit breast cancer survivors into a 6-month home-based, telephone-administered intervention of moderate-to-vigorous intensity exercise or a usual care group.
468 newly diagnosed cases were identified. Of these, 50 women (15.4% of those for which screening calls were made) were enrolled in the study. Women were randomized, on average, 11 weeks after diagnosis (SD = 4.8). Sixty-four percent were randomized before beginning treatment or within the first week of treatment. Time required to obtain physician consent was the primary determinant of diagnosis-to-randomization latency. Enrolled women were more likely than nonenrolled women to be non-Hispanic White and to have a college degree (P < .05).
Tumor registries present a feasible means of recruiting breast cancer survivors before or early in adjuvant treatment. The success of recruiting survivors promptly after diagnosis is largely dependent on ability to rapidly obtain physician consent. Specific effort is needed to counteract self-selection effects that may lead to under-representation of minorities.
Lisa Cadmus-Bertram, Melinda Irwin, Catherine Alfano, Kristin Campbell, Catherine Duggan, Karen Foster-Schubert, Ching-Yun Wang and Anne McTiernan
The purpose of this study was to (a) examine demographic, psychosocial, and physiological predictors of exercise adherence in a yearlong exercise intervention and (b) describe the trajectory of adherence over time.
Participants were 51 men and 49 women aged 40 to 75 years. The supervised and home-based intervention consisted of 60 minutes/day, 6 days/week of moderate-to-vigorous intensity exercise. Three adherence measures were used: (1) minutes/week, (2) MET-hours/week, and (3) change in cardiopulmonary fitness (VO2max). Predictors of adherence were determined separately by sex using mixed models and multivariable regression.
Participants performed 287 ± 98 minutes/week of moderate-to-vigorous activity with 71% adhering to at least 80% (288 minutes/week) of the prescription. Men adhered better than women (P < .001). Among women, adiposity-related variables were significantly related to poorer adherence on all 3 measures (P < .05). A less consistent pattern was observed among men but in follow-up analyses, adiposity was associated with fewer MET-hours/week of exercise. Social support, pain, and perceived benefits were predictive in some models. Men and nonobese women experienced peak adherence at 4 to 6 months, while obese women peaked during months 0 to 3.
When provided with supervision and support, previously sedentary men and women can achieve and maintain high levels of aerobic activity.
Kristin Campbell, Karen Foster-Schubert, Liren Xiao, Catherine Alfano, Lisa Cadmus Bertram, Catherine Duggan, Melinda Irwin and Anne McTiernan
The risk of musculoskeletal injury with the introduction of moderate-to-vigorous exercise in sedentary adults is not well established. The purpose of this report is to examine the effect of a 12-month exercise intervention on musculoskeletal injury and bodily pain in predominately overweight, sedentary men (n = 102) and women (n = 100), ages 40 to 75 years.
Participants were randomized to a moderate-to-vigorous aerobic exercise intervention (EX) (6 d/wk, 60 min/d, 60% to 85% max. heart rate) or usual lifestyle control (CON). Participants completed a self-report of musculoskeletal injury and body pain at baseline and 12-months.
The number of individuals reporting an injury (CON; 28% vs. EX; 28%, P = .95) did not differ by group. The most commonly injured site was lower leg/ankle/foot. The most common causes of injury were sports/physical activity, home maintenance, or “other.” In the control group, bodily pain increased over the 12 months compared with the exercise group (CON −7.9, EX −1.4, P = .05). Baseline demographics and volume of exercise were not associated with injury risk.
Previously sedentary men and women randomized to a 12-month aerobic exercise intervention with a goal of 360 min/wk reported the same number of injuries as those in the control group and less bodily pain.
Stephanie M. George, Catherine M. Alfano, Ashley Wilder Smith, Melinda L. Irwin, Anne McTiernan, Leslie Bernstein, Kathy B. Baumgartner and Rachel Ballard-Barbash
Many cancer survivors experience declines in health-related quality of life (HRQOL) and increases in fatigue as a result of cancer and its treatment. Exercise is linked to improvements in these outcomes, but little is known about the role of sedentary behavior. In a large, ethnically-diverse cohort of breast cancer survivors, we examined the relationship between sedentary time, HRQOL, and fatigue, and examined if that relationship differed by recreational moderate-vigorous physical activity (MVPA) level.
Participants were 710 women diagnosed with stage 0-IIIA breast cancer in the Health, Eating, Activity, and Lifestyle Study. Women completed questionnaires at approximately 30-months postdiagnosis (sedentary time; recreational MVPA) and 41-months postdiagnosis (HRQOL; fatigue). In multivariate models, we regressed these outcomes linearly on quartiles of daily sedentary time, and a variable jointly reflecting sedentary time quartiles and MVPA categories (0; >0 to <9; ≥9 MET-hrs/wk).
Sedentary time was not independently related to subscales or summary scores of HRQOL or fatigue. In addition, comparisons of women with high vs. low (Q4:Q1) sedentary time by MVPA level did not result in significant differences in HRQOL or fatigue.
In this breast cancer survivor cohort, self-reported sedentary time was not associated with HRQOL or fatigue, 3.5 years postdiagnosis.