Intelligent physical activity versus modified behavioral activation in adolescent and young adult cancer patients with psychological distress: A randomized, controlled pilot trial

Abstract

Background More than 80% of adolescent and young adult cancer patients (AYACPs) experienced psychological distress. Physical activity and behavioral activation are effective to relieve the psychological distress in AYACPs. Methods Participants aged 15–39 years diagnosed with malignant tumors were included. A total of 143 eligible AYACPs were randomly assigned to three groups. The treatment‐as‐usual group (N = 48) received routine care, the physical activity group (N = 47) received 8 weeks of physical activity program based on intelligent wearable devices, and the behavioral activation group (N = 48) received an internet‐based modified behavioral activation program for 8 weeks. Objective outcome measures included salivary cortisol and testosterone. Results Linear mixed‐model analyses showed significant differences between treatment‐as‐usual, physical activity and behavioral activation in salivary cortisol, as well as total scores on depression and anxiety, physical activity, self‐efficacy, and social support. Significantly stronger effect sizes for physical activity group compared with behavioral activation group were found on physical activity (d = 0.53) (1 week after intervention), moderate activity (d = 0.61), and walking activity (d = 0.57) (3‐month follow‐up). Conclusions Intelligent, wearable, device‐based physical activity program is more effective in alleviating anxiety and depression, reducing saliva cortisol, and improving physical activity in AYACPs than internet‐based modified behavioral activation program. Intelligent, wearable, device‐based physical activity program can reduce the time cost of AYACPs to ensure that the intervention is carried out.

Current evidence of integrative oncology modalities for managing adverse effects and survivorship issues among adolescents and young adult (AYA) cancer patients and survivors

“…These studies were designed to provide symptomatic relief of AYA patients from anxiety, depression, sleep disturbances, and pain. Overall, we have observed that PA, MBSR, massage and BWL were found effective in relieving chemotherapy induced fatigue, anxiety and depression compared to controls [22,25,27,41].…”

“…PA, massage, BWL and yoga studies reported improved sleep quality [31,38,41]. However, there is limited research on PA use in AYA [25,26] and survivorship issues [9]. Several barriers have been identified to conduct research on PA in AYAC [42] including schedule-related barriers (time, vacations, visitors), health-related barriers (pain, fatigue) and unfavorable circumstances like weather and lack of motivation that may limit PA and exercise use in AYAC [42].…”

“…On the other hand, mHealth PA (using social media to enhance PA) was not more effective than the self-help group [24]. Moreover, a 10-week exercise program improved cardiorespiratory fitness and peak oxygen uptake (VO 2 peak) in AYA but did not significantly impact quality of life (QoL) or fatigue [25].…”

The Effect of Social Isolation, Loneliness, and Physical Activity on Depressive Symptoms of Older Adults during COVID-19: A Moderated Mediation Analysis

“…Physical activity is not only known as an evidence-based treatment for depression [42] but is also known to be related to behavioral activation therapy for depression, which induces behavioral attitudes and healthy behaviors [43]. Behavioral activation is targeted at reducing behavioral inertia and avoidance, which often accompanies depression, by increasing daily activities [44].…”

Influence of stress‐specific interventions on biomarker levels and cognitive function in cancer patients: Systematic review and meta‐analysis

“…Eleven trials investigated the impact of stress-specific interventions on cortisol, six of which (Antoni et al, 2009;Banasik et al, 2011;Dodds et al, 2015;Hoyt et al, 2021;Hsiao et al, 2012;Penedo et al, 2021) used log-transformed data to analyse cortisol, and the remaining researches (Black et al, 2017;Cruess et al, 2000;Li et al, 2023;Mirmahmoodi et al, 2020;Vadiraja et al, 2009) displayed the cortisol level with raw data. As shown in Figure 6, except for morning cortisol using raw data, the analysis indicated that stress-specific interventions did not reduce the cortisol level at different periods ( p > .05).…”