Abstract
Exercise could reduce the side-effects of adjuvant breast cancer treatment; however, socio-demographic, health, and intervention conditions may affect patients’ adherence to interventions. This study aimed to examine adherence to a 12-month outdoor post-surgery exercise program among newly diagnosed breast cancer patients during adjuvant treatment, and to identify socio-demographic and health-related predictors. In total, 47 women with invasive breast cancer stage I–II or ductal/lobular carcinoma grade 3 were included pre-surgery and randomized two weeks post-surgery to exercise (2 × 60 min/week). Patient characteristics (body-mass index (BMI), socioeconomic status, comorbidity, physical activity, and maximal oxygen uptake (VO2max)) were recorded pre-surgery. Correlations between adherence and patient characteristics and statistics for between-group differences were performed. The mean age was 54.2 years, mean BMI 27.8 kg/m2, and 54.2% received chemotherapy. Completers had a mean adherence of 81%, independent of season. Withdrawals (23%) occurred after a mean of 6.5 weeks (0–24 weeks), they were suggestively older, had lower socioeconomic status and pre-surgery VO2max, and higher BMI. Household income was significantly lower among withdrawals. There were insignificant correlations between adherence and health conditions. High adherence is achievable in a Nordic outdoor physical exercise program in breast cancer patients during adjuvant treatment, including chemotherapy. Additional studies are needed to clarify follow-up needs in some groups.
Highlights
Physical activity (PA) has consistently been observed to reduce the risk of postmenopausal breast cancer [1,2,3]
Unstandardized adherence measures, different intervention designs, and the fact that patients differ in terms of physical fitness at baseline, prevent us from establishing which adherence rate would be sufficient for a PA intervention to be effective
Studies support that 12-month exercise programs for breast cancer patients results in physical benefits compared to a 6-month exercise program [18]
Summary
Physical activity (PA) has consistently been observed to reduce the risk of postmenopausal breast cancer [1,2,3]. The effect of PA in a clinical PA intervention depends on how the intervention is designed as part of breast cancer rehabilitation (i.e., time to start, type, intensity and doses of PA), as well as the patients’ opportunity to participate, considering their sociodemographic characteristics and health conditions. Adjuvant breast cancer treatment may be challenging [6] and give side-effects such as nausea, fatigue, hair loss and chills [7], which can make maximal PA intervention adherence difficult [1]. Because patients are more susceptible to infections during adjuvant breast cancer treatment, for them to accomplish the types and doses of PA needed to achieve the intended effect, the interventions must be performed within secure and trustworthy settings, regarding the risk of infection
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