Activity In Cancer Survivors Research Articles

Living life post cancer treatment (LLPCT): An assessment of a 12-week multidimensional wellness intervention to improve quality of life and physical activity in cancer survivors.

12052 Background: Cancer survivors face unique health challenges with implications on health-related quality of life (HRQoL) and physical, social, and emotional wellbeing. With advancements in cancer treatment and aging populations, the prevalence of cancer survivors is expected to grow prompting the need for improved survivorship care delivery and comprehensive rehabilitative services. Living Life Post Cancer Treatment (LLPCT) is a community-based 12-week program that provides multidimensional support to patients of any cancer diagnosis transitioning from active treatment to post-treatment life. This single-arm intervention study aims to assess the program’s impact on HRQoL and physical activity in cancer survivors. Methods: A total of 125 participants within 2 years of treatment completion were enrolled in a 12-week program comprised of 9 sessions of engaging workshops, personalized exercise training, and nutrition and psychosocial counseling with an interprofessional team of oncology providers, social workers, exercise trainers, and dietitians. The program consisted of 8 consecutive weekly sessions followed by a 1-month follow-up session at week 12. Ninety-six (77%) participants completed the eighth or ninth session of the program and were included in the analysis. A series of questionnaires were administered at baseline and weeks 8 and 12. Primary outcomes assessed were HRQoL using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire and physical activity using average daily steps by pedometer and 2-minute step test performance. Results: Among the 96 participants (mean age 60.4 ± 11.7) who completed the program, the majority were female, white, and married. Post-intervention median FACT-G scores significantly increased from baseline at weeks 8 (+8.8, p = 0.002) and 12 (+7.3, p < 0.001). Average daily steps by pedometer increased by 1063 (p = 0.003) and 1233 (p = 0.015) and 2-minute step test performance increased by 18 (p < 0.001) and 21 (p < 0.001) steps at weeks 8 and 12, respectively. Participants reported high levels of satisfaction and improved self-efficacy to incorporate lifestyle modifications. Conclusions: These findings suggest that this 12-week intervention improves HRQoL and step-based physical activity levels in cancer survivors and could serve as a multidimensional model for post-treatment support. Further research is needed to determine if these benefits are sustained long-term.

Response to "Built and Natural Environment Barriers and Facilitators to Physical Activity in Rural, Suburban, and Small Urban Neighborhoods".

DeGuzman et al. (2019) should be commended for their article "Built and Natural Environment Barriers and Facilitators to Physical Activity in Rural, Suburban, and Small Urban Neighborhoods." The work is a meaningful contribution to the oncology field, given the health disparity among patients with cancer living in rural and suburban communities. Nurses need to be part of the larger conversation and advocate for patients through policy reform that supports access to an equitable built environment. DeGuzman et al.'s (2019) article starts this conversation. In this letter, I wish to build on that initial conversation by deepening the discussion of built environment and costs as significant barriers to physical activity in cancer survivors.

Predicting physical activity among cancer survivors: Meta-analytic path modeling of longitudinal studies.

We conducted meta-analyses and meta-analytic structural equation modeling of longitudinal studies among cancer survivors to (a) quantify associations between psychosocial predictors and physical activity, (b) test how psychosocial predictors combine to influence physical activity, and (c) identify study, demographic, and clinical characteristics that moderate associations. Eligible studies used a longitudinal, observational design, included a sample of cancer survivors, and measured both a psychosocial predictor at baseline and physical activity at a later time-point. Of 2,431 records located through computerized searches, 25 independent tests (N = 5,897) met the inclusion criteria for the review. Random effects meta-analyses and meta-analytic structural equation modeling were conducted. Eight psychosocial predictors of physical activity were identified. Self-efficacy (r+ = 0.26) and intentions (r+ = 0.33) were the strongest predictors in bivariate analyses. The structural equation models included attitudes, injunctive norms, self-efficacy, intentions, and physical activity (k = 22, N = 4,385). The model with the best fit, χ2(2) = 0.11, p = .95, root mean square error of approximation = .00, comparative fit index = 1.00, Tucker-Lewis index = 1.00, indicated that all specified paths were significant. Intentions were the strongest predictor of physical activity (β = 0.27, p < .001), and attitudes and self-efficacy were strong predictors of intentions (both βs = 0.29, ps < .001). Few significant moderators were observed. This review indicates that self-efficacy and intentions are direct predictors of physical activity in cancer survivors. Further, attitudes and norms predict physical activity through intentions. Findings inform intervention development to increase physical activity engagement among cancer survivors. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Abstract 54: Addressing Cardiovascular Health Using Artificial Intelligence: Randomized Clinical Trial to Increase Physical Activity in Cancer Survivors Using Intelligent Voice Assist (Amazon Alexa) for Patient Coaching

Importance: Physical Activity (PA) has numerous health benefits to cancer survivors, but motivation remains problematic. Coaching may increase PA and improve survivorship outcomes, but it is challenging to deliver personalized coaching at scale Objective: To determine if the use of a novel Artificial Intelligence (AI) agent delivered by smart speaker (Amazon Echo) increases PA among overweight or obese cancer survivors compared to autonomous SMS or standard health education publications Method: A single center 3-arm randomized clinical trial in Maryland, USA with 1:1:1 allocation. One-week base-line period followed by 4-week interventions. Participants were adult overweight or obese physically inactive cancer survivors (who completed their active treatments three or more months prior to the time of recruitment) with an emphasis on racial/ethnic minorities. Interventions were: (A) on-demand AI coaching using interactive digital voice assist on Amazon Echo; (B) autonomous data-driven text message via mobile phone; or (C) NCI health education materials about the benefit of PA for cancer survivors (Control). Outcome was the change in average steps per day from baseline to the end of follow-up Results: Of 90 candidates, 42 were enrolled and randomized (N=14 in each arm). 90.5% of the participants were female, 36% Black/African American, average age was 62.1(SD 9.8) years, with average BMI of 32.9(SD 5.0). The majority were breast cancer survivors (85.7%). No differences in baseline characteristics or baseline PA levels found between the groups. After 4-week intervention, only group (A) achieved significant gain in PA adding 3618.2 steps/day (95% CI: 2490.1 - 4764.2, P &lt;0.001). Group (A) also achieved significant net gain in PA compared to group (B) &amp; (C), table 1. Group (A) also peaked around 10k steps/day each week, figure 1. Conclusions: Using AI voice-assist may be a practical method to deliver scalable individualized behavioral health coaching to address cardiovascular health in cancer survivors.

Original Research: Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors

The American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention recommend an adequate level of physical activity for cancer prevention and survivorship. Many adults have been diagnosed with arthritis, with a significantly higher rate in women. People with arthritis tend to be less physically active than those without arthritis, and are less likely to engage in moderate or vigorous activity. The proportion of adults meeting ACS physical activity guidelines is especially low among those with arthritis. We wanted to explore the extent to which arthritis-related functional limitations are predictive of inadequate physical activity in female adult cancer survivors after accounting for other known predictors. Data included in the analyses were from a sample of 729 adult women diagnosed with cancer who participated in the U.S. National Health and Nutrition Examination Survey between 2011 and 2016. Inadequate physical activity was defined as not meeting ACS physical activity guidelines. Bivariate and multivariate logistic regression analyses were conducted to identify correlates of inadequate physical activity. Being age 65 years or older, having no more than a high school education, being overweight or obese, being clinically depressed, and having arthritis-related functional limitations were found to be significant correlates of inadequate physical activity in the study population. Our results indicate that, in addition to previously identified predictors of inadequate physical activity in cancer survivors, having arthritis-related functional limitations is a significant predictor of inadequate physical activity in female adult cancer survivors. Assessment and management of arthritis-related functional limitations by health care providers are needed to facilitate successful adherence to physical activity guidelines.

Nutrition and physical activity recommendations for cancer survivors in Scotland: Feasibility of a short course to promote behaviour change

AbstractMore people are living for longer following a cancer diagnosis; however, long‐term survivors are more likely to experience chronic illnesses. Improving their diet and physical activity behaviours may increase survival and reduce the risk of cancer recurrence and other non‐communicable diseases. The World Cancer Research Fund and American Institute for Cancer Research recommend that cancer survivors aim to be a healthy weight and physically active; eat a diet rich in wholegrains, vegetables, fruits and beans; limit consumption of ‘fast foods’, red and processed meat, sugar‐sweetened drinks and alcohol; and meet nutritional needs through diet alone rather than relying on supplements. Evidence suggests that cancer survivors are receptive to receiving advice and making dietary and physical activity changes, but barriers to improving the diet and being physically active need to be explored and addressed. We collaborated with CLAN Cancer Support (an independent charity) to assess the feasibility of a 2‐day course designed to improve diet and physical activity in cancer survivors in Scotland. Further, it explored the barriers and facilitators that cancer survivors identify in relation to eating a healthy diet and being physically active. The course included presentations, practical activities and group discussions. Initial analysis indicates that factors specific to this population need to be designed into the delivery of the course to enhance recruitment and promote behaviour change. Research then needs to be translated into sustainable support programmes accessible by all cancer survivors. This article describes the rationale behind the study, its design and expected outcomes.

Effect of respiratory muscle training on physical performance in a group of patients with Hodgkin's and Non-Hodgkin's lymphoma

In recent years, studies have tried to find the positive benefits of regular and controlled physical activity for cancer survivors. The purpose of this study was to examine the potential effects of respiratory training (RT) in a group of hematological patients. Nine Hodgkin's lymphoma and two Non- Hodgkin's lymphoma cancer survivors (mean ± SD age: 55.1 ± 14.8 years, height: 172.0 ± 9.49 cm, body mass 76.09 ± 19.48 kg) participated in the study. All participants had finished their main oncological treatment (only chemotherapy or chemotherapy and radiotherapy) one to three months before the study. The respiratory training was realized with Threshold® IMT/PEP. During the training, the resistance level was set up to 30 % of discovered maximum inspiration pressure (MIP)/maximum expiration pressure (MEP) (in a range of 5–20 cmH2O). The respiratory training lasted eight weeks, and patients performed an intervention on a daily basis.The results of this study did show that RT shows a significant increase in forced vital capacity (FVC) (+7.73%), MIP (+31.21%) and MEP (+14.50%). This study concludes that RT can have the positive effect on next regular and prescribed physical activity for cancer survivors.

Przygotowanie studentów i nauczycieli wychowania fizycznego do pracy z dziećmi z chorobą nowotworową

&lt;span&gt;Nauczyciel wychowania fizycznego we współczesnej szkole powinien posiadać szereg kompetencji do pracy z uczniem z chorobą przewlekłą, w tym z uczniem po zakończonej terapii przeciwnowotworowej. Rola aktywności fizycznej dla ozdrowieńców z choroby nowotworowej jest ogromna. Dlatego też uczeń ten nie powinien być zwalniany z uczestnictwa w szkolnym wychowaniu fizycznym, ale należy dołożyć wszelkich starań, aby aktywność fizyczna stała się elementem jego stylu życia do późnej starości. Celem badań jest diagnoza stanu przygotowania studentów i nauczycieli wychowania fizycznego do pracy z dzieckiem po zakończonym leczeniu przeciwnowotworowym. Grupę badanych stanowiło 172 nauczycieli wychowania fizycznego oraz 672 studentów kończących studia wychowania fizycznego. W badaniach posłużono się autorskim kwestionariuszem ankiety. Respondenci nie czują się przygotowani do pracy z dzieckiem po chorobie nowotworowej i niemal wszyscy chcieliby poszerzać swoją wiedzę w tym zakresie. Połowa badanych nie zna roli aktywności fizycznej w życiu ozdrowieńców, a około 30% nie wie, czy dzieci po zakończonej kuracji przeciwnowotworowej mogą uczestniczyć w wychowaniu fizycznym. Należy wprowadzić zmiany w procesie kształcenia nauczycieli wychowania fizycznego, aby przygotować ich do pracy z dzieckiem po chorobie nowotworowej. Należy stworzyć ofertę szkoleń podnoszących kompetencje nauczycieli wychowania fizycznego do pracy z dzieckiem z chorobą przewlekłą.&lt;/span&gt;

An Ecological Momentary Assessment Study Investigating Self-efficacy and Outcome Expectancy as Mediators of Affective and Physiological Responses and Exercise Among Endometrial Cancer Survivors.

Previous studies have shown affective and physiological states in response to exercise as predictors of daily exercise, yet little is known about the mechanism underlying such effects. To examine the mediating effects of self-efficacy and outcome expectancy on the relationships between affective and physiological responses to exercise and subsequent exercise levels in endometrial cancer survivors. Ecological momentary assessment (EMA) surveys were delivered up to eight 5- to 7-day periods over 6 months. Participants (n = 100) rated their affective and physiological states before and after each exercise session (predictors) and recorded their self-efficacy and outcome expectancy each morning (mediators). Exercise (outcome) was based on self-reported EMA surveys and accelerometer measures. A 1-1-1 multilevel mediation model was used to disaggregate the within-subject (WS) and between-subject (BS) effects. At the WS level, a more positive affective state after exercise was associated with higher self-efficacy and positive outcome expectation the next day, which in turn was associated with higher subsequent exercise levels (ps < .05). At the BS level, participants who typically had more positive affective and experienced less intense physiological sensation after exercise had higher average self-efficacy, which was associated with higher average exercise levels (ps < .05). In endometrial cancer survivors, affective experience after exercise, daily self-efficacy and positive outcome expectation help explain the day-to-day differences in exercise levels within-person. Findings from this study highlight potentials for behavioral interventions that target affective experience after exercise and daily behavioral cognitions to promote physical activity in cancer survivors' everyday lives.

Activation of NK cells in male cancer survivors by fucoidan extracted from Cladosiphon okamuranus.

Cancer survivors are highly motivated to seek information about the use of dietary supplements and complementary nutritional therapies to improve their quality of life. Fucoidan, a sulfated polysaccharide extracted from brown marine alga, exhibits a wide range of bioactivities, including anticancer activity. As natural killer (NK) cells serve an important role in defenses against tumor cells, the present study examined the effects of fucoidan extracted from Cladosiphon Okamuranus on NK cell activity in cancer survivors. A prospective, open-label clinical study was conducted on cancer survivors treated with fucoidan via oral administration; 11 cancer survivors with a performance status of 0 or 1 participated and consumed 3 g of fucoidan for 6 months. No significant changes were observed in the mean activities of NK cells in total subjects following the ingestion of fucoidan. An analysis of each sex revealed that NK cell activity was significantly increased by the ingestion of fucoidan in male, yet not female subjects. Serum fucoidan levels were markedly increased following the ingestion of fucoidan and the peak levels ranged between 30 and 198 ng/ml. Tumor markers remained within the reference range during the trial period in subjects, in whom primary tumors were eradicated by treatment. The basal values of tumor markers were elevated in three cases; tumor markers were increased in two cases and decreased in one by the ingestion of fucoidan. These findings suggest that fucoidan enhances the activation of NK cells in male cancer survivors.

Affective determinants of physical activity in cancer survivors

Objective: Research with non-cancer survivor populations finds affective variables to be important determinants of physical activity. This study assessed the ability of explicit and implicit affective variables to predict the physical activity of cancer survivors, above that accounted for by cognitive variables. The study also tested whether the affective variables were connected to physical activity directly or indirectly through their association with behavioural intentions. Design: In a cross-sectional design, cancer survivors (n = 122) completed questionnaires and an implicit affect task. Main outcome measures: Self-report measures assessed three affective variables (e.g. positive affective associations), five cognitive variables (e.g. cognitive beliefs), physical activity estimates, behavioural intentions and participants also completed an implicit affect task regarding physical activity. Results: Two of the three explicit affect variables and the implicit affect variable accounted for significant variability in physical activity estimates beyond that accounted for by the cognitive variables. Positive affective associations were the strongest predictor in multivariate analyses. Behavioural intentions did not mediate the link between the affect variables and physical activity estimates. Conclusions: Explicit and implicit affective variables are direct and unique predictors of physical activity in cancer survivors. Physical activity interventions for cancer survivors should target both explicit affect and implicit affect.

A randomised control trial and cost-consequence analysis to examine the effects of a print-based intervention supported by internet tools on the physical activity of UK cancer survivors

ObjectiveThe objective of this study was to evaluate the effectiveness of a print-based intervention supported by Internet tools at improving physical activity in cancer survivors compared with a standard letter recommendation. Prediagnosis physical activity and self-efficacy were hypothesised to predict physical activity improvement. Study designWaiting list randomised control trial and cost-consequence analysis. MethodsAdult cancer survivors who could become physically active without prior medical approval were randomised to receive either a print-based intervention supported by Internet tools (intervention, n = 104) or a standard letter recommendation (control, n = 103). Physical activity was assessed at 12 weeks with maintenance assessed at 24 weeks in the intervention arm. The number needed to treat was calculated, and a cost-consequence analysis completed. ResultsParticipants in receipt of a print-based intervention supported by Internet tools improved their physical activity by 36.9% over 12 weeks compared with 9.1% in the control arm. Physical activity was maintained at 24 weeks in the intervention arm. A total of 6.29 cancer survivors needed to receive the intervention for one cancer survivor to improve their physical activity over a standard letter recommendation. Intervention delivery cost £8.19 per person. Prediagnosis physical activity and self-efficacy did not predict physical activity improvement. ConclusionA print-based intervention supported by Internet tools offers a promising low-cost means to intervene to improve physical activity in cancer survivors.The study was registered with the International Standard Randomised Controlled Trials Number registry (registration number: 66418871), and ethical approval was received from the University of Surrey (reference: UEC/2017/023/FHMS).

Is it all in the Wrist? The Potential of Activity Trackers to Rise Physical Activity in Cancer Survivors

Is it all in the Wrist? The Potential of Activity Trackers to Rise Physical Activity in Cancer Survivors

Is it all in the Wrist? The Potential of Activity Trackers to Rise Physical Activity in Cancer Survivors

Is it all in the Wrist? The Potential of Activity Trackers to Rise Physical Activity in Cancer Survivors

Fatigue and physical activity in cancer survivors: A cross-sectional population-based study.

PurposeA substantial proportion of cancer survivors experience fatigue after diagnosis. Physical activity (PA) can impact fatigue after cancer. In this study, we evaluated the prevalence and association of fatigue and the practice of PA in a population with early cancer.MethodsUsing the national population‐based French cross‐sectional study Vie après le cancer 2, we included 1984 patients with early breast (61.1%), prostate (21.5%), and colorectal (17.4%) cancer. Severe fatigue at 2 years postdiagnosis was defined by a score ≥40 in the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ C30) fatigue subscale. PA was defined as (a) self‐reported PA before diagnosis (active/inactive) and (b) change in PA since diagnosis (increased/maintained exposure vs decreased exposure/remaining inactive). Multivariate regression examined associations of severe fatigue with PA, adjusting for baseline clinical and treatment variables.ResultsMedian age was 52 years. 51.5% of patients experienced severe fatigue 2 years post‐diagnosis. 87.7% reported to be physically active before cancer diagnosis; 53.3% of patients either decreased PA or remained inactive at 2 years postdiagnosis. At 2 years postdiagnosis, severe fatigue was associated with a change in PA since diagnosis: patients with decreasing PA/remaining inactive from pre‐ to postdiagnosis had a higher risk of severe fatigue vs those with increasing/maintaining PA (adjusted odds ratio [95% confidence interval] 2.32 [1.85‐2.90]).ConclusionFatigue continues to be a substantial problem for cancer survivors 2 years after cancer diagnosis and is associated with PA decreasing/remaining inactive since diagnosis. Interventions to maintain or increase PA for cancer survivors should be tested to mitigate long‐term fatigue after cancer.

Group-based exercise interventions for increasing physical activity in cancer survivors: a systematic review of face-to-face randomized and non-randomized trials.

To increase physical activity (PA), interventions based on group dynamics may be superior to interventions that target aggregates of people but do not have formal strategies to enhance cohesion. This review examined the extent to which group dynamics processes have been integrated within exercise and/or PA interventions in cancer survivors, and explored the implementation and effectiveness of these interventions for increasing PA. A systematic review was conducted of English articles published January 2005-March 13, 2017 using the electronic databases PsycINFO, CINAHL, and PubMed Medline (National Library of Medicine). Studies in adult cancer survivors that had a controlled or uncontrolled experimental design, included face-to-face exercise, had a group-based component, and reported PA pre- and post-intervention were included. Self-reported PA effect sizes were estimated for pre- to post-intervention, separately for studies that implemented ≥ 1 group dynamics strategy versus none. Twenty-three studies were reviewed, 34.8% (n = 8) included ≥ 1 group dynamics strategy (M = 1.6 ± 0.7, range = 1-3). Most interventions were delivered in a healthcare or rehabilitation setting by an exercise professional, and face-to-face exercise dose ranged from 72.0-6000.0min. PA effect size ranged from 0.3-1.2 for studies that implemented ≥ 1 group dynamics strategy versus 0.4-2.4 for those with none. Studies reviewed lacked detailed examples of group dynamics strategies, and none measured group cohesion. The additional benefit of group dynamics-based interventions for increasing PA in cancer survivors remains unclear. More research is needed to enhance the generalizability of face-to-face exercise interventions, and determine how to maximize the potential of including group dynamics strategies.

Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials.

PurposeThe purpose of this systematic review and meta-analysis is to investigate how physical activity (PA) can be effectively promoted in cancer survivors. The effect of PA-promoting interventions in general, behavior change techniques (BCTs), and further variables as moderators in particular are evaluated.MethodsThis study included randomized controlled trials of lifestyle interventions aiming at an increase in PA that can be carried out independently at home, published by December 2016, for adults diagnosed with cancer after completion of the main treatment. Primary outcomes were subjective and objective measures of PA prior to and immediately after the intervention. Meta-analysis and meta-regression were used to estimate effect sizes (ES) in terms of standardized mean differences, variation between ES in terms of heterogeneity indices (I2), and moderator effects in terms of regression coefficients.ResultsThis study included 30 studies containing 45 ES with an overall significant small positive effect size of 0.28 (95% confidence interval=0.18–0.37) on PA, and I2=54.29%. The BCTs Prompts, Reduce prompts, Graded tasks, Non-specific reward, and Social reward were significantly related to larger effects, while Information about health consequences and Information about emotional consequences, as well as Social comparison were related to smaller ES. The number of BCTs per intervention did not predict PA effects. Interventions based on the Theory of Planned Behavior were associated with smaller ES, and interventions with a home-based setting component were associated with larger ES. Neither the duration of the intervention nor the methodological quality explained differences in ES.ConclusionCertain BCTs were associated with an increase of PA in cancer survivors. Interventions relying on BCTs congruent with (social) learning theory such as using prompts and rewards could be especially successful in this target group. However, large parts of between-study heterogeneity in ES remained unexplained. Further primary studies should directly compare specific BCTs and their combinations.

Motivational interviewing added to oncology rehabilitation did not improve moderate-intensity physical activity in cancer survivors: a randomised trial.

Does adding weekly, physiotherapist-delivered motivational interviewing to outpatient oncology rehabilitation for cancer survivors increase physical activity levels and improve physical and psychosocial outcomes that are typically impaired in this cohort? Randomised controlled trial with blinded outcome assessment, concealed allocation and intention-to-treat analysis. A heterogeneous sample of 46 cancer survivors (n=29 female; mean age 59 years) participating in a public outpatient oncology rehabilitation program. Participants were randomly allocated to receive oncology rehabilitation (n=24) or oncology rehabilitation with motivational interviewing delivered once weekly for 7 weeks via telephone by a physiotherapist (n=22). The primary outcome was amount of physical activity of at least moderate intensity completed in 10-minute bouts, measured by an accelerometer worn continuously for 1 week. Secondary outcomes included other measures of physical activity, sedentary behaviour, physical function, psychosocial function, and quality of life. When added to oncology rehabilitation, motivational interviewing caused no appreciable increase in the amount of moderate-intensity physical activity (MD -1.2 minutes/day, 95% CI -2.5 to 0.02). Among many secondary outcomes, the only statistically significant result was a small effect on nausea, which probably represents a Type I error. However, several secondary outcomes related to lower-intensity physical activity had non-significant confidence intervals that included large effects such as: sedentary time (SMD -0.67, 95% CI -1.32 to 0.02), light-intensity physical activity (SMD 0.56, 95% CI -0.12 to 1.21) and daily step count (SMD 0.37, 95% CI -0.30 to 1.02). Adding motivational interviewing to oncology rehabilitation did not increase moderate-intensity physical activity. Favourable trends on measures of lower-intensity physical activity suggest that motivational interviewing should be further investigated for its effects on reducing sedentary time and improving light-intensity physical activity for cancer survivors participating in rehabilitation. ANZCTR 12616001079437. [Dennett AM, Shields N, Peiris CL, Prendergast LA, O'Halloran PD, Parente P, Taylor NF (2018) Motivational interviewing added to oncology rehabilitation did not improve moderate-intensity physical activity in cancer survivors: a randomised trial. Journal of Physiotherapy 64: 255-263].

PS02.171: STUDY OF LONG TERM FOLLOW-UP OF EXERCISE LEVELS FOLLOWING PARTICIPATION IN A PREHABILITATION PROGRAMME IN OESOPHAGO-GASTRIC (OG) CANCER SURGERY

Abstract Background Sedentary behaviour is emerging as an important field of scientific enquiry for cancer survivorship research. The aim of this study is to evaluate the impact of PREPARE, a multi-modal pre-operative optimization programme, and the impact this has on sustained activity following completion of cancer treatment. Methods 66 patients were approached in clinic or sent letters to consent for the study. Median follow up time was 14 months. Patients either consented to telephone questionnaire or exercise testing or both. Telephone questionnaire included the validated Godin-Shephard Leisure-Time physical activity questionnaire in oncology, and exercise testing included the validated Chester-Step test, to obtain an accurate METS score. Scores were calculated at baseline (P1), 6–8 weeks postoperative (P4) and at follow up. Results 66 patients were included in the study. Of these, 13 (19%) patients were excluded due to disease progression, death or declined to participate. The remaining 43 (65%) who were included in the study either consented for telephone questionnaire (74%) or exercise testing (60%) or both. Median follow up time was 14 months since surgery. Majority of the patients remained active at follow up; 23 (77%) were active, 5 (16%) were moderately active and, 4 (12%) were insufficiently active/sedentary. Overall, the median weekly METS scores were 5.8 (equivalent moderate intensity activity). On exercise testing, there was an improvement in median METS scores. At P1, baseline median METS were 5.0, at P4 5.0 and at 14 months 6.5. There was an overall increase in median self-efficacy scores. At P1, baseline scores were 8.3, at P4 8.5 and at 14 months 9. Conclusion There is emerging evidence to support the benefits of physical activity in cancer survivors and the impact this has on overall survival, quality of life and symptomatology. Starting prehabilitation at the time of diagnosis leads to improved confidence and sustained activity levels in the post-treatment period. Disclosure All authors have declared no conflicts of interest.

The Promoting Activity in Cancer Survivors (PACES) trial: a multiphase optimization of strategy approach to increasing physical activity in breast cancer survivors

BackgroundDespite the significant, empirically supported benefits of physical activity, the majority of breast cancer survivors do not meet recommended guidelines for physical activity. A variety of effective strategies to increase physical activity in breast cancer survivors have been identified. However, it is unknown which of these strategies is most effective or how these strategies might be combined to optimize intervention effectiveness.MethodsThe proposed trial uses multiphase optimization strategy (MOST) to evaluate four evidence-based intervention strategies for increasing physical activity in breast cancer survivors. We will enroll 500 breast cancer survivors, age 18 and older, who are 3-months to 5 years post-treatment. Using a full-factorial design, participants will be randomized to receive a combination: 1) supervised exercise, 2) facility access, 3) self-monitoring, and 4) group-based active living counseling. The primary outcome, moderate-to-vigorous physical activity (MVPA) will be measured at baseline, 3 months, and 6 months using an Actigraph GT3X+. To evaluate intervention effects, a linear mixed-effects model will be conducted with MVPA as the outcome and with time (3 months and 6 months) as the within-subjects factor and intervention (i.e., supervised exercise, facility access, self-monitoring, and active living counseling) as the between subjects factor, along with all two-way interactions.DiscussionThe purpose of the PACES study is to evaluate multiple strategies for increasing physical activity in breast cancer survivors. Results of this study will provide in an optimized intervention for increasing physical activity in breast cancer survivors.Trial registrationClinicaltrials.gov Identifier: NCT03060941. Registered February 23, 2017.