Background: Breast cancer remains the leading cause of cancer mortality among Latina women in the US. Physical activity (PA) and exercise have been shown to reduce morbidity and mortality from cardiometabolic diseases and cancer while improving individual fitness; disability and health related quality of life (HRQoL). However, Latinas, particularly those who speak only Spanish, have not been included in studies in sufficient numbers to identify factors to promote their participation in cancer prevention interventions.
Purpose: To compare physical fitness, disability, and HRQoL between physically active and sedentary Hispanic breast cancer survivors.
Methods: A total of 94 women (Age: 55.4 ± 9.9; BMI: 29.87 ± 5.62; ) from the Puerto Rico Comprehensive Cancer Center and MD Anderson Cancer Center in Houston, TX participating in Project VIVA! were recruited for this study. The VIVA! Program is a 16-week exercise intervention emphasizing in the minimum guidelines from The American College of Sports Medicine targeting aerobic endurance, muscular strength, balance, and muscle endurance. Participants visited the clinic for fitness testing and assessment of physical activity (PA), disability, and HRQoL through a battery of self-administered questionnaires previous to starting the intervention. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) in the preferred language of the participant; English or Spanish. The physical fitness assessment included: anthropometrics (BMI & waist to hip ratio) measures, adiposity (% body fat) by skinfolds measurement, six-minute walk test (6MWT), lumbar and isquiotibial flexibility by sit-and-reach, grip strength by hand dynamometry, lower extremity endurance testing by sit-to-stand in 30 seconds, upper extremity, low back, and leg strength by Jackson strength testing protocol, shoulder range of motion (ROM) with inclinometer, and balance testing by a functional reach test. Upper and lower extremity function, joint motion and disability were assessed by The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) and The Western Ontario McMaster University Osteoarthritis Index (WOMAC), respectively. HRQoL was measured by the short version of the QOL (SF-36) questionnaire. For physical activity analyses, sample was divided into two groups based on results from the IPAQ; those with less than 150 min/wk (n = 58) and those exceeding 150 min/wk (n = 36). For analyses of sedentary time, sample was also divided into two groups based on the IPAQ; those spending less than 180 min/day in sitting (n = 46) and those spending greater than 180 mins/day sitting (n = 45). Groups were compared for all variables using analysis of variance (ANOVA).
Results: ANOVA for physical activity revealed that those participants engaging in more than 150 min/wk of PA have better 6MWT (p = 0.04) and 30-second sit-to-stand ( p = 0.027) results demonstrating greater cardiorespiratory fitness and muscular endurance, respectively. Those participants spending less than 180 mins/day sitting exhibited better mental component scores in the SF-36 than those spending more time sitting (p = 0.012).
Conclusion: It appears that meeting or exceeding the minimum recommended amount of PA and decreasing time spent in sedentary activities have positive physical fitness and HRQoL outcomes in Hispanic women breast cancer survivors. Even though the relationship between PA and sedentary behaviors with measures of physical fitness, disability, and HRQoL are difficult to establish, it is sound for clinicians to start considering PA as a preventive and rehabilitative strategy to improve breast cancer survivors HRQoL.
Funding Sources: This project was partially supported by the Center for Energy Balance in Cancer Prevention and Survivorship, Duncan Family Institute, and by the following NIH awards: U54 CA 96297; P30 CA016672; R25T CA057730; and K01 CA 134550.
Citation Format: Alexis Ortiz, Maribel Tirado-Gomez, Daniel C. Hughes, Velda Gonzalez, Karen Basen-Engquist. Differences in physical fitness, disability, and health-related quality of life between physical active and sedentary Hispanic breast cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B29.