Exercise Level and Its Related Factors in Patients with Colorectal Cancer Comorbid Diabetes Mellitus undergoing Chemotherapy（a cross-sectional study）

Exercise Level and Its Related Factors in Patients with Colorectal Cancer Comorbid Diabetes Mellitus undergoing Chemotherapy（a cross-sectional study） | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exercise Level and Its Related Factors in Patients with Colorectal Cancer Comorbid Diabetes Mellitus undergoing Chemotherapy（a cross-sectional study） Huan Liu, Huihua Zhao, Zhuojun Yang, Yi Gu, Wen Zhang, Jiao Zhou, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3852672/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim To investigate the status quo of exercise management as well as its related factors among patients with colorectal cancer comorbid diabetes mellitus to provide reference for clinical exercise intervention programs. Methods A cross-sectional study of 124 patients with colorectal cancer comorbid diabetes mellitus who were undergoing chemotherapy in Shanghai from December, 2022 to April, 2023, was undertaken. Two self-made questionnaires were used to investigate the exercise management and its related factors, and multiple linear regression analysis was used to explore the potential related factors. Results The mean amount of exercise per week was 3.70 ± 3.50 MET-h/week. The stepwise regression results revealed that exercise level was positively correlated with motor function (r = 0.305, p = 0.001), self-efficacy (r = 0.582, p = 0.000), social support (r = 0.434, p = 0.000), and health behavior change techniques (r = 0.419, p = 0.000). Conclusion The current status of exercise management in patients with colorectal cancer comorbid diabetes mellitus during chemotherapy is pessimistic and contradictory. It is urgent to pay attention to the influence of comorbidity on exercise. Sex, adverse reactions of chemotherapy, self-efficacy, motor function and social support have the greatest influence on their level of exercise. colorectal cancer type 2 diabetes mellitus comorbidity exercise chemotherapy 1 INTRODUCTION With the increase in average life expectancy, the global population is aging, and the number of people with two chronic diseases, colorectal cancer and diabetes, is also increasing [ 1 ] . Diabetes is one of the most common comorbidities in cancer patients, with a prevalence of 14% in patients with colorectal cancer (CRC) [ 2 ] . Colorectal cancer (CRC) has a high mortality rate, with about 880,000 deaths worldwide in 2018, making it the third leading cause of cancer death [ 3 ] . At the same time, studies project that the T2D epidemic will affect 642 million people worldwide by 2040 [ 4 ] . The most common type of diabetes in China is T2D, which accounts for more than 90% of all diabetes. These two chronic diseases share many common risk factors, including advanced age, unhealthy diet, physical inactivity, and obesity [ 5 ] . Evidence suggests that a diagnosis of diabetes is accompanied by an increased risk of cancer and worse disease prognosis [ 6 ] . Patients diagnosed with colorectal cancer comorbid diabetes mellitus will experience a variety of consequences due to the nature of their disease and the process of their treatment. As a result of their treatment, patients can suffer from significant physical, social and mental morbidity. In addition, these individuals may also have to endure adverse physical and psychological symptoms as a result of treatments such as chemotherapy and radiation therapy, which may last long after the treatments were completed. [ 7 ] . Thus, patients with colorectal cancer comorbid diabetes mellitus require during-treatment assistance to ensure the continuation of chemoradiotherapy and prevent any recurrence of disease. Exercise can be used as a therapeutic strategy for managing T2D. Studies have shown that physical activity can improve insulin sensitivity, reduce blood glucose and blood lipids, control body weight, and thus improve the occurrence and development of diabetes, and The World Health Organization has highlighted the need to strengthen community-based campaigns as one of the most cost-effective measures to combat the impact of T2D [ 8 ] . Exercise is of great significance in improving the clinical prognosis of patients and inhibiting the development of the disease, which runs through the whole process of prevention, treatment and rehabilitation of patients with CRC. In a study of patients undergoing chemotherapy for stage III colon cancer, cancer recurrence and mortality decreased significantly as physical activity increased [ 9 ] . Numerous studies have shown and demonstrated the importance of physical activity in CRC and T2D. However, not enough research has been done in regards to influencing factors of exercise management in patients with colorectal cancer comorbid diabetes mellitus. The majority of patients affected by CRC often leads sedentary lifestyles. Due to the adverse effects of radiotherapy and chemotherapy such as fatigue and negative emotions, patients receiving colon cancer treatment often have limited exercise capacity and are unwilling to exercise. Understanding the circumstances and reasons which affect patients' desire to exercise will greatly benefit in helping patients find suitable rehabilitation programs to boost their independence, and/or prevent the worsening of their colorectal cancer comorbid diabetes mellitus. The aim of this study was to investigate the status quo of exercise management and to investigate the factors that influence exercise in patients with colorectal cancer comorbid diabetes mellitus. 2 MATERIAL AND METHODS 2.1 Study design and participants This was a cross-sectional study. A total of 124 subjects were recruited from four tertiary hospitals in Shanghai, China, including Zhongshan Hospital of Fudan University, Fudan University Shanghai Cancer Center, Fudan University Huadong Hospital, and Central Hospital of Xuhui District. We used a convenient sampling method and collected data from December, 2022 to April, 2023. This study was approved by the approval of the Ethics Committee of Zhongshan Hospital of Fudan University. The necessary explanations about the study were given to our participants and all individual participants who were included in the study gave informed consent. Participants selected for this study had to satisfy the following inclusion criteria: (i) be at least 18 years of age; (ii) diagnosed with T2DM; (iii) pathological diagnosed with colorectal cancer; (iv) have stage II–III CRC according to the tumor, node, and metastasis (TNM) classification; (v) have a performance status of 0 to 2 according to the Eastern Cooperative Oncology Group Performance Status (ECOG-PS); (vi) be able to read, write, and understand Chinese; and (vii) be willing and able to take part in the study. Participants were excluded from this study based on the following exclusion criteria: (i) with tumors other than colorectal tumors; (ii)with severe impairment of other important organs (such as liver, lung, kidney); (iii) with communication barriers or mental disorders. 2.2 Sample size According to Kendall method, the sample size should be 5 to 10 times the number of observed variables. In this study, the number of independent variables was 21. Therefore, we considered the sample size to be 105. Based on a 10% sample attrition rate, 117 research participants were needed in total. 2.3 Measures Two self-made questionnaires were used in this study. The first was general information questionnaire including :1) socio-demographic information, gender, age, marital status, education level, and BMI; 2) disease-related data included CRC or T2D course, concomitant diseases, diabetes complications, HbA1c, family history, adverse reactions to chemotherapy and its effect on exercise. The second was the exercise management ability questionnaire. Because there is no scale on exercise management ability of patients with colorectal cancer comorbid diabetes mellitus during chemotherapy at present, this study based on literature review, "knowledge-attitude-practice" model as the theoretical basis, modified items after expert discussion, finally completed the questionnaire, including daily exercise habits, exercise-related knowledge, motor function assessment, self-efficacy and social support assessment, with a total of 44 items. According to the brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC) [ 10 ] , the MET-values were assigned 3.0 for walking, 4.5 for moderate-intensity physical activity, and 6.0 for high-intensity physical activity to denote activity intensity in the daily exercise habit items. The total amount of exercise per week = MET-values (MET-h/week) * exercise times(h) in this study. Self-efficacy, motor function assessment and social support were scored by Likert5, and the higher the score, the higher the level of exercise management. The Cronbach's α of the questionnaire was 0.96, and the content validity index (S-CVI) was 0.87. 2.4 Data collection All questionnaires were administered by the investigators ourselves, and all assessments lasted approximately 20 minutes. Data on sociodemographic and clinical characteristics and on laboratory tests were obtained from face-to-face interviews with participants and from records in the archive of the Medical Oncology Department. In cases where the subject is an elderly with poor eyesight, or where the subject is not comfortable with filling in the questionnaires by themself; the researcher read the questions orally to those individuals and recorded their answers on their behalf. The researcher also recorded on behalf of individuals who chose to answer the questions orally. All results from the questionnaires were checked on site to ensure each questionnaire’s accuracy and authenticity. 2.5 Statistical analyses Data were analyzed using the IBM SPSS Statistics v. 22.0 (IBM, Armonk, New York). For continuous variables with normal distribution, such as age and BMI, the mean and standard deviation were reported, while for variables without normal distribution, the median (P25, P75) was reported. Categorical variables such as gender and educational level are reported as frequencies and percentages. We then analyzed which characteristics were considerably influencing the participants’ exercise level. In univariate analysis, factors with P < 0.05 were included in the multiple linear regression model. In addition, to ensure that there was no multicollinearity between variables, we only accepted models with all VIF values less than 10. The level of significance was set at 0.05, and all comparisons were two-sided. 3 RESULTS 3.1 Participant characteristics A total of 124 (95 male, 29 female) patients diagnosed with colorectal cancer comorbid diabetes mellitus were included in this study. The age of the subjects ranged from 39 to 90 years old, with an average age of 65.22 ± 8.87 years old. The duration of DM was 1–30 years, with an average of 9.19 ± 7.57 years and a median of 7 years. The duration of CRC was 1–7 years, with an average of 1.44 ± 1.97years and a median of 1 year. 57.3% of colorectal cancer patients had two or more chronic diseases besides diabetes. More than half (54.0%) of the patients combined with one to three kinds of adverse reactions to chemotherapy, and 35.5% of the patients indicated that the adverse reactions had a negative impact on daily exercise. The mean amount of exercise per week was 3.70 ± 3.50 MET-h/week. The characteristics of the study subjects are shown in Table 1 . Table 1 The characteristics of the participants(n = 124) Variables n = 124 Categorical Variables Frequency Percent (%) Sex male 95 76.6 female 29 23.4 Marital status spinsterhood 3 2.4 married 118 95.2 separate 0 0 divorced 1 0.8 widowed 2 1.6 Education primary school and below 25 20.2 junior high school 32 25.8 high school and technical secondary school 42 33.9 specialized college course or above 25 20.2 Per capita monthly household income 5000 79 63.7 Body mass index 24kg/m 2 41 33.1 Comorbidity absence of Comorbidities 53 42.7 combined hypertension 52 41.9 combined Coronary heart disease 20 16.1 combined cerebral infarction 5 4.0 combined hyperlipidemia 4 3.2 other 7 5.6 T2D family history yes 41 33.1 no 83 66.9 CRC family history yes 11 8.9 no 113 91.1 Diabetic complication yes 11 8.9 no 113 91.1 Adverse reactions of chemotherapy nausea 38 30.6 vomit 21 16.9 fatigue 55 44.4 diarrhea 21 16.9 Peripheral neurotoxicity 46 37.1 liver function damage 1 0.8 renal function damage 0 0.0 anemia 10 8.1 myelosuppression 13 10.5 alopecia 3 2.4 canker sore 2 1.6 This adverse reaction of chemotherapy has affected your exercise yes 44 35.5 no 80 64.5 Continuous Variables Mean ± SD Age(years) 65.22 ± 8.87 Duration(years) T2D duration 9.19 ± 7.57 CRC duration 1.44 ± 1.97 The total amount of exercise per week (MET-h/week) 3.70 ± 3.50 Abbreviation: T2D type 2 diabetes, CRC colorectal cancer, SD standard deviation 3.2 Participant daily exercise habits According to the daily exercise habits of the participants in the past six months, 33 (26.6%) never had exercise habits, and 91 (73.4%) had exercise habits. Walking was the main physical activity of 90 (72.6%) participants. Most participants who had exercise habits exercised more than five times per week (45.2%), followed by three to five times per week (23.4%). 88 (71%) participants never engaged in vigorous-intensity physical activity and 72 (58.1%) participants never engaged in moderate-intensity physical activity. Their daily walking time was mainly 30-60 minutes (34.7%), and their daily sedentary time was 4-6 hours (34.7%). Most of the subjects did not carry sweets with them during exercise (62.9%), did not warm up before exercise (65.3%), and did not stretch after exercise (60.5%). Most participants exercised for a fixed amount of time (50%) (Table 2). Table 2 The daily exercise habits of the participants(n = 124) Categorical Variables Frequency Percent (%) Type of exercise (multiple choices) never exercise 33 26.6 walk 90 72.6 jogging 5 4.0 ball sports 0 0.0 Tai Chi 5 4.0 ride a bike 6 4.8 yoga 0 0.0 dancing 1 0.8 swimming 0 0.0 dumbbells or elastic bands 2 1.6 other 0 0.0 Frequency never exercise 33 26.6 less than three times a week 6 4.8 three to five times a week 29 23.4 more than five times a week 56 45.2 Duration of vigorous physical activity per week no vigorous physical activity or 90 min 0 0.0 Duration of moderate intensity physical activity per week no moderate physical activity or 150 min 0 0.0 Daily walking time 90 min 8 6.5 Daily sedentary time 2-4h 28 22.6 4-6h 43 34.7 6-8h 20 16.1 >8h 0 0.0 Self-monitoring Blood glucose during exercise yes 3 2.4 no 88 71.0 Take candy when exercising yes 13 10.5 no 78 62.9 Warm-up before exercise yes 10 8.1 no 81 65.3 Stretch after exercise yes 16 12.9 no 75 60.5 Exercise time fixed yes 62 50.0 no 29 23.4 3.3 T-test and one-way analysis of variance We then used the T-test and one-way analysis of variance to analyze which categorical variables considerably influencing exercise behavior were related to the total amount of exercise per week (MET-h/week). The data were shown in Table 3 and Table 4. Table 3 T-test results(n = 124) Variables t p Sex 2.842 0.006* male female Comorbidity 0.168 0.867 yes no Combined hypertension -0.890 0.375 yes no Combined Coronary heart disease -0.334 0.739 yes no Combined cerebral infarction 0.955 0.341 yes no Combined hyperlipidemia -0.118 0.906 yes no T2D family history -1.674 0.097 yes no CRC family history 1.194 0.235 yes no Diabetic complication 3.705 0.002* yes no Adverse reactions of chemotherapy 1.987 0.049* yes no Nausea -1.714 0.089 yes no Vomit -0.216 0.83 yes no Fatigue -2.04 0.044* yes no Diarrhea -1.153 0.251 yes no Peripheral neurotoxicity -0.179 0.858 yes no Liver function damage -1.061 0.291 yes no Anemia -2.166 0.047* yes no Myelosuppression -0.255 0.799 yes no Alopecia -0.347 0.729 yes no Canker sore 1.247 0.215 yes no Know the definition of exercise therapy 2.535 0.013* yes no Abbreviation: T2D type 2 diabetes, CRC colorectal cancer *P<0.05 Table 4 one-way analysis of variance results(n = 124) Variables F p Marital status 1.266 0.289 spinsterhood married separate divorced widowed Education 4.828 0.003* primary school and below junior high school high school and technical secondary school specialized college course or above Per capita monthly household income 3.528 0.009* 5000 Body mass index 1.301 0.276 24kg/m 2 Daily sedentary time 56.173 0.000* 2-4h 4-6h 6-8h >8h We need to warm up before exercising 6.645 0.002* yes no unclear We need to stretch after exercise 7.405 0.001* yes no unclear Exercise can alleviate the adverse reactions of chemotherapy 7.400 0.001* yes no unclear *P<0.05 3.4 Bivariate correlations The bivariate correlation results showed that the total amount of exercise per week had moderate correlations with motor function (r = 0.305, p = 0.001), self-efficacy (r = 0.582, p = 0.000), social support (r = 0.434, p = 0.000), and health behavior change techniques (r = 0.419, p = 0.000). 3.5 Hierarchical multiple regression analysis The multiple linear regression analysis revealed that sex, adverse reaction to chemotherapy, self-efficacy, motor function and social support were significant and independent predictors of the total amount of exercise per week in patients with colorectal cancer comorbid diabetes mellitus, explaining 46.9% of the variance in the total amount of exercise per week (Table 5). Table 5 Hierarchical multiple regression analysis(n = 124) Variables B SE Beta t P Sex -1.355 0.519 -0.165 -2.549 0.012 Adverse reactions of chemotherapy 0.864 0.456 0.160 2.230 0.028 Self-efficacy 1.673 0.433 0.225 2.592 0.011 Motor function 1.288 0.730 0.145 2.156 0.033 Social support -0.938 0.440 0.138 -2.131 0.035 Abbreviation: B unstandardized regression coefficient, SE standard error Notes: Adjusted R 2 = 0.469(F = 107.625, P < 0.001) 4 DISCUSSION 4.1 Current status of exercise management in patients with colorectal cancer comorbid diabetes mellitus The patients with colorectal cancer comorbid diabetes mellitus evaluated in this study had a low level of exercise, and the mean amount of exercise per week was 3.70 ± 3.50 MET-h/week, lower than the level of exercise in patients with a single chronic diseases such as colorectal cancer and diabetes [ 11 , 12 ] . The epidemic of COVID-19 in recent years may be one of the reasons for the low exercise level of patients. During COVID-19, residents have been asked to reduce gatherings, go out, and even work from home, resulting in increased sedentary time and decreased physical activity. [ 13 ] Secondly, 57.3% of colorectal cancer patients in this study combined with two or more chronic diseases besides diabetes, and cancer comorbidity is associated with a variety of adverse outcomes. Compared with patients without diabetes, patients with colorectal cancer comorbid diabetes mellitus are more likely to have weakened physical function, higher rate of unplanned admission, lymph node and distant metastasis, and limited motor function. As a result, the difficulty of exercise increased [ 14 , 15 ] . However, studies [ 16 ] have pointed out that exercise is safe and effective for patients with cancer comorbidities, and even the frailest patients during chemotherapy can benefit from exercise that they can tolerate. Exercise is considered as an anti-inflammatory therapy, which can reverse the inflammatory state of the disease, improve insulin resistance, inhibit the growth of tumor cells, and significantly improve the clinical prognosis of colorectal and diabetic patients [ 17 ] . It has been reported [ 18 ] that doctors and nurses do not actively guide colorectal cancer patients to exercise due to conservative concepts and insufficient knowledge. In this study, most patients were not aware of the concept of exercise therapy (84.7%), and some patients were not aware of the effect of exercise on adverse reactions of chemotherapy (41.1%), which may be an important factor leading to low exercise level. Third, adverse reactions to chemotherapy during treatment, especially fatigue [ 19 ] and peripheral neurotoxicity [ 20 ] , affect exercise levels in patients with colorectal cancer comorbid diabetes mellitus. More than half (54.0%) of the patients combined with one to three kinds of adverse reactions to chemotherapy, and 35.5% of the patients indicated that the adverse reactions had a negative impact on daily exercise in this study. Therefore, when prescribing exercise for patients with chemotherapy, we should pay attention to assess the severity of adverse reactions in the current cycle of chemotherapy, and give corresponding response guidance. Low exercise levels may also be related to the fact that most current exercise management only targets a single disease and is ineffective for patients with comorbidities, and in some cases even contradictory [ 21 ] , such as colorectal cancer clinical guidelines recommend weight-bearing training, while diabetes clinical guidelines warn that patients with advanced peripheral neuropathy should avoid weight-bearing exercise. Patients with comorbidities mainly received scattered treatment and care, with poor nursing continuity and lack of evidence for medical decision-making. In addition, chemotherapy, as one of the main treatment methods for cancer patients, has intensified the conflict of exercise management for patients with comorbidity. For example, during chemotherapy, patients with colorectal cancer and diabetes must dynamically adjust exercise prescription according to the severity of adverse reactions of chemotherapy and blood glucose levels [ 22 , 23 ] , resulting in the failure of universal and independent exercise guidance for colorectal cancer and diabetes. Therefore, as an important modifiable lifestyle management strategy, exercise has important therapeutic potential under the background of the current heavy burden of drug therapy. However, insufficient physical activity suggests that there is an urgent need to pay attention to the current status of exercise management in patients with cancer comorbidities. At the same time, exercise management for patients with multimorbidity cannot be copied from a single chronic disease model, and needs to be individualized by combining the characteristics of multimorbidity, considering multiple guidelines, and combining with a multidisciplinary team. 4.2 Daily exercise habits of patients with colorectal cancer comorbid diabetes mellitus The exercise intensity of the participants in this study was low, and most of the patients chose walking as a low-intensity exercise type, without moderate-to-high-intensity physical activity, which was consistent with the survey results of Yang Zhongfang et al [ 12 ] . on exercise items of elderly patients with diabetes mellitus in Shanghai. The patients with colorectal cancer comorbid diabetes mellitus expect a home-based, low-intensity exercise program that is unregulated, free of equipment, and free of additional costs. As a kind of aerobic exercise, walking is loved by the majority of patients with cancer because of its conveniences, low intensity, and no limitation of time and place [ 12 ] . However, the American College of Sports Medicine [ 24 ] recommends at least 150 minutes of moderate-intensity exercise per week, and trying different exercises each time such as yoga, dancing, leisurely bicycling, ball sports or tai chi to keep the experience fresh. The exercise preferences of patients should be taken into account and a variety of exercise types should be promoted in future research. It is suggested that patients can start with low-intensity exercise, and gradually transition to moderate-to-high intensity exercise as they become more comfortable with physical activity. At the same time, we should pay attention to exercise-related health education, publicize the benefits of exercise and the harms of sedentary during chemotherapy, and gradually increase their exercise intensity under their condition of tolerance, so as to ensure the positive effects of exercise can be achieved. The type of exercise should be easily accessible to the general public such as tai chi, square dancing and other activities which can be appropriately added. Most participants in the study did not warm up before exercise, did not stretch after exercise, and did not regularly monitor blood glucose, which may be related to the lack of exercise knowledge and the lack of awareness of the benefits of exercise. However, bad exercise habits can increase the risk of strain and hypoglycemia during exercise, which is harmful to the long-term adherence to exercise and also affects the process of periodic chemotherapy. Therefore, we should pay attention to exercise-related health education for patients, take the "knowledge-attitude-action" model as the theoretical basis, integrate colorectal cancer and diabetes to give personalized and comprehensive exercise guidance, help patients with colorectal cancer comorbid diabetes mellitus to develop good exercise habits and improve exercise safety and compliance. 4.3 Factors Influencing Exercise in Patients with Colorectal Cancer Comorbid Diabetes Mellitus The linear regression results showed that gender was negatively associated with the level of physical activity in patients with colorectal cancer comorbid diabetes mellitus, which was consistent with the results of Boulo et al. 's study of 1200 elderly people from 24 districts in Lebanon [ 25 ] . Some scholars have pointed out that the incidence of osteoporosis in elderly women is higher than that of elderly men of the same age due to the decline of estrogen after menopause, which leads to a lower level of amateur exercise in elderly women [ 26 ] . In addition, Chinese women have a stronger sense of responsibility for the family than men. As a result, they pay more attention to performing daily low-intensity housework and see that as a type of exercise, believing that housework is equal to proper exercise or even can replace exercise. In addition, the lack of correct cognition for exercise therapy also affects the daily exercise level of this population to a certain extent. The chemotherapeutic drugs commonly used in clinical treatment of colorectal cancer, such as oxaliplatin, are highly toxic to the peripheral nervous system. The most common symptom of peripheral neuropathy is paresthesia in the extremities, such as burning pain, tingling, and numbness, resulting in decreased balance and an increased risk of falls. [ 27 ] They worry about the safety of exercise which affects the level of exercise. A systematic review showed that various forms of exercise, such as treadmill exercise, endurance training, aerobic exercise, balance training, and whole-body vibration therapy, can alleviate the symptoms of CIPN to some extent [ 28 ] . Fifty-five (44.4%) of the participants reported that fatigue had affected their daily activities in the past two weeks, and 44 (35.5%) reported that their daily activities had been affected by the side effects of chemotherapy in this study. Fatigue is one of the important symptoms of cancer patients, which is related to the disease itself and the adverse reactions of chemotherapy, and greatly affects the exercise level and disease recovery of patients. Clinical trials have shown that aerobic exercise can well control fatigue symptoms in patients with comorbid cancer, and it is recommended by the American Psychological Association for patients with comorbid cancer [ 16 ] . In general, exercise as a method appeared safe in a few published studies. Future research should include individualized exercise management protocols with chemotherapy-induced peripheral neuropathy and fatigue as primary points of focus. Exercise research should be conducted based on patient-reported outcomes and scales for objective assessment of peripheral neuropathy, fatigue, balance ability, and fall risk, and exercise safety in people with high fall risk should be rigorously evaluated. [ 29 ] The results in this study showed that participants with a low level of self-efficacy had a lower level of exercise. This suggests that exercise self-efficacy can be used as an important predictor of exercise level in patients with colorectal cancer comorbid diabetes mellitus. While helping to improve the physical activity level of patients, clinical medical staff can use the exercise self-efficacy scale to measure the exercise self-efficacy of patients, better understand the exercise belief level of patients, and use it as an important intervention index. When the exercise self-efficacy scale is used in combination with different intervention methods such as peer support, health behavior change techniques, self-feedback and so on; doing so can better promote the maintenance of physical activity of patients with colorectal cancer comorbid diabetes mellitus. The results of the study showed that subjects with good motor function had higher exercise levels. In this study, the motor function was mainly evaluated by assessing the ability to get up and down the bed, up and down the stairs, turn 360°, and walk indoors. Patients with good motor function had fewer concerns about exercise safety and were more willing to exercise. According to the American College of Sports Medicine physical activity guidelines [ 29 ] , health care providers should assess motor function to ensure the safety of exercise before prescribing exercise for patients. The linear regression results of this study showed that social support was negatively correlated with physical activity level, which was different from the results of previous studies [ 30 ] . This may be due to the limited care received by patients or in the initial stage of the disease, they are stronger and more independent, have stronger confidence in overcoming the disease, and are more willing to improve their health status through exercise. At the same time, this phenomenon was further investigated in the later qualitative interview. Limitations This study has some limitations. First, we only enrolled patients with stage II/III CRC, so the findings cannot be generalized to patients with different stages of CRC. Second, this study was cross-sectional and no inferences could be made about causal relationships between variables. Third, this study was only conducted in Shanghai, and the sample size was small. More large-sample prospective cohort studies and randomized controlled trials are needed to support the results of this study. A fourth limitation is that although our homemade questionnaire was reliable and valid in assessing exercise management, more objective measurement tools such as motion sensors may make the findings more scientific. 5 CONCLUSIONS The current status of exercise management in patients with colorectal cancer comorbid diabetes mellitus during chemotherapy is pessimistic and contradictory. It is urgent to pay attention to the influence of comorbidity on exercise. Sex, adverse reactions of chemotherapy, self-efficacy, motor function and social support have the greatest influence on their level of exercise. In the future, exercise management with good compliance and taking into account the degree of adverse reactions and blood glucose levels during chemotherapy under the comorbidity model should be actively explored. DECLARATIONS Acknowledgements We would like to thank all study participants. Author contributions HL: Conceptualization; Data management and analysis; Data interpretation; Writing original draft. HZ: Data analysis and inter pretation; Writing review & editing. ZY: Provided scholastic views and data collection. YG,WZ,JZ,YY,HL,RZ: recruitment of participants and data collection. All other authors report that there are no competing interests to declare. Funding This work was supported by Fudan University-Fosun Nursing Research Foundation [grant number FNF202208]. Availability of data and materials The datasets used and/or analyzed during the current study are stored in a permanent repository and are available from the corresponding author on reasonable request. Ethics approval and consent to participate All procedures in studies involving human participants were carried out in line with the institutional and/or national research committee's ethical standards, as well as the 1964 Helsinki declaration and its subsequent amendments or comparable ethical standards. Researchers briefed patients were given the opportunity to review the consent form and ask questions. Informed consent was obtained from all participants. This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University (B2022-558R). Consent for publication Not applicable. Competing interests The authors declare that they have no conflict of interest. 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Living with and beyond cancer with comorbid illness: a qualitative systematic review and evidence synthesis.[J]. Journal of cancer survivorship : research and practice, 2019,13(1). Dekker J, Buurman B M, van der Leeden M. Exercise in people with comorbidity or multimorbidity.[J]. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2019,38(9). Jones S A, Jenkins B J. Recent insights into targeting the IL-6 cytokine family in inflammatory diseases and cancer[J]. Nat Rev Immunol, 2018,18(12):773-789.DOI:10.1038/s41577-018-0066-7. Miles A, Simon A, Wardle J. Answering patient questions about the role lifestyle factors play in cancer onset and recurrence: what do health care professionals say?[J]. J Health Psychol, 2010,15(2):291-298.DOI:10.1177/1359105309351245. Husebo A, Dalen I, Soreide J A, et al. Cancer-related fatigue and treatment burden in surgically treated colorectal cancer patients - A cross-sectional study[J]. J Clin Nurs, 2022,31(21-22):3089-3101.DOI:10.1111/jocn.16135. Brewer J R, Morrison G, Dolan M E, et al. Chemotherapy-induced peripheral neuropathy: Current status and progress[J]. Gynecol Oncol, 2016,140(1):176-183.DOI:10.1016/j.ygyno.2015.11.011. Mu X. Multimorbidity Pattern Mining and Prevention and Control Mode of Chronic Diseases in the Elderly[D]. Jilin University, 2021.10.27162/d.cnki.gjlin.2021.000089. Oncology C S O N, Regulation K L O C, Care B A O O. Consensus of Chinese experts on exercise therapy for cancer patients[J]. Electron J Metab Nutr Cancer, 2022,9(03):298-311.DOI:10.16689/j.cnki.cn11-9349/r.2022.03.006. Society O O C A, Chongqing O C O. Guidelines for the management of tumor-associated hyperglycemia (2021 edition)[J]. CHINA ONCOLOGY, 2021,31(07):651-688.DOI:10.19401/j.cnki.1007-3639.2021.07.013. Campbell K L, Winters-Stone K M, Wiskemann J, et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable[J]. Med Sci Sports Exerc, 2019,51(11):2375-2390.DOI:10.1249/MSS.0000000000002116. Boulos C, Salameh P, Barberger-Gateau P. The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics[J]. BMC Public Health, 2013,13:573.DOI:10.1186/1471-2458-13-573. Wei L. Correlation of volleyball exercise with bone mineral density in females at different ages[J]. Chinese Journal of Tissue Engineering Research, 2018,22(24):3780-3785. Gao R, Yu T, Liu L, et al. Exercise intervention for post-treatment colorectal cancer survivors: a systematic review and meta-analysis[J]. J Cancer Surviv, 2020,14(6):878-893.DOI:10.1007/s11764-020-00900-z. Brami C, Bao T, Deng G. Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review[J]. Crit Rev Oncol Hematol, 2016,98:325-334.DOI:10.1016/j.critrevonc.2015.11.014. Piercy K L, Troiano R P, Ballard R M, et al. The Physical Activity Guidelines for Americans[J]. JAMA, 2018,320(19):2020.DOI:10.1001/jama.2018.14854. Zhu Y, Cheng K, Wang H, et al. Exercise Adherence and Compliance and Its Related Factors Among Elderly Patients with Type 2 Diabetes in China: A Cross-Sectional Study[J]. Patient Prefer Adherence, 2022,16:3329-3339.DOI:10.2147/PPA.S374120. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3852672","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267403467,"identity":"a90b474c-89d4-44ee-9cbf-4688e9349506","order_by":0,"name":"Huan Liu","email":"","orcid":"","institution":"School of Nursing, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Huan","middleName":"","lastName":"Liu","suffix":""},{"id":267403468,"identity":"e4eafc1a-8949-4428-8eba-b1657729d0a5","order_by":1,"name":"Huihua Zhao","email":"data:image/png;base64,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","orcid":"","institution":"Cancer Center, Zhongshan Hospital, Fudan University","correspondingAuthor":true,"prefix":"","firstName":"Huihua","middleName":"","lastName":"Zhao","suffix":""},{"id":267403469,"identity":"2745479a-18d8-48a8-9a96-8e303a65a840","order_by":2,"name":"Zhuojun Yang","email":"","orcid":"","institution":"School of Nursing, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Zhuojun","middleName":"","lastName":"Yang","suffix":""},{"id":267403470,"identity":"4ad1221e-4d45-4dc8-b6a6-51020ea07606","order_by":3,"name":"Yi Gu","email":"","orcid":"","institution":"Department of International Medicine, Zhongshan Hospital, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Yi","middleName":"","lastName":"Gu","suffix":""},{"id":267403471,"identity":"e9a879e1-0fb2-4537-a4e6-dc23bff89ec9","order_by":4,"name":"Wen Zhang","email":"","orcid":"","institution":"Department of General Surgery, Zhongshan Hospital, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Wen","middleName":"","lastName":"Zhang","suffix":""},{"id":267403472,"identity":"98198bab-2128-4192-b637-f8c974602521","order_by":5,"name":"Jiao Zhou","email":"","orcid":"","institution":"Emergency ward of General Surgery, Zhongshan Hospital, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Jiao","middleName":"","lastName":"Zhou","suffix":""},{"id":267403473,"identity":"bad50b3e-8bca-4a30-85a6-6a489190ec49","order_by":6,"name":"Yang Yang","email":"","orcid":"","institution":"Department of Oncology, Fudan University Shanghai Cancer Center","correspondingAuthor":false,"prefix":"","firstName":"Yang","middleName":"","lastName":"Yang","suffix":""},{"id":267403474,"identity":"a17ee81d-2871-44e8-9514-0d49d71f0323","order_by":7,"name":"Haiyan Li","email":"","orcid":"","institution":"Department of Nursing, Central Hospital of Xuhui District","correspondingAuthor":false,"prefix":"","firstName":"Haiyan","middleName":"","lastName":"Li","suffix":""},{"id":267403475,"identity":"1d799fb1-8890-4915-98f9-e79345ccde31","order_by":8,"name":"Renmin Zhu","email":"","orcid":"","institution":"Department of Nursing, Huadong Hospital, Fudan University","correspondingAuthor":false,"prefix":"","firstName":"Renmin","middleName":"","lastName":"Zhu","suffix":""}],"badges":[],"createdAt":"2024-01-11 07:30:39","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3852672/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3852672/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":71093883,"identity":"1cf54831-95c5-4f28-9028-5a1ae6d26661","added_by":"auto","created_at":"2024-12-11 05:33:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1325353,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3852672/v1/8909b70d-08a1-4ad0-b01b-62dcc45f26b7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exercise Level and Its Related Factors in Patients with Colorectal Cancer Comorbid Diabetes Mellitus undergoing Chemotherapy（a cross-sectional study）","fulltext":[{"header":"1 INTRODUCTION","content":"\u003cp\u003eWith the increase in average life expectancy, the global population is aging, and the number of people with two chronic diseases, colorectal cancer and diabetes, is also increasing \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Diabetes is one of the most common comorbidities in cancer patients, with a prevalence of 14% in patients with colorectal cancer (CRC) \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Colorectal cancer (CRC) has a high mortality rate, with about 880,000 deaths worldwide in 2018, making it the third leading cause of cancer death\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. At the same time, studies project that the T2D epidemic will affect 642\u0026nbsp;million people worldwide by 2040\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. The most common type of diabetes in China is T2D, which accounts for more than 90% of all diabetes. These two chronic diseases share many common risk factors, including advanced age, unhealthy diet, physical inactivity, and obesity\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Evidence suggests that a diagnosis of diabetes is accompanied by an increased risk of cancer and worse disease prognosis \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. Patients diagnosed with colorectal cancer comorbid diabetes mellitus will experience a variety of consequences due to the nature of their disease and the process of their treatment. As a result of their treatment, patients can suffer from significant physical, social and mental morbidity. In addition, these individuals may also have to endure adverse physical and psychological symptoms as a result of treatments such as chemotherapy and radiation therapy, which may last long after the treatments were completed. \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Thus, patients with colorectal cancer comorbid diabetes mellitus require during-treatment assistance to ensure the continuation of chemoradiotherapy and prevent any recurrence of disease.\u003c/p\u003e \u003cp\u003eExercise can be used as a therapeutic strategy for managing T2D. Studies have shown that physical activity can improve insulin sensitivity, reduce blood glucose and blood lipids, control body weight, and thus improve the occurrence and development of diabetes, and The World Health Organization has highlighted the need to strengthen community-based campaigns as one of the most cost-effective measures to combat the impact of T2D\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Exercise is of great significance in improving the clinical prognosis of patients and inhibiting the development of the disease, which runs through the whole process of prevention, treatment and rehabilitation of patients with CRC. In a study of patients undergoing chemotherapy for stage III colon cancer, cancer recurrence and mortality decreased significantly as physical activity increased\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eNumerous studies have shown and demonstrated the importance of physical activity in CRC and T2D. However, not enough research has been done in regards to influencing factors of exercise management in patients with colorectal cancer comorbid diabetes mellitus. The majority of patients affected by CRC often leads sedentary lifestyles. Due to the adverse effects of radiotherapy and chemotherapy such as fatigue and negative emotions, patients receiving colon cancer treatment often have limited exercise capacity and are unwilling to exercise. Understanding the circumstances and reasons which affect patients' desire to exercise will greatly benefit in helping patients find suitable rehabilitation programs to boost their independence, and/or prevent the worsening of their colorectal cancer comorbid diabetes mellitus. The aim of this study was to investigate the status quo of exercise management and to investigate the factors that influence exercise in patients with colorectal cancer comorbid diabetes mellitus.\u003c/p\u003e"},{"header":"2 MATERIAL AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study design and participants\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study. A total of 124 subjects were recruited from four tertiary hospitals in Shanghai, China, including Zhongshan Hospital of Fudan University, Fudan University Shanghai Cancer Center, Fudan University Huadong Hospital, and Central Hospital of Xuhui District. We used a convenient sampling method and collected data from December, 2022 to April, 2023. This study was approved by the approval of the Ethics Committee of Zhongshan Hospital of Fudan University. The necessary explanations about the study were given to our participants and all individual participants who were included in the study gave informed consent.\u003c/p\u003e \u003cp\u003eParticipants selected for this study had to satisfy the following inclusion criteria: (i) be at least 18 years of age; (ii) diagnosed with T2DM; (iii) pathological diagnosed with colorectal cancer; (iv) have stage II\u0026ndash;III CRC according to the tumor, node, and metastasis (TNM) classification; (v) have a performance status of 0 to 2 according to the Eastern Cooperative Oncology Group Performance Status (ECOG-PS); (vi) be able to read, write, and understand Chinese; and (vii) be willing and able to take part in the study.\u003c/p\u003e \u003cp\u003eParticipants were excluded from this study based on the following exclusion criteria: (i) with tumors other than colorectal tumors; (ii)with severe impairment of other important organs (such as liver, lung, kidney); (iii) with communication barriers or mental disorders.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Sample size\u003c/h2\u003e \u003cp\u003eAccording to Kendall method, the sample size should be 5 to 10 times the number of observed variables. In this study, the number of independent variables was 21. Therefore, we considered the sample size to be 105. Based on a 10% sample attrition rate, 117 research participants were needed in total.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Measures\u003c/h2\u003e \u003cp\u003eTwo self-made questionnaires were used in this study. The first was general information questionnaire including :1) socio-demographic information, gender, age, marital status, education level, and BMI; 2) disease-related data included CRC or T2D course, concomitant diseases, diabetes complications, HbA1c, family history, adverse reactions to chemotherapy and its effect on exercise.\u003c/p\u003e \u003cp\u003eThe second was the exercise management ability questionnaire. Because there is no scale on exercise management ability of patients with colorectal cancer comorbid diabetes mellitus during chemotherapy at present, this study based on literature review, \"knowledge-attitude-practice\" model as the theoretical basis, modified items after expert discussion, finally completed the questionnaire, including daily exercise habits, exercise-related knowledge, motor function assessment, self-efficacy and social support assessment, with a total of 44 items. According to the brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC)\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e, the MET-values were assigned 3.0 for walking, 4.5 for moderate-intensity physical activity, and 6.0 for high-intensity physical activity to denote activity intensity in the daily exercise habit items. The total amount of exercise per week\u0026thinsp;=\u0026thinsp;MET-values (MET-h/week) * exercise times(h) in this study. Self-efficacy, motor function assessment and social support were scored by Likert5, and the higher the score, the higher the level of exercise management. The Cronbach's α of the questionnaire was 0.96, and the content validity index (S-CVI) was 0.87.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Data collection\u003c/h2\u003e \u003cp\u003eAll questionnaires were administered by the investigators ourselves, and all assessments lasted approximately 20 minutes. Data on sociodemographic and clinical characteristics and on laboratory tests were obtained from face-to-face interviews with participants and from records in the archive of the Medical Oncology Department. In cases where the subject is an elderly with poor eyesight, or where the subject is not comfortable with filling in the questionnaires by themself; the researcher read the questions orally to those individuals and recorded their answers on their behalf. The researcher also recorded on behalf of individuals who chose to answer the questions orally. All results from the questionnaires were checked on site to ensure each questionnaire\u0026rsquo;s accuracy and authenticity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Statistical analyses\u003c/h2\u003e \u003cp\u003eData were analyzed using the IBM SPSS Statistics v. 22.0 (IBM, Armonk, New York). For continuous variables with normal distribution, such as age and BMI, the mean and standard deviation were reported, while for variables without normal distribution, the median (P25, P75) was reported. Categorical variables such as gender and educational level are reported as frequencies and percentages. We then analyzed which characteristics were considerably influencing the participants\u0026rsquo; exercise level. In univariate analysis, factors with P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were included in the multiple linear regression model. In addition, to ensure that there was no multicollinearity between variables, we only accepted models with all VIF values less than 10. The level of significance was set at 0.05, and all comparisons were two-sided.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 RESULTS","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.1 Participant characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA total of 124 (95 male, 29 female) patients diagnosed with colorectal cancer comorbid diabetes mellitus were included in this study. The age of the subjects ranged from 39 to 90 years old, with an average age of 65.22\u0026thinsp;\u0026plusmn;\u0026thinsp;8.87 years old. The duration of DM was 1\u0026ndash;30 years, with an average of 9.19\u0026thinsp;\u0026plusmn;\u0026thinsp;7.57 years and a median of 7 years. The duration of CRC was 1\u0026ndash;7 years, with an average of 1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97years and a median of 1 year. 57.3% of colorectal cancer patients had two or more chronic diseases besides diabetes. More than half (54.0%) of the patients combined with one to three kinds of adverse reactions to chemotherapy, and 35.5% of the patients indicated that the adverse reactions had a negative impact on daily exercise. The mean amount of exercise per week was 3.70\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50 MET-h/week. The characteristics of the study subjects are shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe characteristics of the participants(n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003en\u0026thinsp;=\u0026thinsp;124\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategorical Variables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003espinsterhood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eseparate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ewidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eprimary school and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ejunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ehigh school and technical secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003especialized college course or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePer capita monthly household income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1000\u0026thinsp;~\u0026thinsp;3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3001\u0026thinsp;~\u0026thinsp;5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody mass index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;18kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18-24kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;24kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbidity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eabsence of Comorbidities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e42.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecombined hypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecombined Coronary heart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecombined cerebral infarction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecombined hyperlipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2D family history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRC family history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetic complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdverse reactions of chemotherapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003enausea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003evomit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003efatigue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ediarrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePeripheral neurotoxicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eliver function damage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003erenal function damage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eanemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emyelosuppression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ealopecia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ecanker sore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eThis adverse reaction of chemotherapy has affected your exercise\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eContinuous Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e65.22\u0026thinsp;\u0026plusmn;\u0026thinsp;8.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eT2D duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e9.19\u0026thinsp;\u0026plusmn;\u0026thinsp;7.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCRC duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e1.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe total amount of exercise per week (MET-h/week)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e3.70\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003eAbbreviation: T2D type 2 diabetes, CRC colorectal cancer, SD standard deviation\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cstrong\u003e3.2 Participant daily exercise habits\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAccording to the daily exercise habits of the participants in the past six months, 33 (26.6%) never had exercise habits, and 91 (73.4%) had exercise habits. Walking was the main physical activity of 90 (72.6%) participants. Most participants who had exercise habits exercised more than five times per week (45.2%), followed by three to five times per week (23.4%). 88 (71%) participants never engaged in vigorous-intensity physical activity and 72 (58.1%) participants never engaged in moderate-intensity physical activity. Their daily walking time was mainly 30-60 minutes (34.7%), and their daily sedentary time was 4-6 hours (34.7%). Most of the subjects did not carry sweets with them during exercise (62.9%), did not warm up before exercise (65.3%), and did not stretch after exercise (60.5%). Most participants exercised for a fixed amount of time (50%) (Table 2).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe daily exercise habits of the participants(n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategorical Variables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eType of exercise (multiple choices)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003enever exercise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ewalk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ejogging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eball sports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTai Chi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eride a bike\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyoga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edancing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eswimming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edumbbells or elastic bands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003enever exercise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eless than three times a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ethree to five times a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emore than five times a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of vigorous physical activity per week\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno vigorous physical activity or \u0026lt;10 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u0026ndash;30 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;60 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u0026ndash;90 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;90 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of moderate intensity physical activity per week\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno moderate physical activity or \u0026lt;10 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10-90min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90-120min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e120\u0026ndash;150 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;150 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDaily walking time\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;10 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10-30min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;60 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u0026ndash;90 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;90 min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDaily sedentary time\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2-4h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4-6h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6-8h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;8h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-monitoring Blood glucose during exercise\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eTake candy when exercising\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWarm-up before exercise\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eStretch after exercise\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eExercise time fixed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cstrong\u003e3.3 T-test and one-way analysis of variance\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eWe then used the T-test and one-way analysis of variance to analyze which categorical variables considerably influencing exercise behavior were related to the total amount of exercise per week (MET-h/week). The data were shown in Table 3 and Table 4.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eT-test results(n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.842\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003efemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbidity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.867\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCombined hypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.890\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCombined Coronary heart disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.739\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCombined cerebral infarction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.955\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.341\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCombined hyperlipidemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.906\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2D family history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.674\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRC family history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetic complication\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.705\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdverse reactions of chemotherapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.987\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.049*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNausea\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eVomit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFatigue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.044*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiarrhea\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePeripheral neurotoxicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.858\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiver function damage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnemia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.047*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMyelosuppression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.799\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlopecia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.729\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCanker sore\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnow the definition of exercise therapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.013*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003eAbbreviation: T2D type 2 diabetes, CRC colorectal cancer\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e*P\u0026lt;0.05\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eone-way analysis of variance results(n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.289\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003espinsterhood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eseparate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003edivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ewidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.003*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eprimary school and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ejunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ehigh school and technical secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003especialized college course or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePer capita monthly household income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.009*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1000\u0026thinsp;~\u0026thinsp;3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3001\u0026thinsp;~\u0026thinsp;5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody mass index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.276\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;18kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18-24kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;24kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDaily sedentary time\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2-4h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4-6h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6-8h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;8h\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWe need to warm up before exercising\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eunclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWe need to stretch after exercise\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.405\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eunclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eExercise can alleviate the adverse reactions of chemotherapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eno\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eunclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e*P\u0026lt;0.05\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cstrong\u003e3.4 Bivariate correlations\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe bivariate correlation results showed that the total amount of exercise per week had moderate correlations with motor function (r = 0.305, p = 0.001), self-efficacy (r = 0.582, p = 0.000), social support (r = 0.434, p = 0.000), and health behavior change techniques (r = 0.419, p = 0.000).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3.5 Hierarchical multiple regression analysis\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe multiple linear regression analysis revealed that sex, adverse reaction to chemotherapy, self-efficacy, motor function and social support were significant and independent predictors of the total amount of exercise per week in patients with colorectal cancer comorbid diabetes mellitus, explaining 46.9% of the variance in the total amount of exercise per week (Table 5).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eHierarchical multiple regression analysis(n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eBeta\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.355\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.549\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAdverse reactions of chemotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.864\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.456\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.673\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.592\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMotor function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.730\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.033\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSocial support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.938\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003eAbbreviation: B unstandardized regression coefficient, SE standard error\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003eNotes: Adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.469(F\u0026thinsp;=\u0026thinsp;107.625, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"4 DISCUSSION","content":"\u003cp\u003e\u003cstrong\u003e4.1 Current status of exercise management in patients with colorectal cancer comorbid diabetes mellitus\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patients with colorectal cancer comorbid diabetes mellitus evaluated in this study had a low level of exercise, and the mean amount of exercise per week was 3.70\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50 MET-h/week, lower than the level of exercise in patients with a single chronic diseases such as colorectal cancer and diabetes \u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. The epidemic of COVID-19 in recent years may be one of the reasons for the low exercise level of patients. During COVID-19, residents have been asked to reduce gatherings, go out, and even work from home, resulting in increased sedentary time and decreased physical activity.\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e Secondly, 57.3% of colorectal cancer patients in this study combined with two or more chronic diseases besides diabetes, and cancer comorbidity is associated with a variety of adverse outcomes. Compared with patients without diabetes, patients with colorectal cancer comorbid diabetes mellitus are more likely to have weakened physical function, higher rate of unplanned admission, lymph node and distant metastasis, and limited motor function. As a result, the difficulty of exercise increased\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. However, studies\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e have pointed out that exercise is safe and effective for patients with cancer comorbidities, and even the frailest patients during chemotherapy can benefit from exercise that they can tolerate. Exercise is considered as an anti-inflammatory therapy, which can reverse the inflammatory state of the disease, improve insulin resistance, inhibit the growth of tumor cells, and significantly improve the clinical prognosis of colorectal and diabetic patients\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. It has been reported\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e that doctors and nurses do not actively guide colorectal cancer patients to exercise due to conservative concepts and insufficient knowledge. In this study, most patients were not aware of the concept of exercise therapy (84.7%), and some patients were not aware of the effect of exercise on adverse reactions of chemotherapy (41.1%), which may be an important factor leading to low exercise level. Third, adverse reactions to chemotherapy during treatment, especially fatigue\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e and peripheral neurotoxicity\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e, affect exercise levels in patients with colorectal cancer comorbid diabetes mellitus. More than half (54.0%) of the patients combined with one to three kinds of adverse reactions to chemotherapy, and 35.5% of the patients indicated that the adverse reactions had a negative impact on daily exercise in this study. Therefore, when prescribing exercise for patients with chemotherapy, we should pay attention to assess the severity of adverse reactions in the current cycle of chemotherapy, and give corresponding response guidance.\u003c/p\u003e\n\u003cp\u003eLow exercise levels may also be related to the fact that most current exercise management only targets a single disease and is ineffective for patients with comorbidities, and in some cases even contradictory\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e, such as colorectal cancer clinical guidelines recommend weight-bearing training, while diabetes clinical guidelines warn that patients with advanced peripheral neuropathy should avoid weight-bearing exercise. Patients with comorbidities mainly received scattered treatment and care, with poor nursing continuity and lack of evidence for medical decision-making. In addition, chemotherapy, as one of the main treatment methods for cancer patients, has intensified the conflict of exercise management for patients with comorbidity. For example, during chemotherapy, patients with colorectal cancer and diabetes must dynamically adjust exercise prescription according to the severity of adverse reactions of chemotherapy and blood glucose levels\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e, resulting in the failure of universal and independent exercise guidance for colorectal cancer and diabetes. Therefore, as an important modifiable lifestyle management strategy, exercise has important therapeutic potential under the background of the current heavy burden of drug therapy. However, insufficient physical activity suggests that there is an urgent need to pay attention to the current status of exercise management in patients with cancer comorbidities. At the same time, exercise management for patients with multimorbidity cannot be copied from a single chronic disease model, and needs to be individualized by combining the characteristics of multimorbidity, considering multiple guidelines, and combining with a multidisciplinary team.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2 Daily exercise habits of patients with colorectal cancer comorbid diabetes mellitus\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe exercise intensity of the participants in this study was low, and most of the patients chose walking as a low-intensity exercise type, without moderate-to-high-intensity physical activity, which was consistent with the survey results of Yang Zhongfang et al\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. on exercise items of elderly patients with diabetes mellitus in Shanghai. The patients with colorectal cancer comorbid diabetes mellitus expect a home-based, low-intensity exercise program that is unregulated, free of equipment, and free of additional costs. As a kind of aerobic exercise, walking is loved by the majority of patients with cancer because of its conveniences, low intensity, and no limitation of time and place\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. However, the American College of Sports Medicine\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e recommends at least 150 minutes of moderate-intensity exercise per week, and trying different exercises each time such as yoga, dancing, leisurely bicycling, ball sports or tai chi to keep the experience fresh. The exercise preferences of patients should be taken into account and a variety of exercise types should be promoted in future research. It is suggested that patients can start with low-intensity exercise, and gradually transition to moderate-to-high intensity exercise as they become more comfortable with physical activity. At the same time, we should pay attention to exercise-related health education, publicize the benefits of exercise and the harms of sedentary during chemotherapy, and gradually increase their exercise intensity under their condition of tolerance, so as to ensure the positive effects of exercise can be achieved. The type of exercise should be easily accessible to the general public such as tai chi, square dancing and other activities which can be appropriately added.\u003c/p\u003e\n\u003cp\u003eMost participants in the study did not warm up before exercise, did not stretch after exercise, and did not regularly monitor blood glucose, which may be related to the lack of exercise knowledge and the lack of awareness of the benefits of exercise. However, bad exercise habits can increase the risk of strain and hypoglycemia during exercise, which is harmful to the long-term adherence to exercise and also affects the process of periodic chemotherapy. Therefore, we should pay attention to exercise-related health education for patients, take the \"knowledge-attitude-action\" model as the theoretical basis, integrate colorectal cancer and diabetes to give personalized and comprehensive exercise guidance, help patients with colorectal cancer comorbid diabetes mellitus to develop good exercise habits and improve exercise safety and compliance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.3 Factors Influencing Exercise in Patients with Colorectal Cancer Comorbid Diabetes Mellitus\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe linear regression results showed that gender was negatively associated with the level of physical activity in patients with colorectal cancer comorbid diabetes mellitus, which was consistent with the results of Boulo et al. 's study of 1200 elderly people from 24 districts in Lebanon\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. Some scholars have pointed out that the incidence of osteoporosis in elderly women is higher than that of elderly men of the same age due to the decline of estrogen after menopause, which leads to a lower level of amateur exercise in elderly women\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. In addition, Chinese women have a stronger sense of responsibility for the family than men. As a result, they pay more attention to performing daily low-intensity housework and see that as a type of exercise, believing that housework is equal to proper exercise or even can replace exercise. In addition, the lack of correct cognition for exercise therapy also affects the daily exercise level of this population to a certain extent.\u003c/p\u003e\n\u003cp\u003eThe chemotherapeutic drugs commonly used in clinical treatment of colorectal cancer, such as oxaliplatin, are highly toxic to the peripheral nervous system. The most common symptom of peripheral neuropathy is paresthesia in the extremities, such as burning pain, tingling, and numbness, resulting in decreased balance and an increased risk of falls.\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e They worry about the safety of exercise which affects the level of exercise. A systematic review showed that various forms of exercise, such as treadmill exercise, endurance training, aerobic exercise, balance training, and whole-body vibration therapy, can alleviate the symptoms of CIPN to some extent\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. Fifty-five (44.4%) of the participants reported that fatigue had affected their daily activities in the past two weeks, and 44 (35.5%) reported that their daily activities had been affected by the side effects of chemotherapy in this study. Fatigue is one of the important symptoms of cancer patients, which is related to the disease itself and the adverse reactions of chemotherapy, and greatly affects the exercise level and disease recovery of patients. Clinical trials have shown that aerobic exercise can well control fatigue symptoms in patients with comorbid cancer, and it is recommended by the American Psychological Association for patients with comorbid cancer\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. In general, exercise as a method appeared safe in a few published studies. Future research should include individualized exercise management protocols with chemotherapy-induced peripheral neuropathy and fatigue as primary points of focus. Exercise research should be conducted based on patient-reported outcomes and scales for objective assessment of peripheral neuropathy, fatigue, balance ability, and fall risk, and exercise safety in people with high fall risk should be rigorously evaluated.\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe results in this study showed that participants with a low level of self-efficacy had a lower level of exercise. This suggests that exercise self-efficacy can be used as an important predictor of exercise level in patients with colorectal cancer comorbid diabetes mellitus. While helping to improve the physical activity level of patients, clinical medical staff can use the exercise self-efficacy scale to measure the exercise self-efficacy of patients, better understand the exercise belief level of patients, and use it as an important intervention index. When the exercise self-efficacy scale is used in combination with different intervention methods such as peer support, health behavior change techniques, self-feedback and so on; doing so can better promote the maintenance of physical activity of patients with colorectal cancer comorbid diabetes mellitus.\u003c/p\u003e\n\u003cp\u003eThe results of the study showed that subjects with good motor function had higher exercise levels. In this study, the motor function was mainly evaluated by assessing the ability to get up and down the bed, up and down the stairs, turn 360\u0026deg;, and walk indoors. Patients with good motor function had fewer concerns about exercise safety and were more willing to exercise. According to the American College of Sports Medicine physical activity guidelines\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e, health care providers should assess motor function to ensure the safety of exercise before prescribing exercise for patients.\u003c/p\u003e\n\u003cp\u003eThe linear regression results of this study showed that social support was negatively correlated with physical activity level, which was different from the results of previous studies\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e. This may be due to the limited care received by patients or in the initial stage of the disease, they are stronger and more independent, have stronger confidence in overcoming the disease, and are more willing to improve their health status through exercise. At the same time, this phenomenon was further investigated in the later qualitative interview.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has some limitations. First, we only enrolled patients with stage II/III CRC, so the findings cannot be generalized to patients with different stages of CRC. Second, this study was cross-sectional and no inferences could be made about causal relationships between variables. Third, this study was only conducted in Shanghai, and the sample size was small. More large-sample prospective cohort studies and randomized controlled trials are needed to support the results of this study. A fourth limitation is that although our homemade questionnaire was reliable and valid in assessing exercise management, more objective measurement tools such as motion sensors may make the findings more scientific.\u003c/p\u003e"},{"header":"5 CONCLUSIONS","content":"\u003cp\u003eThe current status of exercise management in patients with colorectal cancer comorbid diabetes mellitus during chemotherapy is pessimistic and contradictory. It is urgent to pay attention to the influence of comorbidity on exercise. Sex, adverse reactions of chemotherapy, self-efficacy, motor function and social support have the greatest influence on their level of exercise. In the future, exercise management with good compliance and taking into account the degree of adverse reactions and blood glucose levels during chemotherapy under the comorbidity model should be actively explored.\u003c/p\u003e"},{"header":"DECLARATIONS","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all study participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHL: Conceptualization; Data management and analysis; Data interpretation; Writing original draft. HZ: Data analysis and inter pretation; Writing review \u0026amp; editing. ZY: Provided scholastic views and data collection. YG,WZ,JZ,YY,HL,RZ: recruitment of participants and data collection. All other authors report that there are no competing interests to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by Fudan University-Fosun Nursing Research Foundation [grant number FNF202208].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are stored in a permanent repository and are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures in studies involving human participants were carried out in line with the institutional and/or national research committee\u0026apos;s ethical standards, as well as the 1964 Helsinki declaration and its subsequent amendments or comparable ethical standards. Researchers briefed patients were given the opportunity to review the consent form and ask questions. Informed consent was obtained from all participants. This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University (B2022-558R).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e"},{"header":"REFERENCES","content":"\u003col\u003e\n\u003cli\u003eMiller K D, Nogueira L, Devasia T, et al. Cancer treatment and survivorship statistics, 2022.[J]. CA: a cancer journal for clinicians, 2022,72(5).\u003c/li\u003e\n\u003cli\u003eCheng Y, Cheng Y X, Liu X Y, et al. 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Consensus of Chinese experts on exercise therapy for cancer patients[J]. Electron J Metab Nutr Cancer, 2022,9(03):298-311.DOI:10.16689/j.cnki.cn11-9349/r.2022.03.006.\u003c/li\u003e\n\u003cli\u003eSociety O O C A, Chongqing O C O. Guidelines for the management of tumor-associated hyperglycemia (2021 edition)[J]. CHINA ONCOLOGY, 2021,31(07):651-688.DOI:10.19401/j.cnki.1007-3639.2021.07.013.\u003c/li\u003e\n\u003cli\u003eCampbell K L, Winters-Stone K M, Wiskemann J, et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable[J]. Med Sci Sports Exerc, 2019,51(11):2375-2390.DOI:10.1249/MSS.0000000000002116.\u003c/li\u003e\n\u003cli\u003eBoulos C, Salameh P, Barberger-Gateau P. The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics[J]. BMC Public Health, 2013,13:573.DOI:10.1186/1471-2458-13-573.\u003c/li\u003e\n\u003cli\u003eWei L. Correlation of volleyball exercise with bone mineral density in females at different ages[J]. Chinese Journal of Tissue Engineering Research, 2018,22(24):3780-3785.\u003c/li\u003e\n\u003cli\u003eGao R, Yu T, Liu L, et al. Exercise intervention for post-treatment colorectal cancer survivors: a systematic review and meta-analysis[J]. J Cancer Surviv, 2020,14(6):878-893.DOI:10.1007/s11764-020-00900-z.\u003c/li\u003e\n\u003cli\u003eBrami C, Bao T, Deng G. Natural products and complementary therapies for chemotherapy-induced peripheral neuropathy: A systematic review[J]. Crit Rev Oncol Hematol, 2016,98:325-334.DOI:10.1016/j.critrevonc.2015.11.014.\u003c/li\u003e\n\u003cli\u003ePiercy K L, Troiano R P, Ballard R M, et al. The Physical Activity Guidelines for Americans[J]. JAMA, 2018,320(19):2020.DOI:10.1001/jama.2018.14854.\u003c/li\u003e\n\u003cli\u003eZhu Y, Cheng K, Wang H, et al. Exercise Adherence and Compliance and Its Related Factors Among Elderly Patients with Type 2 Diabetes in China: A Cross-Sectional Study[J]. Patient Prefer Adherence, 2022,16:3329-3339.DOI:10.2147/PPA.S374120.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"colorectal cancer, type 2 diabetes mellitus, comorbidity, exercise, chemotherapy","lastPublishedDoi":"10.21203/rs.3.rs-3852672/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3852672/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eTo investigate the status quo of exercise management as well as its related factors among patients with colorectal cancer comorbid diabetes mellitus to provide reference for clinical exercise intervention programs.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study of 124 patients with colorectal cancer comorbid diabetes mellitus who were undergoing chemotherapy in Shanghai from December, 2022 to April, 2023, was undertaken. Two self-made questionnaires were used to investigate the exercise management and its related factors, and multiple linear regression analysis was used to explore the potential related factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean amount of exercise per week was 3.70\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50 MET-h/week. The stepwise regression results revealed that exercise level was positively correlated with motor function (r\u0026thinsp;=\u0026thinsp;0.305, p\u0026thinsp;=\u0026thinsp;0.001), self-efficacy (r\u0026thinsp;=\u0026thinsp;0.582, p\u0026thinsp;=\u0026thinsp;0.000), social support (r\u0026thinsp;=\u0026thinsp;0.434, p\u0026thinsp;=\u0026thinsp;0.000), and health behavior change techniques (r\u0026thinsp;=\u0026thinsp;0.419, p\u0026thinsp;=\u0026thinsp;0.000).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe current status of exercise management in patients with colorectal cancer comorbid diabetes mellitus during chemotherapy is pessimistic and contradictory. It is urgent to pay attention to the influence of comorbidity on exercise. Sex, adverse reactions of chemotherapy, self-efficacy, motor function and social support have the greatest influence on their level of exercise.\u003c/p\u003e","manuscriptTitle":"Exercise Level and Its Related Factors in Patients with Colorectal Cancer Comorbid Diabetes Mellitus undergoing Chemotherapy（a cross-sectional study）","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-17 17:56:21","doi":"10.21203/rs.3.rs-3852672/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"24ff369b-047e-499d-abed-e7d9a38005c3","owner":[],"postedDate":"January 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-11T05:24:32+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-17 17:56:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3852672","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3852672","identity":"rs-3852672","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}