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Maintenance of physical activity in breast cancer survivors after a randomized trial
Vallance JK, Courneya KS, Plotnikoff RC, Dinu I, Mackey JR
Medicine and Science in Sports and Exercise 2008 Jan;40(1):173-180
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: The purpose of this study was to examine the longer-term effects of pedometers and print materials on changes in physical activity (PA) and health-related quality of life (HRQoL) in breast cancer survivors who participated in a 3-month behavior change intervention. METHODS: Breast cancer survivors (n = 377) were randomly assigned to receive either (a) a standard public health recommendation for PA (SR), (b) previously developed breast cancer-specific PA print materials (PM), (c) a step pedometer (PED), or (d) a combination of the two (COM). The primary endpoint was self-reported moderate/vigorous PA minutes per week at 6-month follow-up after the initial 3-month intervention period. RESULTS: Seventy-one percent (266/377) of participants completed the 6-month follow-up assessment. According to intention-to-treat linear mixed-model analyses, self-reported moderate to vigorous PA increased by 9 min/wk in the SR group compared with 39 min/wk in the PM group (mean difference = 30 min/wk; 95% CI -44 to 104; p = 0.425), 69 min/wk in the PED group (mean difference = 60 min/wk; 95% CI -13 to 132; p = 0.107), and 56 min/wk in the COM group (mean difference = 47 min/wk; 95% CI -26 to 119; p = 0.210). The same pattern was observed for self-reported, brisk walking. No differences were found for HRQoL or fatigue. CONCLUSION(S): Breast cancer-specific PM and PED did not maintain significantly higher PA or HRQoL at 6-month follow-up in breast cancer survivors, but the magnitude of the effect on PA (30 to 60 min/wk) was consistent with the immediate postintervention effect observed at the 3-month postintervention time point. Issues of power resulting from additional loss to follow-up may account for the failure to achieve statistical significance. Additional research with larger sample sizes and more complete follow-up is warranted.

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