Physical Activity, Sedentary Behavior, And Symptom Reporting In Inactive Breast And Endometrial Cancer Survivors Using Ecological Momentary Assessment

Abstract

PURPOSE: To examine the relationship between daily symptom burden, physical activity, and sedentary behavior among breast and endometrial cancer survivors. METHODS: Survivors (N=74, Mage= 56.3±9.6 years; MBMI= 30.8±7.9 kg/m2) wore an ActiGraph accelerometer to assess daily activity (sedentary behavior (SB), light intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) and completed ecological momentary assessment prompts 4x/day to assess symptoms (fatigue, pain, mood, anxiety, depression, physical function) for seven consecutive days as part of baseline assessments for a physical activity promotion intervention. Symptom ratings were on a 5-point scale. Separate mixed models assessed the between-person and within-person associations of current daily symptoms with minutes of SB, LPA, and MVPA that same day, controlling for relevant covariates (age, BMI, treatment, wear time). RESULTS: Survivors averaged 516±96 minutes of SB, 271±90 minutes of LPA, and 17±10 minutes of MVPA per day. There were no significant between or within-person associations between daily symptoms and daily LPA or MVPA. There were significant between-person associations for fatigue (β=27.5±8.9 minutes, p=0.002), pain (β=20.6±7.4 minutes, p=0.006), mood (β=28.9±9.5 minutes, p=0.002), and physical function (β=19.9±9.1 minutes, p=0.03) on SB such that those with higher symptom burden spent more time spent sedentary. There were a significant within-person associations for anxiety (β=31.8±14.4 minutes, p=0.028) and depression (β=54.5±21.7 minutes, p=0.013) and SB such that when participants reported higher anxiety or depression than their average on a given day, they spent more time sedentary that day. CONCLUSIONS: Inactive breast and endometrial cancer survivors that reported higher symptom burden spent more time sedentary. Additionally, results indicated a significant temporal, day-level association between anxiety and depression and time spent sedentary but there was no association between any symptoms and time spent in LPA or MVPA. Future interventions targeting changing sedentary time in this population should consider overall fatigue, pain, mood, and physical functioning in their programming, in addition to daily changes in depression and anxiety symptoms.