Quality of life and physical activity in long-term (≥5 years post-diagnosis) colorectal cancer survivors - systematic review

Eyl, Ruth Elisa; Xie, Kun; Koch-Gallenkamp, Lena; Brenner, Hermann; Arndt, Volker

doi:10.1186/s12955-018-0934-7

Table 5 Association of PA and QOL - Different levels of PA and linear association

From: Quality of life and physical activity in long-term (≥5 years post-diagnosis) colorectal cancer survivors - systematic review

		Statistical significance (p <0.05) and clinical relevance
	Different levels of PA	+/−: significant positive/negative association ns: not statistically significant .: not reported						^a,b,cclinical relevance
Study	C30	QL		PF		RF		EF		SF		CF
Van Roekel 2015 [32]	>LPA (Q4 = ≥23.0 h/wk) vs. <LPA (Q1 = ≤2.0 h/wk)	ns		+^b		+^b		.		ns		.
	>LPA (Q3 = 10.0-22.0 h/wk) vs. <LPA (Q1 = ≤2.0 h/wk)	.		.		.		.		.		.
	>MVPA (Q4 = ≥15.5 h/wk) vs. <MVPA (Q1 = ≤4.3 h/wk)	ns		+^b		ns		.		ns		.
	>MVPA (Q3 = 8.7-15.0 h/wk) vs. <MVPA (Q1 = ≤4.3 h/wk)	ns		.		+^b		.		+^b		.
Study	SF-36	PF	RP	BP	SF	MH	RE	VT	GH	GCS	PCS	MCS
Thraen-Borowski 2013 [37]	>MVPA (Q4 = ≥11.3 h/wk) vs. <MVPA (Q1 = 0.0 h/wk)	.	.	.	.	.	.	.	.	.	+^b	ns
	>LPA (Q4 = ≥13.0 h/wk) vs. <LPA (Q1 = ≤1.5 h/wk)^d	.	.	.	.	.	.	.	.	.	ns	ns
	>LPA (Q4 = ≥9.0 h/wk) vs. <LPA (Q1 = 0.0 h/wk)^e	.	.	.	.	.	.	.	.	.	+^b	+^b
	>Planned exercise^f (Q4 = ≥9.5 h/wk) vs. <Planned exercise (Q1 = 0.0 h/wk)	.	.	.	.	.	.	.	.	.	+^b	ns
	>Non-exercise^g (Q4 = ≥16.5 h/wk) vs. <Non-exercise (Q1 = ≤1.6 h/wk)	.	.	.	.	.	.	.	.	.	+	ns
Study	WHODAS/ CIS/ HADS	DIS				FA				DIST
Van Roekel 2015 [32]	>LPA (Q4 = ≥23.0 h/wk) vs. <LPA (Q1 = ≤2.0 h/wk)	–^c				ns				ns
	>LPA (Q3 = 10.0-22.0 h/wk) vs. <LPA (Q1 = ≤2.0 h/wk)	ns				–^c				ns
	>MVPA (Q4 = ≥15.5 h/wk) vs. <MVPA (Q1 = ≤4.3 h/wk)	ns				ns				ns
	>MVPA (Q3 = 8.7-15.0 h/wk) vs. <MVPA (Q1 = ≤4.3 h/wk)	–^c				–^c				–^c
Study	PROMIS/ EQ-5D	Physical HRQOL				Mental HRQOL				Overall HRQOL
Rodriguez 2015 [36]	MVPA min/wk. No MVPA - Ref. ≤60, 61–149, 150+	ns				ns				+^c (61–149, 150+) ns (≤ 60)
Linear association PA and QOL (continuous results)
Study	C30	QL		PF		RF		EF		SF		CF
Hussonn 2015 [34]	Continuous: Additional hour of MVPA/wk., Interindividual^h	+		+		+		+		+		+
Hussonn 2015 [34]	Continuous: Additional hour of MVPA/wk., Intraindividualⁱ	ns		+		ns		ns		ns		+
Van Roekel 2016 [33]	Single-variable model, PA^j	ns		+		ns		.		ns		.
	Partition model, PA^k	ns		+		ns		.		ns		.
	Substituting 1 h/day of sedentary time with PA	ns		+^a		ns		.		ns		.
	Substituting 1 h/day of standing time with PA	ns		ns		ns		.		ns		.
Study	WHODAS/ CIS/ HADS	DIS				FA		ANX				DEP
Van Roekel 2016 [33]	Single-variable model PA^j	–^c				ns		ns				ns
	Partition model PA^k	ns				ns		ns				ns
	Substituting 1 h/day of sedentary time with PA	ns				ns		ns				ns
	Substituting 1 h/day of standing time with PA	ns				ns		ns				ns

PA physical activity, QOL quality of life, C30 (European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire), QL global quality of life, PF physical functioning, RF role functioning, EF emotional functioning, SF social functioning, CF cognitive functioning; > more; < less, LPA light physical activity (<3 MET), Q Quartile, h/wk hours per week, MVPA moderate to vigorous physical activity (≥3 MET), SF-36 (The Short Form Health Survey) PF physical functioning, RP role limitations due to physical health problems, BP bodily pain, SF social functioning, MH general mental health, RE role limitations due to emotional problems, VT vitality, GH general health perceptions, GCS global health composite score, PCS physical composite score, MCS mental composite score, WHODAS (World Health Organization Disability Assessment Schedule II) DIS disability, CIS (Checklist Individual Strength) FA fatigue, HADS (Hospital Anxiety and Depression Scale), DIST distress, ANX anxiety, DEP depression, PROMIS (Patient-Reported Outcomes Measurement Information System), EQ-5D (EuroQol Five-Dimensions Questionnaire), Ref. Reference, ^aclinical relevance reported by authors; ^bclinical relevance calculated by RE; ^cclinical relevance: no values, no cut-off for calculation available; ^dparticipants reported LPA and MVPA; ^eparticipants reported only LPA; ^fintentional exercise e.g. jogging; ^gnon-intentional exercise e.g. gardening; ^hinterindividual: patients average amount of PA/ average level PA of total group; ⁱintraindividual: patients PA level at one time point/ patients average PA level; ^jPA was entered separately in a single confounder-adjusted model, without adjustment for any of the other activities (sedentary, standing); ^kall activity categories (sedentary, standing, PA) were entered simultaneously in a single confounder-adjusted model, to estimate independent associations of each activity category

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