Effect of a videoconference-delivered physical activity intervention on quality of life in colorectal cancer survivors
Date
2023
Journal Title
Journal ISSN
Volume Title
Abstract
INTRODUCTION: Colorectal cancer is the fourth most common cancer diagnosed in both men and women in the United States. For every 100 people diagnosed with colon cancer, 64 are expected to live five or more years after diagnosis. With this growing number of colorectal cancer survivors, quality of life (QOL) becomes an important patient reported outcome within this population. QOL is multidimensional and includes various dimensions of wellbeing (e.g., physical, emotional, social) that can be improved with physical activity. Previous research has established that face-to-face supervised physical activity (PA) interventions can improve QOL among colorectal cancer survivors (CRC) (Mishra et al., 2012). However, these interventions require a lot of resources, and may be difficult to access. Thus, researchers have turned to distance-based physical activity (PA) interventions (digital health tools, text messaging, prerecorded home-based workouts etc.) to increase access and scalability of PA interventions for CRC survivors. Previous studies that have examined the effect of distance-based PA interventions for improving QOL in CRC survivors did not find improvements in QOL. For example, Kim et al. (2019) found no significant improvements in QOL following an unsupervised, homebased, DVD exercise program, and Chan et al. (2022) found no significant changes in QOL, following a text messaging intervention. These finding suggest that distance-based PA interventions may not be as effective as face-to-face for improving QOL in CRC survivors and may be due to a lack of contact with other survivors and/or diminished PA adherence/compliance due to lack of supervision and instruction from an exercise professional. Since the COVID-19 pandemic, videoconference PA interventions have grown in popularity, and may be able to overcome some of the limitations of both face-to-face and distance-based PA interventions for improving QOL in CRC survivors. However, to date there are no previous studies that have examined the effect of a videoconference intervention on QOL in CRC survivors. This study will examine changes in QOL in colorectal cancer survivors following a 12-week, videoconference, PA intervention. This study will be a secondary data analysis of participants enrolled in Testing Group Activity CorrelaTes In Colorectal Cancer Survivors (TACTICS), a pilot randomized controlled trial with the primary aims of determining feasibility, and preliminary effects on physical activity. METHODS: TACTICS is a 12-week pilot randomized controlled trial where the intervention group received group-based exercise sessions 2x/week, and five behavior change discussion sessions delivered via Zoom. The control group received standard physical activity recommendations. QOL was measured at baseline and 12-weeks using the Functional Assessment of Cancer Therapy–Colorectal (FACT-C). Mean change, standard deviation, and effect size were reported to measure improvements in QOL. Established minimal clinically important differences (MCID) are a Δ5 points for total and a Δ2 points for QOL subscales. The proportion achieving MCID's in intervention vs. control were compared using Fisher's Exact tests, and independent t-tests or chi square tests explored differences in participant characteristics between those did vs. did not achieve MCID. RESULTS: Participants (n= 13 intervention, n=12 control) were mostly 56% female and M=61.2±11.7 years old. Among intervention participants, proportion who achieved MCID was 23.1% total, 15.4% physical, 38.5% functional, 23.1% social, and 15.4 % emotional, compared to 41.7% total, 33.3% physical, 25.0% functional, 41.7% social wellbeing, and 16.7% emotional among control. None of these proportions differed between groups (p>.05). For the physical QOL subscale, BMI was higher [t(11)=2.92, p=.014] and baseline scores were lower [t(7)=-2.34, p=.052] among those who achieved MCID. CONCLUSION: We observed small improvements in QOL within CRC survivors. There were no statistically significant differences in achieving clinically relevant improvements in QOL between intervention and control group participants. Larger randomized studies are needed to definitively determine if a videoconference exercise intervention can elicit clinically relevant improvements in QOL compared to a control group.
Description
Rights Access
Embargo expires: 12/29/2024.
Subject
exercise
physical activity
exercise oncology
colorectal cancer