Exercise Barriers and Adherence to Recommendations in Patients With Cancer

2021 ◽  
pp. OP.20.00625
Author(s):  
Amy H. Ng ◽  
An Ngo-Huang ◽  
Marieberta Vidal ◽  
Ariadne Reyes-Garcia ◽  
Diane D. Liu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Sports Medicine ◽  
Exercise Adherence ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Well Being ◽  
Moderate Intensity ◽  
Adult Cancer Survivors ◽  
Exercise Guidelines

PURPOSE: The American College of Sports Medicine exercise guidelines for cancer survivors encourage a combination of 150 minutes of moderate-intensity aerobic activity and 2-3 weekly sessions of strength training. Cancer survivors often experience more barriers to meeting recommended guidelines because of side effects from cancer treatments. Our aim was to measure the cancer survivors’ adherence and barriers with these recommendations. METHODS: Two hundred adult cancer survivors completed surveys (Stanford Patient Education Research Center Exercise Behaviors Survey and an exercise barrier scale) reporting their physical activity, barriers to physical activity, and symptom assessment. RESULTS: A total of 68/200 participants (34%) reported adhering to the recommended physical activity guidelines of 150 minutes or more per week. Those who adhered to the guidelines reported fewer barriers to exercise (mean of 2.44 compared with 4.15 barriers, P < .0001). Female participants ( P = .01), higher number of barriers, and feeling of poor well-being were less likely to report at least 60 or 150 minutes of exercise time. Lack of interest ( P = .003) and self-discipline ( P = .001) were reported as barriers. These participants were more likely to report high symptom burden of pain ( P = .007) and fatigue ( P = .005). Participants who reported < 60 minutes of exercise reported lack of enjoyment ( P = .03), lack of equipment ( P = .01), and symptoms of poor appetite, poor well-being, and increased dyspnea. CONCLUSION: Although recommendations are given for exercise, adherence to recommendations is low. Issues of motivation, including lack of interest and self-discipline, and symptoms of pain and fatigue were some of the main reported barriers to adhering to the recommended exercise guidelines. Therefore, interventions aimed at increasing motivation and treating symptoms could improve cancer survivor adherence to recommended exercise guidelines.

scholarly journals Role of Adjuvant and Posttreatment Exercise Programs in Breast Health

2011 ◽  
Vol 9 (2) ◽  
pp. 251-256 ◽  
Author(s):  
Jennifer A. Ligibel
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Sports Medicine ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Moderate Intensity ◽  
Cancer Society ◽  
Breast Cancer Death

Growing evidence suggests that physical activity may be an important part of survivorship care for women with a history of breast cancer. Observational evidence suggests that women who are physically active after breast cancer diagnosis have a 30% to 50% lower risk of breast cancer recurrence, breast cancer death, and overall death compared with sedentary individuals. Although randomized controlled trials have not been performed to test the ability of exercise to improve outcomes in women with early-stage breast cancer, many small intervention studies have shown the safety and potential benefits of exercise in the adjuvant and posttreatment settings. These studies have shown that physical activity can be performed safely both during and after adjuvant treatment for breast cancer, and that women who increase physical activity in these settings experience improvements in fitness, strength, quality of life, and other end points. Although more research is needed to fully define the role of exercise in breast cancer survivors, the many proven benefits of physical activity have led the American Cancer Society and American College of Sports Medicine to encourage regular participation in moderate-intensity recreational activity for most breast cancer survivors. This article reviews the growing evidence that exercise could be an important part of breast cancer survivorship, and describes current exercise guidelines for breast cancer survivors.

scholarly journals Information and Communications Technology-Based Telehealth Approach for Occupational Therapy Interventions for Cancer Survivors: A Systematic Review

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 355
Author(s):  
Na-Kyoung Hwang ◽  
Young-Jin Jung ◽  
Ji-Su Park
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Occupational Therapy ◽  
Cognitive Behavioral Therapy ◽  
Cancer Survivors ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Moderate Intensity ◽  
Occupational Engagement ◽  
Adult Cancer Survivors

(1) Background: Occupational therapy (OT) practice has a unique perspective that addresses the complex needs of cancer survivors. Despite the expanded research and application of OT services using telehealth (TH) to promote clients’ health and well-being, studies on OT services using TH for cancer survivors are rare. This study aimed to review the TH approaches in the scope of OT and the outcome of factors affecting occupational engagement in adult cancer survivors. (2) Materials and Methods: This systematic review performed a literature search of five databases (Medline Complete, PubMed, CINAHL, PsycINFO, Web of Science) using a combination of keywords and cross-referencing. Studies were included if they described a TH intervention within the scope of OT practice to improve occupational engagement. (3) Results: Fifteen studies (12 randomized controlled trials, three quasiexperimental studies) were reviewed. Physical activity had a positive effect on physical and cognitive function. Symptom self-management showed positive effects on the relief of symptom burden. Psychosocial interventions, which included cognitive behavioral therapy, problem-solving, cognitive behavioral therapy for insomnia, mind–body training, reduced sleep disturbance, and improved physical activity. Lifestyle behavior change interventions improved participation in moderate-intensity physical activity and diet quality. In addition, these interventions reduced cancer-related symptoms such as pain, depression, fatigue, distress, and improved quality of life. There were no direct outcomes of occupational engagement, excluding sleep, that could be confirmed through this review. (4) Conclusion: This review explored and confirmed the usefulness of TH approaches in the scope of OT practice in adult cancer survivors. It also supports the notion that OT-specific research using TH interventions for cancer survivors will be needed in the future.

scholarly journals Young adult cancer survivors’ experience of taking part in a 12-week exercise referral programme: a qualitative study of the Trekstock RENEW initiative

2020 ◽  
Author(s):  
N. Below ◽  
A. Fisher ◽  
S. Epstone ◽  
J. Reynolds ◽  
G Pugh
Keyword(s):  
Physical Activity ◽  
Young Adult ◽  
Cancer Survivors ◽  
Physical Function ◽  
Hospital Setting ◽  
Well Being ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Exercise Referral

Abstract Purpose There is emerging evidence that physical activity interventions have the potential to improve the physical function and psychosocial well-being of young adult cancer survivors. However, most existing interventions for young adult cancer survivors have been delivered in an in-patient hospital setting. The purpose of this study is to explore young adult cancer survivors’ (YACS) experiences of the RENEW programme, a 12-week community-based exercise referral scheme delivered by Trekstock, a UK-based cancer charity. Methods Sixteen semi-structured interviews were conducted with YACS (mean age, 33 years; 87.5% female) who participated in the RENEW exercise referral programme. Each interview followed the same semi-structured interview guide which asked participants about their experiences of the RENEW programme and their ideas for the future development of the scheme. Data was audio-recorded, transcribed full verbatim and analysed using framework analysis. Results YACs predominantly chose to take part in the RENEW programme as a means to improve their health and overcome cancer related impairments (e.g. fatigue, loss of strength, low body confidence). The offer of one-to-one tailored support and unlimited gym access was often cited as a factor which motivated enrolment. Overall, YACS experience of the programme was positive with many describing improvements in physical function and general well-being. Barriers to participating in the programme included sign-off from clinicians prior to enrolment, travelling to the gym and fear of exercising alone. Conclusions Exercise referral schemes are acceptable to YACS and provide a promising opportunity for young people with cancer to improve their physical and psychosocial health through physical activity.

scholarly journals A mixed-methods evaluation of a group based trail walking program to reduce anxiety in cancer survivors

2020 ◽  
Vol 40 (1) ◽  
Author(s):  
I. A. Lesser ◽  
J. Prystupa ◽  
L. Belanger ◽  
C. Thomson ◽  
C. P. Nienhuis
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
State Anxiety ◽  
Sleep Disturbances ◽  
Well Being ◽  
Active Immunotherapy ◽  
Generalized Anxiety ◽  
Natural Environments ◽  
Adult Cancer Survivors ◽  
The Impact

Abstract Background Cancer survivorship results in an increased number of physical and psychosocial health issues. Engaging in physical activity in natural environments is often thought of as restorative. Despite the potential benefits of engaging in physical activity in natural environments there are no sustainable community-based programs for cancer survivors that employ this form of physical activity. This study aims to evaluate the impact of an 8-week trail-walking (TW) program on anxiety in a population of adult cancer survivors. Methods The TW program consisted of two trail walks per week for 8 weeks led by a hiking guide. Individuals were eligible to participate if they were 19 years or older, were a cancer survivor, were not on active immunotherapy, and had medical clearance from their physician for physical activity. While 12 participants signed up for the program, 9 participants (N = 9, 8 F, 1 M) completed the program. A mixed methodology included pre-and-post quantitative program surveys and post-program interviews. Questionnaires measured generalized anxiety, sleep disturbances, self-efficacy, self-esteem, psychological well-being and depression as well as pre-and-post hike state anxiety. Data was analysed using paired t-tests. Interviews were transcribed verbatim and an inductive thematic analysis was conducted to consolidate meaning and identify themes using NVivo 11 software. Results Average attendance was 74% of the 16 hikes. There was no significant reduction in the primary outcome of generalized anxiety (p = .38). There was a significant reduction in perceived stress after 8-weeks (p = .03) and a significant reduction in state anxiety after TW (p < .001). None of the other secondary outcomes were statistically significant (p > .05). Four overarching themes, or benefits, emerged from qualitative data analysis: (a) benefits of program design (b) physical benefits, (c) psychological benefits, and (d) social benefits. Conclusions These findings demonstrate the utility of a TW program for cancer survivors in order to promote physical, psychological and social health. Feasibility of a TW program would be contingent on access to natural areas for TW and an instructor-led program with other cancer survivors.

scholarly journals Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors – the randomized phase II Motivate AYA – MAYA trial

2021 ◽  
pp. 026921552199797
Author(s):  
Jannike Salchow ◽  
Barbara Koch ◽  
Julia Mann ◽  
Julia von Grundherr ◽  
Simon Elmers ◽  
...  
Keyword(s):  
Physical Activity ◽  
Young Adult ◽  
Cancer Survivors ◽  
Intervention Group ◽  
Physical Activity Behaviour ◽  
Post Intervention ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Activity Behaviour

Objective: To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors. Design: Randomized controlled phase II trial. Setting: University Cancer Center Hamburg, Germany. Subjects: Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control ( n = 44) or intervention group ( n = 45). Interventions: The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0). Main measures: The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up). Results: Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly ( P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0). Conclusions: A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.

scholarly journals Recall, perceptions and determinants of receiving physical activity advice amongst cancer survivors: a mixed-methods survey

2021 ◽  
Author(s):  
Samuel T. Orange ◽  
Stephen E. Gilbert ◽  
Morven C. Brown ◽  
John M. Saxton
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Cancer Survivors ◽  
Sociodemographic Characteristics ◽  
Physical Activity Guidelines ◽  
Physical Activity Advice ◽  
Exercise Specialist ◽  
Tailored Approach ◽  
The Uk ◽  
Exercise Guidelines

Abstract Purpose This study explored cancer survivors’ views and experiences of receiving physical activity advice post-diagnosis. We also determined the influence of sociodemographic characteristics on the recall of physical activity advice and whether receiving advice was associated with meeting physical activity guidelines. Methods An anonymised, mixed-methods, 27-item survey was distributed to cancer survivors via online cancer communities in the UK. Results Of the 242 respondents, 52% recalled receiving physical activity advice. Of those who recalled receiving advice, only 30% received guidance on type of physical activity and 14% were referred to another source of information or exercise specialist. Advice was most often given after treatment cessation, with only 19% of respondents receiving advice during active treatment. Most respondents (56%) expressed a need for further information. There was no evidence of associations between sociodemographic characteristics and recall of physical activity advice. However, cancer survivors who perceived the physical activity advice they received as being appropriate (odds ratio [OR] 3.8, 95% confidence interval [95% CI]: 1.4–10.7) and those with a higher level of education (OR 3.2, 95% CI: 1.8–5.8) were more likely to meet aerobic exercise guidelines. Females were less likely to meet resistance exercise guidelines than males (OR 0.44, 95% CI: 0.21–0.90). Conclusion There is scope to improve the provision of physical activity advice in cancer care by providing advice in a timely manner after diagnosis, referring patients to a suitable exercise or rehabilitation specialist when indicated, and using a tailored approach to ensure the advice is appropriate for specific sociodemographic groups.

Development of an evidence-informed recommendation guide to facilitate physical activity counseling between oncology care providers and patients in Canada

2021 ◽  
Author(s):  
Angela J Fong ◽  
Catherine M Sabiston ◽  
Michelle B Nadler ◽  
Jonathan Sussman ◽  
Hugh Langley ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Physical Function ◽  
Sports Medicine ◽  
Development Process ◽  
Assessment Criteria ◽  
Care Providers ◽  
Agree Ii ◽  
Physical Activity Counseling ◽  
Oncology Care

Abstract Decision support aids help reduce decision conflict and are reported as acceptable by patients. Currently, an aid from the American College of Sports Medicine exists to help oncology care providers advise, assess, and refer patients to physical activity (PA). However, some limitations include the lack of specific resources and programs for referral, detailed PA, and physical function assessments and not being designed following an international gold standard (Appraisal of Guidelines for Research and Evaluation [AGREE] II). This study aimed to develop a recommendation guide to facilitate PA counseling by assessing the risk for PA-related adverse events and offering a referral to an appropriate recommendation. Recommendation guide development followed AGREE II, and an AGREE methodologist was consulted. Specifically, a stakeholder group of oncology care providers and cancer survivors were engaged to develop the assessment criteria for comorbidities, PA levels, and physical function. Assessment criteria were developed from published PA interventions, consultations with content experts, and targeted web-based searches for cancer-specific PA programs. Feedback on the recommendation guide was solicited from stakeholders and external reviewers with relevant knowledge and clinical experience. Independent AGREE methodologists appraised the development process. The recommendation guide is a five-page document, including a preamble, assessment criteria for absolute contraindications to PA, comorbidities, and PA/functional capacity with a list of appropriate resources. Independent AGREE methodologists rated the development process as strong and recommended the guide for use. The recommendation guide has the potential to facilitate PA counseling between oncology care providers and cancer survivors, thus, potentially impacting PA behavior.

scholarly journals The Role of Physical Activity in Cancer Survivors’ Quality of Life

2020 ◽  
Author(s):  
Tayah M. Liska ◽  
Angie Kolen
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Social Engagement ◽  
Healthcare Providers ◽  
Adult Cancer Survivors

Abstract Purpose: As a result of a cancer diagnosis and treatment, many cancer survivors experience persistent physical, mental, and emotional symptoms that affect their quality of life. Physical activity has been identified as an intervention that may help to manage the side effects of a cancer diagnosis and its treatment. The purpose of this study was to investigate the role of physical activity on overall quality of life in adult cancer survivors. Methods: One-on-one semi structured interviews were conducted in person or via telephone with 13 adult (≥18 yrs) cancer survivors who had completed cancer treatment. Results: These cancer survivors described their physical activity as improving their physical functioning and mental health, as a means of positive social engagement, and adding positivity to their daily life. Conclusion: These results support the role of physical activity to enhance cancer survivors’ quality of life regardless of the individuals’ treatment(s) type, duration, or time since the end of active cancer treatment. Further research is warranted to (a) expand this research with a larger sample, (b) examine healthcare providers’ knowledge and application of exercise guidelines to cancer survivors in cancer care, and (c) explore implementation strategies for greater advocacy for healthcare providers to share the exercise recommendations with cancer survivors.

scholarly journals Feasibility of a Commercially Available Virtual Reality System to Achieve Exercise Guidelines in Youth With Spina Bifida: Mixed Methods Case Study (Preprint)

2020 ◽  
Author(s):  
Byron Lai ◽  
Drew Davis ◽  
Mai Narasaki-Jara ◽  
Betsy Hopson ◽  
Danielle Powell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Virtual Reality ◽  
Spina Bifida ◽  
Moderate Intensity ◽  
Full Time ◽  
Heart Rate Monitor ◽  
Intervention Protocol ◽  
Exercise Guidelines ◽  
Total Average

BACKGROUND Access to physical activity among youth with spina bifida (SB) is much lower than it is for children without disability. Enjoyable home-based exercise programs are greatly needed. OBJECTIVE Our objective is to examine the feasibility of a virtual reality (VR) active video gaming system (ie, bundle of consumer-available equipment) to meet US physical activity guidelines in two youth with SB. METHODS Two youth with SB—a 12-year-old female and a 13-year-old male; both full-time wheelchair users—participated in a brief, 4-week exercise program using a popular VR head-mounted display: Oculus Quest (Facebook Technologies). The system included a Polar H10 (Polar Canada) Bluetooth heart rate monitor, a no-cost mobile phone app (VR Health Exercise Tracker [Virtual Reality Institute of Health and Exercise]), and 13 games. The intervention protocol was conducted entirely in the homes of the participants due to the coronavirus disease 2019 (COVID-19) pandemic. The VR system was shipped to participants and they were instructed to do their best to complete 60 minutes of moderate-intensity VR exercise per day. Exercise duration, intensity, and calories expended were objectively monitored and recorded during exercise using the heart rate monitor and a mobile app. Fatigue and depression were measured via self-report questionnaires at pre- and postintervention. Participants underwent a semistructured interview with research staff at postintervention. RESULTS Across the intervention period, the total average minutes of all exercise performed each week for participants 1 and 2 were 281 (SD 93) and 262 (SD 55) minutes, respectively. The total average minutes of moderate-intensity exercise performed per week for participants 1 and 2 were 184 (SD 103) (184/281, 65.4%) and 215 (SD 90) (215/262, 82.1%) minutes, respectively. One participant had a reduction in their depression score, using the Quality of Life in Neurological Disorders (Neuro-QoL) test, from baseline to postintervention, but no other changes were observed for fatigue and depression scores. Participants reported that the amount of exercise they completed was far higher than what was objectively recorded, due to usability issues with the chest-worn heart rate monitor. Participants noted that they were motivated to exercise due to the enjoyment of the games and VR headset as well as support from a caregiver. CONCLUSIONS This study demonstrated that two youth with SB who used wheelchairs could use a VR system to independently and safely achieve exercise guidelines at home. Study findings identified a promising protocol for promoting exercise in this population and this warrants further examination in future studies with larger samples.

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