Abstract PS9-32: Physical activity platform to improve bone health in cancer survivors
Authors: Skinner Cathy 
Published: February 2021

Abstract
Background:Cancer treatment-induced bone loss in female breast cancer survivors affects not onlyquality of life, but also imposes a significant financial burden on national health care.Aerobic physical activity and resistance exercises can prevent bone health decline, andcan ameliorate side effects including fatigue, anxiety, depression, and muscle loss.Unfortunately, fewer than 25% of breast cancer survivors engage in and adhere toappropriate exercise routines, owing to poor awareness of the benefits of exercise, lackof motivation, and lack of access to tailored exercise programs. Web- and mobile app-based programs that encourage physical activity and exercises can address this gapand can be scaled for broader dissemination.Thrivors+Bone Health (Thrivors+BH™), is a cloud-based digital health product offeringclinically validated bone health exercises that can be customized to a survivor's painand energy levels. The platform provides interactive feedback and supportive modulesfor social connectivity, mindfulness training, nutritional advice, survivorship resourcesand bone health-relevant educational material. The platform's back-end measuresexercise sessions completed, utilization of supportive modules and user-reportedhealth outcomes.Methods:We conducted a single-blind randomized controlled trial (NCT03651037) with Stage 0 -Stage III exercise-naïve breast cancer survivors, to evaluate adherence to a 20-weekprogram of strength training and impact exercises, delivered through Thrivors+BH™.Control arm participants accessed Thrivors Basic, a platform version lacking pain andenergy customization, interactive feedback or bone health resources. All participantswere required to engage in at least two sessions per week, comprising 14-16 differentexercises progressing from foundational to resistance and impact exercises over 20weeks. The primary endpoint, exercise adherence, was defined as the mean number ofcompleted exercise sessions per cohort. Secondary endpoints were user engagement,assessed by the Patient Activation Measure (PAM), Short Form 36v (SF-36v) and user-satisfaction surveys.Results:Demographics (n = 134) were similar between cohorts. The adherence populationanalysis (participants logging in and recording exercises for &gt;1 week) showed that60.0% of Thrivors+BH™ participants (n = 42) completed the 20-week program,compared to 47.8% of Thrivors Basic participants (n = 48). Also, a larger percentageof Thrivors+BH™ arm participants completed between 41-60 exercise sessions,compared to Thrivors Basic participants (17.5% vs. 8.7%) Participants in both armsreported discomfort and low energy as an obstacle to exercising and emphasized theneed for more frequent updates on progress and reminders to exercise.Conclusions:The feasibility study demonstrates breast cancer survivors' willingness to utilize adigital platform to help engage in prescribed exercise routines. Feedback fromparticipants suggest that incorporation of more personalized and interactive featuresmay encourage a higher frequency of engagement in bone-health specific exerciseand/or physical activity. A follow-up study will examine the impact of the exerciseprogram on bone health and the role of coaching to impact sustainable behaviorchange.
Citation Format: Cathy Skinner. Physical activity platform to improve bone health in cancer survivors [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-32.