Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.
BMC Cancer. 2021 Nov 25;21(1):1272. doi: 10.1186/s12885-021-08996-x.
Current knowledge about the promotion of long-term physical activity (PA) maintenance in cancer survivors is limited. The aims of this study were to 1) determine the effect of self-regulatory BCTs on long-term PA maintenance, and 2) identify predictors of long-term PA maintenance in cancer survivors 12 months after participating in a six-month exercise intervention during cancer treatment.
In a multicentre study with a 2 × 2 factorial design, the Phys-Can RCT, 577 participants with curable breast, colorectal or prostate cancer and starting their cancer treatment, were randomized to high intensity exercise with or without self-regulatory behaviour change techniques (BCTs; e.g. goal-setting and self-monitoring) or low-to-moderate intensity exercise with or without self-regulatory BCTs. Participants' level of PA was assessed at the end of the exercise intervention and 12 months later (i.e. 12-month follow-up), using a PA monitor and a PA diary. Participants were categorized as either maintainers (change in minutes/week of aerobic PA ≥ 0 and/or change in number of sessions/week of resistance training ≥0) or non-maintainers. Data on potential predictors were collected at baseline and at the end of the exercise intervention. Multiple logistic regression analyses were performed to answer both research questions.
A total of 301 participants (52%) completed the data assessments. A main effect of BCTs on PA maintenance was found (OR = 1.80, 95%CI [1.05-3.08]) at 12-month follow-up. Participants reporting higher health-related quality-of-life (HRQoL) (OR = 1.03, 95%CI [1.00-1.06] and higher exercise motivation (OR = 1.02, 95%CI [1.00-1.04]) at baseline were more likely to maintain PA levels at 12-month follow-up. Participants with higher exercise expectations (OR = 0.88, 95%CI [0.78-0.99]) and a history of tobacco use at baseline (OR = 0.43, 95%CI [0.21-0.86]) were less likely to maintain PA levels at 12-month follow-up. Finally, participants with greater BMI increases over the course of the exercise intervention (OR = 0.63, 95%CI [0.44-0.90]) were less likely to maintain their PA levels at 12-month follow-up.
Self-regulatory BCTs improved PA maintenance at 12-month follow-up and can be recommended to cancer survivors for long-term PA maintenance. Such support should be considered especially for patients with low HRQoL, low exercise motivation, high exercise expectations or with a history of tobacco use at the start of their cancer treatment, as well as for those gaining weight during their treatment. However, more experimental studies are needed to investigate the efficacy of individual or combinations of BCTs in broader clinical populations.
NCT02473003 (10/10/2014).
目前关于促进癌症幸存者长期身体活动（PA）维持的知识有限。本研究的目的是：1）确定自我调节行为改变技术（BCTs）对长期 PA 维持的影响；2）确定癌症幸存者在参加癌症治疗期间的 6 个月运动干预后 12 个月时长期 PA 维持的预测因素。
在一项具有 2×2 析因设计的多中心研究（Phys-Can RCT）中，招募了 577 名患有可治愈的乳腺癌、结直肠癌或前列腺癌且正在接受癌症治疗的参与者，随机分配到高强度运动加或不加自我调节行为改变技术（如目标设定和自我监测）或低到中等强度运动加或不加自我调节 BCTs。参与者的 PA 水平在运动干预结束时和 12 个月后（即 12 个月随访）使用 PA 监测仪和 PA 日记进行评估。参与者被归类为维持者（有氧运动每周分钟数变化≥0 和/或抗阻训练每周次数变化≥0）或非维持者。在基线和运动干预结束时收集了潜在预测因素的数据。使用多因素逻辑回归分析回答了两个研究问题。
共有 301 名参与者（52%）完成了数据评估。在 12 个月随访时，BCTs 对 PA 维持有显著的主效应（OR=1.80，95%CI[1.05-3.08]）。在基线时报告更高的健康相关生活质量（HRQoL）（OR=1.03，95%CI[1.00-1.06]）和更高的运动动机（OR=1.02，95%CI[1.00-1.04]）的参与者更有可能在 12 个月随访时维持 PA 水平。在基线时报告更高的运动期望（OR=0.88，95%CI[0.78-0.99]）和有吸烟史（OR=0.43，95%CI[0.21-0.86]）的参与者不太可能在 12 个月随访时维持 PA 水平。最后，在运动干预过程中 BMI 增加较多的参与者（OR=0.63，95%CI[0.44-0.90]）不太可能在 12 个月随访时维持 PA 水平。
自我调节 BCTs 可提高 12 个月随访时的 PA 维持率，可推荐给癌症幸存者以促进长期 PA 维持。对于 HRQoL 较低、运动动机较低、运动期望较高或在癌症治疗开始时吸烟史的患者，以及在治疗过程中体重增加的患者，应考虑提供此类支持。然而，需要更多的实验研究来调查在更广泛的临床人群中使用单个或组合 BCT 的疗效。
NCT02473003（2014 年 10 月 10 日）。
