Division of Hematology/Oncology, School of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Campus, PO Box 7305, Chapel Hill, NC, 27599-7305, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Breast Cancer Res Treat. 2018 Feb;168(1):43-55. doi: 10.1007/s10549-017-4565-1. Epub 2017 Nov 9.
Ensuring and measuring adherence to prescribed exercise regimens are fundamental challenges in intervention studies to promote exercise in adults with cancer. This study reports exercise adherence in women who were asked to walk 150 min/week throughout chemotherapy treatment for early breast cancer. Participants were asked to wear a Fitbit throughout their waking hours, and Fitbit steps were uploaded directly into study computers.
Descriptive statistics are reported, and both unadjusted and multivariable linear regression models were used to assess associations between participant characteristics, breast cancer diagnosis, treatment, chemotherapy toxicities, and patient-reported symptoms with average Fitbit steps/week.
Of 127 women consented to the study, 100 had analyzable Fitbit data (79%); mean age was 48 and 31% were non-white. Mean walking steps were 3956 per day. Nineteen percent were fully adherent with the target of 6686 steps/day and an additional 24% were moderately adherent. In unadjusted analysis, baseline variables associated with fewer Fitbit steps were: non-white race (p = 0.012), high school education or less (p = 0.0005), higher body mass index (p = 0.0024), and never/almost never drinking alcohol (p = 0.0048). Physical activity variables associated with greater Fitbit steps were: pre-chemotherapy history of vigorous physical activity (p = 0.0091) and higher self-reported walking minutes/week (p < 0.001), and higher outcome expectations from exercise (p = 0.014). Higher baseline anxiety (p = 0.03) and higher number of chemotherapy-related symptoms rates "severe/very severe" (p = 0.012) were associated with fewer steps. In multivariable analysis, white race was associated with 12,146 greater Fitbit steps per week (p = 0.004), as was self-reported walking minutes prior to start of chemotherapy (p < 0.0001).
Inexpensive commercial-grade activity trackers, with data uploaded directly into research computers, enable objective monitoring of home-based exercise interventions in adults diagnosed with cancer. Analysis of the association of walking steps with participant characteristics at baseline and toxicities during chemotherapy can identify reasons for low/non-adherence with prescribed exercise regimens.
确保并衡量患者对规定运动方案的依从性是促进癌症成人运动的干预研究中的基本挑战。本研究报告了在接受早期乳腺癌化疗期间被要求每周步行 150 分钟的女性的运动依从性。参与者被要求在清醒时佩戴 Fitbit 设备，然后将 Fitbit 数据直接上传到研究电脑中。
报告描述性统计数据，并使用未调整和多变量线性回归模型评估参与者特征、乳腺癌诊断、治疗、化疗毒性和患者报告的症状与平均 Fitbit 每周步数之间的关联。
在同意参加该研究的 127 名女性中，有 100 名女性的 Fitbit 数据可分析（79%）；平均年龄为 48 岁，31%为非白人。平均每天行走 3956 步。19%的人完全遵守每天 6686 步的目标，另外 24%的人属于中度依从。在未调整分析中，与 Fitbit 步数较少相关的基线变量包括：非白人种族（p=0.012）、高中或以下学历（p=0.0005）、较高的体重指数（p=0.0024）和从不/几乎不饮酒（p=0.0048）。与 Fitbit 步数较多相关的身体活动变量包括：化疗前剧烈体力活动史（p=0.0091）和较高的自我报告每周步行分钟数（p<0.001），以及更高的锻炼预期效果（p=0.014）。较高的基线焦虑（p=0.03）和较高的化疗相关症状“严重/非常严重”发生率（p=0.012）与较低的步数相关。在多变量分析中，白人种族与每周多 12146 步 Fitbit 相关（p=0.004），化疗前自我报告的步行分钟数也与每周多 12146 步 Fitbit 相关（p<0.0001）。
廉价的商业级活动追踪器，其数据可直接上传到研究电脑，使基于家庭的癌症成人运动干预的客观监测成为可能。分析步行步数与基线时参与者特征和化疗期间毒性之间的关联，可以确定低依从或不依从规定运动方案的原因。
