Department of Psychology and Educational Sciences, Open University of the Netherlands, PO Box 2960, 6401 DL, Heerlen, The Netherlands.
Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
Int J Behav Nutr Phys Act. 2018 Oct 30;15(1):106. doi: 10.1186/s12966-018-0734-9.
Physical activity (PA) is beneficial in improving negative physical and psychological effects of cancer and cancer treatment, but adherence to PA guidelines is low. Computer-tailored PA interventions can reach large populations with little resources. They match with patients' preference for home-based, unsupervised PA programs and are thus promising for the growing population of cancer survivors. The current study assessed the efficacy of a computer-tailored PA intervention in (four subgroups of) prostate and colorectal cancer survivors.
Prostate and colorectal cancer patients and survivors were randomized to the OncoActive intervention group (N = 249), or a usual-care waiting-list control group (N = 229). OncoActive participants received a pedometer and computer-tailored PA advice, both Web-based via an interactive website and with printed materials. Minutes moderate-to-vigorous PA (MVPA) and days ≥30 min PA were assessed with an accelerometer (ActiGraph) at baseline and 6 months. Further, questionnaires were used to assess self-reported PA, fatigue, distress, and quality of life at baseline, 3 and 6 months. Differences between both groups were assessed using linear regression analyses (complete cases and intention-to-treat). In addition, efficacy in relation to age, gender, education, type of cancer, and time since treatment was examined.
Three months after baseline OncoActive participants significantly increased their self-reported PA (PA days: d = 0.46; MVPA: d = 0.23). Physical functioning (d = 0.23) and fatigue (d = - 0.21) also improved significantly after three months. Six months after baseline, self-reported PA (PA days: d = 0.51; MVPA: d = 0.37) and ActiGraph MVPA (d = 0.27) increased significantly, and ActiGraph days (d = 0.16) increased borderline significantly (p = .05; d = 0.16). Furthermore, OncoActive participants reported significantly improvements in physical functioning (d = 0.14), fatigue (d = - 0.23) and depression (d = - 0.32). Similar results were found for intention-to-treat analyses. Higher increases in PA were found for colorectal cancer participants at 3 months, and for medium and highly educated participants' PA at 6 months. Health outcomes at 6 months were more prominent in colorectal cancer participants and in women.
The OncoActive intervention was effective at increasing PA in prostate and colorectal cancer patients and survivors. Health-related effects were especially apparent in colorectal cancer participants. The intervention provides opportunities to accelerate cancer recovery. Long-term follow-up should examine further sustainability of these effects.
The study was registered in the Dutch Trial Register ( NTR4296 ) on October 17 2018.
身体活动(PA)有益于改善癌症和癌症治疗的负面生理和心理影响,但对 PA 指南的遵循率较低。计算机量身定制的 PA 干预措施可以用很少的资源覆盖大量人群。它们符合患者对基于家庭、无需监督的 PA 计划的偏好,因此对不断增长的癌症幸存者群体具有很大的潜力。本研究评估了计算机量身定制的 PA 干预措施在前列腺癌和结直肠癌幸存者(四个亚组)中的疗效。
前列腺癌和结直肠癌患者和幸存者被随机分配到 OncoActive 干预组(N=249)或常规护理等待名单对照组(N=229)。OncoActive 参与者通过互动网站和印刷材料获得计步器和计算机量身定制的 PA 建议,这两种方式均基于网络。在基线和 6 个月时使用加速度计(ActiGraph)评估中等至剧烈 PA(MVPA)和≥30 分钟 PA 的天数。此外,在基线、3 个月和 6 个月时使用问卷评估自我报告的 PA、疲劳、困扰和生活质量。使用线性回归分析(完整案例和意向治疗)评估两组之间的差异。此外,还检查了与年龄、性别、教育程度、癌症类型和治疗后时间相关的疗效。
基线后 3 个月,OncoActive 参与者的自我报告 PA 显著增加(PA 天数:d=0.46;MVPA:d=0.23)。三个月后,身体机能(d=0.23)和疲劳(d=-0.21)也显著改善。基线后 6 个月,自我报告的 PA(PA 天数:d=0.51;MVPA:d=0.37)和 ActiGraph MVPA(d=0.27)显著增加,ActiGraph 天数(d=0.16)也略有显著增加(p=0.05;d=0.16)。此外,OncoActive 参与者报告身体机能(d=0.14)、疲劳(d=-0.23)和抑郁(d=-0.32)显著改善。意向治疗分析也得出了类似的结果。3 个月时,结直肠癌参与者的 PA 增加幅度较高,6 个月时,中等和高学历参与者的 PA 增加幅度较高。6 个月时的健康结果在结直肠癌参与者和女性中更为明显。
OncoActive 干预措施在增加前列腺癌和结直肠癌患者和幸存者的 PA 方面是有效的。健康相关的效果在结直肠癌参与者中尤为明显。该干预措施为加速癌症康复提供了机会。长期随访应进一步检查这些效果的可持续性。
该研究于 2018 年 10 月 17 日在荷兰试验注册中心(NTR4296)注册。