重新分配久坐时间为体力活动：Phys-Can 项目中对乳腺癌患者疲劳和生活质量的影响。
Reallocating sedentary time to physical activity: effects on fatigue and quality of life in patients with breast cancer in the Phys-Can project.
机构信息
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Oncology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
出版信息
Support Care Cancer. 2023 Feb 4;31(2):151. doi: 10.1007/s00520-023-07614-9.
PURPOSE
We aimed to investigate the effects of reallocating sedentary time to an equal amount of light (LPA) or moderate-to-vigorous intensity physical activity (MVPA) on cancer-related fatigue and health-related quality of life (HRQoL) in patients with breast cancer. We also aimed to determine the daily amount of sedentary time needed to be reallocated to LPA or MVPA to produce minimal clinically important changes in these outcomes.
METHODS
Pooled baseline data from three studies were used, including women with breast cancer who participated in the Phys-Can project. Fatigue was assessed with the Multidimensional Fatigue Inventory questionnaire (MFI; five dimensions, 4-20 scale) and HRQoL with the European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30; 0-100 scale). Sedentary time and physical activity were measured with accelerometry. Isotemporal substitution modelling was used for the analyses.
RESULTS
Overall, 436 participants (mean age 56 years, fatigue 11 [MFI], HRQoL 66 [EORTC QLQ-C30], LPA 254 min/day, MVPA 71 min/day) were included. Fatigue significantly decreased in two MFI dimensions when reallocating 30 min/day of sedentary time to LPA: reduced motivation and reduced activity (β = - 0.21). Fatigue significantly decreased in three MFI dimensions when reallocating 30 min/day of sedentary time to MVPA: general fatigue (β = - 0.34), physical fatigue (β = - 0.47) and reduced activity (β = - 0.48). To produce minimal clinically important changes in fatigue (- 2 points on MFI), the amount of sedentary time needed to be reallocated to LPA was ≈290 min/day and to MVPA was ≥ 125 min/day. No significant effects were observed on HRQoL when reallocating sedentary time to LPA or MVPA.
CONCLUSIONS
Our results suggest that reallocating sedentary time to LPA or MVPA has beneficial effects on cancer-related fatigue in patients with breast cancer, with MVPA having the greatest impact. In relatively healthy and physically active breast cancer populations, a large amount of time reallocation is needed to produce clinically important changes. Future studies are warranted to evaluate such effects in broader cancer populations.
TRIAL REGISTRATION
NCT02473003 (10/10/2014) and NCT04586517 (14/10/2020).
目的
我们旨在探讨将久坐时间重新分配等量的低强度（LPA）或中高强度体力活动（MVPA）对乳腺癌患者相关疲劳和健康相关生活质量（HRQoL）的影响。我们还旨在确定需要重新分配多少久坐时间来产生这些结果的最小临床重要变化。
方法
使用来自三个研究的汇总基线数据，包括参加 Phys-Can 项目的乳腺癌患者。疲劳使用多维疲劳清单问卷（MFI；五个维度，4-20 分制）进行评估，HRQoL 使用欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30；0-100 分制）进行评估。使用加速度计测量久坐时间和体力活动。等时替代模型用于分析。
结果
总体而言，纳入了 436 名参与者（平均年龄 56 岁，疲劳 11 [MFI]，HRQoL 66 [EORTC QLQ-C30]，LPA 254 分钟/天，MVPA 71 分钟/天）。当每天重新分配 30 分钟的久坐时间用于 LPA 时，MFI 的两个维度的疲劳明显减少：降低的动力和活动减少（β= -0.21）。当每天重新分配 30 分钟的久坐时间用于 MVPA 时，MFI 的三个维度的疲劳明显减少：一般疲劳（β= -0.34）、身体疲劳（β= -0.47）和活动减少（β= -0.48）。为了在疲劳方面产生最小的临床重要变化（MFI 减少 2 分），需要重新分配的久坐时间量为 LPA 约 290 分钟/天，MVPA 则需要≥125 分钟/天。当重新分配久坐时间用于 LPA 或 MVPA 时，对 HRQoL 没有观察到显著影响。
结论
我们的结果表明，将久坐时间重新分配用于 LPA 或 MVPA 对乳腺癌患者相关疲劳有有益影响，MVPA 的影响最大。在相对健康和体力活动活跃的乳腺癌人群中，需要大量的时间重新分配才能产生临床重要的变化。需要进一步的研究来评估更广泛的癌症人群中的这种影响。
试验注册
NCT02473003（2014 年 10 月 10 日）和 NCT04586517（2020 年 10 月 14 日）。
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