Supportive Care in Cancer

, Volume 15, Issue 2, pp 203–211 | Cite as

Evaluation of a 12-week home-based walking intervention for breast cancer survivors

  • Charles E. MatthewsEmail author
  • Sara Wilcox
  • Cara L. Hanby
  • Cheryl Der Ananian
  • Sue P. Heiney
  • Tebeb Gebretsadik
  • Ayumi Shintani
Original Article


Goals of work

To evaluate a 12-week home-based walking intervention among breast cancer survivors and to quantify changes in physical activity (PA) behaviors, body weight, and body composition in response to the intervention.

Patients and methods

Breast cancer survivors that were in the posttreatment period were randomized to intervention (n=23) or wait-list usual care (n=13). PA was assessed by self-report, and in a study subsample (n=23), by an accelerometer. Intention to treat principles were employed to estimate the intervention effect on PA behaviors, body weight, and body composition. Intervention adherence was calculated as the proportion of exercise sessions completed relative to the number of exercise sessions recommended, as reported each week on walking logs.

Main results

Thirty-four of 36 women randomized (94%) completed the study. Average intervention adherence over 12 weeks was 94%. Intervention participants reported a significantly greater increase in walking for exercise [+11.9 metabolic equivalent (MET)-h/week] over time than did usual care participants (+1.7 MET-h/week, p=0.01). Objective measures of activity also indicated that intervention participants increased their activity levels over time as compared to usual care participants [i.e., counts/min/day and steps/day (p≤0.04)]. No significant changes in body weight or composition were observed.


We found that a 12-week home-based walking intervention was safe and effective for increasing short-term PA levels in breast cancer survivors. Future studies are needed to assess the ability of brief interventions to facilitate the maintenance of increased activity levels and to produce favorable quality of life and risk factor outcomes.


Exercise Physical activity Behavior change Accelerometer 



We would like to thank Ms. Amy Skiba, M.S., for her dedicated efforts on behalf or the Breast Cancer Walking Study. This research was supported financially by the Vanderbilt-Ingram Cancer Center, the South Carolina Cancer Center, and the Vanderbilt General Clinical Research Center (M01 RR-00095).


  1. 1.
    ACSM (2004) ACSM position stand on the appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports 33:2145–2156Google Scholar
  2. 2.
    American Cancer Society (2005) Cancer facts and figures—2005. American Cancer Society, Atlanta, GAGoogle Scholar
  3. 3.
    Byers T, Nestle M, McTiernan A, Doyle C, Currie-Williams A, Gansler T, Thun M (2002) American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk for cancer with healthy food choices and physical activity. CA Cancer J Clin 52:92–119PubMedCrossRefGoogle Scholar
  4. 4.
    Cardinal BJ, Esters J, Cardinal MK (1996) Evaluation of the revised physical activity readiness questionnaire in older adults. Med Sci Sports Exerc 28:468–472PubMedCrossRefGoogle Scholar
  5. 5.
    Castro CM, King AC (2002) Telephone-assisted counseling for physical activity. Exerc Sport Sci Rev 30:64–68PubMedCrossRefGoogle Scholar
  6. 6.
    Chlebowski RT, Aiello E, McTiernan A (2002) Weight loss in breast cancer patient management. J Clin Oncol 20:1128–1143PubMedCrossRefGoogle Scholar
  7. 7.
    Conn VS, Hafdhal A, Porock DC, McDaniel R, Nielsen PJ (2006) A meta-analysis of exercise interventions among people treated for cancer. Support Care Cancer 14:699–712PubMedCrossRefGoogle Scholar
  8. 8.
    Courneya KS (2003) Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc 35:1846–1852PubMedCrossRefGoogle Scholar
  9. 9.
    Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS (2003) A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care 12:347–357CrossRefGoogle Scholar
  10. 10.
    Courneya KS, Friedenreich CM, Sela RA, Quinney HA, Rhodes RE, Handman M (2003) The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psycho-Oncology 12:357–374PubMedCrossRefGoogle Scholar
  11. 11.
    Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS (2003) Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol 21:1660–1668PubMedCrossRefGoogle Scholar
  12. 12.
    Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR (2003) Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomark Prev 12:721–727Google Scholar
  13. 13.
    Frison L, Pocock SJ (2005) Repeated measures in clinical trials: analysis using mean summary statistics and its implications for design. Stat Med 11:1685–1704Google Scholar
  14. 14.
    Ganz PA, Kwan L, Stanton AL, Krupnick JL, Rowland JH, Meyerowitz BE, Bower JE, Belin TR (2004) Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst 96:376–387PubMedCrossRefGoogle Scholar
  15. 15.
    Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486PubMedCrossRefGoogle Scholar
  16. 16.
    Jones LW, Courneya KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10:208–215PubMedCrossRefGoogle Scholar
  17. 17.
    Kotler DP, Burastero S, Wang J, Pierson RN Jr (1996) Prediction of body cell mass, fat-free mass, and total body water with bioelectrical impedance analysis: effects of race, sex, and disease. Am J Clin Nutr 64:489S–497SPubMedGoogle Scholar
  18. 18.
    Kristal AR, Curry SJ, Shattuck AL, Feng Z, Li S (2000) A randomized trial of a tailored, self-help dietary intervention: the puget sound eating patterns study. Prev Med 31:380–389PubMedCrossRefGoogle Scholar
  19. 19.
    Laird NM, Ware JH (1982) Random-effects models for longitudinal data. Biometrics 38:963–974PubMedCrossRefGoogle Scholar
  20. 20.
    Littell R, Milliken G, Stroup W, Wolfinger R (1996) SAS system for mixed models. SAS, Cary, NC, p 633Google Scholar
  21. 21.
    Matthews CE, Ainsworth BE, Hanby CL, Pate RR, Addy C, Freedson PS, Jones DA, Macera CA (2005) Development and testing of a short physical activity recall questionnaire. Med Sci Sports Exerc 37:986–994PubMedGoogle Scholar
  22. 22.
    McTiernan A, Ulrich C, Kumai C, Bean D, Schwartz R, Mahloch J, Hastings R, Gralow J, Potter JD (1998) Anthropometric and hormone effects of an eight-week exercise-diet intervention in breast cancer patients: results of a pilot study. Cancer Epidemiol Biomark Prev 7:477–481Google Scholar
  23. 23.
    McTiernan A, Tworoger SS, Ulrich CM, Yasui Y, Irwin ML, Rajan KB, Sorensen B, Rudolph RE, Bowen D, Stanczyk FZ, Potter JD, Schwartz RS (2004) Effect of exercise on serum estrogens in postmenopausal women: a 12-month randomized clinical trial. Cancer Res 64:2923–2928PubMedCrossRefGoogle Scholar
  24. 24.
    Mock V, Pickett M, Ropka ME, Muscari LE, Stewart KJ, Rhodes VA, McDaniel R, Grimm PM, Krumm S, McCorkle R (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 9:119–127PubMedCrossRefGoogle Scholar
  25. 25.
    Partridge AH, Burstein HJ, Winer EP (2001) Side effects of chemotherapy and combined chemohormonal therapy in women with early-stage breast cancer. J Natl Cancer Inst Monographs 30:135–142PubMedGoogle Scholar
  26. 26.
    Pinto BM, Clark MM, Maruyama NC, Feder SI (2003) Psychological and fitness changes associated with exercise participation among women with breast cancer. Psycho-Oncology 12:118–126PubMedCrossRefGoogle Scholar
  27. 27.
    Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH (2005) Home-based physical activity intervention for breast cancer patients. J Clin Oncol 23:3577–3587PubMedCrossRefGoogle Scholar
  28. 28.
    Schwartz AL (2004) Physical activity after a cancer diagnosis: psychosocial outcomes. Cancer Investig 22:82–92CrossRefGoogle Scholar
  29. 29.
    Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J, Woodard S, Wells G, Reid R (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19:657–665PubMedGoogle Scholar
  30. 30.
    Segar ML, Katch VL, Roth RS, Garcia AW, Portner TI, Glickman SG, Haslanger S, Wilkins EG (1998) The effect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors. Oncol Nurs Forum 25:107–113PubMedGoogle Scholar
  31. 31.
    Stewart AL, Mills KM, King AC, Haskell WL, Gillis D, Ritter PL (2001) CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc 33:1126–1141PubMedGoogle Scholar
  32. 32.
    Thompson FE, Subar AF, Smith AF, Midthune D, Radimer KL, Kahle LL, Kipnis V (2002) Fruit and vegetable assessment: performance of 2 new short instruments and a food frequency questionnaire. J Am Diet Assoc 102:1764–1772PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Charles E. Matthews
    • 1
    Email author
  • Sara Wilcox
    • 2
  • Cara L. Hanby
    • 1
  • Cheryl Der Ananian
    • 3
  • Sue P. Heiney
    • 4
  • Tebeb Gebretsadik
    • 5
  • Ayumi Shintani
    • 5
  1. 1.Department of Medicine, Division of General Internal Medicine and Public Health, Vanderbilt-Ingram Cancer CenterVanderbilt University School of MedicineNashvilleUSA
  2. 2.Department of Exercise Science, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  3. 3.Institute for Health Research and PolicyUniversity of Illinois at ChicagoChicagoUSA
  4. 4.Department of Neuropsychiatry, Psychosocial Oncology Palmetto Health, South Carolina Cancer CenterUniversity of South Carolina School of MedicineColumbiaUSA
  5. 5.Department of Biostatistics, Vanderbilt-Ingram Cancer CenterVanderbilt University School of MedicineNashvilleUSA

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