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乳腺癌确诊后，虽然积极运动的获益已经得到公认，但是大多数乳腺癌生存者不够积极。
2019年4月23日，美国癌症学会《癌症》在线发表澳大利亚墨尔本大学、维多利亚州癌症协会、贝克医学研究中心、圣文森特医院、昆士兰大学、南澳大利亚大学、美国凯萨医疗集团华盛顿州医疗研究中心、加拿大阿萨巴斯卡大学、阿尔伯特省医疗服务局、卡尔加里大学的随机对照研究（ACTIVATE）报告，分析了智能运动手环等可穿戴技术干预对于乳腺癌生存者增加体力活动以及减少久坐行为的效果。
该随机对照研究于2016年7月～2017年7月从澳大利亚入组被确诊为I～III期乳腺癌并已完成初步治疗的无症状绝经后女性83例，随机分入干预组或对照组，并于12周内进行干预。通过智能运动手环（GARMIN VIVOfit 2）结合行为反馈和目标设定会议，以及五次健康指导电话会议，增加中等至剧烈体力活动，并且减少久坐行为。干预前和干预结束时，通过智能运动手表（ActiGraph）和运动监测芯片（activPAL）对积极运动（中等至剧烈体力活动）和久坐行为（至少20分钟）进行定量分析。
结果，该研究参与者坚持率较高，其中80例（96%）参与者完成干预结束时数据收集。
干预结束时，干预组与对照组相比：
每周积极运动增加69分钟（95%置信区间：+22～+116，P<0.01）
每天静坐时间减少37分钟（95%置信区间：-72～-2，P=0.01）
每天久坐时间减少42分钟（95%置信区间：-83～-2，P=0.04）
干预组干预结束12周后与干预结束时相比：
此外，干预组干预结束时，对照组也收到智能运动手环，12周后：
因此，该研究结果表明，利用智能运动手环等可穿戴技术，可以提供成本不高并且容易推广的机会，增加积极运动、减少久坐时间、促进癌症生存者更健康的生活方式。该可穿戴技术干预能否产生可持续的行为改变，应该成为未来研究的主题。
相关阅读
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Cancer. 2019 Apr 23. [Epub ahead of print]
A randomized controlled trial of a wearable technology-based intervention for increasing moderate to vigorous physical activity and reducing sedentary behavior in breast cancer survivors: The ACTIVATE Trial.
Lynch BM, Nguyen NH, Moore MM, Reeves MM, Rosenberg DE, Boyle T, Vallance JK, Milton S, Friedenreich CM, English DR.
Cancer Council Victoria, Melbourne, Victoria, Australia; The University of Melbourne, Melbourne, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; St. Vincent's Hospital, Melbourne, Victoria, Australia; The University of Queensland, Brisbane, Queensland, Australia; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia; Athabasca University, Athabasca, Alberta, Canada; Alberta Health Services, Calgary, Alberta, Canada; University of Calgary, Calgary, Alberta, Canada.
A randomized controlled trial evaluated a 12-week wearable technology-based intervention to increase moderate to vigorous physical activity (MVPA) and reduce sitting time in breast cancer survivors. The intervention increased total MVPA (between-group change = 69 min/week, 95% CI = 22-116) and decreased total sitting time (-37 min/d; 95% CI = -72 to -2).
BACKGROUND: The benefits of an active lifestyle after a breast cancer diagnosis are well recognized, but the majority of survivors are insufficiently active. The ACTIVATE Trial examined the efficacy of an intervention (use of the GARMIN VIVOfit 2 activity monitor coupled with a behavioral feedback and goal-setting session and 5 telephone-delivered health coaching sessions) to increase moderate to vigorous physical activity (MVPA) and reduce sedentary behavior in breast cancer survivors.
METHODS: This randomized controlled trial recruited 83 inactive, postmenopausal women diagnosed with stage I-III breast cancer who had completed primary treatment. Participants were randomly assigned to the intervention group or to the control group, and the intervention was delivered over a 12-week period. MVPA and sedentary behavior were measured with ActiGraph and activPAL accelerometers at baseline (T1) and at the end of the intervention (T2).
RESULTS: Retention in the trial was high, with 80 (96%) of participants completing T2 data collection. At T2, there was a significant between-group difference in MVPA (69 min/wk; 95% CI = 22-116) favoring the intervention group. The trial resulted in a statistically significant decrease in both total sitting time and prolonged bouts (≥20 min) of sitting, with between-group reductions of 37 min/d (95% CI = -72 to -2) and 42 min/d (95% CI = -83 to -2), respectively, favoring the intervention group.
CONCLUSION: Results from the ACTIVATE Trial suggest that the use of wearable technology presents an inexpensive and scalable opportunity to facilitate more active lifestyles for cancer survivors. Whether or not such wearable technology-based interventions can create sustainable behavioral change should be the subject of future research.
KEYWORDS: accelerometry; breast neoplasms; exercise; fitness trackers; randomized controlled trial; sedentary lifestyle; survivors
DOI: 10.1002/cncr.32143
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Cancer. 2019 Apr 23. [Epub ahead of print]
Maintenance of physical activity and sedentary behavior change, and physical activity and sedentary behavior change after an abridged intervention: Secondary outcomes from the ACTIVATE Trial.
Lynch BM, Nguyen NH, Moore MM, Reeves MM, Rosenberg DE, Boyle T, Milton S, Friedenreich CM, Vallance JK, English DR.
Cancer Council Victoria, Melbourne, Victoria, Australia; The University of Melbourne, Melbourne, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; St. Vincent's Hospital, Melbourne, Victoria, Australia; The University of Queensland, Brisbane, Queensland, Australia; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; University of South Australia, Adelaide, South Australia, Australia; Alberta Health Services, Calgary, Alberta, Canada; University of Calgary, Calgary, Alberta, Canada; Athabasca University, Athabasca, Alberta, Canada.
Participants who receive the ACTIVATE Trial intervention successfully maintain an increased level of moderate to vigorous physical activity (MVPA) across the 12-week follow-up period, but the reduction in sedentary behavior is eroded. Receipt of the GARMIN VIVOfit 2 activity tracker alone is associated with a significant increase in MVPA and a reduction in sedentary behavior within the waitlist control arm.
BACKGROUND: This brief report examines the maintenance of moderate to vigorous physical activity (MVPA) and sedentary behavior changes approximately 12 weeks after the delivery of the ACTIVATE Trial primary intervention (use of the GARMIN VIVOfit 2 activity tracker coupled with a behavioral feedback and goal-setting session and 5 telephone-delivered health coaching sessions). We also examine the efficacy of an abridged intervention (use of the GARMIN VIVOfit 2 only) in the waitlist control group.
METHODS: A pre-post design was employed to examine the secondary aims of the ACTIVATE Trial (n = 80; mean age = 62 years). MVPA and sedentary behavior were measured using ActiGraph and activPAL accelerometers after delivery of the primary intervention (T2), and again 12 weeks later (T3). Linear mixed models with random effects were used to examine within-group changes in MVPA and sitting time variables.
RESULTS: After the 12-week follow-up period, women in the primary intervention group had maintained their higher levels of MVPA (change from T2 to T3 = 14 min/wk; 95% CI = -18 to 46; P = .37). However, their sitting time increased slightly, by 7 min/d (95% CI = -20 to 34; P = .58), but it did not return to its preintervention level. After receiving the GARMIN VIVOfit 2, the waitlist control group increased their MVPA by 33 min/wk (95% CI = 3-64; P = .03) and reduced their sitting time by 38 min/d (95% CI = -69 to -7; P = .02) over the same 12-week period.
CONCLUSION: The secondary outcomes from the ACTIVATE Trial suggest that wearable technology may generate sustainable changes in MVPA and sitting time. Wearable technology alone may be sufficient to change behavior, at least in the short term.
KEYWORDS: accelerometry breast neoplasms exercise fitness trackers sedentary lifestyle survivors
DOI: 10.1002/cncr.32142
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