Evaluating changes in muscle strength and aerobic endurance in endometrial cancer survivors following a home-based exercise intervention
Creators: name: Babcock, Andrea
Publisher: name: University of Iowa
Year: 2025
Subjects: Aerobic
Cancer Survivors
Functional Fitness
Intervention
Muscle Strength
Exercise

description: Background: Incidence rates for endometrial cancer are quickly growing, and with low mortality rates, the prevalence of endometrial cancer survivors is expected to exceed one million. Muscle strengthening and aerobic physical activity is recommended for cancer survivors, yet many endometrial cancer survivors do not meet recommended activity levels. The home-based approach facilitates exercise from home as opposed to traveling to a facility, such as a gym. Muscle strengthening and aerobic physical activity is known to improve physical function. The functional fitness test is validated in older adults to measure multiple domains of physical function, but the complete battery of tests is seldom used as an outcome measure in gynecologic cancer survivors. To our knowledge, there is currently no study that has measured changes in functional fitness following a home-based combined muscle strengthening and aerobic exercise intervention in endometrial cancer survivors. Specific Aim: The purpose of this study was to measure changes in functional fitness following a ten-week, home-based exercise intervention. We hypothesized this intervention would yield improvements in functional fitness. Methods: Ten post-treatment endometrial cancer survivors were enrolled from the University of Iowa Gynecologic Oncology clinic to complete a home-based exercise program. Participants were asked to complete muscle strengthening exercises for ≥ 2 sets of 8-12 repetitions twice per week and gradually increase aerobic exercise to 150 minutes of moderate intensity each week for 10 weeks. Evidence based behavior change techniques, informed by the Social Cognitive Theory, were used to facilitate home-based exercise. The primary outcome of this study was changes in functional fitness from baseline to follow-up. Exploratory outcomes included changes in anthropometrics, accelerometer-measured ambulatory activity, adherence, and acceptability. Results: Ten Stage I (IA and IB) endometrial cancer survivors completed all baseline and follow-up study measures. On average, participants were 63.7 ± 8.3 years of age with BMI of 38.3 ± 7.6 kg/m2. Functional fitness assessments with significant improvements included: 30-second chair sit to stand (Cohen’s d = .71, p = 0.06 ), 30-second arm curl (d = 1.21, p = 0.01), 6-minute walk test (d = .56, p = 0.003), chair sit and reach (d = .58, p = 0.08), and the 8-foot up and go (d = .30, p = 0.1). Accelerometer measured total wear time increased (5474.8 ± 393.4 vs. 5757.2 ± 625.6), revealing no meaningful changes measured in total minutes of moderate to vigorous intensity aerobic activity (MVPA). Participants spent 2% of their wear time in MVPA during baseline and follow-up accelerometer wear. Adherence rates were 54% for muscle strengthening, 89% for aerobic, and 95% for health coaching. The intervention was acceptable and rated very/extremely important to overall health and health behaviors. Discussion: These findings suggest a ten-week home-based combined muscle strengthening and aerobic exercise intervention promotes meaningful improvements in upper and lower body muscle strength, aerobic endurance, lower body flexibility, and agility in endometrial cancer survivors. No meaningful changes were measured in accelerometer-measured activity or anthropometrics. This intervention was feasible, acceptable, and clinically relevant, justifying advancing this intervention to an efficacy trial.