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Abstract Number: 2091

Adaptation and Preliminary Testing of An Arthritis Walking Program to Reduce Joint Pain for Elderly Breast Cancer Survivors On Aromatase Inhibitor Therapy

Kirsten A. Nyrop1, Betsy Hackney1, Rebecca J. Cleveland1, Mary Altpeter2, Hyman Muss3 and Leigh F. Callahan4, 1Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 2UNC Center for Health Promotion and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, 3Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 4Thurston Arthritis Res Ctr, University of North Carolina, Chapel Hill, NC

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Intervention, pain management and physical activity

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Session Information

Session Title: ARHP Orthopedics, Low Back Pain and Rehabilitation: Rehabilitation Sciences

Session Type: Abstract Submissions (ARHP)

Background/Purpose: Joint pain/stiffness/achiness (arthralgia) is a common side-effect among postmenopausal women with breast cancer (BC) who are hormone receptor positive (HR+) for whom standard adjuvant endocrine treatment includes an aromatase inhibitor (AI).  AI discontinuation due to side-effect severity is an estimated 20-32%. There is a need for effective alternative or adjunctive approaches to arthralgia management that enable BC survivors to remain on AI therapy while optimizing as pain-free a life as possible. This study investigates the feasibility of adapting and testing an evidence-based self-directed 6-week physical activity program (PA) for adults with arthritis – Arthritis Foundation’s Walk With Ease (WWE) – among female BC survivors age 65+ on AIs who report joint pain.

Methods: Design: Mixed methods design: (a) semi-structured interviews (qualitative) to adapt the WWE program and (b) one-arm pre-post pilot test (quantitative) to gather preliminary data on program impact. Initial sample of 10 BC survivors completed questionnaires and interviews about barriers and facilitators to moderate intensity PA; findings were used to develop an insert (WWE-Breast Cancer) for the WWE workbook. New sample of 20 was recruited to participate in the WWE program, complete pre- and post-intervention questionnaires, and complete a post-intervention interview to refine the WWE-Breast Cancer insert. Recruitment: BC survivors age 65+ were recruited through the oncology clinic of a university-affiliated hospital. Eligibility: age 65+; Stage I-III breast cancer; currently on AI therapy; self-reported joint pain/stiffness; physician permission to engage in PA; English speaking. Measures: (1) walking – number of days per week and number of minutes per walk, and (2) visual analog scales (VAS) for joint pain, fatigue and stiffness. Statistics: t-test evaluation of changes in mean values.

Results: Total sample (N=30) – mean age 70 (range 65-87), 90% Caucasian, 30% < high school degree. Within the walking sample (N=20): 100% would recommend WWE to other breast cancer survivors experiencing joint pain or stiffness; 100% thought they had learned how joint pain or stiffness could be lessened by physical activity, and how to safely engage in moderate-intensity physical activity; 90% thought WWE had motivated them to become more physically active, and how to overcome physical and mental barriers to walking; and 90% were fairly to extremely confident they would continue walking. At 6 weeks, all three walking measures showed significant improvements: number of times increased by 1.9 (effect size = 0.68, p<0.001), number of minutes increased by 8.8 (effect size = 0.48, p<0.05), and total minutes per week increased by 62.6 (effect size = 0.53, p<0.001). Mean joint pain decreased 10% (p=0.63), fatigue decreased 19% (p=0.31), joint stiffness decreased 32% (p=0.07).  

Conclusion: A moderate-intensity self-directed walking program is feasible for elderly breast cancer patients on AI therapy who have joint pain. The program significantly increased total walking time per week over a 6 week period and was perceived as informative and motivational.


Disclosure:

K. A. Nyrop,
None;

B. Hackney,
None;

R. J. Cleveland,
None;

M. Altpeter,
None;

H. Muss,
None;

L. F. Callahan,
None.

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