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EFFECT OF HOME-BASED EXERCISE ON PHYSICAL ACTIVITY IN BREAST AND PROSTATE CANCER SURVIVORS: A META-ANALYSIS

Abstract

Kyle M. Edgar, Cameron K. Stopforth, Lauren C. Bates, Sasha Riley, Kaileigh Moertl, Erik D. Hanson, FACSM, Lee Stoner, FACSM. University of North Carolina Chapel Hill, Chapel Hill, NC.

INTRODUCTION AND OBJECTIVE: Breast (BCa) and prostate cancer (PCa) are common but highly treatable. However, survivors are often burdened with prolonged side effects following treatments that lead to reduced total physical activity (TPA). Low TPA levels are associated with decreased quality of life and increased risk of all-cause mortality. Although exercise interventions are designed to increase TPA, the extent to which home-based exercise improves TPA levels in BCa/PCa is unclear. Therefore, the objective of this meta-analysis was to investigate the effects of home-based exercise on TPA in BCa and PCa survivors. All studies reporting pre-and post-intervention TPA values were eligible for inclusion. METHODS: Electronic databases were searched from inception to July 2021. Standardized mean differences (SMD) were calculated to account for differing TPA assessment types. Effects estimates were pooled using a 3-level model with restricted maximum likelihood estimation. The alpha was set at 5% for the pooled estimate and 10% for effect moderators. SMD of <0.2, 0.2, 0.5, and 0.8 were defined as trivial, small, moderate, and large respectively. RESULTS: Ten articles with 14 effects (n=630) met inclusion criteria. Overall, home-based exercise led to small improvements in TPA [SMD=0.49; 95% CI (0.26, 0.75); p<0.001]. TPA assessment was a significant effect moderator (p=0.069). Moderate improvements were reported with self-reported TPA [SMD=0.54; 95% CI (0.27, 0.80); p<0.001], whereas smaller, non-significant effects were seen with accelerometry [SMD=0.28; 95% CI (-0.07, 0.63); p=0.113]. Cancer type (p=0.133), intervention duration (p=0.109), age (p=0.130), and modality (p=0.245) were all non-significant effect moderators. CONCLUSIONS: Home-based exercise appears to increase TPA in BCa/PCa, presenting a plausible option for survivors living without access to supervised exercise facilities. However, moderator analysis indicated that the increase in TPA was greater when self-reported and may overestimate actual TPA. Given the small number of effect estimates (n=3) for objective measures, confirmational research is warranted to investigate differences between self-reported and objectively measured TPA.

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