The impact of a meditative movement practice intervention on short- and long-term changes in physical activity among breast cancer survivors

Authors: SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); JAMES, DARA - University Of South Alabama; HAN, SEUNGYONG - Kaiser Permanente; LARKEY, LINDA - Arizona State University

Submitted to: Journal of Cancer Survivorship
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/10/2023
Publication Date: 7/28/2023
Citation: Soltero, E.G., James, D.L., Han, S., Larkey, L.K. 2023. The impact of a meditative movement practice intervention on short- and long-term changes in physical activity among breast cancer survivors. Journal of Cancer Survivorship. https://doi.org/10.1007/s11764-023-01430-0.
DOI: https://doi.org/10.1007/s11764-023-01430-0

Interpretive Summary: Physical activity plays a critical role in reducing post-treatment symptoms among breast cancer survivors and can also lower the risk for cancer recurrence. National physical activity recommendations state that adults should engage in 150 minutes of moderate-intensity or 75 minutes of vigorous intensity to reduce their risk for disease. However, many survivors do not achieve this benchmark due to physical and psychological post-treatment symptoms such as pain, fatigue, depression, and reduced quality of life. There is a great need for activity programs that address the specific needs of breast cancer survivors while taking a more gradual, 'staircase' approach to engaging survivors in an active lifestyle. The purpose of this study was test the effects of an 8-week Tai Chi Easy intervention on physical activity among breast cancer survivors. Tai Chi is a low-impact, meditative movement practice and this study found that while the intervention did not lead to any significant short- or long-term changes in objectively measured physical activity, participants did self-report increased physical activity that was sustained up to 9 months after the intervention. Findings from this study indicate that Tai Chi is an appropriate activity strategy for beginning to engage survivors that may lead to modest improvements in overall physical activity. More research is needed to examine the long-term impact of meditative movement practices on other physical outcomes like mobility, pain, and physical functioning. Also, given that this is a mind-body practice, future research should also explore the impact of the intervention on psychological outcomes.

Technical Abstract: Tai Chi Easy (TCE) is a low-impact, meditative movement practice that is feasible for breast cancer survivors, even in the face of post-treatment symptoms, and may even serve as a gateway into developing an active lifestyle and improving overall physical activity (PA). In the context of a randomized controlled trial testing effects of an 8-week TCE intervention on breast cancer survivors' symptoms, we examined the short- (8-week) and long-term (9-month) impact on total PA compared to an educational control group. Participants were recruited from two hospital systems, local community organizations, and different media platforms. Eligible participants were predominant non-Hispanic White (82%), college educated (92%), and middle- to high-income (65%), and most commonly reported stage 1 (40%) or 2 breast cancer (38%). After baseline assessments, participants were randomized to the 8-week TCE intervention (N=51) or education control (N=53). Weekly intervention TCE classes were led by a trained instructor. Weekly educational control classes focused on a series of readings and group discussions. Total PA and steps were objectively measured via accelerometry, and the international physical activity questionnaire was used to measure self-reported total PA.Multilevel mixed-effects linear regression models revealed no significant short- or long-term changes in objectively measured total PA or steps in either group; however, participants in the intervention reported short- and long-term changes in self-reported total PA. TCE is an appropriate PA strategy for survivors that may lead to modest improvements in PA; however, more research is needed to examine the long-term impact on PA as well as other physical and psychological outcomes (i.e., flexibility, mobility, stress).