Courneya Kerry S, Segal Roanne J, Gelmon Karen, Reid Robert D, Mackey John R, Friedenreich Christine M, Proulx Caroline, Lane Kirstin, Ladha Aliya B, Vallance Jeffrey K, McKenzie Donald C
Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada.
Med Sci Sports Exerc. 2008 Jun;40(6):1180-7. doi: 10.1249/MSS.0b013e318168da45.
Exercise adherence is difficult during cancer treatments, but few studies have examined the predictors of such exercise. Here, we report the predictors of adherence to supervised exercise training during breast cancer chemotherapy.
Breast cancer patients (N = 242) initiating adjuvant chemotherapy in Edmonton, Ottawa, and Vancouver were randomly assigned to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy. Baseline data on standard demographic, medical, behavioral, fitness, and psychosocial variables as well as motivational variables from the Theory of Planned Behavior were collected. Adherence was assessed by objective attendance records.
Adherence to supervised exercise was 70.2%. Univariate analyses indicated significant or borderline significant associations between exercise adherence and location/center (r = 0.30; P < 0.001), V[spacing dot above]O2peak (r = 0.21; P = 0.008), muscular strength (r = 0.21; P = 0.008), percent body fat (r = -0.21; P = 0.012), disease stage (r = 0.17; P = 0.031), education (r = 0.15; P = 0.053), depression (r = -0.14; P = 0.073), and smoking (r = -0.14; P = 0.081). In multivariate analysis, location/center (beta = 0.28; P = 0.001), V[spacing dot above]O2peak ([beta] = 0.19; P = 0.016), disease stage (beta = 0.18; P = 0.015), and depression (beta = -0.16; P = 0.033) remained significant and explained 21% of the variance in exercise adherence. Participants in Vancouver, with higher aerobic fitness, more advanced disease stage, and lower depression, achieved better adherence.
Adherence to supervised exercise training was predicted by unique aspects of the location/center, disease stage, aerobic fitness, and depression but not motivational variables. Location/center in our trial may have been a proxy for the amount of one-on-one attention received during supervised exercise. These findings may have implications for improving adherence during breast cancer chemotherapy.
在癌症治疗期间坚持锻炼很困难，但很少有研究探讨此类锻炼的预测因素。在此，我们报告乳腺癌化疗期间坚持接受监督性运动训练的预测因素。
在埃德蒙顿、渥太华和温哥华开始辅助化疗的乳腺癌患者（N = 242）在化疗期间被随机分配至常规护理组（n = 82）、监督性抗阻运动组（n = 82）或监督性有氧运动组（n = 78）。收集了关于标准人口统计学、医学、行为、体能和心理社会变量以及计划行为理论中的动机变量的基线数据。通过客观出勤记录评估依从性。
监督性运动的依从率为70.2%。单因素分析表明，运动依从性与地点/中心（r = 0.30；P < 0.001）、最大摄氧量（r = 0.21；P = 0.008）、肌肉力量（r = 0.21；P = 0.008）、体脂百分比（r = -0.21；P = 0.012）、疾病分期（r = 0.17；P = 0.031）、教育程度（r = 0.15；P = 0.053）、抑郁（r = -0.14；P = 0.073）和吸烟（r = -0.14；P = 0.081）之间存在显著或临界显著关联。在多因素分析中，地点/中心（β = 0.28；P = 0.001）、最大摄氧量（β = 0.19；P = 0.016）、疾病分期（β = 0.18；P = 0.015）和抑郁（β = -0.16；P = 0.033）仍然显著，并解释了运动依从性变异的21%。温哥华的参与者，有氧适能较高、疾病分期较晚且抑郁程度较低，依从性更好。
监督性运动训练的依从性可由地点/中心、疾病分期、有氧适能和抑郁的独特方面预测，而非动机变量。我们试验中的地点/中心可能是监督性运动期间获得的一对一关注量的替代指标。这些发现可能对改善乳腺癌化疗期间的依从性有影响。
