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02-07-2020 | Uitgave 11/2020 Open Access

Quality of Life Research 11/2020

Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer

Quality of Life Research > Uitgave 11/2020
E. H. van Roekel, J. Duchâteau, M. J. L. Bours, L. van Delden, J. J. L. Breedveld-Peters, J. L. Koole, M. Kenkhuis, P. A. van den Brandt, R. L. Jansen, I. Kant, V. Lima Passos, K. Meijer, S. O. Breukink, M. L. G. Janssen-Heijnen, E. Keulen, M. P. Weijenberg
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The online version of this article (https://​doi.​org/​10.​1007/​s11136-020-02566-7) contains supplementary material, which is available to authorized users.
E. H. van Roekel and J. Duchâteau have contributed equally to this work.

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Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. However, these associations have not been investigated in longitudinal studies that provide the opportunity to analyse how within-individual changes in LPA affect HRQoL. We investigated longitudinal associations of LPA with HRQoL outcomes in CRC survivors, from 6 weeks to 2 years post-treatment.


Data were used of a prospective cohort study among 325 stage I–III CRC survivors (67% men, mean age: 67 years), recruited between 2012 and 2016. Validated questionnaires were used to assess hours/week of LPA (SQUASH) and HRQoL outcomes (EORTC QLQ-C30, Checklist Individual Strength) at 6 weeks, and 6, 12 and 24 months post-treatment. We applied linear mixed regression to analyse longitudinal confounder-adjusted associations of LPA with HRQoL.


We observed statistically significant longitudinal associations between more LPA and better global quality of life and physical, role and social functioning, and less fatigue over time. Intra-individual analysis showed that within-person increases in LPA (per 8 h/week) were related to improved HRQoL, including better global quality of life (β = 1.67, 95% CI 0.71; 2.63; total range scale: 0–100) and less fatigue (β = − 1.22, 95% CI − 2.37; − 0.07; scale: 20–140). Stratified analyses indicated stronger associations among participants below the median of moderate-to-vigorous physical activity (MVPA) at diagnosis.


Higher levels of LPA were longitudinally associated with better HRQoL and less fatigue in CRC survivors up to two years post-treatment. Further prospective studies using accelerometer data are necessary to inform development of interventions targeting LPA.

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