Skip to main content

Advertisement

SpringerLink
Log in

Breast cancer survivors reduce accelerometer-measured sedentary time in an exercise intervention

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

Cancer survivors are highly sedentary and have low physical activity. How physical activity interventions impact sedentary behavior remains unclear. This secondary analysis examined changes in sedentary behavior among breast cancer survivors participating in a physical activity intervention that significantly increased moderate-to-vigorous physical activity (MVPA).

Methods

Insufficiently active breast cancer survivors were randomized to a 12-week physical activity intervention (exercise arm) or control arm. The intervention focused solely on increasing MVPA with no content targeting sedentary behavior. Total sedentary behavior, light physical activity (LPA), and MVPA were measured at baseline and 12 weeks (ActiGraph GT3X+ accelerometer). Separate linear mixed-effects models tested intervention effects on sedentary behavior, intervention effects on LPA, the relationship between change in MVPA and change in sedentary behavior, and potential moderators of intervention effects on sedentary behavior.

Results

The exercise arm had significantly greater reductions in sedentary behavior than the control arm (mean − 24.9 min/day (SD = 5.9) vs. − 4.8 min/day (SD = 5.9), b = − 20.1 (SE = 8.4), p = 0.02). Larger increases in MVPA were associated with larger decreases in sedentary behavior (b = − 1.9 (SE = 0.21), p < 0.001). Women farther out from surgery had significantly greater reductions in sedentary behavior than women closer to surgery (b = − 0.91 (SE = 0.5), p = 0.07). There was no significant group difference in change in LPA from baseline to 12 weeks (b = 5.64 (SE = 7.69), p = 0.48).

Conclusions

Breast cancer survivors in a physical activity intervention reduced total sedentary time in addition to increasing MVPA.

Implications for Cancer Survivors

Both increasing physical activity and reducing sedentary behavior are needed to promote optimal health in cancer survivors. These results show that MVPA and sedentary behavior could be successfully targeted together, particularly among longer-term cancer survivors.

Clinical trial registration

This study is registered at www.ClinicalTrials.gov (NCT 02332876).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271–89.

    Article  Google Scholar 

  2. Sabiston CM, Brunet J, Vallance JK, Meterissian S. Prospective examiniation of objectively-assessed physical activity and sedentary time after breast cancer treatment: sitting on the crest of the teachable moment. Cancer Epidemiol Biomark Prev. 2014;23(7):1324–30.

    Article  CAS  Google Scholar 

  3. Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control. 2010;21(2):283–8.

    Article  PubMed  Google Scholar 

  4. Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer. 2015;121(22):4044–52.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gennuso KP, et al. Sedentary behavior, physical activity, and markers of health in older adults. Med Sci Sports Exerc. 2013;45(8):1493–500.

    Article  PubMed  PubMed Central  Google Scholar 

  6. de Rezende LF. et al. Sedentary behavior and health outcomes among older adults: a systematic review. BMC Public Health; 2014. 14: p. 333

  7. Gianoudis J, Bailey CA, Daly RM. Associations between sedentary behaviour and body composition, muscle function and sarcopenia in community-dwelling older adults. Osteoporos Int. 2015;26(2):571–9.

    Article  CAS  PubMed  Google Scholar 

  8. Mañas A, del Pozo-Cruz B, García-García FJ, Guadalupe-Grau A, Ara I. Role of objectively measured sedentary behaviour in physical performance, frailty and mortality among older adults: a short systematic review. Eur J Sport Sci. 2017;17(7):940–53.

    Article  PubMed  Google Scholar 

  9. Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162(2):123–32.

    Article  PubMed  Google Scholar 

  10. Nelson SH, Marinac CR, Patterson RE, Nechuta SJ, Flatt SW, Caan BJ, et al. Impact of very low physical activity, BMI, and comorbidities on mortality among breast cancer survivors. Breast Cancer Res Treat. 2016;155(3):551–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Phillips SM, Lloyd GR, Awick EA, McAuley E. Correlates of objectively measured sedentary behavior in breast cancer survivors. Cancer Causes Control. 2016;27(6):787–95.

    Article  PubMed  PubMed Central  Google Scholar 

  12. George SM, Alfano CM, Groves J, Karabulut Z, Haman KL, Murphy BA, et al. Objectively measured sedentary time is related to quality of life among cancer survivors. PLoS One. 2014;9(2):e87937.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Hartman SJ, Marinac CR, Bellettiere J, Godbole S, Natarajan L, Patterson RE, et al. Objectively measured sedentary behavior and quality of life among survivors of early stage breast cancer. Support Care Cancer. 2017;25(8):2495–503.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Craft LL, Zderic TW, Gapstur SM, VanIterson EH, Thomas DM, Siddique J, et al. Evidence that women meeting physical activity guidelines do not sit less: an observational inclinometry study. Int J Behav Nutr Phys Act. 2012;9(1):122.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chomistek AK, Manson JE, Stefanick ML, Lu B, Sands-Lincoln M, Going SB, et al. Relationship of sedentary behavior and physical activity to incident cardiovascular disease: results from the Women’s Health Initiative. J Am Coll Cardiol. 2013;61(23):2346–54.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Zhou Y, Zhao H, Peng C. Association of sedentary behavior with the risk of breast cancer in women: update meta-analysis of observational studies. Ann Epidemiol. 2015;25(9):687–97.

    Article  PubMed  Google Scholar 

  17. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302–10.

    Article  PubMed  Google Scholar 

  18. Stamatakis E, Ekelund U, Ding D, Hamer M, Bauman AE, Lee, IM. Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings. Br J Sports Med. 2018;53(6):377–82.

  19. Bellettiere J, Winkler EAH, Chastin SFM, Kerr J, Owen N, Dunstan DW, et al. Associations of sitting accumulation patterns with cardio-metabolic risk biomarkers in Australian adults. PLoS One. 2017;12(6):e0180119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Lynch BM, Dunstan DW, Vallance JK, Owen N. Don’t take cancer sitting down: a new survivorship research agenda. Cancer. 2013;119(11):1928–35.

    Article  PubMed  Google Scholar 

  21. Bluethmann SM, Vernon SW, Gabriel KP, Murphy CC, Bartholomew LK. Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors. Breast Cancer Res Treat. 2015;149(2):331–42.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity for women with breast cancer after adjuvant therapy. Cochrane Database of Systematic Reviews. 2018;(1):CD011292.

  23. Short CE, James EL, Stacey F, Plotnikoff RC. A qualitative synthesis of trials promoting physical activity behaviour change among post-treatment breast cancer survivors. J Cancer Surviv. 2013;7(4):570–81.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Pinto B, Dunsiger S, Stein K. Does a peer-led exercise intervention affect sedentary behavior among breast cancer survivors? Psycho-Oncology. 2017;26(11):1907–13.

    Article  PubMed  Google Scholar 

  25. Guinan E, Hussey J, Broderick JM, Lithander FE, O’Donnell D, Kennedy MJ, et al. The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors—a pilot study. Support Care Cancer. 2013;21(7):1983–92.

    Article  CAS  PubMed  Google Scholar 

  26. Pinto BM, Stein K, Dunsiger S. Peers promoting physical activity among breast cancer survivors: a randomized controlled trial. Health Psychol. 2015;34(5):463–72.

    Article  PubMed  Google Scholar 

  27. Prince SA, Saunders TJ, Gresty K, Reid RD. A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: a systematic review and meta-analysis of controlled trials. Obes Rev. 2014;15(11):905–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Martin A, Fitzsimons C, Jepson R, Saunders DH, van der Ploeg H, Teixeira PJ, et al. Interventions with potential to reduce sedentary time in adults: systematic review and meta-analysis. Br J Sports Med. 2015;49:1056–63.

    Article  PubMed  Google Scholar 

  29. Conroy DE, Maher JP, Elavsky S, Hyde AL, Doerksen SE. Sedentary behavior as a daily process regulated by habits and intentions. Health Psychol. 2013;32(11):1149–57.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lally P, van Jaarsveld CHM, Pots HWW, Wardle J. How are habits formed: modelling habit formation in the real world. Eur J Soc Psychol. 2010;40(6):998-1009.

  31. Lally P, Wardle J, Gardner B. Experiences of habit formation: a qualitative study. Psychol Health Med. 2011;16(4):484–9.

    Article  PubMed  Google Scholar 

  32. Siddique J, de Chavez PJ, Craft LL, Freedson P, Spring B. The effect of changes in physical activity on sedentary behavior: results from a randomized lifestyle intervention trial. Am J Health Promot. 2017;31(4):287–95.

    Article  PubMed  Google Scholar 

  33. Rowland TW. The biological basis of physical activity. Med Sci Sports Exerc. 1998;30(3):392–9.

    Article  CAS  PubMed  Google Scholar 

  34. Kozey-Keadle S, Staudenmayer J, Libertine A, Mavilia M, Lyden K, Braun B, et al. Changes in sedentary time and physical activity in response to an exercise training and/or lifestyle intervention. J Phys Act Health. 2014;11(7):1324–33.

    Article  PubMed  Google Scholar 

  35. Reinertsen KV, Cvancarova M, Loge JH, Edvardsen H, Wist E, Fosså SD. Predictors and course of chronic fatigue in long-term breast cancer survivors. J Cancer Surviv. 2010;4(4):405–14.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hartman SJ, Nelson SH, Myers E, Natarajan L, Sears DD, Palmer BW, et al. Randomized controlled trial of increasing physical activity on objectively measured and self-reported cognitive functioning among breast cancer survivors: the memory & motion study. Cancer. 2018;124(1):192-202.

  37. Gardner B, Smith L, Lorencatto F, Hamer M, Biddle SJH. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults. Health Psychol Rev. 2016;10:89–112.

    Article  PubMed  Google Scholar 

  38. Keadle SK, et al. Targeting reductions in sitting time to increase physical activity and improve health. Med Sci Sports Exerc. 2017;49(8):1572–82.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Sabiston CM, Lacombe J, Faulkner G, Jones J, Trinh L. Profiling sedentary behavior in breast cancer survivors: links with depression symptoms during the early survivorship period. Psychooncology. 2018;27(2):569–75.

    Article  PubMed  Google Scholar 

  40. Hartman SJ, Natarajan L, Palmer BW, Parker B, Patterson RE, Sears DD. Impact of increasing physical activity on cognitive functioning in breast cancer survivors: rationale and study design of Memory & Motion. Contemp Clin Trials. 2015;45(Pt B):371–6.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci. 1992;17(4):338–45.

    CAS  PubMed  Google Scholar 

  42. Bandura A. Social foundations of thought and action. Englewood Cliffs: Prentice-Hall; 1986.

    Google Scholar 

  43. Carver CS, Scheier MF. Control theory: a useful conceptual framework for personality-social, clinical, and health psychology. Psychol Bull. 1982;92(1):111–35.

    Article  CAS  PubMed  Google Scholar 

  44. Carver CS and Scheier M. On the self-regulation of behavior. Cambridge, UK ; New York, NY, USA: Cambridge University Press.; 1998; 439 p

  45. Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009;28(6):690–701.

    Article  PubMed  Google Scholar 

  46. Kelly LA, et al. Validity of actigraphs uniaxial and triaxial accelerometers for assessment of physical activity in adults in laboratory conditions. BMC Med Phys. 2013;13(1):5.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Choi L, et al. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2011;43(2):357–64.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Freedson PS, Melanson E, Sirard J. Calibration of the computer science and applications: Inc. accelerometer. Med Sci Sports Exerc. 1998;30:777–81.

    Article  CAS  PubMed  Google Scholar 

  49. R Core Development Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2017.

    Google Scholar 

  50. Peachey MM, Richardson J, V Tang A, Dal-Bello Haas V, Gravesande J. Environmental, behavioural and multicomponent interventions to reduce adults’ sitting time: a systematic review and meta-analysis. Br J Sports Med. 2018:bjsports-2017-098968.

  51. Del Pozo-Cruz J, et al. Replacing sedentary time: meta-analysis of objective-assessment studies. Am J Prev Med. 2018;55(3):395–402.

    Article  PubMed  Google Scholar 

  52. Atkin AJ, Gorely T, Clemes SA, Yates T, Edwardson C, Brage S, et al. Methods of measurement in epidemiology: sedentary behaviour. Int J Epidemiol. 2012;41(5):1460-71.

  53. Kerr J, et al. Comparison of accelerometry methods for estimating physical activity. Med Sci Sports Exerc. 2017;49(3):617–24.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Kerr J, et al. Objective assessment of physical activity: classifiers for public health. Med Sci Sports Exerc. 2016;48(5):951–7.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kerr J, et al. Improving hip-worn accelerometer estimates of sitting using machine learning methods. Med Sci Sports Exerc. 2018;50:1518–24.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Peddle-Mcintyre CJ, Cavalheri V, Boyle T, Mcveigh JA, Jeffery E, Lynch BM, et al. A review of accelerometer-based activity monitoring in cancer survivorship research. Med Sci Sports Exerc. 2018;50(9):1790–801.

    Article  PubMed  Google Scholar 

  57. Matthew CE. Calibration of accelerometer output for adults. Med Sci Sports Exerc. 2005;37(11):S512–22.

    Article  PubMed  Google Scholar 

  58. Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005;23(24):5814–30.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lynch BM, Nguyen NH, Moore MM, Reeves MM, Rosenberg DE, Boyle T, et al. A randomized controlled trial of a wearable technology-based intervention for increasing moderate to vigorous physical activity and reducing sedentary behavior in breast cancer survivors: the ACTIVATE trial. Cancer. 2019. https://doi.org/10.1002/cncr.32143.

Download references

Funding

This work was supported by the National Cancer Institute of the National Institutes of Health (K07CA181323).

Author information

Authors and Affiliations

  1. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, San Diego, CA, USA

    Lauren S. Weiner, Michelle Takemoto, Suneeta Godbole, Sandahl H. Nelson, Loki Natarajan, Dorothy D. Sears & Sheri J. Hartman

  2. UC San Diego Moores Cancer Center, University of California, San Diego, La Jolla, San Diego, CA, USA

    Lauren S. Weiner, Sandahl H. Nelson, Loki Natarajan, Dorothy D. Sears & Sheri J. Hartman

  3. Department of Medicine, University of California, San Diego, La Jolla, San Diego, CA, USA

    Dorothy D. Sears

  4. College of Health Solutions, Arizona State University, Phoenix, AZ, USA

    Dorothy D. Sears

Authors
  1. Lauren S. Weiner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michelle Takemoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suneeta Godbole
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandahl H. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Loki Natarajan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dorothy D. Sears
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sheri J. Hartman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheri J. Hartman.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclaimer

The content in this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Weiner, L.S., Takemoto, M., Godbole, S. et al. Breast cancer survivors reduce accelerometer-measured sedentary time in an exercise intervention. J Cancer Surviv 13, 468–476 (2019). https://doi.org/10.1007/s11764-019-00768-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-019-00768-8

Keywords

Search

Navigation