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

Abstract

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 ≥5years beyond diagnosis. The second aim is to identify potential predictors of long-term PA levels in this population. Methods: 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 d and Cramér’s V were used to calculate effect sizes. Results: 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 (p<0.05). In the second objective, the regression analysis found "future perspective" (β=0.314; p<0.01) and "insomnia" (β = −0.288; p=0.02) to be significant predictors of higher PA levels (r2 = 0.224). Conclusion: 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. hIMPLICATIONS FOR REHABILITATION 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.