Relationship of different levels of physical activity on the health status of long-term breast cancer survivors: a cross-sectional study

The first objective of this study is to examine the relationship between different levels of physical activity (PA) and the health status of long-term breast cancer survivors (LTBCSs) who have survived ≥5 years beyond diagnosis. The second aim is to identify potential predictors of long-term PA levels in this population. An 80-participant cross-sectional study categorized LTBCSs by PA levels: insufficiently active (very low ≤3 metabolic equivalent task (MET), low 3.1–7.4 MET) and sufficiently active (≥7.5 MET). Variables assessed included PA, pain, self-perceived physical fitness, cancer-related fatigue (CRF), comorbidities, mood, and health-related quality of life (HRQoL). ANOVA, Mann-Whitney U, and Chi-square tests were performed, along with Spearman’s correlation and multiple regression analysis. Cohen’s <i>d</i> and Cramér’s <i>V</i> were used to calculate effect sizes. 66.25% of LTBCSs were insufficiently active, with 17.25% classified as sedentary (≤1.5 MET). In the first objective, and compared to sufficiently active survivors, insufficiently active LTBCSs reported higher levels of pain, breast symptoms, dyspnea, moderate-to-severe CRF, sadness/depression, and anger, along with lower levels of happiness, general fitness, speed/agility, role functioning, and HRQoL (<i>p</i> &lt; 0.05). In the second objective, the regression analysis found "future perspective" (β = 0.314; <i>p</i> &lt; 0.01) and "insomnia" (β = −0.288; <i>p</i> = 0.02) to be significant predictors of higher PA levels (r² = 0.224). Insufficiently active LTBCSs had higher pain, symptoms, CRF, and mood disturbances, with decreased happiness, self-perceived physical fitness, and HRQoL. Future research should focus on interventions that target improving PA levels and managing factors such as "future perspective" and "insomnia," as they are significant predictors of PA adherence. These findings underscore the importance of incorporating PA into rehabilitation programs to enhance overall well-being and HRQoL in LTBCSs. Here are presented the bullet points that highlight the implications for rehabilitation of this study:The majority of long-term breast cancer survivors (≥5 years post-diagnosis) do not meet recommended physical activity guidelines (66.25%). This inactivity is significantly correlated with greater physical and emotional deterioration.Emphasizing adherence to physical activity before, during, and after breast cancer treatment is crucial. Patients should understand that physical activity is not merely a "lifestyle recommendation" but a biological necessity.Developing strategies to promote long-term adherence to physical activity should be a primary focus for future research and rehabilitation programs.Future research should focus on identifying and addressing barriers to physical activity adherence in long-term breast cancer survivors. The majority of long-term breast cancer survivors (≥5 years post-diagnosis) do not meet recommended physical activity guidelines (66.25%). This inactivity is significantly correlated with greater physical and emotional deterioration. Emphasizing adherence to physical activity before, during, and after breast cancer treatment is crucial. Patients should understand that physical activity is not merely a "lifestyle recommendation" but a biological necessity. Developing strategies to promote long-term adherence to physical activity should be a primary focus for future research and rehabilitation programs. Future research should focus on identifying and addressing barriers to physical activity adherence in long-term breast cancer survivors.

本研究的首要目标是探讨不同水平的身体活动（physical activity, PA）与确诊后存活≥5年的乳腺癌长期幸存者（long-term breast cancer survivors, LTBCSs）健康状况之间的关系；次要目标是确定该人群中长期PA水平的潜在预测因素。一项纳入80名参与者的横断面研究根据PA水平将LTBCSs分为两类：活动不足组（极低水平≤3代谢当量任务（metabolic equivalent task, MET）、低水平3.1–7.4 MET）和活动充足组（≥7.5 MET）。评估的变量包括PA、疼痛、自我感知的体能、癌症相关疲劳（cancer-related fatigue, CRF）、合并症、情绪以及健康相关生活质量（health-related quality of life, HRQoL）。采用方差分析（ANOVA）、曼-惠特尼U检验、卡方检验，以及斯皮尔曼相关分析和多元回归分析；使用Cohen's d和Cramér's V计算效应量。66.25%的LTBCSs活动不足，其中17.25%被归类为久坐不动（≤1.5 MET）。在首要目标方面，与活动充足的幸存者相比，活动不足的LTBCSs报告了更高水平的疼痛、乳腺症状、呼吸困难、中重度CRF、悲伤/抑郁和愤怒，同时幸福感、总体体能、速度/敏捷性、角色功能和HRQoL水平更低（p < 0.05）。在次要目标方面，回归分析发现“未来展望”（β=0.314；p<0.01）和“失眠”（β=-0.288；p=0.02）是更高PA水平的显著预测因素（r²=0.224）。活动不足的LTBCSs疼痛、症状、CRF和情绪障碍程度更高，同时幸福感、自我感知体能和HRQoL降低。未来研究应关注旨在提高PA水平和管理“未来展望”及“失眠”等因素的干预措施，因为这些因素是PA依从性的显著预测因素。这些发现强调了将PA纳入康复计划以提升LTBCSs整体福祉和HRQoL的重要性。以下项目符号强调了本研究对康复的意义：大多数乳腺癌长期幸存者（确诊后≥5年）未达到推荐的身体活动指南标准（66.25%）。这种不活动与更严重的身体和情绪恶化显著相关。强调乳腺癌治疗前、治疗期间和治疗后坚持身体活动至关重要。患者应认识到，身体活动不仅仅是“生活方式建议”，更是一种生理必需。制定促进长期坚持身体活动的策略应成为未来研究和康复计划的首要重点。未来研究应关注识别和解决乳腺癌长期幸存者身体活动依从性的障碍。大多数乳腺癌长期幸存者（确诊后≥5年）未达到推荐的身体活动指南标准（66.25%）。这种不活动与更严重的身体和情绪恶化显著相关。强调乳腺癌治疗前、治疗期间和治疗后坚持身体活动至关重要。患者应认识到，身体活动不仅仅是“生活方式建议”，更是一种生理必需。制定促进长期坚持身体活动的策略应成为未来研究和康复计划的首要重点。未来研究应关注识别和解决乳腺癌长期幸存者身体活动依从性的障碍。