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Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

Randomised controlled trial of a home-based physical activity intervention in breast cancer survivors

Authors: Ian M. Lahart, George S. Metsios, Alan M. Nevill, George D. Kitas, Amtul R. Carmichael

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

To improve adherence to physical activity (PA), behavioural support in the form of behavioural change counselling may be necessary. However, limited evidence of the effectiveness of home-based PA combined with counselling in breast cancer patients exists. The aim of this current randomised controlled trial with a parallel group design was to evaluate the effectiveness of a home-based PA intervention on PA levels, anthropometric measures, health-related quality of life (HRQoL), and blood biomarkers in breast cancer survivors.

Methods

Eighty post-adjuvant therapy invasive breast cancer patients (age = 53.6 ± 9.4 years; height = 161.2 ± 6.8 cm; mass = 68.7 ± 10.5 kg) were randomly allocated to a 6-month home-based PA intervention or usual care. The intervention group received face-to-face and telephone PA counselling aimed at encouraging the achievement of current recommended PA guidelines. All patients were evaluated for our primary outcome, PA (International PA Questionnaire) and secondary outcomes, mass, BMI, body fat %, HRQoL (Functional assessment of Cancer Therapy-Breast), insulin resistance, triglycerides (TG) and total (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol were assessed at baseline and at 6-months.

Results

On the basis of linear mixed-model analyses adjusted for baseline values performed on 40 patients in each group, total, leisure and vigorous PA significantly increased from baseline to post-intervention in the intervention compared to usual care (between-group differences, 578.5 MET-min∙wk−1, p = .024, 382.2 MET-min∙wk−1, p = .010, and 264.1 MET-min∙wk−1, p = .007, respectively). Both body mass and BMI decreased significantly in the intervention compared to usual care (between-group differences, −1.6 kg, p = .040, and −.6 kg/m2, p = .020, respectively). Of the HRQoL variables, FACT-Breast, Trial Outcome Index, functional wellbeing, and breast cancer subscale improved significantly in the PA group compared to the usual care group (between-group differences, 5.1, p = .024; 5.6, p = .001; 1.9 p = .025; and 2.8, p = .007, respectively). Finally, TC and LDL-C was significantly reduced in the PA group compared to the usual care group (between-group differences, −.38 mmol∙L−1, p = .001; and −.3 mmol∙L−1, p = .023, respectively).

Conclusions

We found that home-based PA resulted in significant albeit small to moderate improvements in self-reported PA, mass, BMI, breast cancer specific HRQoL, and TC and LDL-C compared with usual care.

ClinicalTrials.gov identifier

NCT02408107 (March 25, 2015)
Literature
6.
go back to reference Bovelli D, Plataniotis G, Roila F, Group EGW. Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO Clinical Practice Guidelines. Ann Oncol. 2010;21 Suppl 5:v277–82. doi:10.1093/annonc/mdq200.CrossRefPubMed Bovelli D, Plataniotis G, Roila F, Group EGW. Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO Clinical Practice Guidelines. Ann Oncol. 2010;21 Suppl 5:v277–82. doi:10.​1093/​annonc/​mdq200.CrossRefPubMed
7.
8.
go back to reference Demark-Wahnefried W, Morey MC, Clipp EC, Pieper CF, Snyder DC, Sloane R, et al. Leading the Way in Exercise and Diet (Project LEAD): intervening to improve function among older breast and prostate cancer survivors. Control Clin Trials. 2003;24(2):206–23.CrossRefPubMed Demark-Wahnefried W, Morey MC, Clipp EC, Pieper CF, Snyder DC, Sloane R, et al. Leading the Way in Exercise and Diet (Project LEAD): intervening to improve function among older breast and prostate cancer survivors. Control Clin Trials. 2003;24(2):206–23.CrossRefPubMed
9.
go back to reference Lahart I, Metsios G, Nevill A, Carmichael A. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncol. 2015;5(54):635–54. doi:10.3109/0284186X.2014.998275.CrossRef Lahart I, Metsios G, Nevill A, Carmichael A. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncol. 2015;5(54):635–54. doi:10.​3109/​0284186X.​2014.​998275.CrossRef
10.
go back to reference Ballard-Barbash R, Hunsberger S, Alciati MH, Blair SN, Goodwin PJ, McTiernan A, et al. Physical activity, weight control, and breast cancer risk and survival: clinical trial rationale and design considerations. J Natl Cancer Inst. 2009;101(9):630–43. doi:10.1093/jnci/djp068.CrossRefPubMedPubMedCentral Ballard-Barbash R, Hunsberger S, Alciati MH, Blair SN, Goodwin PJ, McTiernan A, et al. Physical activity, weight control, and breast cancer risk and survival: clinical trial rationale and design considerations. J Natl Cancer Inst. 2009;101(9):630–43. doi:10.​1093/​jnci/​djp068.CrossRefPubMedPubMedCentral
13.
14.
go back to reference Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD, et al. Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer. 2003;97(7):1746–57. doi:10.1002/cncr.11227.CrossRefPubMedPubMedCentral Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD, et al. Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer. 2003;97(7):1746–57. doi:10.​1002/​cncr.​11227.CrossRefPubMedPubMedCentral
15.
go back to reference Irwin ML, McTiernan A, Bernstein L, Gilliland FD, Baumgartner R, Baumgartner K, et al. Physical activity levels among breast cancer survivors. Med Sci Sports Exerc. 2004;36(9):1484–91.PubMedPubMedCentral Irwin ML, McTiernan A, Bernstein L, Gilliland FD, Baumgartner R, Baumgartner K, et al. Physical activity levels among breast cancer survivors. Med Sci Sports Exerc. 2004;36(9):1484–91.PubMedPubMedCentral
18.
go back to reference Payne JK, Held J, Thorpe J, Shaw H. Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Oncol Nurs Forum. 2008;35(4):635–42. doi:10.1188/08.ONF.635-642.CrossRefPubMed Payne JK, Held J, Thorpe J, Shaw H. Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Oncol Nurs Forum. 2008;35(4):635–42. doi:10.​1188/​08.​ONF.​635-642.CrossRefPubMed
20.
go back to reference Matthews CE, Wilcox S, Hanby CL, Der Ananian C, Heiney SP, Gebretsadik T, et al. Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Support Care Cancer. 2007;15(2):203–11. doi:10.1007/s00520-006-0122-x.CrossRefPubMed Matthews CE, Wilcox S, Hanby CL, Der Ananian C, Heiney SP, Gebretsadik T, et al. Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Support Care Cancer. 2007;15(2):203–11. doi:10.​1007/​s00520-006-0122-x.CrossRefPubMed
21.
go back to reference Herrero F, San Juan AF, Fleck SJ, Balmer J, Perez M, Canete S, et al. Combined aerobic and resistance training in breast cancer survivors: a randomized, controlled pilot trial. Int J Sports Med. 2006;27(7):573–80. doi:10.1055/s-2005-865848.CrossRefPubMed Herrero F, San Juan AF, Fleck SJ, Balmer J, Perez M, Canete S, et al. Combined aerobic and resistance training in breast cancer survivors: a randomized, controlled pilot trial. Int J Sports Med. 2006;27(7):573–80. doi:10.​1055/​s-2005-865848.CrossRefPubMed
23.
go back to reference Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21(9):1660–8. doi:10.1200/JCO.2003.04.093.CrossRefPubMed Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21(9):1660–8. doi:10.​1200/​JCO.​2003.​04.​093.CrossRefPubMed
25.
go back to reference Heim ME, v d Malsburg ML, Niklas A. Randomized controlled trial of a structured training program in breast cancer patients with tumor-related chronic fatigue. Onkologie. 2007;30(8–9):429–34. doi:10.1159/0000104097.PubMed Heim ME, v d Malsburg ML, Niklas A. Randomized controlled trial of a structured training program in breast cancer patients with tumor-related chronic fatigue. Onkologie. 2007;30(8–9):429–34. doi:10.​1159/​0000104097.PubMed
26.
go back to reference Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.1200/JCO.2006.07.9988.CrossRefPubMed Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.​1200/​JCO.​2006.​07.​9988.CrossRefPubMed
27.
go back to reference Baruth M, Wilcox S, Der Ananian C, Heiney S. Effects of home-based walking on quality of life and fatigue outcomes in early stage breast cancer survivors: A 12-Week pilot study. J Phys Act Health. 2013;12 Suppl 1:S110–8. doi:10.1123/jpah.2012-0339. Baruth M, Wilcox S, Der Ananian C, Heiney S. Effects of home-based walking on quality of life and fatigue outcomes in early stage breast cancer survivors: A 12-Week pilot study. J Phys Act Health. 2013;12 Suppl 1:S110–8. doi:10.​1123/​jpah.​2012-0339.
28.
30.
go back to reference Medicine ACoS. ACSM’s Guidelines for exercise testing and prescription. 9th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins; 2013. Medicine ACoS. ACSM’s Guidelines for exercise testing and prescription. 9th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.
31.
go back to reference Rogers LQ, Markwell S, Hopkins-Price P, Vicari S, Courneya KS, Hoelzer K, et al. Reduced barriers mediated physical activity maintenance among breast cancer survivors. J Sport Exerc Psychol. 2011;33(2):235–54.CrossRefPubMedPubMedCentral Rogers LQ, Markwell S, Hopkins-Price P, Vicari S, Courneya KS, Hoelzer K, et al. Reduced barriers mediated physical activity maintenance among breast cancer survivors. J Sport Exerc Psychol. 2011;33(2):235–54.CrossRefPubMedPubMedCentral
32.
go back to reference Jones LW, Courneya KS. Exercise counseling and programming preferences of cancer survivors. Cancer Pract. 2002;10(4):208–15.CrossRefPubMed Jones LW, Courneya KS. Exercise counseling and programming preferences of cancer survivors. Cancer Pract. 2002;10(4):208–15.CrossRefPubMed
33.
go back to reference Rosengren DB. Building motivational interviewing skills: a practitioner workbook. New York; London: Guilford; 2009. Rosengren DB. Building motivational interviewing skills: a practitioner workbook. New York; London: Guilford; 2009.
34.
go back to reference Miller WR, Rollnick S. Motivational interviewing: helping people change. 3rd ed. New York, NY: Guilford Press; 2013. Miller WR, Rollnick S. Motivational interviewing: helping people change. 3rd ed. New York, NY: Guilford Press; 2013.
36.
go back to reference Demura S, Yamaji S, Goshi F, Kobayashi H, Sato S, Nagasawa Y. (2002) The validity and reliability of relative body fat estimates and the construction of new prediction equations for young Japanese adult males. J Sports Sci. 2002;20(2):153–64. doi:10.1080/026404102317200864.CrossRefPubMed Demura S, Yamaji S, Goshi F, Kobayashi H, Sato S, Nagasawa Y. (2002) The validity and reliability of relative body fat estimates and the construction of new prediction equations for young Japanese adult males. J Sports Sci. 2002;20(2):153–64. doi:10.​1080/​0264041023172008​64.CrossRefPubMed
37.
go back to reference Craig C, Marshall A, Sjöström M, Bauman A, Booth M, Ainsworth B, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;8(35):1381–95.CrossRef Craig C, Marshall A, Sjöström M, Bauman A, Booth M, Ainsworth B, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;8(35):1381–95.CrossRef
38.
go back to reference Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast (FACT-B) quality of life instrument. J Clin Oncol. 1997;15:974–86.CrossRefPubMed Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast (FACT-B) quality of life instrument. J Clin Oncol. 1997;15:974–86.CrossRefPubMed
39.
go back to reference Radikova Z. Assessment of insulin sensitivity/resistance in epidemiological studies. Endocr Regul. 2003;37(3):189–94.PubMed Radikova Z. Assessment of insulin sensitivity/resistance in epidemiological studies. Endocr Regul. 2003;37(3):189–94.PubMed
40.
go back to reference Batterham A, Hopkins W. Making meaningful inferences about magnitudes. Int J Sports Physiol Perform. 2006;1(1):50–7.CrossRefPubMed Batterham A, Hopkins W. Making meaningful inferences about magnitudes. Int J Sports Physiol Perform. 2006;1(1):50–7.CrossRefPubMed
41.
go back to reference Hopkins WG. Spreadsheets for analysis of controlled trials, with adjustment for a subject characteristic. Sportsci. 2006;10:46–50. Hopkins WG. Spreadsheets for analysis of controlled trials, with adjustment for a subject characteristic. Sportsci. 2006;10:46–50.
42.
go back to reference Eton DT, Cella D, Yost KJ, Yount SE, Peterman AH, Neuberg DS, et al. A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. J Clin Epidemiol. 2004;57(9):898–910. doi:10.1016/j.jclinepi.2004.01.012.CrossRefPubMed Eton DT, Cella D, Yost KJ, Yount SE, Peterman AH, Neuberg DS, et al. A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. J Clin Epidemiol. 2004;57(9):898–910. doi:10.​1016/​j.​jclinepi.​2004.​01.​012.CrossRefPubMed
44.
go back to reference Pate RR, Heath GW, Dowda M, Trost SG. Associations between physical activity and other health behaviors in a representative sample of US adolescents. Am J Public Health. 1996;86(11):1577–81.CrossRefPubMedPubMedCentral Pate RR, Heath GW, Dowda M, Trost SG. Associations between physical activity and other health behaviors in a representative sample of US adolescents. Am J Public Health. 1996;86(11):1577–81.CrossRefPubMedPubMedCentral
46.
go back to reference Catapano AL, Reiner Z, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis. 2011;217(1):3–46.CrossRefPubMed Catapano AL, Reiner Z, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis. 2011;217(1):3–46.CrossRefPubMed
49.
go back to reference Pattyn N, Cornelissen VA, Eshghi SR, Vanhees L. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials. Sports Med. 2013;43(2):121–33. doi:10.1007/s40279-012-0003-z.CrossRefPubMed Pattyn N, Cornelissen VA, Eshghi SR, Vanhees L. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials. Sports Med. 2013;43(2):121–33. doi:10.​1007/​s40279-012-0003-z.CrossRefPubMed
50.
go back to reference Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Martin BS, et al. Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: a randomized controlled trial. Brain Behav Immun. 2005;19(5):381–8. doi:10.1016/j.bbi.2005.04.001.CrossRefPubMed Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Martin BS, et al. Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: a randomized controlled trial. Brain Behav Immun. 2005;19(5):381–8. doi:10.​1016/​j.​bbi.​2005.​04.​001.CrossRefPubMed
51.
go back to reference Mefferd K, Nichols JF, Pakiz B, Rock CL. A cognitive behavioral therapy intervention to promote weight loss improves body composition and blood lipid profiles among overweight breast cancer survivors. Breast Cancer Res Treat. 2007;104(2):145–52. doi:10.1007/s10549-006-9410-x.CrossRefPubMed Mefferd K, Nichols JF, Pakiz B, Rock CL. A cognitive behavioral therapy intervention to promote weight loss improves body composition and blood lipid profiles among overweight breast cancer survivors. Breast Cancer Res Treat. 2007;104(2):145–52. doi:10.​1007/​s10549-006-9410-x.CrossRefPubMed
52.
go back to reference Nuri R, Kordi MR, Moghaddasi M, Rahnama N, Damirchi A, Rahmani-Nia F, et al. Effect of combination exercise training on metabolic syndrome parameters in postmenopausal women with breast cancer. J Cancer Res Ther. 2012;8(2):238–42. doi:10.4103/0973-1482.98977.CrossRefPubMed Nuri R, Kordi MR, Moghaddasi M, Rahnama N, Damirchi A, Rahmani-Nia F, et al. Effect of combination exercise training on metabolic syndrome parameters in postmenopausal women with breast cancer. J Cancer Res Ther. 2012;8(2):238–42. doi:10.​4103/​0973-1482.​98977.CrossRefPubMed
53.
go back to reference Irwin ML, Varma K, Alvarez-Reeves M, Cadmus L, Wiley A, Chung GG, et al. Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale exercise and survivorship study. Cancer Epidemiol Biomark Prev. 2009;18(1):306–13.CrossRef Irwin ML, Varma K, Alvarez-Reeves M, Cadmus L, Wiley A, Chung GG, et al. Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale exercise and survivorship study. Cancer Epidemiol Biomark Prev. 2009;18(1):306–13.CrossRef
54.
go back to reference Schmitz KH, Ahmed RL, Hannan PJ, Yee D. Safety and efficacy of weight training in recent breast cancer survivors to alter body composition, insulin, and insulin-like growth factor axis proteins. Cancer Epidemiol Biomark Prev. 2005;14(7):1672–80. doi:10.1158/1055-9965.EPI-04-0736.CrossRef Schmitz KH, Ahmed RL, Hannan PJ, Yee D. Safety and efficacy of weight training in recent breast cancer survivors to alter body composition, insulin, and insulin-like growth factor axis proteins. Cancer Epidemiol Biomark Prev. 2005;14(7):1672–80. doi:10.​1158/​1055-9965.​EPI-04-0736.CrossRef
55.
go back to reference Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR. Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomark Prev. 2003;12(8):721–7. Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR. Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomark Prev. 2003;12(8):721–7.
56.
go back to reference Ross SA, Gulve EA, Wang M. Chemistry and biochemistry of type 2 diabetes. Chem Rev. 2004;104(3):1255–82.CrossRefPubMed Ross SA, Gulve EA, Wang M. Chemistry and biochemistry of type 2 diabetes. Chem Rev. 2004;104(3):1255–82.CrossRefPubMed
Metadata
Title
Randomised controlled trial of a home-based physical activity intervention in breast cancer survivors
Authors
Ian M. Lahart
George S. Metsios
Alan M. Nevill
George D. Kitas
Amtul R. Carmichael
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2258-5

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