Characterizing the Exercise Behaviour, Preferences, Barriers, and Facilitators of Cancer Survivors in a Rural Canadian Community: A Cross-Sectional Survey

Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis

BACKGROUND

Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors.

METHODS

Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times.

RESULTS

Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results.

CONCLUSIONS

This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed.

IMPLICATIONS FOR CANCER SURVIVORS

Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.

Case studies on psychosocial factors that help make exercise programmes for prostate cancer patients self-sustaining

OBJECTIVES

Patients with prostate cancer (PCa) benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programmes that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success.

METHODS

We compared the FC Prostata football (soccer) league in Denmark and the 'Butts in a Boat' (BIAB) dragon-boating team in Canada. The FC Prostata Project Coordinator and the BIAB team leaders provided information on their programmes' history and structure.

RESULTS

Both programmes are team-based with regularly scheduled intense exercise at their core. In both cases, social activities evolved spontaneously, starting with the men going out for food and/or drinks after practices. The sustainability of these programmes may be driven by the regular socialisation linked to the fitness activities.

CONCLUSIONS

Our case studies suggest that exercise programmes for PCa patients may have a good chance of being self-sustaining, if they are: (1) centred around intense exercise, (2) of a team nature, (3) structured to promote egalitarianism and avoid one-on-one competition within teams, yet (4) have some competitions between teams. The data suggest that informal social activities organised by patients after team practices may be important for building fellowship and strengthening patients' commitment to exercise both for themselves and for their team members.

Perspectives of patients with metastatic breast cancer on physical exercise programs: results from a survey in five European countries

BACKGROUND

To successfully implement exercise programs for patients with metastatic breast cancer (MBC), services and patient education should consider patients' knowledge, preferences, values, and goals. Hence, gaining insight into their perspectives on exercise and exercise programming is important.

METHOD

In this cross-sectional survey, we recruited patients with MBC from the Netherlands, Germany, Poland, Spain, and Sweden. We collected data on patients' knowledge and skills about exercise and outcome expectations. We identified barriers to and facilitators of participation in exercise programs, and patients' preferences for program content and modes of exercise delivery.

RESULTS

A total of 420 patients participated in the survey. Respondents were, on average, 56.5 years old (SD 10.8) and 70% had bone metastases. Sixty-eight percent reported sufficient skills to engage in aerobic exercise, but only 35% did so for resistance exercise. Respondents expected exercise to have multiple physical benefits, but a few patients expected exercise to worsen their pain (5%). Not having access to an exercise program for cancer patients (27%), feeling too tired (23%), and/or weak (23%) were the most often reported barriers. Facilitators for exercising regularly were previous positive physical (72%) and emotional (68%) experiences with exercising, and receiving personalized advice from a physiotherapist or sport/fitness instructor (62%). Patients were most interested in walking and preferred exercising at a public gym, although there were differences by country. Fifty-seven percent did not know whether their insurance company reimburses exercise programs and only 9% would be willing to pay more than €50 per month to participate.

CONCLUSION

A large percentage of patients with MBC lack the skills to engage in regular exercise as recommended by exercise guidelines for people with cancer. Patients may benefit from personalized advice and appropriate training facilities to overcome barriers. When implementing exercise interventions, attention should be given to reimbursement and the relatively low willingness-to-pay.

Natural patterns of social support for physical activity participation in newly matched breast cancer survivor dyads

BACKGROUND

Physical activity (PA) can be a beneficial strategy to mitigate physical, emotional, and social-related challenges in women living beyond breast cancer treatment (WBC). However, PA levels among WBC remain low. Optimizing social support provided in a peer-matched setting may increase PA behavior. Unfortunately, factors that lead to an ideal peer-match among WBC are not well understood. The purpose of this study was to contextualize the natural social support environment and PA behavior in newly formed peer WBC dyads participating in an ecological momentary assessment study.

METHODS

WBC were matched with a partner and provided with a Fitbit activity tracker. Social support was measured using 21-daily surveys, and a 3-week follow-up survey. Descriptive statistics were calculated. Open-ended survey questions were analyzed using content analysis. Data were analyzed based on (i) social support types (informational, tangible, esteem, and emotional support); and (ii) WBC' reports of being in a good, neutral, or poor match at the end of the study.

RESULTS

Women (n = 46; Mage = 42.4 ± 7.6 years; 89.2% stage I-III breast cancer) connected with their partner (58.1%) and participated in moderate-vigorous PA (MVPA)(77.1%) on most days over the 21-day study period. Women were identified as being in good (63%), neutral (20%), or poor (17%) dyad matches. The most frequently documented social support received by WBC was esteem support. Participants in a good match were more likely to report receiving all types of social support compared to neutral or poor matches.

CONCLUSION & CLINICAL IMPLICATIONS

Findings describe the social support characteristics important to WBC for facilitating their PA participation in a partner-based setting. This study provides valuable insight that can inform the development of partner-based PA interventions for WBC.

The Effect of a Home-Based Tele-Exercise Training Program on the Quality of Life and Physical Performance in Breast Cancer Survivors

The number of breast cancer (BCa) survivors has been steadily increasing due to advances in anti-cancer treatments, though these individuals suffer from various cancer- and treatment-related long-term side effects. The present study aimed at investigating the effects of a home-based tele-exercise training intervention on physical- and mental health-associated parameters in BCa survivors. A total of 13 female BCa survivors (age: 58.31 ± 3.13 years, BMI: 25.68 ± 0.62 kg/m², waist circumference: 96.54 ± 1.84 cm) participated in a two-month group tele-exercise program twice per week which included aerobic, resistance and flexibility exercises. The results of the study revealed that the tele-exercise intervention improved participants' body mass index (BMI) (p < 0.001), waist circumference (p < 0.001), cardiorespiratory fitness (6 min walk test) (p < 0.001) and muscle function (sit to stand (p < 0.01), sit ups (p < 0.001) and push-ups (p < 0.001)). Beneficial effects were also observed on perceived anxiety (Zung Self-Rating Anxiety Scale) (p < 0.001), post-traumatic stress disorder (PTSD) symptoms (PCL-C) (p < 0.01), self-reported fatigue (p < 0.001), quality of life (QoL) (p < 0.05) and physical (p < 0.05), cognitive (p < 0.01) and emotional (p < 0.05) functioning (EORTQ-QLQ-C30). Our findings suggest that common cancer- and treatment-related adverse effects on physical performance, mental health and the overall QoL can be ameliorated through tele-exercise training programs in BCa survivors.

Recent Findings in Physical Exercise for Cancer Survivors

In recent years, the number of cancer survivors has been increasing each year due to advances in the early diagnosis and treatment of cancer. Cancer survivors present a variety of physical and psychological complications due to cancer and its treatment. Physical exercise is an effective nonpharmacological treatment for complications in cancer survivors. Furthermore, recent evidence has shown that physical exercise improves the prognosis of cancer survivors. The benefits of physical exercise have been widely reported, and guidelines for physical exercise for cancer survivors have been published. These guidelines recommend that cancer survivors engage in moderate- or vigorous-intensity aerobic exercises and/or resistance training. However, many cancer survivors have a poor commitment to physical exercise. In the future, it is necessary to promote physical exercise among cancer survivors through outpatient rehabilitation and community support.