{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:07:59Z","timestamp":1772777279690,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:00:00Z","timestamp":1681603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Patients treated for vulvar carcinoma may experience losses in mobility and physical activity. In this study, we assess the prevalence and severity of mobility problems using patient-reported outcomes of three questionnaires: EQ-5D-5L to estimate QoL and perceived health; SQUASH to estimate habitual physical activity; and a problem-specific questionnaire on bicycling. Patients treated for vulvar carcinoma between 2018 and 2021 were recruited, and 84 (62.7%) responded. The mean age was 68 \u00b1 12 years (mean \u00b1 standard deviation). Self-reported QoL and perceived health were 0.832 \u00b1 0.224 and 75.6 \u00b1 20.0, respectively. Dutch physical activity guidelines were met by 34.2% of participants. Compared to baseline values, the times spent walking, bicycling, and participating in sports were all reduced. During bicycling, patients experienced moderate or severe pain in the skin of the vulva (24.5%), pain in the sit bones (23.2%), chafing (25.5%), or itching (8.9%). Overall, 40.3% experienced moderate or severe bicycling problems or could not bicycle, 34.9% felt that their vulva impeded bicycling, and 57.1% wished to make more or longer bicycling journeys. To conclude, vulvar carcinoma and its treatment reduce self-reported health, mobility, and physical activity. This motivates us to investigate ways to reduce discomfort during physical activities, and help women regain their mobility and self-reliance.<\/jats:p>","DOI":"10.3390\/cancers15082324","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T02:02:59Z","timestamp":1681696979000},"page":"2324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Patient-Reported Mobility, Physical Activity, and Bicycle Use after Vulvar Carcinoma Surgery"],"prefix":"10.3390","volume":"15","author":[{"given":"Nick J.","family":"van de Berg","sequence":"first","affiliation":[{"name":"Department of Gynaecological Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franciscus P.","family":"van Beurden","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. C. Wanda","family":"Wendel-Vos","sequence":"additional","affiliation":[{"name":"Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjolein","family":"Duijvestijn","sequence":"additional","affiliation":[{"name":"Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-7412","authenticated-orcid":false,"given":"Heleen J.","family":"van Beekhuizen","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Maliepaard","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1062-4485","authenticated-orcid":false,"given":"Helena C.","family":"van Doorn","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3141\/2074-08","article-title":"Cycling for Everyone Lessons from Europe","volume":"2074","author":"Pucher","year":"2008","journal-title":"Transport. Res. Rec."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1038\/s43247-022-00497-4","article-title":"Historical patterns and sustainability implications of worldwide bicycle ownership and use","volume":"3","author":"Chen","year":"2022","journal-title":"Commun. Earth Environ."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"120846","DOI":"10.1016\/j.jclepro.2020.120846","article-title":"Bike-sharing systems\u2019 impact on modal shift: A case study in Delft, the Netherlands","volume":"259","author":"Ma","year":"2020","journal-title":"J. Clean. Prod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.tra.2019.06.015","article-title":"Bicycle superhighway: An environmentally sustainable policy for urban transport","volume":"137","author":"Agarwal","year":"2020","journal-title":"Transp. Res. Part A Policy Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1111\/j.1600-0838.2011.01299.x","article-title":"Health benefits of cycling: A systematic review","volume":"21","author":"Oja","year":"2011","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_6","unstructured":"CBS, and RIVM (2021). National Health Survey\/Lifestyle Monitor."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1249\/MSS.0000000000001937","article-title":"Physical Activity in Cancer Prevention and Survival: A Systematic Review","volume":"51","author":"McTiernan","year":"2019","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jgo.2012.01.002","article-title":"Exercise and Cancer Treatment Symptoms in 408 Newly Diagnosed Older Cancer Patients","volume":"3","author":"Sprod","year":"2012","journal-title":"J. Geriatr. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.apergo.2018.03.002","article-title":"The effect of saddle nose width and cutout on saddle pressure distribution and perceived discomfort in women during ergometer cycling","volume":"70","author":"Larsen","year":"2018","journal-title":"Appl. Ergon."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jval.2016.01.003","article-title":"Dutch Tariff for the Five-Level Version of EQ-5D","volume":"19","author":"Versteegh","year":"2016","journal-title":"Value Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/S0895-4356(03)00220-8","article-title":"Reproducibility and relative validity of the Short Questionnaire to Assess Health-enhancing physical activity","volume":"56","author":"Schuit","year":"2003","journal-title":"J. Clin. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12966-018-0661-9","article-title":"The 2017 Dutch Physical Activity Guidelines","volume":"15","author":"Weggemans","year":"2018","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1080\/0284186X.2018.1563712","article-title":"Physical activity levels of women with breast cancer during and after treatment, a comparison with the Dutch female population","volume":"58","author":"Gal","year":"2019","journal-title":"Acta Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12955-016-0577-5","article-title":"Quality of life in community-dwelling Dutch elderly measured by EQ-5D-3L","volume":"15","author":"Mangen","year":"2017","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/00140139.2020.1853819","article-title":"A field study investigating sensory manifestations in recreational female cyclists using a novel female-specific cycling pad","volume":"64","author":"Larsen","year":"2021","journal-title":"Ergonomics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ygyno.2015.09.077","article-title":"Sentinel nodes in vulvar cancer: Long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I","volume":"140","author":"Vergote","year":"2016","journal-title":"Gynecol. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s12471-021-01550-1","article-title":"Impact of COVID-19 lockdown on physical activity and sedentary behaviour in Dutch cardiovascular disease patients","volume":"29","author":"Bakker","year":"2021","journal-title":"Neth Heart J."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Schoofs, M.C.A., Bakker, E.A., de Vries, F., Hartman, Y.A.W., Spoelder, M., Thijssen, D.H.J., Eijsvogels, T.M.H., Buffart, L.M., and Hopman, M.T.E. (2022). Impact of Dutch COVID-19 restrictive policy measures on physical activity behavior and identification of correlates of physical activity changes: A cohort study. 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