Physical activity platform to improve bone health in cancer survivors.

Abstract

e24054 Background: Cancer treatment-induced bone loss and the risk of fractures is a significant burden on national health care with the annual cost of osteoporosis at $25.3 billion. Clinical studies report that moderate-intensity resistance exercises prevent a decline in bone health and reduce complications such as fatigue, muscle wasting, and bone loss. Only a small percentage cancer survivors engage in exercise. Several factors account for this low level of engagement such as poor awareness of the benefits, lack of motivation, and access to exercise programs for cancer survivors. Web- and mobile app-based programs that encourage physical activity can potentially address these problems and can be scaled for dissemination. Methods: Thrivors plus Bone Health (Thrivors+BH) is first-of-its-kind, clinically validated platform of bone health exercises that adapts to a cancer survivor's pain and energy levels with several interactive feedback features. The product has physical activity, mindfulness, nutrition, survivorship resources, and bone health education. The platform's back-end tracks and reports module activity. We conducted a single-blind RCT of 142 breast cancer survivors adherence to a 20-week program of resistance and impact exercises. Participants in the control arm accessed Thrivors Basic which lacked interactive feedback. Results: The primary outcome was higher adherence. High adherence equals completion of at least 40 of 60 recommended exercise sessions during the 20-week intervention. The intervention group showed higher measures of platform usage, duration and activity. Intervention group completed the validated jumping protocol after an 8-week program of strength training to prepare for increased intensity exercises. Although some participants discontinued due to various reasons (time constraints or health complications), the supportive modules and feedback from the PI influenced participants to resume exercise after a period of inactivity. The mean scores in the PAM and SF-36v surveys were higher for the intervention group. Conclusions: The study demonstrates breast cancer survivors' willingness to utilize a digital platform with prescribed exercise routines. Feedback suggests that more personalized and interactive features may encourage a higher frequency of engagement in bone-health specific physical activity. A follow-up study will examine the impact of the exercise program on bone health and the role of coaching to impact sustainable behavior change. Clinical trial information: NCT03651037 .