Impact of the COVID-19 pandemic on physical activity among older adults with cancer in a central Canadian province: Results from a survey study
Abstract
Background: Physical activity is important for individuals with cancer. Older adults with cancer (OACA) have been disproportionally vulnerable to both COVID-19 infection and its outcomes. This study investigated how the COVID-19 pandemic and associated restrictions affected physical activity in OACA in one Canadian province.
Method: An online cross-sectional survey was conducted. Quantitative data were analyzed using descriptive and inferential statistics, with SPSS® Version 27. Answers to free-text questions were grouped, based on thematic categories.
Results: One hundred and fifteen OACA participated in this study; more than 46% reported lower levels of physical activity since the COVID-19 pandemic. Participants described increases in sedentary behaviour and reduced physical activity overall. They also described barriers to physical activity, and remained open to remotely delivered physical activity interventions.
Conclusion: The pandemic disrupted physical activity routines among OACA. Future efforts should include an acceleration of research related to remotely delivered interventions given older adults’ growing acceptance of such technologies.
Keywords: aging, cancer, physical activity, COVID-19, geriatric oncology, older adults, nursing
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Antonio, M., Saldaña, J., Carmona-Bayonas, A., Navarro, V., Tebé, C., Nadal, M., Formiga, F., Salazar, R., & Borràs, J. M. (2017). Geriatric assessment predicts survival and competing mortality in elderly patients with early colorectal cancer: Can it help in adjuvant therapy decision-making? The Oncologist, 22(8), 934.
Aspvik, N. P., Viken, H., Ingebrigtsen, J. E., Zisko, N., Mehus, I., Wisløff, U., & Stensvold, D. (2018). Do weather changes influence physical activity level among older adults?–The Generation 100 study. PLOS One, 13(7), e0199463.
Battisti, N. M. L., Mislang, A. R., Cooper, L., O’Donovan, A., Audisio, R. A., Cheung, K.-L., Sarrió, R. G., Stauder, R., Soto-Perez-de-Celis, E., Jaklitsch, M., Williams, G. R., O’Hanlon, S., Alam, M., Cairo, C., Colloca, G., Gil, L. A., Sattar, S., Kantilal, K., Russo, C., … Wildiers, H. (2020). Adapting care for older cancer patients during the COVID-19 pandemic: Recommendations from the International Society of Geriatric Oncology (SIOG) COVID-19 Working Group. Journal of Geriatric Oncology, 11(8), 1190–1198. https://doi.org/10.1016/j.jgo.2020.07.008
BC Cancer. (n.d.). Exercise Support. Provincial Health Services Authority. http://www.bccancer.bc.ca/health-info/coping-with-cancer/exercise-support
Bland, K. A., Bigaran, A., Campbell, K. L., Trevaskis, M., & Zopf, E. M. (2020). Exercising in isolation? The role of telehealth in exercise oncology during the COVID-19 pandemic and beyond. Physical Therapy, 100(10), 1713–1716.
Blaney, J. M., Lowe-Strong, A., Rankin-Watt, J., Campbell, A., & Gracey, J. H. (2013). Cancer survivors’ exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: A questionnaire–survey. Psycho-Oncology, 22(1), 186–194.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77. https://doi.org/10.1191/1478088706qp063oa
Brooke, J., & Jackson, D. (2020). Older people and COVID-19: Isolation, risk and ageism. Journal of Clinical Nursing.
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet.
Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., Zucker, D. S., Matthews, C. E., Ligibel, J. A., & Gerber, L. H. (2019). Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise, 51(11), 2375–2390.
Canadian Society for Exercise Physiology. (2021). Canadian 24-hour movement guidelines for adults aged 65 years and older: An integration of physical activity, sedentary behaviour, and sleep. 24-Hour Movement Guidelines. https://csepguidelines.ca/guidelines/adults-65/
Cancer Care Ontario. (n.d.). Exercise: For people with cancer. https://www.cancercareontario.ca/sites/ccocancercare/files/ExerciseGuide.pdf
Cormier, J. N., Askew, R. L., Mungovan, K. S., Xing, Y., Ross, M. I., & Armer, J. M. (2010). Lymphedema beyond breast cancer: A systematic review and meta-analysis of cancer-related secondary lymphedema. Cancer, 116(22), 5138–5149.
Cunningham, C., & O’Sullivan, R. (2020). Why physical activity matters for older adults in a time of pandemic. European Review of Aging and Physical Activity, 17(1), 1–4.
Dadras, O., SeyedAlinaghi, S., Karimi, A., Shamsabadi, A., Qaderi, K., Ramezani, M., Mirghaderi, S. P., Mahdiabadi, S., Vahedi, F., & Saeidi, S. (2022). COVID-19 mortality and its predictors in the elderly: A systematic review. Health Science Reports, 5(3), e657.
De Looze, C., Ward, M., McDowell, C., Bourke, N., & Kenny, R. A. (2021). Preparing for COVID-19 vaccination: Important learnings from the Irish Longitudinal Study on Ageing (TILDA). The Irish Longitudinal Study on Ageing. https://doi.org/10.38018/TildaRe.2021-00
Deimling, G. T., Pappada, H., Ye, M., Nalepa, E., Ciaralli, S., Phelps, E., & Burant, C. J. (2019). Factors affecting perceptions of disability and self-rated health among older adult, long-term cancer survivors. Journal of Aging and Health, 31(4), 667–684.
Driver, S., Reynolds, M., Brown, K., Vingren, J. L., Hill, D. W., Bennett, M., Gilliland, T., McShan, E., Callender, L., Reynolds, E., Borunda, N., Mosolf, J., Cates, C., & Jones, A. (2022). Effects of wearing a cloth face mask on performance, physiological and perceptual responses during a graded treadmill running exercise test. British Journal of Sports Medicine, 56(2), 107–113. https://doi.org/10.1136/bjsports-2020-103758
Edwards, K. M., & Booy, R. (2013). Effects of exercise on vaccine-induced immune responses. Human Vaccines & Immunotherapeutics, 9(4), 907–910.
Eronen, J., von Bonsdorff, M. B., Törmäkangas, T., Rantakokko, M., Portegijs, E., Viljanen, A., & Rantanen, T. (2014). Barriers to outdoor physical activity and unmet physical activity need in older adults. Preventive Medicine, 67, 106–111.
Fitzmaurice, C., Allen, C., Barber, R. M., Barregard, L., Bhutta, Z. A., Brenner, H., Dicker, D. J., Chimed-Orchir, O., Dandona, R., & Dandona, L. (2017). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: A systematic analysis for the global burden of disease study. JAMA Oncology, 3(4), 524–548.
Galvao, D. A., Taaffe, D. R., Spry, N., Joseph, D., & Newton, R. U. (2010). Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: A randomized controlled trial. Journal of Clinical Oncology, 28(2), 340–347.
Gerber, L. H. (2017). Cancer-related fatigue: Persistent, pervasive, and problematic. Physical Medicine and Rehabilitation Clinics, 28(1), 65–88.
Gericke, R. C., & Gupta, A. K. (2022). The effects of wearing a mask on an exercise regimen. Journal of Osteopathic Medicine, 122(11), 545–552. https://doi.org/10.1515/jom-2022-0045
Gianoudis, J., Bailey, C. A., & Daly, R. M. (2015). Associations between sedentary behaviour and body composition, muscle function and sarcopenia in community-dwelling older adults. Osteoporosis International, 26(2), 571–579.
Hallam, J., Jones, T., Alley, J., & Kohut, M. L. (2022). Exercise after influenza or COVID-19 vaccination increases serum antibody without an increase in side effects. Brain, Behavior, and Immunity, 102, 1–10.
Harvey, J. A., Chastin, S. F., & Skelton, D. A. (2013). Prevalence of sedentary behavior in older adults: A systematic review. International Journal of Environmental Research and Public Health, 10(12), 6645–6661.
Howard, M. C. (2022). The relations between age, face mask perceptions and face mask wearing. Journal of Public Health, 44(2), 447–449. https://doi.org/10.1093/pubmed/fdab018
Ingram, C., Courneya, K. S., & Kingston, D. (2006). The effects of exercise on body weight and composition in breast cancer survivors: An integrative systematic review. Oncology Nursing Forum, 33(5).
Irwin, M. L. (2009). Physical activity interventions for cancer survivors. British Journal of Sports Medicine, 43(1), 32–38.
Kang, H. (2021). Correlates of frailty in community-dwelling older adults with cancer: 2017 Survey of living condition of elderly study in South Korea. Asia-Pacific Journal of Oncology Nursing, 8(3), 287–294.
Khera, A., Baum, S. J., Gluckman, T. J., Gulati, M., Martin, S. S., Michos, E. D., Navar, A. M., Taub, P. R., Toth, P. P., & Virani, S. S. (2020). Continuity of care and outpatient management for patients with and at high risk for cardiovascular disease during the COVID-19 pandemic: A scientific statement from the American Society for Preventive Cardiology. American Journal of Preventive Cardiology, 1, 100009.
Kilari, D., Soto-Perez-de-Celis, E., Mohile, S. G., Alibhai, S. M., Presley, C. J., Wildes, T. M., Klepin, H. D., Demark-Wahnefried, W., Jatoi, A., & Harrison, R. (2016). Designing exercise clinical trials for older adults with cancer: Recommendations from 2015 Cancer and Aging Research Group NCI U13 Meeting. Journal of Geriatric Oncology, 7(4), 293–304.
Kleckner, I. R., Kamen, C., Gewandter, J. S., Mohile, N. A., Heckler, C. E., Culakova, E., Fung, C., Janelsins, M. C., Asare, M., & Lin, P.-J. (2018). Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: A multicenter, randomized controlled trial. Supportive Care in Cancer, 26(4), 1019–1028.
Kline, R. M., Arora, N. K., Bradley, C. J., Brauer, E. R., Graves, D. L., Lunsford, N. B., McCabe, M. S., Nasso, S. F., Nekhlyudov, L., & Rowland, J. H. (2018). Long-term survivorship care after cancer treatment-summary of a 2017 National Cancer Policy Forum Workshop. JNCI: Journal of the National Cancer Institute, 110(12), 1300–1310.
Kohut, M. L., Lee, W., Martin, A., Arnston, B., Russell, D. W., Ekkekakis, P., Yoon, K. J., Bishop, A., & Cunnick, J. E. (2005). The exercise-induced enhancement of influenza immunity is mediated in part by improvements in psychosocial factors in older adults. Brain, Behavior, and Immunity, 19(4), 357–366.
Kumar, A., Langstraat, C. L., DeJong, S. R., McGree, M. E., Bakkum-Gamez, J. N., Weaver, A. L., LeBrasseur, N. K., & Cliby, W. A. (2017). Functional not chronologic age: Frailty index predicts outcomes in advanced ovarian cancer. Gynecologic Oncology, 147(1), 104–109.
Li, Y., Hsu, J. A., & Fernie, G. (2013). Aging and the use of pedestrian facilities in winter—The need for improved design and better technology. Journal of Urban Health, 90(4), 602–617.
Lippi, G., Henry, B. M., & Sanchis-Gomar, F. (2020). Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19). European Journal of Preventive Cardiology, 27(9), 906–908.
Lubejko, B., Struth, D., Bishop, R., & Otte, D. (2021). A quality improvement education pilot project to increase recommendations for physical activity in cancer survivors. The Journal of Continuing Education in Nursing, 52(4), 184–191. https://doi.org/10.3928/00220124-20210315-07
Mathew, T. R. (2000). Invisible women: Understanding the barriers to physical activity for low income, older adult women.
Merchant, R. A., Morley, J. E., & Izquierdo, M. (2021). Exercise, aging and frailty: Guidelines for increasing function. In The Journal of Nutrition, Health & Aging, 25(4), 405–409. Springer.
Mikkelsen, M. K., Juhl, C. B., Lund, C. M., Jarden, M., Vinther, A., & Nielsen, D. L. (2020). The effect of exercise-based interventions on health-related quality of life and physical function in older patients with cancer receiving medical antineoplastic treatments: A systematic review. European Review of Aging and Physical Activity, 17(1), 1–15.
Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., Stein, K. D., Alteri, R., & Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA: A Cancer Journal for Clinicians, 66(4), 271–289.
Mina, D. S., Au, D., Brunet, J., Jones, J., Tomlinson, G., Taback, N., Field, D., Berlingeri, A., Bradley, H., & Howell, D. (2017). Effects of the community-based Wellspring Cancer Exercise Program on functional and psychosocial outcomes in cancer survivors. Current Oncology, 24(5), 284–294.
Mohan, N., Jiang, J., Dokmanovic, M., & Wu, W. J. (2018). Trastuzumab-mediated cardiotoxicity: Current understanding, challenges, and frontiers. Antibody Therapeutics, 1(1), 13–17.
Newton, R. U., Hart, N. H., & Clay, T. (2020). Keeping patients with cancer exercising in the age of COVID-19. JCO Oncology Practice, 16(10), 656–664.
Okechukwu, C. E. (2021). Do oncology nurses have sufficient knowledge of exercise oncology? A mini narrative review. Cancer Research, Statistics, and Treatment, 4(1), 88. https://doi.org/10.4103/crst.crst_315_20
Oldervoll, L. M., Loge, J. H., Lydersen, S., Paltiel, H., Asp, M. B., Nygaard, U. V., Oredalen, E., Frantzen, T. L., Lesteberg, I., & Amundsen, L. (2011). Physical exercise for cancer patients with advanced disease: A randomized controlled trial. The Oncologist, 16(11), 1649–1657.
Park, J., Hung, L., Randhawa, P., Surage, J., Sullivan, M., Levine, H., & Ortega, M. (2023). ‘Now I can bend and meet people virtually in my home’: The experience of a remotely supervised online chair yoga intervention and visual socialisation among older adults with dementia. International Journal of Older People Nursing, 18(1), e12513. https://doi.org/10.1111/opn.12513
Parker, N. H., Arlinghaus, K. R., & Johnston, C. A. (2018). Integrating Physical Activity Into Clinical Cancer Care. American Journal of Lifestyle Medicine, 12(3), 220–223. https://doi.org/10.1177/1559827618759478
Pelosi, A. C., Rostirola, G. C., Pereira, J. S., Silva, K. C., Fontanari, M. E. R., Oliveira, M. S. P., Reis, I. G. M. dos, & Messias, L. H. D. (2023). Remote and unsupervised exercise strategies for improving the physical activity of colorectal cancer patients: A meta-analysis. Healthcare, 11(5), Article 5. https://doi.org/10.3390/healthcare11050723
Rice, P. L., & Ezzy, D. (1999). Qualitative research methods: A health focus. Oxford University Press.
Roberts, A. L., Potts, H. W. W., Stevens, C., Lally, P., Smith, L., & Fisher, A. (2019). Cancer specialist nurses’ perspectives of physical activity promotion and the potential role of physical activity apps in cancer care. Journal of Cancer Survivorship, 13(5), 815–828. https://doi.org/10.1007/s11764-019-00801-w
Santa Mina, D., Connor, M. K., Alibhai, S. M., Toren, P., Guglietti, C., Matthew, A. G., Trachtenberg, J., & Ritvo, P. (2013). Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: A randomized study. Canadian Urological Association Journal, 7(11–12), E692.
SaskJobs. (n.d.). Lifestyle, Climate, and Living in Saskatchewan. https://www.saskjobs.ca/saskatchewan-info.jsp#:~:text=Temperatures%20range%20between%20a%20low,the%20snow%20dry%20and%20powdery
Sattar, S., Effa, C., Nedeljak, J., Haase, K. R., Alibhai, S. M., Kuster, S., Amir, E., Campbell, D., & McNeely, M. (2021). Feasibility of a virtual hybrid resistance and balance training program for older patients with cancer and its preliminary effects on lower body strength and balance. Wolters Kluwer Health.
Sattar, S., Haase, K. R., Bradley, C., Papadopoulos, E., Kuster, S., Santa Mina, D., Tippe, M., Kaur, A., Campbell, D., Joshua, A. M., Rediger, C., Souied, O., & Alibhai, S. (2021). Barriers and facilitators related to undertaking physical activities among men with prostate cancer: A scoping review. Prostate Cancer and Prostatic Diseases. https://doi.org/10.1038/s41391-021-00399-0
Sattar, S., Haase, K. R., Milisen, K., Campbell, D., Kim, S. J., Chalchal, H., & Kenis, C. (2021). Oncology clinic nurses’ attitudes and perceptions regarding implementation of routine fall assessment and fall risk screening: A survey study. Canadian Oncology Nursing Journal / Revue Canadienne de Soins Infirmiers En Oncologie, 31(4), Article 4.
Sattar, S., Kenis, C., Haase, K., Burhenn, P., Stolz-Baskett, P., Milisen, K., Ayala, A. P., & Puts, M. T. E. (2020). Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper. Journal of Geriatric Oncology, 11(1), 1–7. https://doi.org/10.1016/j.jgo.2019.03.020
Schmidt, M. E., Wiskemann, J., & Steindorf, K. (2018). Quality of life, problems, and needs of disease-free breast cancer survivors 5 years after diagnosis. Quality of Life Research, 27(8), 2077–2086.
Speck, R. M., Courneya, K. S., Mâsse, L. C., Duval, S., & Schmitz, K. H. (2010). An update of controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Journal of Cancer Survivorship, 4(2), 87–100.
Stubblefield, M. D. (2017). Neuromuscular complications of radiation therapy. Muscle & Nerve, 56(6), 1031–1040.
The Encyclopedia of Saskatchewan. (n.d.). Climate. https://esask.uregina.ca/entry/climate.jsp
Wangüemert Pérez, F., Wangüemert Guerra, M., Caballero Dorta, E., Acosta Materan, C. J., Tormo Juarez, J. P., Godoy Camacho, C., Cardenes Leon, A., Segura Villalobos, F., Medina Gil, J. M., Perez, M. L., García Salvador, J. J., Mateos Cañero, G. O., Jiménez Rivero, C., & Martínez-Quintana, E. (2023). Impacto del uso de la mascarilla durante la realización de la prueba de esfuerzo en tapiz rodante. Medicina Clínica, 160(3), 101–106. https://doi.org/10.1016/j.medcli.2022.05.006
Wasley, D., Gale, N., Roberts, S., Backx, K., Nelson, A., van Deursen, R., & Byrne, A. (2018). Patients with established cancer cachexia lack the motivation and self-efficacy to undertake regular structured exercise. Psycho-Oncology, 27(2), 458–464.
Winters-Stone, K. M., Boisvert, C., Li, F., Lyons, K. S., Beer, T. M., Mitri, Z., Meyers, G., Eckstrom, E., & Campbell, K. L. (2022). Delivering exercise medicine to cancer survivors: Has COVID-19 shifted the landscape for how and who can be reached with supervised group exercise? Supportive Care in Cancer, 30(3), 1903–1906. https://doi.org/10.1007/s00520-021-06669-w
Winters-Stone, K. M., Horak, F., Jacobs, P. G., Trubowitz, P., Dieckmann, N. F., Stoyles, S., & Faithfull, S. (2017). Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy. Journal of Clinical Oncology, 35(23), 2604.
WorldData.info. (n.d.). Climate: Saskatchewan in Canada. Worlddata.Info. https://www.worlddata.info/america/canada/climate-saskatchewan.php
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