Feasibility of a Pedometer-Based Walking Program for Survivors of Breast and Head and Neck Cancer Undergoing Radiation Therapy

Abstract

Purpose: This pilot study assessed the feasibility and acceptability of a pedometer-based walking program for people with breast cancer and head and neck cancer (HNC) undergoing radiation therapy treatment. Methods: Participants were given a pedometer and prescribed a home-based walking program that included an individualized weekly step-count goal during the 3-to 5-week course of radiation therapy. Feasibility was determined by calculating recruitment rate, completion rate, and rate of adherence. Secondary outcomes included 6-minute walk test (6MWT) distance, step count, physical activity level, and psychological outcomes of depression, happiness, self-esteem, and sleep quality. Results: A total of 21 participants were recruited. All participants completed the study; adherence to prescribed step counts was 91% at follow-up. Analysis found a significant improvement in happiness, as measured by the Oxford Happiness Questionnaire (mean difference 0.3, p ¼ 0.003), and a borderline significant improvement in 6MWT distance (mean difference 35 m, p ¼ 0.008). Conclusion: This pilot study demonstrated the feasibility of a pedometer-based walking program for survivors of breast cancer and HNC undergoing radiation therapy.Key Words: breast cancer; head and neck cancer; physical activity; radiation therapy; walking. RÉ SUMÉObjet: Cette é tude pilote a é valué la faisabilité et l'acceptabilité d'un programme de marche à base de podomè tre pour les personnes qui ont un cancer du sein et un cancer de la tê te et du cou (CTC), et qui suivent une radiothé rapie. Mé thodes: Les participants ont reç u un podomè tre et on leur a prescrit un programme de marche à domicile comportant un nombre personnalisé de pas par semaine à effectuer au cours de la radiothé rapie d'une duré e de 3 à 5 semaines. On a dé terminé la faisabilité en calculant le taux d'inscription, le taux d'achè vement et le taux d'observation. Les ré sultats secondaires ont inclus la distance parcourue pendant le test de marche de 6 minutes (TM6M), le nombre de pas, le niveau d'activité physique (AP) et les ré sultats psychologiques lié s à la dé pression, au bonheur, à l'estime de soi et à la qualité du sommeil. Ré sultats: Au total, 21 participants ont é té recruté s. Tous les participants ont terminé l'é tude et avaient effectué le nombre de pas prescrit dans une proportion de 91% au moment du suivi. L'analyse a ré vé lé une amé lioration importante du bonheur mesuré au moyen du questionnaire d'Oxford sur le bonheur (diffé rence moyenne de 0,3, p ¼ 0,003) et une amé lioration significative limite de la distance parcourue pendant le TM6M (diffé rence moyenne de 35 m, p ¼ 0,008). Conclusion: Cette é tude pilote a dé montré la faisabilité d'un programme de marche à base de podomè tre pour les survivants d'un cancer du sein et d'un CTC qui suivent une radiothé rapie.Physical exercise has been shown to be safe and effective for cancer survivors 1 and to produce benefits for both physical and psychological outcomes. 2,3 Research studies examining physical activ...

Tracking steps in oncology: the time is now

“…A number of trials have tested exercise programs for cancer patients. Many recent trials testing exercise during treatment with chemotherapy 54 – 56 or radiotherapy 57 , 58 or in the survivorship setting 24 , 40 , 59 – 66 have incorporated fitness trackers in their study design. Many of these have been randomized trials, 24 , 54 , 55 , 58 , 61 – 65 , 67 and most have focused on breast cancer patients.…”

“… 54 In several trials, the intervention was simply the provision of a pedometer along with print materials and/or step count goals. 57 , 59 , 60 , 63 These studies are particularly illuminating, as the exercise programs they tested require few resources and could be implemented easily in a widespread fashion. Findings largely support the role for increasing physical activity in order to improve cancer outcomes in patients undergoing active treatment and in the survivorship period.…”

Promise of Wearable Physical Activity Monitors in Oncology Practice

“…41 Pedometerbased walking programs have also been demonstrated to be a feasible way to improve objective measures, such as the 6-minute walk test, and subjective measures, such as happiness (measured by the Oxford Happiness Questionnaire) in survivors of breast or head and neck cancer. 42 Physical activity monitors may also play a role in cancer survivorship; in a study of 46 adult survivors of childhood cancer, the stimulation of daily physical activity using exercise counseling and a pedometer over 10 weeks led to a significant decrease in fatigue, and this benefit lasted more than 3 years. 43…”

CanWalk: a feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer

“…2 3 Despite growing evidence of significant health benefits, physical activity declines considerably during cancer treatment and remains low afterwards. 4 There is some evidence that maintaining or increasing physical activity in patients with cancer can enhance quality of life (QoL) and well-being as disease progresses. 5 6 However, activity-based interventions are typically supervised and require attendance at specialist facilities, potentially limiting acceptability and economic sustainability.…”