Predictors of follow-up exercise behavior 6 months after a randomized trial of exercise training during breast cancer chemotherapy
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Purpose Exercise during breast cancer chemotherapy is beneficial but it needs to be maintained into survivorship to optimize long-term benefits. Here, we report the predictors of follow-up exercise behavior 6 months after a randomized exercise trial in breast cancer patients. Methods Breast cancer patients (N = 242) initiating adjuvant chemotherapy 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. At baseline and postintervention, data were collected on demographic, medical, behavioral, fitness, psychosocial, and motivational variables. At 6-month follow-up, participants were mailed a questionnaire that assessed exercise behavior over the past 6 months and were categorized as either meeting both aerobic and resistance exercise guidelines, either exercise guideline, or neither exercise guideline. Results Two hundred one (83.1%) participants provided 6-month follow-up data with 85 (42.3%) meeting neither exercise guideline, 74 (36.8%) meeting either exercise guideline, and 42 (20.9%) meeting both exercise guidelines. In multivariate regression analysis, seven variables independently predicted the likelihood of meeting exercise guidelines at follow-up including higher pretrial exercise (β = 0.23; P = 0.002), younger age (β = −0.15; P = 0.028), breast conserving surgery (β = 0.15; P = 0.033), strength improvements (β = 0.15; P = 0.028), lower postintervention fatigue (β = 0.13; P = 0.067), a more positive attitude (β = 0.12; P = 0.086), and lower postintervention body mass index (β = −0.11; P = 0.105). Conclusion Exercise behavior 6 months after a randomized trial was predicted by a wide range of demographic, medical, behavioral, fitness, psychosocial, and motivational variables. These findings may help facilitate the uptake of exercise behavior during the transition from breast cancer patient to survivor.
KeywordsAdherence Cancer survivors Determinants Physical activity Quality of life Survivorship
This study was funded by a grant from the Canadian Breast Cancer Research Alliance. KSC is supported by the Canada Research Chairs Program. CMF is supported by a health scholar award from the Alberta Heritage Foundation for Medical Research (AHFMR). JKV was supported by a Canada graduate scholarship from CIHR and an incentive award from AHFMR. The authors gratefully acknowledge Donald C. McKenzie, MD, PhD, Kirstin Lane, PhD, Lisa Workman, MA, Neil Eves, PhD, John McGavock, PhD, Kristin Campbell, PhD, Margaret McNeely, BScPT, MSc, Diana Jespersen, RN, Chris Scott, BSc, Lianne Dolan, MSc, Ben Wilson, BSc, Christopher Sellar, MS, and Diane Cook, BPE for their assistance with the trial.
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