Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after color
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Longitudinal associations of light‑intensity physical activity with quality of life, functioning and fatigue after colorectal cancer E. H. van Roekel1 · J. Duchâteau1 · M. J. L. Bours1 · L. van Delden2 · J. J. L. Breedveld‑Peters1 · J. L. Koole1 · M. Kenkhuis1 · P. A. van den Brandt1,2 · R. L. Jansen3 · I. Kant2 · V. Lima Passos4 · K. Meijer5 · S. O. Breukink6 · M. L. G. Janssen‑Heijnen1,7 · E. Keulen8 · M. P. Weijenberg1 Accepted: 19 June 2020 © The Author(s) 2020
Abstract Purpose Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. However, these associations have not been investigated in longitudinal studies that provide the opportunity to analyse how within-individual changes in LPA affect HRQoL. We investigated longitudinal associations of LPA with HRQoL outcomes in CRC survivors, from 6 weeks to 2 years post-treatment. Methods Data were used of a prospective cohort study among 325 stage I–III CRC survivors (67% men, mean age: 67 years), recruited between 2012 and 2016. Validated questionnaires were used to assess hours/week of LPA (SQUASH) and HRQoL outcomes (EORTC QLQ-C30, Checklist Individual Strength) at 6 weeks, and 6, 12 and 24 months post-treatment. We applied linear mixed regression to analyse longitudinal confounder-adjusted associations of LPA with HRQoL. Results We observed statistically significant longitudinal associations between more LPA and better global quality of life and physical, role and social functioning, and less fatigue over time. Intra-individual analysis showed that within-person increases in LPA (per 8 h/week) were related to improved HRQoL, including better global quality of life (β = 1.67, 95% CI 0.71; 2.63; total range scale: 0–100) and less fatigue (β = − 1.22, 95% CI − 2.37; − 0.07; scale: 20–140). Stratified analyses indicated stronger associations among participants below the median of moderate-to-vigorous physical activity (MVPA) at diagnosis. Conclusion Higher levels of LPA were longitudinally associated with better HRQoL and less fatigue in CRC survivors up to two years post-treatment. Further prospective studies using accelerometer data are necessary to inform development of interventions targeting LPA. Keywords Colorectal cancer survivor · Light-intensity physical activity · Longitudinal · Health-related quality of life · Functioning · Fatigue
Introduction
E. H. van Roekel and J. Duchâteau have contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-020-02566-7) contains supplementary material, which is available to authorized users. * E. H. van Roekel [email protected] Extended author information available on the last page of the article
Colorectal cancer (CRC) ranks as the third most prevalent cancer in men and second in women worldwide, with an estimated 4.8 million people diagnosed with CRC in th
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