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一项随机试验后乳腺癌幸存者身体活动的维持情况

Maintenance of physical activity in breast cancer survivors after a randomized trial.

作者信息

Vallance Jeffrey K, Courneya Kerry S, Plotnikoff Ronald C, Dinu Irina, Mackey John R

机构信息

Faculty of Physical Education and Recreation, Cross Cancer Institute, University of Alberta, Edmonton, Canada.

出版信息

Med Sci Sports Exerc. 2008 Jan;40(1):173-80. doi: 10.1249/mss.0b013e3181586b41.

Abstract

PURPOSE

The purpose of this study was to examine the longer-term effects of pedometers and print materials on changes in physical activity (PA) and health-related quality of life (HRQoL) in breast cancer survivors who participated in a 3-month behavior change intervention.

METHODS

Breast cancer survivors (N = 377) were randomly assigned to receive either (a) a standard public health recommendation for PA (SR), (b) previously developed breast cancer-specific PA print materials (PM), (c) a step pedometer (PED), or (d) a combination of the two (COM). The primary endpoint was self-reported moderate/vigorous PA minutes per week at 6-month follow-up after the initial 3-month intervention period.

RESULTS

Seventy-one percent (266/377) of participants completed the 6-month follow-up assessment. According to intention-to-treat linear mixed-model analyses, self-reported moderate to vigorous PA increased by 9 min x wk(-1) in the SR group compared with 39 min x wk(-1) in the PM group (mean difference = 30 min x wk(-1); 95% CI = -44 to 104; P = 0.425), 69 min x wk(-1) in the PED group (mean difference = 60 min x wk(-1); 95% CI = -13 to 132; P = 0.107), and 56 min x wk(-1) in the COM group (mean difference = 47 min x wk(-1); 95% CI = -26 to 119; P = 0.210). The same pattern was observed for self-reported, brisk walking. No differences were found for HRQoL or fatigue.

CONCLUSION(S): Breast cancer-specific PM and PED did not maintain significantly higher PA or HRQoL at 6-month follow-up in breast cancer survivors, but the magnitude of the effect on PA (30-60 min x wk(-1)) was consistent with the immediate postintervention effect observed at the 3-month postintervention time point. Issues of power resulting from additional loss to follow-up may account for the failure to achieve statistical significance. Additional research with larger sample sizes and more complete follow-up is warranted.

摘要

目的

本研究旨在探讨计步器和印刷材料对参与了为期3个月行为改变干预的乳腺癌幸存者身体活动(PA)变化及健康相关生活质量(HRQoL)的长期影响。

方法

乳腺癌幸存者(N = 377)被随机分配接受以下干预措施之一:(a)关于身体活动的标准公共卫生建议(SR);(b)先前制定的针对乳腺癌患者的身体活动印刷材料(PM);(c)一个计步器(PED);或(d)两者结合(COM)。主要终点是在最初3个月干预期后的6个月随访时自我报告的每周中等强度/剧烈身体活动分钟数。

结果

71%(266/377)的参与者完成了6个月的随访评估。根据意向性分析的线性混合模型分析,自我报告的中等至剧烈身体活动在SR组中增加了9分钟×周⁻¹,而在PM组中增加了39分钟×周⁻¹(平均差异 = 30分钟×周⁻¹;95%置信区间 = -44至104;P = 0.425),在PED组中增加了69分钟×周⁻¹(平均差异 = 60分钟×周⁻¹;95%置信区间 = -13至132;P = 0.107),在COM组中增加了56分钟×周⁻¹(平均差异 = 47分钟×周⁻¹;95%置信区间 = -26至119;P = 0.210)。自我报告的快走情况也呈现相同模式。在健康相关生活质量或疲劳方面未发现差异。

结论

针对乳腺癌患者的印刷材料和计步器在6个月随访时并未使乳腺癌幸存者的身体活动或健康相关生活质量显著维持在较高水平,但对身体活动的影响幅度(30 - 60分钟×周⁻¹)与干预后3个月时间点观察到的即时干预效果一致。因更多失访导致的效能问题可能是未达到统计学显著性的原因。有必要进行样本量更大且随访更完整的进一步研究。

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