Relationship between changes in physical activity and physical and mental health in breast cancer survivors during the COVID-19 pandemic restrictions in Japan

Purpose This study evaluated the relationship between changes in physical activity (PA) and mental and physical health in breast cancer survivors during the COVID-19 pandemic restrictions in Japan. Methods A questionnaire survey was conducted among 345 outpatient female breast cancer survivors aged between 29 and 69 years. The questionnaire was based on the International Physical Activity Questionnaire, the Patient Health Questionnaire-9, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, and the Fear of COVID-19 Scale, and also included patient characteristics, change in PA during the pandemic restrictions, and needs for exercise support. The analysis categorized PA changes into two groups according to activity levels. The relationship between changes in PA and physical and mental health was evaluated by logistic regression analysis. Results Patients with decreased PA accounted for 65.5% of the study population. Regardless of the activity level, these patients were aware of an increased susceptibility to COVID-19, showed a fear of the disease and a tendency for depression, and reported low life satisfaction and declined physical function. Of the patients who stopped exercising, 82.9% reported a decline in PA. Compared with those who had never exercised, those who stopped exercising saw their risk of depression increase by 15.6%. There was a high demand for personalized exercise support from healthcare professionals. Conclusion Regardless of the activity level, decreasing PA during the pandemic decreased mental health and physical function in breast cancer survivors. There was a higher risk of depression among patients who stopped exercising.