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Purpose <p>Explore if a clinical workflow algorithm that connected Stage I-III newly diagnosed breast cancer (BC) patients to exercise and rehabilitation services from diagnosis throughout care associated with a lower percentage of time spent in sedentary behavior (SB)compared with standard of care (SOC). We also examined the relationship between SB and ECOG performance status scores, a measure of functional status.</p> Methods <p>This secondary data analysis from the Comprehensive Oncology Rehabilitation and Exercise (CORE) program was carried out among 51 BC survivors (CORE = 33, SOC = 18) with evaluable wrist-worn accelerometer data. Percentage of time in SB was assessed using wrist-worn specific cut-points (Montoye) and traditional cut-points (Freedson) three times during BC care: preoperative, first postoperative visit, and 24&#xa0;weeks postoperative. Repeated measures analysis of covariance tests (RM-ANCOVA; adjusted for age, cancer stage, and number of postoperative treatments) with post-hoc comparisons evaluated SB over time within and between groups. Poisson regression evaluated associations between SB and ECOG.</p> Results <p>Participants were mostly white (76.5%), non-Hispanic (90.2%), with mean age 58.8 ± 12.3&#xa0;years, diagnosed with Stage I BC (86.3%) and had a history of more than two adjuvant treatments (56.9%), with no significant differences between groups (p &gt; 0.05). Proportion of time spent in SB (Montoye cut-points) was 73.95% (95% CI 70.60, 77.30) preoperatively; 77.79% (95% CI 74.23, 81.35) postoperatively; and 75.05% (95% CI 71.88, 78.22) 24&#xa0;weeks postoperatively, although these time effect results did not reach statistical significance in the adjusted model. A time x group interaction was observed with Freedson cut-points (mean difference: 6.15%, 95% CI 0.42, 11.88). Between preoperative and 24&#xa0;weeks postoperative timepoints, pairwise comparisons indicated that CORE intervention group participants exhibited a significant increase in percentage of time in SB (mean difference: 6.09%, 95% CI 0.24, 11.93). ECOG scores at each timepoint were not associated with SB (p &gt; 0.05).</p> Conclusion <p>CORE program participation was not associated with reduced SB. Strategies to reduce SB should be incorporated within programs aimed at increasing physical activity engagement.</p>

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The association of an exercise and rehabilitation clinical workflow algorithm on sedentary behavior and performance status from time of breast cancer diagnosis and throughout care

  • 期刊论文

  • 发表日期：

    2026年4月17日

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  • Kelsey E. Maslana,
  • Ryan D. Burns,
  • Yang Bai,
  • Mary C. Playdon,
  • Paul A. Estabrooks,
  • Carson Saviers-Steiger,
  • Emily R. Dunston,
  • Patrick Galyean,
  • Elisabeth R. Kimball,
  • Susan L. Zickmund,
  • Pamela A. Hansen,
  • Cornelia M. Ulrich,
  • Paul C. LaStayo,
  • David Steinberg,
  • Christopher S. Noren,
  • A.’Lisha Finch,
  • Leanne Seckinger,
  • Sonal Oza,
  • Kirstyn E. Brownson,
  • Adriana M. Coletta

摘要

Purpose

Explore if a clinical workflow algorithm that connected Stage I-III newly diagnosed breast cancer (BC) patients to exercise and rehabilitation services from diagnosis throughout care associated with a lower percentage of time spent in sedentary behavior (SB)compared with standard of care (SOC). We also examined the relationship between SB and ECOG performance status scores, a measure of functional status.

Methods

This secondary data analysis from the Comprehensive Oncology Rehabilitation and Exercise (CORE) program was carried out among 51 BC survivors (CORE = 33, SOC = 18) with evaluable wrist-worn accelerometer data. Percentage of time in SB was assessed using wrist-worn specific cut-points (Montoye) and traditional cut-points (Freedson) three times during BC care: preoperative, first postoperative visit, and 24 weeks postoperative. Repeated measures analysis of covariance tests (RM-ANCOVA; adjusted for age, cancer stage, and number of postoperative treatments) with post-hoc comparisons evaluated SB over time within and between groups. Poisson regression evaluated associations between SB and ECOG.

Results

Participants were mostly white (76.5%), non-Hispanic (90.2%), with mean age 58.8 ± 12.3 years, diagnosed with Stage I BC (86.3%) and had a history of more than two adjuvant treatments (56.9%), with no significant differences between groups (p > 0.05). Proportion of time spent in SB (Montoye cut-points) was 73.95% (95% CI 70.60, 77.30) preoperatively; 77.79% (95% CI 74.23, 81.35) postoperatively; and 75.05% (95% CI 71.88, 78.22) 24 weeks postoperatively, although these time effect results did not reach statistical significance in the adjusted model. A time x group interaction was observed with Freedson cut-points (mean difference: 6.15%, 95% CI 0.42, 11.88). Between preoperative and 24 weeks postoperative timepoints, pairwise comparisons indicated that CORE intervention group participants exhibited a significant increase in percentage of time in SB (mean difference: 6.09%, 95% CI 0.24, 11.93). ECOG scores at each timepoint were not associated with SB (p > 0.05).

Conclusion

CORE program participation was not associated with reduced SB. Strategies to reduce SB should be incorporated within programs aimed at increasing physical activity engagement.