A Personalized, Dynamic Physical Activity Intervention Is Feasible and Improves Energetic Capacity, Energy Expenditure, and Quality of Life in Breast Cancer Survivors

Abstract

Purpose: Despite survival and quality of life benefits associated with physical activity, many breast cancer survivors remain inactive. Effective, sustainable interventions must account for individual differences in capability, motivation, and environment. Here, we evaluate the feasibility, mechanics, and efficacy of delivering an individualized, dynamic intervention to increase energetic capacity and energy expenditure.

Methods: Stage 0-III breast cancer patients who had completed primary treatment were enrolled. Prior to the intervention, detailed movement data was collected with a wearable GPS and accelerometer for 3 weeks to establish baseline activity. Movement data was collected continuously throughout the 12-week intervention, during which patients received electronically delivered, tailored, dynamic activity "prescriptions", adjusted based on demonstrated individual capability, daily movement in their environment, and progress.

Results: Of 66 enrolled, 57 participants began and completed the intervention. The intervention resulted in significant improvements in average steps (+558 steps/day, p = 0.01), energetic capacity measured by power generation on a stationary bicycle (1.76 to 1.99 W/kg lean mass, p < 0.01), and quality of life (FACT-B TOI, 72.8 to 74.8, p = 0.02). The greatest improvement in functional energetic capacity was seen in the lowest performing tertile at baseline (0.76 to 1.12 W/kg, p < 0.01).

Discussion: Wearable technology delivery of personalized activity prescriptions based on individual capability and movement behaviors demonstrates feasibility and early effectiveness. The high variability seen in baseline activity and function, as well as in response to the intervention, supports the need for future work in precision approaches to physical activity (NCT03158519).

Keywords: accelerometry; activity trackers; breast cancer; physical activity; survivors.

Conflict of interest statement

TO reports non-financial support from iMETx Inc during the conduct of the study and from iMETx Inc outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Ballinger, Althouse, Olsen, Miller and Sledge.

Figures

Figure 1

Example of patient interface and energy expenditure data. (A) displays patient view of movement prescription to incorporate bursts of more vigorous activity into her walks. (B) displays the same patient’s movement within her community, incorporating the prescription as evidenced by changes in her pace and heart rate.

Figure 2

CONSORT diagram.