Abstract
Background: In inoperable lung cancer, evidence is limited regarding physical activity (PA) and associations with other outcomes. Aims: in the usual care (UC) group of an RCT to (1) explore whether baseline PA was associated with improved follow-up outcomes, (2) identify baseline variables associated with higher follow-up PA and in all RCT participants, to (3) analyse patterns of objectively measured PA, and (4) report on characteristics of those who were able to maintain or increase PA levels. Methods: exploratory analyses of an assessor-blinded RCT. Outcomes, assessed at baseline, nine weeks and six months, included PA (seven-days of accelerometry), six-minute walk distance (6MWD), muscle strength, symptoms, mood and health-related quality of life (HRQoL). Results: 92 participants were randomised, 80 completed baseline accelerometry (39 intervention group (IG), 41 UC), characteristics: mean (SD) age 63.0 (12.3) years, 56% male, 51% stage IV disease. Baseline PA: median (IQR) steps/day 2859.6 (2034.0–3849.2) IG versus 3195.2 (2161.2–4839.0) UC. Associations between baseline PA and six-month outcomes were significant for HRQoL and 6MWD. PA at six months was significantly associated with baseline age, 6MWD and quadriceps strength. Between-group change score (steps/day) mean differences (95% CI) at nine weeks (174.5 (−1504.7 to 1853.7), p = 0.84) and six months (574.0 (−1162.3 to 2310.3), p = 0.52). Conclusions: further research is required to determine patient subgroups deriving the greatest benefits from PA interventions.
Highlights
The general health benefits of being physically active are well established
The aims of this study in the usual care (UC) group of an RCT were to (1) explore whether baseline physical activity (PA) was associated with improved follow-up outcomes, (2) identify baseline variables associated with higher follow-up PA, and in all RCT participants, to (3) analyse patterns of objectively measured PA, and (4) report on characteristics of those that were able to maintain or increase PA levels
Ninety-two participants were randomised (45 IG, 47 UC) to the overall trial [31]. Eighty participants of those recruited into the trial (87%) completed a valid measure of baseline accelerometry (39 IG, 41 UC)
Summary
The general health benefits of being physically active are well established. Compared to inactivity, low doses of moderate-intensity exercise are associated with a 22% reduction in all-cause mortality risk in healthy older adults [1]. US Department of Health and Human Services recommendations for PA in cancer survivors are in line with current recommendations for the healthy population: to perform at least 150 min of moderate-intensity (or 75 min vigorous-intensity) aerobic exercise and two to three resistance-training sessions per week [11,12]. This equates to 30 min of moderate-intensity aerobic exercise five days per week. Conclusions: further research is required to determine patient subgroups deriving the greatest benefits from PA interventions
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