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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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Nemkov T, Cendali F, Dzieciatkowska M, Stephenson D, Hansen KC, Jankowski CM, D’Alessandro A, Marker RJ. A Multiomics Assessment of Preoperative Exercise in Pancreatic Cancer Survivors Receiving Neoadjuvant Therapy: A Case Series. PATHOPHYSIOLOGY 2024; 31:166-182. [PMID: 38535623 PMCID: PMC10975467 DOI: 10.3390/pathophysiology31010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/01/2024] Open
Abstract
To molecularly characterize the impact of exercise on mitigating neoadjuvant treatment (NAT)-induced physical decline in pancreatic ductal adenocarcinoma (PDAC) patients, a multi-omics approach was employed for the analysis of plasma samples before and after a personalized exercise intervention. Consisting of personalized aerobic and resistance exercises, this intervention was associated with significant molecular changes that correlated with improvements in lean mass, appendicular skeletal muscle index (ASMI), and performance in the 400-m walk test (MWT) and sit-to-stand test. These alterations indicated exercise-induced modulation of inflammation and mitochondrial function markers. This case study provides proof-of-principal application for multiomics-based assessments of supervised exercise, thereby supporting this intervention as a feasible and beneficial intervention for PDAC patients to potentially enhance treatment response and patient quality of life. The molecular changes observed here underscore the importance of physical activity in cancer treatment protocols, advocating for the development of accessible multiomics-guided exercise programs for cancer patients.
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Affiliation(s)
- Travis Nemkov
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Francesca Cendali
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Daniel Stephenson
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Kirk C. Hansen
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | | | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Ryan J. Marker
- Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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Dunston ER, Malouf A, Podlog LW, Newton M, Bai Y, Oza S, Coletta AM. Experiences participating in a telehealth exercise program among older adults with cancer: a qualitative study. J Cancer Surviv 2024:10.1007/s11764-024-01564-9. [PMID: 38492170 DOI: 10.1007/s11764-024-01564-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/10/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Telehealth delivery of exercise programs has rapidly increased in recent years; yet, little is known regarding older cancer survivors' (OCS) experiences participating in telehealth exercise. The purpose of this study was to determine OCS barriers and facilitators to participation in telehealth-delivered exercise. METHODS OCS who participated in a 12-week, one-on-one telehealth exercise program were recruited to participate in one of three focus groups. Focus groups were conducted virtually using a semi-structured interview guide. Focus groups were audio recorded, transcribed verbatim, and analyzed utilizing thematic analysis with Atlas.ti. RESULTS Fourteen OCS (age range 65-79 years) participated in the focus groups, five (35.7%) of which had not completed a telehealth follow-up assessment. The most common cancer type was breast (n = 6, 42.9%), and all cancer stages were represented. Three overall themes were identified: having adequate space to exercise, meeting OCS physical and psychosocial needs, and OCS learning throughout the exercise program. Within these themes, five facilitators and two barriers were identified. Facilitators included the individualization of the exercise program, no travel, accountability, learning to exercise, and support from staff and family. The barriers identified were having limited space to exercise and a learning curve with technology. CONCLUSION OCS viewed telehealth exercise positively. Identified barriers aligned with those in younger cancer survivors (≥18 years), indicating that OCS are able to engage with telehealth exercise programs alongside their younger counterparts. IMPLICATIONS FOR CANCER SURVIVORS Telehealth exercise mitigates exercise barriers in OCS and should be used as a strategy to support exercise participation among cancer survivors, regardless of age.
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Affiliation(s)
- Emily R Dunston
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Alec Malouf
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Leslie W Podlog
- Université de Montréal, School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Montréal, Québec, Canada
- CHU Sainte-Justine Research Center, Montréal, Québec, Canada
| | - Maria Newton
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Sonal Oza
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Adriana M Coletta
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
- The Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA.
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Murphy K, Denieffe S, Kehoe B, Hacking D, Fairman CM, Harrison M. Designing effective exercise intervention trials for prostate cancer cohorts: a qualitative study on experiences and views of exercise oncology researchers. BMC Sports Sci Med Rehabil 2023; 15:145. [PMID: 37904240 PMCID: PMC10614306 DOI: 10.1186/s13102-023-00756-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/21/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Exercise intervention research has shown promising results in preventing and reversing the side effects caused by prostate cancer and its' treatment. However, there are still unanswered questions and the need for additional research. As the field of exercise oncology in the context of prostate cancer presents unique challenges and complexities, seeking the advice of experienced exercise oncology researchers before initiating a similar trial could help to design more effective and efficient studies and help avoid pitfalls. METHODS A qualitative descriptive study design and a nonprobability, purposive sampling method was employed. An interview guide was developed and included topics such as recruitment, retention, programme goals, research design, health considerations, treatment considerations, adverse events, exercise prescription and outcome tools. Individual semi-structured interviews were conducted and interviews were transcribed and analysed using thematic analysis. RESULTS Eight individuals with extensive experience working with prostate cancer patients in exercise oncology research settings were interviewed. Four main themes and seven subthemes were generated and supported by the data. Theme 1 highlighted the critical role of recruitment, with associated subthemes on recruitment barriers and recruitment methods. Theme 2 explored the positives and negatives of home-based programmes. Theme 3 focused on specific health characteristics, exercise prescription and outcome measure factors that must be considered when working with prostate cancer cohorts. Finally, theme 4 centered around the emotional dimensions present in exercise oncology trials, relating to both researchers and study participants. CONCLUSION Exercise oncology remains a challenging area in which to conduct research. Learning from experienced personnel in the field offers valuable information and guidance that could impact the success of future trials.
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Affiliation(s)
- Kira Murphy
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Suzanne Denieffe
- School of Humanities, South East Technological University, College Street Campus, Waterford, Ireland.
| | - Bróna Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Dayle Hacking
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Ciaran M Fairman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Harrison
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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Wilson RL, Christopher CN, Yang EH, Barac A, Adams SC, Scott JM, Dieli-Conwright CM. Incorporating Exercise Training into Cardio-Oncology Care: Current Evidence and Opportunities: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2023; 5:553-569. [PMID: 37969654 PMCID: PMC10635898 DOI: 10.1016/j.jaccao.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/30/2023] [Indexed: 11/17/2023] Open
Abstract
Cancer treatment-induced cardiotoxicities are an ongoing concern throughout the cancer care continuum from treatment initiation to survivorship. Several "standard-of-care" primary, secondary, and tertiary prevention strategies are available to prevent the development or further progression of cancer treatment-induced cardiotoxicities and their risk factors. Despite exercise's established benefits on the cardiovascular system, it has not been widely adopted as a nonpharmacologic cardioprotective strategy within cardio-oncology care. In this state-of-the-art review, the authors discuss cancer treatment-induced cardiotoxicities, review the existing evidence supporting the role of exercise in preventing and managing these sequelae in at-risk and affected individuals living after cancer diagnoses, and propose considerations for implementing exercise-based services in cardio-oncology practice.
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Affiliation(s)
- Rebekah L. Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Cami N. Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Eric H. Yang
- Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Ana Barac
- Inova Schar Heart and Vascular and Inova Schar Cancer Institute, Falls Church, Virginia, USA
| | - Scott C. Adams
- Department of Cardiology, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
- Ted Rogers Cardiotoxicity Prevention Program, Peter Munk Cardiac Centre, Toronto, Ontario, Canada
| | - Jessica M. Scott
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Christina M. Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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Atoui S, Bernard P, Carli F, Liberman AS. Association Between Physical Activity, Sedentary Behaviors, and Sleep-Related Outcomes Among Cancer Survivors: a Cross-Sectional Study. Int J Behav Med 2023:10.1007/s12529-023-10216-8. [PMID: 37656309 DOI: 10.1007/s12529-023-10216-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Limited research has examined the association between moderate to vigorous physical activity (MVPA), sedentary behavior (SB), and sleep-related outcomes in cancer survivors. Therefore, this study aimed to examine these associations using a nationally representative sample of US adults. METHODS Data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. A total of 3229 adults with cancer histories were included. Physical activity was measured through accelerometry, and questions on daily activities, sedentary time, and sleep were collected during the household interview. Weighted multivariable analyses were conducted after accounting for the complex sampling design of the NHANES dataset. RESULTS After adjustments, physical activity and SB outcomes were associated with several self-reported sleep-related parameters. Increases in minutes of self-reported MVPA and SB were associated with a decreased likelihood of reporting ≥ 8 h of sleep (OR = 0.92, 95% CI = 0.86, 0.99 and OR = 0.88, 95% CI = 0.82, 0.95). Converse associations were found between device-measured MVPA and SB with the likelihood of reporting often/always feeling overly sleepy during the day (OR = 0.86, 95% CI = 0.75 and OR = 1.13, 95% CI = 1.05, respectively). However, an increased likelihood of waking up too early in the morning (OR = 1.22, 95% CI = 1.04) was observed with increases in minutes of device-measured MVPA. CONCLUSIONS A sensible strategy to decrease the frequency of sedentary breaks and increase minutes of physical activity throughout the day may reduce sleep complaints reported in cancer survivors.
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Affiliation(s)
- Sarah Atoui
- Division of Experimental Surgery, Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, Room L10.106, Montreal, QC, H3G 1A4, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, 141, Avenue du Président Kennedy, Montreal, QC, H2X 1Y4, Canada
- Research Centre, University Institute of Mental Health in Montreal, Montreal, QC, Canada
| | - Francesco Carli
- Department of Anesthesia, McGill University Health Centre, 1650 Cedar Ave, Room E10.160, Montreal, QC, H3G 1A4, Canada
| | - A Sender Liberman
- Division of Experimental Surgery, Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, Room L10.106, Montreal, QC, H3G 1A4, 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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Aflague TF, Hammond K, Delos Reyes B, Rios D, De Leon E, Leon Guerrero RT, Esquivel MK. Barriers, Facilitators, and Strategies for Developing a Culturally Informed Lifestyle Intervention for Native Hawaiian, CHamoru, and Filipino Breast Cancer Survivors: Mixed-Methods Findings from Focus Group Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6075. [PMID: 37372662 DOI: 10.3390/ijerph20126075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/15/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023]
Abstract
Breast cancer disproportionately impacts Native Hawaiian, CHamoru, and Filipino women. Few culturally informed interventions addressing breast cancer survivors exist and none have been developed or tested specifically for Native Hawaiian, CHamoru, and Filipino women. This study aimed to conduct focus groups with Native Hawaiian, CHamoru, and Filipino women previously diagnosed with breast cancer to inform future research in Guam and Hawai'i. Convenience sampling and grounded theory approaches were used. Focus group sessions were conducted during summer 2023 and included questions to understand the barriers, motivators, and implementation recommendations for lifestyle interventions aimed at reducing the risk for breast cancer recurrence among the target population. Data saturation was reached after a total of seven focus groups (an average of four survivors/group per site) were conducted (three in Hawai'i and four in Guam), which represented 28 breast cancer survivors. Themes from the focus groups emerged around developing support systems with other survivors, providing physical activity and nutrition intervention activities and materials in multiple formats, and incorporating activities and foods that accommodate the side effects of breast cancer treatments and are culturally relevant. The average desired intervention length was eight weeks. These findings will inform the development and feasibility testing of a culturally informed lifestyle intervention for breast cancer survivors in Guam and Hawai'i.
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Affiliation(s)
- Tanisha F Aflague
- College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96923, USA
| | - Kristi Hammond
- Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - Bernice Delos Reyes
- Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| | - Dareon Rios
- Office of Research and Sponsored Programs, University of Guam, Mangilao, GU 96923, USA
| | - Elaine De Leon
- College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96923, USA
| | | | - Monica K Esquivel
- Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
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Craig BAP, McDonough MH, Culos-Reed SN, Bridel W. Social Support Behaviours and Barriers in Group Online Exercise Classes for Adults Living with and beyond Cancer: A Qualitative Study. Curr Oncol 2023; 30:3735-3754. [PMID: 37185397 PMCID: PMC10136529 DOI: 10.3390/curroncol30040284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Social support can be facilitated through exercise programs for people living with cancer, but there is limited research on how best to foster it in online exercise oncology classes. This study examined current training that fitness professionals receive on the provision and facilitation of social support, experiences people living with cancer have with social support, and supportive behaviours and barriers for providing and obtaining support in online group exercise oncology programs in Calgary, Alberta, Canada. Guided by interpretive description methodology, training materials were reviewed, observations of fitness professional training and online exercise classes (n = 10) were conducted, and adults living with and beyond cancer (n = 19) and fitness professionals (n = 15) were interviewed. These data were collected from January 2021 to June 2021. Analysis of the data collected resulted in the identification of three themes: Creating a welcoming environment, helping improve exercise ability and reach goals, and learning to provide and facilitate support online. A catalogue of supportive behaviours that can help to provide and facilitate and barriers that can hinder the provision and obtaining of social support in exercise oncology classes is presented. The findings provide guidance when structuring online classes and inform developing strategies for fitness professionals to use in online classes to foster social support by considering the wants and needs of participants, facilitating support between participants with similar experiences and interests, and integrating support into physical activity.
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Leach HJ, Crisafio ME, Howell MJ, Nicklawsky A, Marker RJ. A Group-Based, Videoconference-Delivered Physical Activity Program for Cancer Survivors. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2023; 8:e000221. [PMID: 37974897 PMCID: PMC10653091 DOI: 10.1249/tjx.0000000000000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Introduction/Purpose Virtually supervised, group-based exercise presents an innovative way to expand the reach of exercise-oncology programs and help cancer survivors increase physical activity (PA) and connect with other participants. This study examined the feasibility, acceptability, and preliminary effects of a group-based PA program delivered exclusively using videoconferencing software. Methods This study used a single-group pre-post design. The 8-wk program consisted of aerobic and resistance exercise sessions once per week and three PA behavior change discussion sessions in groups of four to six. Feasibility was determined by enrollment, retention, safety, and adherence. Postprogram surveys evaluated acceptability using a Likert scale and open-ended responses. Changes in PA (Godin Leisure-Time Exercise Questionnaire), quality of life (QOL; Functional Assessment of Cancer Therapy- General), and upper and lower body muscular endurance (bicep curl and sit-to-stand test) were also evaluated. Results Enrollment was feasible (n = 61 of 65 who expressed interest in the program), and retention (86.9%) and adherence (88% for exercise, 91% for discussion) were high; no adverse events were reported. Participants (mean age, 59.9 ± 10.1 yr; 96.2% female; 64.2% ovarian cancer, 28.3% breast cancer, 7.5% other cancer) reported they enjoyed the program (median, 7 of 7), and videoconferencing software was easy to use and had good video and audio quality (median, 5 of 5). From preprogram to postprogram, participants increased their weekly minutes of aerobic (mean (SD) change, 82.4 (144.2)) and resistance (mean (SD) change, 31.9 (42.7)) PA; sit-to-stand (mean (SD) change, 1.4 (3.9)) and bicep curl (mean (SD) change, 5.3 (6.8)) repetitions; and emotional (mean (SD) change, 0.82 (2.3) points), functional (mean (SD) change, 1.2 (3.6) points), and total QOL (mean (SD) change, 3 (7.9) points; all P < 0.05). Conclusions A group-based PA program delivered using videoconference technology is feasible and acceptable for cancer survivors, and may increase PA and improve physical fitness and some aspects of QOL. A larger, controlled intervention is needed to determine efficacy, as well as pragmatic studies to directly compare this approach with conventional strategies (i.e., face-to-face programs).
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Affiliation(s)
- Heather J. Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO
- Department of Community and Behavioral Health, Colorado School of Public Health, Fort Collins, CO
| | - Mary E. Crisafio
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO
| | | | - Andrew Nicklawsky
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ryan J. Marker
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO
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Virtual or In-Person: A Mixed Methods Survey to Determine Exercise Programming Preferences during COVID-19. Curr Oncol 2022; 29:6735-6748. [PMID: 36290806 PMCID: PMC9601145 DOI: 10.3390/curroncol29100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/24/2022] [Accepted: 09/09/2022] [Indexed: 01/13/2023] Open
Abstract
A survey was conducted to identify barriers and facilitators to engaging in virtual and in-person cancer-specific exercise during COVID-19. A theory-informed, multi-method, cross-sectional survey was electronically distributed to 192 individuals with cancer investigating preferences towards exercise programming during COVID-19. Respondents had previously participated in an exercise program and comprised two groups: those who had experience with virtual exercise programming ('Virtual') and those who had only taken part in in-person exercise ('In-Person'). Quantitative data were summarized descriptively. Qualitative data were thematically categorized using framework analysis and findings were mapped to an implementation model. The survey completion response rate was 66% (N = 127). All respondents identified barriers to attending in-person exercise programming during COVID-19 with concerns over the increased risk of viral exposure. Virtual respondents (n = 39) reported: (1) feeling confident in engaging in virtual exercise; and (2) enhanced motivation, accessibility and effectiveness as facilitators to virtual exercise. In-Person respondents (n = 88) identified: (1) technology as a barrier to virtual exercise; and (2) low motivation, accessibility and exercise effectiveness as barriers towards virtual exercise. Sixty-six percent (n = 58) of In-Person respondents reported that technology support would increase their willingness to exercise virtually. With appropriately targeted support, perceived barriers to accessing virtual exercise-including motivation, accessibility and effectiveness-may become facilitators. The availability of technology support may increase the engagement of individuals with cancer towards virtual exercise programming.
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12
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Exercise oncology during and beyond the COVID-19 pandemic: Are virtually supervised exercise interventions a sustainable alternative? Crit Rev Oncol Hematol 2022; 174:103699. [PMID: 35526668 PMCID: PMC9069989 DOI: 10.1016/j.critrevonc.2022.103699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/08/2023] Open
Abstract
During the COVID-19 pandemic, new challenges are presented in clinical research settings to increase exercise levels, particularly in vulnerable populations such as cancer survivors. While in-person supervised exercise is an effective format to improve patient-reported outcomes and physical function for cancer survivors, the COVID-19 pandemic limited this form of exercise as a feasible option within research and cancer care. As such, exercise oncology interventions were adapted to home-based instruction. In this review, we examine the current evidence of exercise interventions in cancer populations during and beyond the COVID-19 pandemic. We identified that group-based virtually supervised home-based exercise was the most used format among exercise oncology interventions during the pandemic. Preliminary results support feasibility and effectiveness of this emerging exercise setting in cancer survivors; however, it needs to be further investigated in adequately designed larger trials. Additionally, we provide recommendations and perspective for the implementation of virtually supervised home-based exercise.
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Gorzelitz JS, Bouji N, Stout NL. Program Barriers and Facilitators in Virtual Cancer Exercise Implementation: A Qualitative Analysis. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7. [DOI: 10.1249/tjx.0000000000000199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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