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.
K. A. Nyrop,
R. J. Cleveland,
L. F. Callahan,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/adaptation-and-preliminary-testing-of-an-arthritis-walking-program-to-reduce-joint-pain-for-elderly-breast-cancer-survivors-on-aromatase-inhibitor-therapy/