PALM studie (WC2016-001)


Starting date: 01/09/2015

The Physical Activity Levels in patients with Mamma-carcinoma (PALM) study is part of the MEchanisms of TRaining In patients with Cancer (METRIC) project.

Physical activity guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for all cancer survivors. In 2010, the American College of Sports Medicine (ACSM) organized a roundtable and formulated exercise guidelines for cancer survivors. The ACSM recommends avoiding physical inactivity and being as physically active as abilities and conditions allow. If possible, adult cancer survivors are recommended to engage in at least 150 minutes per week of moderate intensity or 75 min per week of vigorous intensity aerobic physical activity or an equivalent combination of moderate and vigorous intensity aerobic physical activity, for at least 10 min per session. In addition, muscle-strengthening activities involving all major muscle groups are recommended at least 2 days per week. The ACSM acknowledges that some activity is better than nothing and exceeding the guideline is likely to provide additional health benefits. At present, the guidelines are rather generic and resemble the age-appropriate physical activity guidelines for the general population.

Physical activity levels of cancer survivors are lower than in the general population, and they tend to decline during cancer treatment and remain lower for years after cancer treatment. In addition, breast cancer survivors are more sedentary and participate in less light-intensity physical activity than age matched non-cancer controls. Sedentary behavior is characterized by a low energy expenditure (i.e. ≤ 1.5 metabolic equivalents (METs)). Similar to findings in the general population, excessive sedentary behavior, as distinct from insufficient physical activity, may be linked to negative health effects. Recent experimental studies have indicated the importance of breaking up prolonged sedentary time for improving health. Thus far, studies on the pattern in which both sedentary behavior and physical activity is accumulated and the effects of such patterns on health outcomes (e.g. fatigue and HRQoL) suggest that sedentary behavior may be related to adverse cancer outcomes, fatigue, pain, depression and a decreased quality of life (14-16). Objective measurement of both physical activity and sedentary behavior are obtained using accelerometers. Following data reduction procedures (e.g. non-wear time, valid day definition), time spent in sedentary, light, moderate or vigorous physical activity behavior are subsequently assessed by applying cut-points. As these cut-points are validated in the general publication, which generally have a higher fitness level, they may not be appropriate for cancer survivors. Therefore, alternative cut-points or innovative predictions of accelerometer-based physical activity and sedentary behavior may be required to capture the pattern of both physical activity and sedentary behavior. The aim of the current study is to validate accelerometer output to differentiate between different types of physical activity and sedentary behavior, making it possible to optimize accelerometer-based physical activity and sedentary behaviour assessment.