Pedometer, Exercise Guidebook Help Ca Survivors Enhance Life


WASHINGTON — Breast cancer survivors may be more likely to increase their physical activity and quality of life if they are given step pedometers and an exercise guidebook, Jeffrey K.H. Vallance reported at the annual meeting of the Society of Behavioral Medicine.

In a recent prospective observational study, exercising after treatment for breast cancer and into breast cancer survivorship was associated with a 26%–40% reduction in the risk of breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality (JAMA 2005;293:2479–86).

Since most breast cancer survivors do not meet the physical activity recommendations, there is a need for studies that don't require patients to come to a clinic to exercise under supervision and for distance- and home-based behavior-change interventions, said Mr. Vallance, a Ph.D. candidate in the faculty of physical education at the University of Alberta, Edmonton.

In preliminary results of a randomized trial of 377 breast cancer survivors from the Alberta Cancer Registry, Mr. Vallance and his colleagues found that patients who received an exercise guidebook alone (94), a step pedometer alone (94), or both (93) all reported significantly greater increases in moderate to vigorous physical activity per week and self-reported brisk walking at the end of 12 weeks than did patients who were given the standard physical activity recommendation over the telephone (96). The increases amounted to an additional 40–60 minutes a week of moderate to vigorous physical activity and an additional 60–90 minutes a week of brisk walking, compared with patients who were given the standard recommendation.

But only the patients who used both the guidebook and the step pedometer had significant changes in their quality of life and level of fatigue at the end of 12 weeks. There were no significant differences in quality of life and fatigue among the three intervention groups. The changes in quality of life and fatigue for patients in the combined treatment group “approached the minimal cut points for what we can term a clinically important difference,” which is any difference that might necessitate or qualify for change in a patient's management or approach to her management, Mr. Vallance said.

“This study provides some preliminary support for more distance-based behavior-change approaches,” he said, adding that it was relatively inexpensive at only $30 a person.

“I think we need to start pushing these distance-based approaches. If we consider that there are approximately 10 million cancer survivors in the [United States] alone today, then it's these novel, public health-based, distance-based approaches that might be able to target and have an impact on the greatest number of survivors.”

The investigators are currently analyzing 6-month follow-up data.

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