ACE-Neuro: A tailored exercise oncology program for neuro-oncology patients – Study protocol

Daun, Julia T.; Capozzi, L; Urgoiti, Gloria Roldan; McDonough, Meghan H.; Easaw, Jacob C.; McNeely, Margaret L.; Francis, George J.; Williamson, Tanya; Danyluk, Jessica M.; McLaughlin, Emma; Ospina, Paula; Wilding, Marie de Guzman; Radke, Lori; Driga, Amy; Lesiuk, Christine; Culos‐Reed, S. Nicole

doi:10.1016/j.conctc.2022.100925

Cited by 7 publications

(10 citation statements)

References 44 publications

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“…There are several effective interventions targeting fatigue in cancer patients, including cognitive behavioral therapy, mindfulness, exercise, activity enhancement, problem-solving therapy, and acceptance and commitment therapy 26,48 . Those interventions might also be promising in treating fatigue in patients with glioma [48][49][50] .…”

Section: Discussionmentioning

confidence: 99%

“…26,46 Those interventions might also be promising in treating fatigue in patients with glioma. [46][47][48] Unfortunately, we did not assess whether antiepileptic drugs (AEDs) were associated with fatigue, since some studies do suggest that AEDs could result in fatigue. 5,10,49 Therefore it might be worthwhile to investigate whether switching between AEDs or lowering the dosage would be a useful approach to ameliorate fatigue.…”

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confidence: 99%

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Toward unraveling the correlates of fatigue in glioma

Röttgering

Belgers

Hamer

et al. 2022

Preprint

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Background: Even though fatigue is one of the most prevalent and burdensome symptoms in patients with glioma, its etiology and determinants are still poorly understood. We aimed to identify which demographic, tumor- and treatment-related characteristics and patient-reported outcome measures (PROMs) are associated with fatigue in glioma, and aimed to find predictors of postoperative fatigue. Methods: In this retrospective cohort study, we collected data from patients with diffuse glioma who had performed preoperative and postoperative assessments consisting of PROMs on fatigue, depression, cognitive deficits, and health-related quality of life (HRQoL). Linear mixed models were used to identify which clinical factors and PROMs were associated with fatigue and linear multiple regression was used to find predictors of postoperative fatigue. Results: In this study, 222 glioma patients were included, who had performed 333 assessments (193 preoperative and 116 postoperative). Of all assessments, 39% were indicative of severe fatigue. Several HRQoL domains, depression, and having a right-sided tumor were significantly associated with fatigue (marginal R2 = 0.63). Contrary to common expectations, tumor type, treatment-related factors, the timing of the assessment, and disease status, were not associated with fatigue. In a subgroup of 70 patients with complete follow-up assessments, preoperative fatigue and self-reported physical functioning were predictors of postoperative fatigue (adjusted R2 = 0.31). Conclusion: Fatigue is a complex symptom, which should not solely be attributed to the tumor or its treatment, but is instead related to different aspects of mood and HRQoL. These insights are of importance in understanding fatigue and could guide symptom management.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Toward unraveling the correlates of fatigue in glioma

Röttgering

Belgers

Hamer

et al. 2022

Preprint

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“…Although enrolment through self-referral highlighted the effective community-based outreach from the EX-CEL hubs, the HCP referral pathway is critical for sustainability within the cancer care system [14,25]. Ongoing work in both neuro-oncology [34] and head and neck cancer [35] populations are utilizing rehabilitation triage clinics in collaboration with physiatrists within cancer care settings to embed both exercise screening and referral into clinical workflows. This work, in addition to the continued development of the HCP referral pathways that EXCEL established across regions, will directly address recent calls to action for integrating exercise-oncology resources into cancer care [25,36,37].…”

Section: Reach and Adoptionmentioning

confidence: 99%

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

Wagoner

Dreger

Keats

et al. 2023

IJERPH

Self Cite

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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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“…This study was approved by the University of Calgary Health Research Ethics Board of Alberta (HREBA)-Cancer Committee (CC)-HREBA.CC-20-0322, and is a component of a larger study, Alberta Cancer Exercise-Neuro (ACE-Neuro) [25]. The triage clinic was conducted in Calgary, Alberta, and does not include ACE-Neuro patients from the Edmonton, Alberta site.…”

Section: Study Design and Ethical Approvalmentioning

confidence: 99%

“…Therefore, the objective of this research was to identify rehabilitation and exercise needs in an underserved oncology population, and study triage and referral processes to enhance patient rehabilitation and care. This manuscript presents data on the feasibility of the rehabilitation and exercise triage clinic as part of the Alberta Cancer Exercise-Neuro-Oncology study (ACE-Neuro) [25]. Specifically, the implementation of the triage clinic is reported, including the (a) assessment of rehabilitation and exercise needs of patients with brain tumours (i.e., neuro-oncology patients) and (b) the triage and referral of participants to physiatry, physiotherapy, occupational therapy, and/or exercise (i.e., ACE-Neuro) based on pre-determined cut-offs.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Implementation of an Oncology Rehabilitation Triage Clinic: Assessing Rehabilitation, Exercise Need, and Triage Pathways within the Alberta Cancer Exercise–Neuro-Oncology Study

et al. 2023

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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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ACE-Neuro: A tailored exercise oncology program for neuro-oncology patients – Study protocol

Cited by 7 publications

References 44 publications

Toward unraveling the correlates of fatigue in glioma

Toward unraveling the correlates of fatigue in glioma

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

Feasibility and Implementation of an Oncology Rehabilitation Triage Clinic: Assessing Rehabilitation, Exercise Need, and Triage Pathways within the Alberta Cancer Exercise–Neuro-Oncology Study

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