title: Functional Impairment and Physical Activity Adherence Among Gynecologic Cancer Survivors: A Population-Based Study.
abstract: OBJECTIVE
  Adherence to physical activity guidelines after cancer diagnosis improves physical functioning. The purpose of this study was to estimate the prevalence of physical activity in a population-based sample of gynecologic cancer survivors (GCSs) and to examine the association between functional impairment and adherence to physical activity guidelines.
  
  
  METHODS
  Using the 2009 Behavioral Risk Factor Surveillance System survey, we identified 5,015 GCSs aged 20 years or older who were 1 year or more after diagnosis. We used multinomial logistic regression with survey weighting to examine the association between functional impairment and adherence to physical activity guidelines (using 3 levels: sedentary, somewhat active, and meeting physical activity guidelines), controlling for demographic and clinical factors.
  
  
  RESULTS
  We found that 55% of GCSs did not adhere to physical activity guidelines and that 38% reported functional impairment. Gynecologic cancer survivors with functional impairment were less likely to meet guidelines (adjusted odds ratio [AOR], 0.34; 95% confidence interval [CI], 0.25-0.47) or to be somewhat active (AOR, 0.43; 95% CI, 0.31-0.59) compared with those without impairment. Having more than high school education (AOR, 1.66; 95% CI, 1.15-2.40), fewer comorbidities (AOR, 0.55; 95% CI, 0.33-0.91), and not being obese (OR, 0.53; 95% CI, 0.36-0.77) were associated with meeting physical activity guidelines compared with being sedentary.
  
  
  CONCLUSIONS
  Gynecologic cancer survivors do not meet physical activity guidelines and experience functional impairment, which is associated with lower adherence to physical activity recommendations. Prospective studies are needed to better elucidate the relation between functional impairment and physical activity.
authors.affiliation: *Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; †Department of Health Promotion and Behavioral Sciences, ‡Department of Behavioral Sciences, and §Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, TX; and ∥Department of Health Services, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Pratibha
authors.initials: P
authors.lastname: Nayak
authors.forename: Sally W
authors.initials: SW
authors.lastname: Vernon
authors.forename: Lara S
authors.initials: LS
authors.lastname: Savas
authors.forename: Karen
authors.initials: K
authors.lastname: Basen-Engquist
authors.forename: Robert O
authors.initials: RO
authors.lastname: Morgan
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D005833:Genital Neoplasms, Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D057185:Sedentary Behavior; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult