Physical Activity for Adolescent and Young Adult Cancer Survivors

Exploring the Feasibility, Safety, and Potential Benefits of a 12-week Home-based Physical Activity Intervention

More adolescents and young adults are surviving cancer than ever before. Many endure negative effects related to their cancer and its treatment, which reduces their quality of life and functioning. Physical activity is one strategy that has been shown to promote quality of life amongst cancer survivors. However, very little research has focused on adolescent and young adult cancer survivors. Therefore, the purpose of this pilot randomized controlled trial is to explore the feasibility, safety, and potential benefits of a 12-week home-based physical activity intervention in adolescent and young adult cancer survivors.

Study Overview

• Status: Completed
• Conditions: Adolescent and Young Adult Cancer Survivors
• Intervention / Treatment: Behavioral: Physical Activity

• Study Type: Interventional
• Enrollment (Actual): 17
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Ottawa, Ontario, Canada, K1N 6N5
      • University of Ottawa

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 44 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

INCLUSION CRITERIA:

1. Have been diagnosed with cancer for the first time between the ages of 15 and 39 years;
2. Have completed cancer treatment within 5 years;
3. Currently between the ages of 15 to 44 years;
4. Have no current evidence of progressive disease, secondary cancer (i.e., cancer cells that have spread from the primary cancer), or second cancers (i.e., a new different cancer);
5. Live within 100 km of the University of Ottawa;
6. Be inactive or insufficiently active as determined by a single item screening question (i.e., participants must respond "no" to the following question: are you currently engaging in moderate physical activity, defined as activity that increases your heart rate and causes you to sweat, on 3 or more days a week?). Screening participants based on their level of physical activity will ensure only those individuals for whom the intervention will have the largest effect are recruited;
7. Able to read, understand, and provide informed consent in English;
8. Ready for physical activity as indicated by answering Physical Activity Readiness Questions (PAR-Q). If participants are not ready for physical activity as determined by the PAR-Q they will need to complete a Physical Activity Readiness Medical Examination Form.

EXCLUSION CRITERIA:

1. Physical impairments precluding participation in physical activity;
2. Unwilling or unable to sign the Participant Informed Consent Form;
3. Received a diagnosis of brain cancer or thyroid cancer. Brain cancer survivors will be excluded as a function of the cognitive impairments associated with their diagnosis and treatment and thyroid cancer survivors will be excluded due to the vastly different treatment regimens. That is, both of these cancers may result in different physical, psychological/emotional, and social effects that could impact the outcomes of interest.

Eligible participants who want to participate in the other pre-specified outcome measures to assess cognitive functioning must also meet the following additional inclusion/exclusion criteria.

ADDITIONAL INCLUSION CRITERIA:

1. Right-handedness, because language is lateralized and has been shown to be left side dominant (for right handers) during fMRI tasks;
2. Able to read, understand, and provide informed consent in English for the additional assessments.

ADDITIONAL EXCLUSION CRITERIA:

1. Metal implants (e.g., pacemaker) or metal dental work (aside from fillings) that would preclude scanning;
2. Claustrophobia;
3. Poor eyesight (not correctable with contact lenses) that precludes viewing stimuli presented in the scanner;
4. Lower back pain that would preclude a person from lying relatively still for one hour;
5. Substance use disorder as assessed by a single item question (i.e., participants must respond "no" to the following question: Have you been told, in the last five years, by your healthcare provider that you have a substance use disorder?).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Physical Activity; Participants in the experimental arm (i.e., physical activity) will be asked to complete the 12-week home-based physical activity program and to complete all study assessments.	Behavioral: Physical Activity; Participants will receive a 12-week home-based physical activity program that has been individualized using their baseline assessment results. The program will be comprised of aerobic training (2 days/week) and resistance training (2 days/week). The aerobic training will be performed unsupervised. The resistance training will be performed under the supervision of a study team member (who will visit participants homes) for the first 6 weeks to ensure proper form and safety.
No Intervention: Wait-List Control; Participants in the no intervention arm (i.e., wait-list control) will be asked to maintain their usual lifestyle activities and to complete all study assessments. Participants in this arm will be provided with the 12-week home-based physical activity program in the exact same way as participants in the experimental arm (i.e., physical activity) at the end of the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Recruitment Rates	The number of eligible participants who enrol in the study out of the number who are referred.	Through study completion, an average of 12-24 weeks
Retention Rates	The number of participants completing the intervention and all scheduled assessments.	Through study completion, an average of 12-24 weeks
Adherence Rates	The number of physical activity sessions engaged in out of the total recommended as part of the intervention.	Through study completion, an average of 12-24 weeks
Number of Participants with Adverse Events	The number of participants reporting or presenting adverse events (e.g., injury) that occurs as a result of participating in the physical activity intervention and/or its assessments.	Through study completion, an average of 12-24 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physical Activity Behaviour: Daily Physical Activity Logbook	Change in daily self-reported daily physical activity from baseline, to mid-intervention, to post-intervention, to follow-up (if applicable; i.e., if participant consents and is eligible to participate in the additional assessments testing cognitive functioning).	Through study completion, an average of 12-24 weeks
Physical Activity Behaviour: Leisure Time Exercise Questionnaire (Godin & Shephard, 1985)	Change in self-reported physical activity (over the past 7 days) from baseline, to mid-intervention, to post-intervention, to follow-up (if applicable; i.e., if participant consents and is eligible to participate in the additional assessments testing cognitive functioning).	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12), follow-up (week 24)
Physical Activity Behaviour: 7-Day Accelerometer Wear (Objective Physical Activity Behaviour)	Change in objective levels of physical activity as measured by accelerometers (Actigraph wGT3XP-BT), which will be worn for a 7 day period from baseline, to mid-intervention, to post-intervention, to follow-up (if applicable; i.e., if participant consents and is eligible to participate in the additional assessments testing cognitive functioning).	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12), follow-up (week 24)
Resting Heart Rate	Change in resting heart rate, as measured by a heart rate monitor (Polar A300), from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Blood Pressure	Change in resting blood pressure, using a blood pressure monitor (HealthSmart Digital Blood Pressure Monitor), from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Body Composition: Body Mass Index	Change in body mass as determined by a Tanita scale (TBF-310 GS) that uses bioelectrical impedance to assess body composition from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Aerobic Capacity: 6-Minute Walk Test (CSEP, 2013; Irwin, 2012)	Change in aerobic capacity (i.e., total distance walked in 6 minutes) from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Musculoskeletal Strength: Combined Grip Strength using a Handheld Dynamometer (CSEP, 2013; Irwin, 2012)	Change in musculoskeletal strength (i.e., force exerted in kilograms on the handheld dynamometer) from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Muscular Endurance: 30-Second Sit to Stand Test (Rikli & Jones, 2001)	Change in muscular endurance (i.e., number of times participants can stand from a seated position in 30 seconds) from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Self-Efficacy: Single-Item Version of the Exercise Self-Efficacy Scale (McAuley, 1993)	Change in participants self-reported self-efficacy from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Physical Competence and Physical Self-Esteem: Physical Self-Description Questionnaire Short-Form Appearance, Strength, Endurance, Body Fat, and Physical Self-Esteem scales (Marsh, Martin, & Jackson, 2010)	Change in participants self-reported physical competence and physical self-esteem from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Global Self-Esteem: Rosenberg Global Self-Esteem Scale (Rosenberg, 1965)	Change in participants self-reported global self-esteem from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Body Image: Multidimensional Body-Self Relations Questionnaire Appearance Evaluation and Body Areas Satisfaction scales (Cash, 2000)	Change in participants self-reported body image from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Posttraumatic Growth: Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996)	Change in participants self-reported posttraumatic growth from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Quality of Life: Medical Outcomes Study 36-Item Short-Form Health Survey (Ware & Sherbourne, 1992)	Change in participants self-reported quality of life from baseline, to mid-intervention, to post-intervention.	Baseline (week 0), mid-intervention (weeks 6), post-intervention (week 12)
Participants Experiences: Qualitative Interviews	Participants experiences in the intervention (i.e., with physical activity if in the experimental arm or with engaging in their usual lifestyle if in the wait-list control arm) and subsequent changes, if any, in behavioural, physical, psychological, and quality of life outcomes as explored via qualitative interviews (following an interview schedule containing a series of open-ended questions and probes) from baseline to post-intervention.	Baseline (week 0), post-intervention (week 12)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive Functioning: Single Open-Ended Question	Change in participants responses to a single open-ended question: "Do you ever feel like you have a hard time thinking and/or remembering?" from baseline, to post-intervention, to follow-up. NOTE: Once recruited to the main trial, participants will have the option to participate in additional assessments testing cognitive functioning. If interested, participants must meet additional inclusion/exclusion criteria for the additional assessments.	Baseline (week 0), post-intervention (week 12), follow-up (week 24)
Cognitive Functioning: Magnetic Resonance Imaging (MRI) Scans	Change in participants cognitive functioning, as assessed by a structural scan, a resting state functional MRI (fMRI) procedure, four fMRI tasks, and a diffusion tensor imaging sequence (lasting approximately 60 minutes), from baseline, to post-intervention, to follow-up. NOTE: Once recruited to the main trial, participants will have the option to participate in additional assessments testing cognitive functioning. If interested, participants must meet additional inclusion/exclusion criteria for the additional assessments.	Baseline (week 0), post-intervention (week 12), follow-up (week 24)
Socio-Demographic and Medical Information Questionnaire	The socio-demographic and medical information collected will be used to describe the sample.	Baseline (week 0)

Collaborators and Investigators

• Sponsor: University of Ottawa
• Investigators: Principal Investigator: Jennifer Brunet, PhD, University of Ottawa

Publications and helpful links

General Publications

• Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.
• Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985 Sep;10(3):141-6.
• Tedeschi RG, Calhoun LG. The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. J Trauma Stress. 1996 Jul;9(3):455-71. doi: 10.1007/BF02103658.
• McAuley E. Self-efficacy and the maintenance of exercise participation in older adults. J Behav Med. 1993 Feb;16(1):103-13. doi: 10.1007/BF00844757.
• Canadian Society for Exercise Physiology (CSEP). CSEP-Physical activity training for health (CSEP-PATH). Ottawa, ON: CSEP, 2013.
• Irwin, ML. American College of Sports Medicine's guide to exercise and cancer survivorship. Champaign, IL: Human Kinetics, 2012.
• Rikli R, Jones J. Senior fitness test manual. Champaign, IL: Human Kinetics, 2001.
• Marsh HW, Martin AJ, Jackson S. Introducing a short version of the physical self description questionnaire: new strategies, short-form evaluative criteria, and applications of factor analyses. J Sport Exerc Psychol. 2010 Aug;32(4):438-82. doi: 10.1123/jsep.32.4.438. Erratum In: J Sport Exerc Psychol. 2010 Dec;32(6):909-11.
• Rosenberg M. Soceity and adolescent self-image. Princeton, NJ: Princeton University Press, 1965.
• Cash TF. The multidimensional body-self relations questionnaire. MBSRQ Users' Manual 3rd Revision. Available: http://www.body-images.com, 2000.
• Wurz A, Ayson G, Smith AM, Brunet J. A proof-of-concept sub-study exploring feasibility and preliminary evidence for the role of physical activity on neural activity during executive functioning tasks among young adults after cancer treatment. BMC Neurol. 2021 Aug 4;21(1):300. doi: 10.1186/s12883-021-02280-y.
• Wurz A, Price J, Brunet J. Understanding adolescents' and young adults' self-perceptions after cancer treatment in the context of a two-arm, mixed-methods pilot randomized controlled physical activity trial. Support Care Cancer. 2021 Aug;29(8):4439-4450. doi: 10.1007/s00520-020-05974-0. Epub 2021 Jan 15.
• Wurz A, Brunet J. Exploring the feasibility and acceptability of a mixed-methods pilot randomized controlled trial testing a 12-week physical activity intervention with adolescent and young adult cancer survivors. Pilot Feasibility Stud. 2019 Dec 20;5:154. doi: 10.1186/s40814-019-0530-6. eCollection 2019.

Study record dates

Study Major Dates

• Study Start (Actual): September 11, 2017
• Primary Completion (Actual): April 16, 2019
• Study Completion (Actual): May 5, 2019

Study Registration Dates

• First Submitted: December 24, 2016
• First Submitted That Met QC Criteria: January 6, 2017
• First Posted (Estimate): January 11, 2017

Study Record Updates

• Last Update Posted (Actual): May 31, 2019
• Last Update Submitted That Met QC Criteria: May 29, 2019
• Last Verified: May 1, 2019

More Information

Terms related to this study

• Keywords: physical activity; randomized controlled trial; exercise; cancer; pilot study; AYA; adolescent and young adult
• Other Study ID Numbers: Ottawa

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No