title: Self-reported physical activity behavior of breast cancer survivors during and after adjuvant therapy: 12 months follow-up of two randomized exercise intervention trials.
abstract: BACKGROUND
  Exercise during and after breast cancer treatment has shown several health benefits. However, little is known about the courses, patterns, and determinants of physical activity of breast cancer patients, and the role of exercise interventions on their physical activity behavior in the long run.
  
  
  METHODS
  Self-reported physical activity was assessed in 227 breast cancer survivors before, during, and three, six, and 12 months post-intervention within two randomized resistance exercise trials performed during adjuvant chemo- or radiotherapy, respectively, with similar designs. Multiple ordinal logistic regression analyses were performed to identify determinants of physical activity at these time points.
  
  
  RESULTS
  While the intervention group exercised a median 1.8 h/week during adjuvant therapy (interquartile range 1.4-2.5), 68% of controls did not engage in any exercise. At 12-months follow-up 32% of patients did not engage in any exercise irrespective of the intervention. Of the patients who cycled for transportation pre-diagnosis about half stopped cycling in the long term in both groups. In contrast, walking was maintained over time. Major determinants of low levels of exercise at 12-months follow-up were low pre-diagnosis levels of exercise, lower education, being postmenopausal, and having breast problems or depressive symptoms. Further, the intervention appeared to influence the type of sports performed, with strength exercise being the most common type of exercise at follow-up in the exercise group, more frequently compared to the control group.
  
  
  CONCLUSIONS
  The exercise intervention effectively countervailed the decrease in physical activity during cancer therapy and boosted strength exercise in the months following the intervention, but in the longer term many survivors were insufficiently active. Breast cancer survivors may need continued motivation and practical support tailored to their individual characteristics and physical activity history to incorporate exercise in everyday routine in the long term.
authors.affiliation: a Division of Physical Activity, Prevention and Cancer , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Martina E
authors.initials: ME
authors.lastname: Schmidt
authors.affiliation: b Division of Medical Oncology , National Center for Tumor Diseases (NCT) and Heidelberg University Hospital , Heidelberg , Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Wiskemann
authors.affiliation: c Department of Population Health Sciences , Huntsman Cancer Institute and University of Utah , Salt Lake City , UT , USA.
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ulrich
authors.affiliation: d Division Gynecologic Oncology , National Center for Tumor Diseases (NCT) and University Hospital , Heidelberg , Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schneeweiss
authors.affiliation: a Division of Physical Activity, Prevention and Cancer , National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
authors.forename: Karen
authors.initials: K
authors.lastname: Steindorf
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000534:rehabilitation* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D057566:Self Report; D017741:Survivors / Q000706:statistics & numerical data