Physical activity among adult survivors of childhood lower-extremity sarcoma

Abstract

Introduction: Adult survivors of childhood lower-extremity sarcoma are largely physically inactive, a behavior which potentially compounds their health burden. Altering this behavior requires understanding those factors that contribute to their physical inactivity. Therefore, this investigation sought to identify factors associated with inactivity in this subpopulation of cancer survivors.

Methods: Demographic, personal, treatment, and physical activity information from adult survivors of childhood lower-extremity sarcomas was obtained from the Childhood Cancer Survivor Study (CCSS) cohort. Generalized linear models were used to identify variables that best identified those individuals who were physically inactive.

Results: Only 41% of survivors met Center for Disease Control (CDC) activity guidelines. Survivors were 1.20 (95% confidence intervals (CI) 1.11-1.30) more likely compared to CCSS sibling cohort and 1.12 (95% CI 1.10-1.15) times more likely than the general population to fail to meet CDC guidelines. Significant predictors of physical inactivity included female sex, hemipelvectomy surgery, and platinum and vinca alkaloid chemotherapy.

Conclusions: The primary findings of this study are that survivors of childhood onset lower-extremity sarcoma are (1) highly likely to be physically inactive and (2) less likely than their siblings or the general population to regularly exercise. This study has identified treatment-related risk factors associated with inactivity that will help health and wellness practitioners develop successful exercise interventions to help these survivors achieve recommended levels of physical activity for health.

Implications for cancer survivors: These results suggest that physical activity interventions for adult survivors of childhood lower-extremity sarcomas should be sex specific and responsive to unique physical late effects experienced by these survivors.

Figure 1

A description of how CCSS cohort participants were chosen for this retrospective analysis.

Figure 2

Behavioral Risk Factor Surveillance Survey questions answered by study participants in the Childhood Cancer Survivor Study 2003 Questionnaire.

Figure 3

Percentage of sarcoma survivors, siblings and members of the general population who completed the 2003 Behavioral Risk Factor Surveillance System (BRFSS) survey who did not meet the Centers for Disease Control and Prevention physical activity guidelines. Prevalence ratios (PR) and 95% confidence intervals (CI) were adjusted for age, sex, and in the sibling comparison adjusted for intrafamily correlation.