JMIR Publications

ABSTRACT

Background:

Sedentary behavior among breast cancer survivors is associated with increased risk of poor physical function and worse quality of life. While moderate to vigorous physical activity can improve outcomes for cancer survivors, many are unable to engage in that intensity of physical activity. Decreasing sitting time may be a more feasible behavioral target to potentially mitigate the impact of cancer and its treatments.

Objective:

The purpose of the study was to investigate the feasibility and preliminary impact of an intervention to reduce sitting time on changes to physical function and quality of life in breast cancer survivors, from baseline to a 3-month follow-up.

Methods:

Female breast cancer survivors with self-reported difficulties with physical function received one on one in-person personalized health coaching sessions aimed at reducing sitting time. At baseline and follow-up, participants wore the activPAL (thigh-worn accelerometer) for 3 months and completed physical function tests (4-Meter Walk Test, Timed Up and Go, and 30-Second Chair Stand) and PROMIS self-reported outcomes. Changes in physical function and sedentary behavior outcomes were assessed by linear mixed models.

Results:

On average, participants (N=20) were 64.5 years old (SD=9.4), had a BMI 30.4 kg/m2 (SD=4.5), and identified as Non-Hispanic and White (55%), Hispanic/Latina (20%), and Black/African American (15%). Average time since diagnosis was 5.8 years (SD=2.2) with participants receiving chemotherapy (40%), radiotherapy (90%), and/or endocrine therapy (85%). The intervention led to significant reductions in sitting time: activPAL average daily sitting time decreased from 645.7 to 532.7 minutes (β=-112.9, P=.001) and average daily long sitting bouts (bout length ≥20minute) decreased from 468.3 to 366.9 minutes (β=-101.4, P=.002). All physical function tests had significant improvements: on average, 4-Meter Walk Test decreased from 4.23 to 3.61 seconds (β=-0.63, P=.002), Timed Up and Go decreased from 10.30 to 8.84 seconds (β=-1.46, P=.003) and 30-Second Chair Stand performance increased from 9.75 to 13.20 completions (β=3.45, p<.0001). PROMIS self-reported physical function score improved from 44.59 to 47.12 (β=2.53, P=.05) and average fatigue decreased from 52.51 to 47.73 (β=-4.78, P=.02).

Conclusions:

This 3-month pilot study suggests that decreasing time spent sitting may be helpful for breast cancer survivors experiencing difficulties with physical function and fatigue. Reducing sitting time is a novel and potentially more feasible approach to improving health and quality of life in cancer survivors. Clinical Trial: ClinicalTrials.gov: NCT05260723