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Borsati A, Toniolo L, Trestini I, Tregnago D, Belluomini L, Fiorio E, Lanza M, Schena F, Pilotto S, Milella M, Avancini A. Feasibility of a novel exercise program for patients with breast cancer offering different modalities and based on patient preference. Eur J Oncol Nurs 2024; 70:102554. [PMID: 38615512 DOI: 10.1016/j.ejon.2024.102554] [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: 01/10/2024] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Exercise improves quality of life and reduces the side effects of cancer therapies. Nevertheless, attendance to exercise programs remains a challenge for patients. This study explored the feasibility of an exercise program in which women with breast cancer may be allowed to choose among three exercise delivery modalities. METHODS Forty-seven patients with breast cancer (stage I-IV) participated in a 12-week combined aerobic and resistance training program. The exercise modality was chosen by patients according to their preferences and needs among three options: the personal training program, the home-based program, or the group-based program. Exercise prescription was similar between the three modalities. Whereas the primary endpoint was feasibility, assessed through recruitment rate, attendance, adherence, dropout rate, tolerability, and safety, secondary endpoints included health-related skills and quality of life. RESULTS Out of 47 recruited patients, 24 chose the home-based program, 19 the personal training program, and four the group-based program. Six dropouts (13%) were registered, and no severe adverse events were recorded. The median program attendance was 98% for personal training programs, 96% for home-based programs, and 100% for group-based programs, whereas compliance resulted in more than 90% in each modality. At postintervention, a significant increase in cardiorespiratory fitness, lower body flexibility, and body weight was observed. Different quality-of-life domains were improved following the intervention, including physical and social functioning, fatigue, and appetite loss. No significant changes in other parameters were detected. CONCLUSIONS An exercise prescription based on a patient-preferred delivery modality showed high feasibility in women with breast cancer.
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Affiliation(s)
| | - Linda Toniolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Ilaria Trestini
- Dietetic Service, Medical Direction, University Hospital of Verona (AOUI), Italy
| | - Daniela Tregnago
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Lorenzo Belluomini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Elena Fiorio
- Section of Oncology, University of Verona Hospital Trust (AOUI) Verona, Italy
| | - Massimo Lanza
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Sara Pilotto
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Michele Milella
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Alice Avancini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy.
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Wagoner CW, Friedenreich CM, Courneya KS, Wang Q, Vallance JK, Matthews CE, Yang L, McNeely ML, Bell GJ, Morielli AR, McNeil J, Dickau L, Culos-Reed SN. Social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in newly diagnosed women with breast cancer. Support Care Cancer 2023; 31:537. [PMID: 37624525 DOI: 10.1007/s00520-023-08001-0] [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: 03/28/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Identifying correlates of physical activity and sedentary behaviour allows for the identification of factors that may be targeted in future behaviour change interventions. This study sought to determine the social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in individuals recently diagnosed with breast cancer. METHODS Data were collected from 1381 participants within 90 days of diagnosis in the Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study. Physical activity and sedentary behaviour were measured with ActiGraph GT3X+® and activPALTM devices, respectively, for seven consecutive days. Correlates were collected via a self-reported questionnaire, medical record extraction, or measured by staff. RESULTS Multivariable models were fitted for sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity. Greater sedentary behaviour was associated with higher body fat percentage (BF%) (ß=0.044; p<0.001) and being single (ß=0.542; p<0.002). Lower light physical activity was associated with higher BF% (ß=-0.044; p<0.001), higher body mass index (ß=-0.039; p<0.001), greater disease barrier influence (ß=-0.006; p<0.001), a HER2-positive diagnosis (ß=-0.278; p=0.001), and being single (ß=-0.385; p= 0.001). Lower moderate-to-vigorous physical activity was associated with higher BF% (ß =-0.011; p=0.001), greater disease barrier influence (ß=-0.002; p<0.001), and being of Asian (ß=-0.189; p=0.002) or Indian/South American (ß=-0.189; p=0.002) descent. Greater moderate-to-vigorous physical activity was associated with having greater intentions (ß=0.049; p=0.033) and planning (ß=0.026; p=0.015) towards physical activity. CONCLUSION Tailoring interventions to increase physical activity for individuals recently diagnosed with breast cancer may improve long-term outcomes across the breast cancer continuum.
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Affiliation(s)
- Chad W Wagoner
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada.
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Gordon J Bell
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - Jessica McNeil
- Department of Kinesiology, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, USA
| | - Leanne Dickau
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Edmonton, Canada
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Capozzi LC, Daun JT, Francis GJ, de Guzman Wilding M, Urgoiti GR, Langelier D, Culos-Reed N. Feasibility and Implementation of an Oncology Rehabilitation Triage Clinic: Assessing Rehabilitation, Exercise Need, and Triage Pathways within the Alberta Cancer Exercise-Neuro-Oncology Study. Curr Oncol 2023; 30:6220-6245. [PMID: 37504321 PMCID: PMC10377964 DOI: 10.3390/curroncol30070461] [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: 05/15/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Individuals living with and beyond cancer face physical impairment and inactivity in survivorship. Neuro-oncology populations have especially high rates of sedentary behaviour and functional deficits, including impaired balance, motor skills, and cognition. Our purpose was to assess the rehabilitation and exercise needs of patients with brain tumours while examining the feasibility of a rehabilitation triage clinic as a part of the Alberta Cancer Exercise-Neuro-Oncology study, where patients were referred to a triage clinic, where health, neurologic, and functional status was assessed, followed by a referral to one or multiple resources, including exercise, physiotherapy, occupational therapy, or physiatry. Qualitative perception of the triage clinic was collected. Overall, the triage clinic was feasible and safe for participants, facilitating referral into rehabilitation and exercise resources. Pre-determined enrollment and attendance rates were met, but referral rates to the triage clinic were not met. Oncology clinic staff reported forgetting to refer patients or uncertainty of who was appropriate for rehabilitation as barriers. Oncology clinic-based screening may improve the identification of patients who are sedentary or have a physical impairment. A proposed screening tool, the Cancer Rehabilitation and Exercise Screening Tool (CREST), is presented within our Cancer Rehabilitation and Exercise Pathways Model. The CREST can identify patients who are sedentary or have a functional impairment, facilitating referral to appropriate rehabilitation resources and ultimately improving patient recovery and functioning.
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Affiliation(s)
- Lauren C Capozzi
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - George J Francis
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Marie de Guzman Wilding
- Supportive Care: Psychosocial and Rehabilitation Oncology, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Gloria Roldan Urgoiti
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - David Langelier
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Supportive Care, Cancer Rehabilitation and Survivorship, Princess Margaret Hospital, Toronto, ON M5G 2C1, Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Supportive Care: Psychosocial and Rehabilitation Oncology, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
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Breast Cancer: How Hippotherapy Bridges the Gap between Healing and Recovery-A Randomized Controlled Clinical Trial. Cancers (Basel) 2023; 15:cancers15041317. [PMID: 36831658 PMCID: PMC9953804 DOI: 10.3390/cancers15041317] [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: 01/09/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Breast cancer is the most diagnosed women's cancer, and has a high survival rate. Despite great progress in detection and treatment, life reconstruction requires comprehensive cross-sectoral approaches between different disciplines and deeper consideration of the patient's challenges. Hippotherapy is an emerging specialized rehabilitation approach, performed by accredited health professionals and equine specialists, on specially trained horses via their movement, activating major paths for physical, mental, psychic and social reinforcement, and is synergistic to rehabilitative and supportive care. METHODS We conducted a randomized open, prospective, two-armed, controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy). The 6-month program included, in the treated group, an initial 1-week daily hippotherapy session, followed by three short 2-day sessions with an interval of 2 months between each, where the patients received conventional supportive care. The control group received 6 months of conventional supportive care. The primary end point was quality of life. Cognitive performances, fatigue, anxiety, depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. RESULTS We observed statistical differences in the evolution of the measured parameters over time between the two groups. The hippotherapy group showed a much faster, favorable and continuous improvement until the end of the program for each function assessed. The most striking improvements were observed in global quality of life, and fatigue, while breast cancer-specific quality of life, cognitive performance, anxiety and depression and body image showed a less marked but still statistically significant difference at the final post-treatment evaluation. CONCLUSIONS We demonstrate the therapeutic relevance of hippotherapy, a one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on cancer treatments' efficiency and reconstruction of patient's life and ecosystem. This work reveals a layer of complexity that needs to be broadly considered. TRIAL REGISTRATION ClincalTrials.gov NCT04350398 accessed on 1 January 2022. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.
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Wagoner CW, Dreger J, Keats MR, Santa Mina D, McNeely ML, Cuthbert C, Capozzi LC, Francis GJ, Trinh L, Sibley D, Langley J, Chiekwe J, Ester M, Foucaut AM, Culos-Reed SN. First-Year Implementation of the EXercise for Cancer to Enhance Living Well (EXCEL) Study: Building Networks to Support Rural and Remote Community Access to Exercise Oncology Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1930. [PMID: 36767296 PMCID: PMC9915392 DOI: 10.3390/ijerph20031930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 05/27/2023]
Abstract
Barriers to exercise-oncology programs remain for those living with and beyond cancer in rural and remote communities, including geographic isolation and access to programs. The EXercise for Cancer to Enhance Living Well (EXCEL) study was designed to support exercise-oncology implementation in rural and remote communities across Canada. The purpose of this analysis was to evaluate the first-year reach, adoption, and implementation of the EXCEL study. Reach outcomes included participant characteristics, study enrolment, and referral type (self vs. healthcare-provider [HCP] referral). Adoption outcomes included the number of clinical contacts, trained qualified exercise professionals (QEPs), and QEPs delivering EXCEL exercise classes. Implementation outcomes included retention, adherence, assessment completion rates, and adverse-event reporting. A total of 290 individuals living with cancer enrolled in EXCEL in year one, with an 81.4% retention to the study intervention. Most participants self-referred to EXCEL (75.8%). EXCEL's HCP network consisted of 163 clinical contacts, and the QEP network included 45 trained QEPs, 22 of whom delivered EXCEL classes. Adherence to the exercise intervention was 78.2%, and only one adverse event (mild) was reported. Fitness assessment and patient-reported outcome completion rates were above 85% pre- and post-intervention. EXCEL has developed HCP and QEP networks supporting exercise referral and online delivery, and the intervention is meeting feasibility markers. These implementation findings will inform the continued gathering of feedback across stakeholders to ensure that best evidence informs best practices.
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Affiliation(s)
- Chad W. Wagoner
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Julianna Dreger
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Melanie R. Keats
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Medicine, Division of Medical Oncology, Nova Scotia Health, Halifax, NS B3H 2Y9, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada
- Supportive Care Services, Cancer Care Alberta, Edmonton, AB T5J 3E4, Canada
| | - Colleen Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 4V8, Canada
| | - Lauren C. Capozzi
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - George J. Francis
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada
| | - Daniel Sibley
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada
| | - Jodi Langley
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Joy Chiekwe
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Manuel Ester
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Aude-Marie Foucaut
- Health Educations and Promotion Laboratory, UR 3412, University Sorbonne Paris North, F-93000 Bobigny, France
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Culos-Reed N, Wagoner CW, Dreger J, McNeely ML, Keats M, Santa Mina D, Cuthbert C, Capozzi LC, Francis GJ, Chen G, Ester M, McLaughlin E, Eisele M, Sibley D, Langley J, Chiekwe J, Christensen T. Implementing an exercise oncology model to reach rural and remote individuals living with and beyond cancer: a hybrid effectiveness-implementation protocol for project EXCEL (EXercise for Cancer to Enhance Living Well). BMJ Open 2022; 12:e063953. [PMID: 36581419 PMCID: PMC9806055 DOI: 10.1136/bmjopen-2022-063953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Individuals living with and beyond cancer from rural and remote areas lack accessibility to supportive cancer care resources compared with those in urban areas. Exercise is an evidence-based intervention that is a safe and effective supportive cancer care resource, improving physical fitness and function, well-being and quality of life. Thus, it is imperative that exercise oncology programs are accessible for all individuals living with cancer, regardless of geographical location. To improve accessibility to exercise oncology programs, we have designed the EXercise for Cancer to Enhance Living Well (EXCEL) study. METHODS AND ANALYSIS EXCEL is a hybrid effectiveness-implementation study. Exercise-based oncology knowledge from clinical exercise physiologists supports healthcare professionals and community-based qualified exercise professionals, facilitating exercise oncology education, referrals and programming. Recruitment began in September 2020 and will continue for 5 years with the goal to enroll ~1500 individuals from rural and remote areas. All tumour groups are eligible, and participants must be 18 years or older. Participants take part in a 12-week multimodal progressive exercise intervention currently being delivered online. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework is used to determine the impact of EXCEL at participant and institutional levels. Physical activity, functional fitness and patient-reported outcomes are assessed at baseline and 12-week time points of the EXCEL exercise intervention. ETHICS AND DISSEMINATION The study was approved by the Health Research Ethics Board of Alberta. Our team will disseminate EXCEL information through quarterly newsletters to stakeholders, including participants, qualified exercise professionals, healthcare professionals and community networks. Ongoing outreach includes community presentations (eg, support groups, fitness companies) that provide study updates and exercise resources. Our team will publish manuscripts and present at conferences on EXCEL's ongoing implementation efforts across the 5-year study. TRIAL REGISTRATION NUMBER NCT04478851.
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Affiliation(s)
- Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Chad W Wagoner
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Julianna Dreger
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Margaret L McNeely
- Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
- Supportive Care Services, Cancer Care Alberta, Edmonton, Alberta, Canada
| | - Melanie Keats
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine, Division of Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
- Cancer Rehabilitation and Survivorship, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Colleen Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Lauren C Capozzi
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - George J Francis
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Guanmin Chen
- Data and Analytics, Alberta Health Services Board, Calgary, Alberta, Canada
| | - Manuel Ester
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Max Eisele
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Sibley
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Jodi Langley
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joy Chiekwe
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Thomas Christensen
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
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Daun JT, Twomey R, Dort JC, Capozzi LC, Crump T, Francis GJ, Matthews TW, Chandarana SP, Hart RD, Schrag C, Matthews J, McKenzie CD, Lau H, Culos-Reed SN. A Qualitative Study of Patient and Healthcare Provider Perspectives on Building Multiphasic Exercise Prehabilitation into the Surgical Care Pathway for Head and Neck Cancer. Curr Oncol 2022; 29:5942-5954. [PMID: 36005207 PMCID: PMC9406549 DOI: 10.3390/curroncol29080469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
Head and neck cancer (HNC) surgical patients experience a high symptom burden. Multiphasic exercise prehabilitation has the potential to improve patient outcomes, and to implement it into the care pathway, the perspectives of patients and healthcare providers (HCPs) must be considered. The purpose of this study was thus to gather feedback from HNC surgical patients and HCPs on building exercise into the standard HNC surgical care pathway. Methods: Semi-structured interviews were conducted with patients and HCPs as part of a feasibility study assessing patient-reported outcomes, physical function, and in-hospital mobilization. Interview questions included satisfaction with study recruitment, assessment completion, impact on clinical workflow (HCPs), and perceptions of a future multiphasic exercise prehabilitation program. This study followed an interpretive description methodology. Results: Ten patients and ten HCPs participated in this study. Four themes were identified: (1) acceptability and necessity of assessments, (2) the value of exercise, (3) the components of an ideal exercise program, and (4) factors to support implementation. Conclusion: These findings highlight the value of exercise across the HNC surgical timeline from both the patient and the HCP perspective. Results have informed the implementation of a multiphasic exercise prehabilitation trial in HNC surgical patients.
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Affiliation(s)
- Julia T. Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Rosie Twomey
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Joseph C. Dort
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Section of Otolaryngology Head & Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
| | - Lauren C. Capozzi
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Trafford Crump
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - George J. Francis
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - T. Wayne Matthews
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Section of Otolaryngology Head & Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
| | - Shamir P. Chandarana
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Section of Otolaryngology Head & Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
| | - Robert D. Hart
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Section of Otolaryngology Head & Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
| | - Christiaan Schrag
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Jennifer Matthews
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - C. David McKenzie
- Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Foothills Medical Centre, Alberta Health Services, Calgary, AB T2N 2T9, Canada
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Harold Lau
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- 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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