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Smith GVH, Myers SA, Fujita RA, Yu C, Campbell KL. Virtually Supervised Exercise Programs for People With Cancer: A Scoping Review. Cancer Nurs 2024:00002820-990000000-00236. [PMID: 38598778 DOI: 10.1097/ncc.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Exercise has been shown to improve physical function and quality of life for individuals with cancer. However, low rates of exercise adoption and commonly reported barriers to accessing exercise programming have demonstrated a need for virtual exercise programming in lieu of traditional in-person formats. OBJECTIVE The aim of this study was to summarize the existing research on supervised exercise interventions delivered virtually for individuals living with and beyond cancer. METHODS We conducted a scoping review of randomized controlled trials, pilot studies, or feasibility studies investigating virtually supervised exercise interventions for adults either during or after treatment of cancer. The search included EMBASE, MEDLINE, CINAHL, SPORTDiscus, Cochrane Library, and conference abstracts. RESULTS Fifteen studies were included. The interventions were delivered mostly over Zoom in a group format, with various combinations of aerobic and resistance exercises. Attendance ranged from 78% to 100%, attrition ranged from 0% to 29%, and satisfaction ranged from 94% to 100%. No major adverse events were reported, and only 3 studies reported minor adverse events. Significant improvements were seen in upper and lower body strength, endurance, pain, fatigue, and emotional well-being. CONCLUSION Supervised exercise interventions delivered virtually are feasible and may improve physical function for individuals with cancer. The supervision included in these virtual programs promoted similar safety as seen with in-person programming. More randomized controlled trials with large cohorts are needed to validate these findings. IMPLICATIONS FOR PRACTICE Individuals living with and beyond cancer can be encouraged to join virtually supervised exercise programs because they are safe, well enjoyed, and may improve physical function and quality of life.
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Affiliation(s)
- Gillian V H Smith
- Author Affiliations: Department of Physical Therapy, University of British Columbia (Mss Smith, Myers, and Yu; Mr Fujita; and Dr Campbell), Vancouver, Canada; and University of São Paulo (Mr Fujita), Brazil
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Gell NM, Dittus K, Caefer J, Martin A, Bae M, Patel KV. Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial. J Cancer Surviv 2024; 18:596-605. [PMID: 36374436 PMCID: PMC9662104 DOI: 10.1007/s11764-022-01292-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The study aimed to determine the feasibility of remotely delivered exercise (tele-exercise) for older, rural cancer survivors and to explore the effects of tele-exercise on physical function, physical activity, and patient-reported outcomes. METHODS Participants were rural cancer survivors age ≥ 60 years (79% female; mean age 70.4 ± 5.7) randomly assigned to the remotely delivered EnhanceFitness (tele-EF) exercise program, inclusive of aerobic, strength, and balance training and led by American Council on Exercise certified instructors for 1 h, 3 days/week for 16 weeks (n = 20) or to a waitlist control group (n = 19). We assessed feasibility, physical function, accelerometer-measured physical activity, and patient-reported outcomes at baseline and post intervention. RESULTS Among those screened as eligible, 44 (64%) consented to participate with 39 randomized after completing baseline measures. Attrition was equivalent between groups (n = 1, each) with 95% completing the study. The median class attendance rate was 86.9% (interquartile range: 79-94%). Compared to controls, tele-EF participants had statistically significant improvement in the five-time sit-to-stand test (- 3.4 vs. - 1.1 s, p = 0.03, effect size = 0.44), mean daily light physical activity (+ 38.5 vs 0.5 min, p = 0.03, effect size = 0.72) and step counts (+ 1977 vs. 33, p = 0.01, effect size = 0.96). There were no changes in self-efficacy for exercise, fatigue, or sleep disturbance between groups. CONCLUSIONS Findings indicate that tele-EF is feasible in older, rural cancer survivors and results in positive changes in physical function and physical activity. IMPLICATIONS FOR CANCER SURVIVORS Tele-EF addresses common barriers to exercise for older, rural cancer survivors, including limited accessible opportunities for professional instruction and supervision.
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Affiliation(s)
- Nancy M Gell
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA.
- University of Vermont Cancer Center, Burlington, VT, USA.
| | - Kim Dittus
- University of Vermont Cancer Center, Burlington, VT, USA
- Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Jacqueline Caefer
- Department of Physical Therapy Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Anita Martin
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA
| | - Myeongjin Bae
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA
| | - Kushang V Patel
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, USA
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Ester M, McDonough MH, Bansal M, Dreger J, Daun JT, McNeely ML, Luu T, Culos-Reed SN. Perspectives on Ease of Use and Value of a Self-Monitoring Application to Support Physical Activity Maintenance among Individuals Living with and beyond Cancer. Curr Oncol 2024; 31:1572-1587. [PMID: 38534953 PMCID: PMC10969407 DOI: 10.3390/curroncol31030120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Physical activity (PA) can improve the physical and psychosocial health of individuals with cancer, yet PA levels remain low. Technology may address PA maintenance barriers in oncology, though the intervention effectiveness to date remains mixed. Qualitative research can reveal the nuances of using technology-based PA maintenance tools. The present study aimed to understand the perspectives of individuals with cancer on using an app to support PA maintenance. METHODS Individuals were interviewed after using a self-monitoring app for 24 weeks, asking about their app use, ease of use, and perceived value for supporting PA. Analyses were guided by an interpretive description. RESULTS Eighteen individuals were interviewed. The participants were 37-75 years old; lived in seven Canadian provinces/territories; identified as White, South Asian, or Indigenous; and had eight different cancers. Four themes were developed: some did not need the app to stay physically active, some valued the app for helping them maintain their PA, the user experience ranged from intuitive to confusing, and the time burden of app use ranged from acceptable to overwhelming. CONCLUSIONS The participants provided insights on using a self-monitoring app to improve PA maintenance in oncology. Work is needed to capture additional perspectives and apply findings to the development of technology-based PA maintenance tools.
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Affiliation(s)
- Manuel Ester
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Meghan H. McDonough
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Julianna Dreger
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Julia T. Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Department of Oncology, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Rehabilitation Medicine, Cross Cancer Institute, Edmonton, AB T6G 1Z2, Canada
| | - Thompson Luu
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (M.B.); (J.T.D.); (T.L.)
- Department of Oncology, Cummings School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB T2N 4N2, Canada
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Duchek D, McDonough MH, Bridel W, McNeely ML, Culos-Reed SN. Understanding In-Person and Online Exercise Oncology Programme Delivery: A Mixed-Methods Approach to Participant Perspectives. Curr Oncol 2023; 30:7366-7383. [PMID: 37623015 PMCID: PMC10453684 DOI: 10.3390/curroncol30080534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/22/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023] Open
Abstract
Alberta Cancer Exercise (ACE) is an exercise oncology programme that transitioned from in-person to online delivery during COVID-19. The purpose of this work was to understand participants' experiences in both delivery modes. Specifically, survivors' exercise facilitators and barriers, delivery mode preference, and experience with programme elements targeting behaviour change were gathered. A retrospective cohort design using explanatory sequential mixed methods was used. Briefly, 57 participants completed a survey, and 19 subsequent, optional interviews were conducted. Most participants indicated preferring in-person programmes (58%), followed by online (32%), and no preference (10%). There were significantly fewer barriers to (i.e., commute time) (p < 0.01), but also fewer facilitators of (i.e., social support) (p < 0.01), exercising using the online programme. Four themes were generated from the qualitative data surrounding participant experiences in both delivery modes. Key differences in barriers and facilitators highlighted a more convenient experience online relative to a more socially supportive environment in-person. For future work that includes solely online delivery, focusing on building social support and a sense of community will be critical to optimising programme benefits. Beyond the COVID-19 pandemic, results of this research will remain relevant as we aim to increase the reach of online exercise oncology programming to more underserved populations of individuals living with cancer.
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Affiliation(s)
- Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (W.B.); (S.N.C.-R.)
| | - Meghan H. McDonough
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (W.B.); (S.N.C.-R.)
| | - William Bridel
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (W.B.); (S.N.C.-R.)
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada;
- Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, Canada
- Supportive Care, Cancer Care Alberta, Edmonton, AB T5J 3E4, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (M.H.M.); (W.B.); (S.N.C.-R.)
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB T2N 4N2, Canada
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Mama SK, Lopez-Olivo MA, Bhuiyan N, Leach HJ. Effectiveness of Physical Activity Interventions among Rural Cancer Survivors: A Systematic Review and Meta-Analysis. Cancer Epidemiol Biomarkers Prev 2021; 30:2143-2153. [PMID: 34620628 PMCID: PMC8643319 DOI: 10.1158/1055-9965.epi-21-0871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/06/2021] [Accepted: 10/04/2021] [Indexed: 12/24/2022] Open
Abstract
This review estimated the effectiveness of behavior change interventions to increase physical activity (PA) among rural adult cancer survivors. PubMed Medline, CINAHL, and PsychINFO were systematically searched through July 2020. Two independent investigators screened citations to identify studies to increase PA in adults residing in rural areas who had received any cancer diagnosis. Meta-analyses were conducted to assess proportion of participants achieving PA goal, paired mean difference (MD) in aerobic PA and strength training, and retention from baseline to post-intervention. Seven studies met inclusion criteria encompassing a total of 722 participants (591 in intervention and 131 controls). Overall quality of evidence was low to medium. The pooled proportion of participants achieving PA goals (150-225 min/wk) was 39% [95% confidence interval (CI), 18%-62%]. The mean time spent engaging in aerobic PA increased from baseline to post-intervention (range, 6-52 weeks) by 97.7 min/wk (95% CI, 75.0-120.4), and the MD in time spent on strength training was 12.2 min/wk (95% CI, -8.3-32.8). The pooled retention rate was 82% (95% CI, 69%-92%) at 6 to 78 weeks. Because of the modest intervention effects, low quality of evidence, and small number of studies, further rigorously designed behavior change interventions, including randomized controlled trials with long-term follow up, are needed to confirm efficacy for increasing PA in rural cancer survivors and to test innovative implementation strategies to enhance reach and effectiveness.
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Affiliation(s)
- Scherezade K Mama
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Maria A Lopez-Olivo
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nishat Bhuiyan
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Heather J Leach
- Department of Health and Exercise Science, College of Health and Human Science, Colorado State University, Fort Collins, Colorado
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Meeting the Rehabilitation and Support Needs of Patients With Breast Cancer During COVID-19: Opening New Frontiers in Models of Care. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maxwell-Smith C, Hagger MS, Kane R, Cohen PA, Tan J, Platell C, Makin GB, Saunders C, Nightingale S, Lynch C, Sardelic F, McCormick J, Hardcastle SJ. Psychological correlates of physical activity and exercise preferences in metropolitan and nonmetropolitan cancer survivors. Psychooncology 2020; 30:221-230. [PMID: 32920935 DOI: 10.1002/pon.5553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Interventions to increase physical activity (PA) in cancer survivors have often adopted a "one-size-fits-all" approach and may benefit from being tailored to psychological constructs associated with behavior. The study objective was to investigate the exercise preferences and psychological constructs related to PA among cancer survivors. METHODS Posttreatment colorectal, endometrial, and breast cancer survivors (n = 183) living in metropolitan and nonmetropolitan areas completed survey measures of PA, exercise preferences, attitudes, self-efficacy, perceived behavioral control (PBC), and intention toward PA. RESULTS A structural equation model with adequate fit and quality indices revealed that instrumental attitude and self-efficacy were related to PA intention. Intention was related to behavior and mediated the relationship between self-efficacy and behavior. Preferred exercise intensity was related to self-efficacy, PBC, attitudes, and intention, while preferred exercise company was related to self-efficacy and PBC. Participants preferred moderate-intensity PA (71%), specifically self-paced (52%) walking (65%) in an outdoor environment (58%). CONCLUSIONS Since instrumental attitude and self-efficacy were associated with PA, incorporating persuasive communications targeting attitudes in PA interventions may promote PA participation. As cancer survivors who prefer low-intensity exercise and exercising with others report lower self-efficacy and PBC, interventions targeting confidence and successful experience in this group may also be warranted.
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Affiliation(s)
- Chloe Maxwell-Smith
- School of Psychology, Curtin University, Perth, Western Australia, Australia.,Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Martin S Hagger
- School of Psychological Sciences, University of California, Merced, USA.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Robert Kane
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Paul A Cohen
- St John of God Hospital, Subiaco, Western Australia, Australia
| | - Jason Tan
- St John of God Hospital, Subiaco, Western Australia, Australia
| | - Cameron Platell
- St John of God Hospital, Subiaco, Western Australia, Australia
| | | | | | | | - Craig Lynch
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Frank Sardelic
- Tamara Private Hospital, Tamworth, New South Wales, Australia
| | | | - Sarah J Hardcastle
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.,School of Health and Human Performance, Dublin City University, Dublin, Ireland
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