Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study

Latka, Rebecca; Alvarez-Reeves, Marty; Cadmus, Lisa; Irwin, Melinda L.

doi:10.1007/s11764-009-0088-z

Cited by 48 publications

(61 citation statements)

References 38 publications

(56 reference statements)

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“…The mean duration of the RCTs was 17 weeks, but the supervised exercise and/or counseling sessions associated with each intervention ranged from 3 sessions (1×/month over 12 weeks) [37] to 78 sessions (3×/week for 26 weeks) [28, 38, 40]. Most studies reported sessions that were 45 minutes or less.…”

Section: Resultsmentioning

confidence: 99%

Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors

Bluethmann

Vernon

Gabriel

et al. 2015

Breast Cancer Res Treat

162

142

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Purpose Research has shown that recent post-treatment breast cancer survivors face significant challenges around physical activity as they transition to recovery. This review examined randomized controlled trials targeting physical activity behavior change in breast cancer survivors <5 years post-treatment and describes 1) characteristics of interventions for breast cancer survivors as well as 2) effect size estimates for these studies. Methods A systematic search was conducted following PRISMA guidelines with Medline, PubMed, PsycINFO, CINAHL, and Scopus databases. Data were abstracted for primary intervention strategies and other details (e.g., setting, duration, theory use). A subgroup analysis was conducted to assess intensity of exercise supervision/monitoring and intervention effectiveness. Results The search produced 14 unique behavior intervention trials from the US and abroad published 2005-2013. The mean sample size was 153 participants per study. All interventions included moderate-intensity activities plus various behavioral change strategies. Most interventions were partially or entirely home-based. The overall standardized mean difference was 0.47 (0.23, 0.67) with p < 0.001. Conclusion Most interventions were effective in producing short-term behavior changes in physical activity, but varied greatly relative to intervention strategies and intensity of supervision/monitoring. Highly structured interventions tended to produce larger behavior change effects overall, but many larger effect sizes came from interventions supported by phone counseling or email. We observed that ‘more’ may not be better in terms of direct supervision/monitoring in physical activity behavior interventions. This may be important in exploring less resource-intensive options for effective behavior change strategies for recent post-treatment survivors.

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Section: Resultsmentioning

confidence: 99%

Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors

Bluethmann

Vernon

Gabriel

et al. 2015

Breast Cancer Res Treat

162

142

View full text Add to dashboard Cite

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“…In four studies [39,40,47,50], exercise adherence was defined as a percentage of the prescribed number of sessions attended (mean: 62-78%), three studies [44,46,49] used the average minutes of exercise per week (mean: 92–141 min/week), three studies [42,43,48] used the percentage of survivors meeting the exercise prescriptions (mean: 54-74%), and two studies [41,45] used the number of completed exercise sessions (mean: 3 of 12 [41] and 28 of 36 [45] sessions), see Table 2. Maintenance was defined by average minutes of PA per week (mean: 92–175) in two studies [51,55], by percentage of survivors meeting the PA guideline (mean: 37-56%) in three studies [52,53,56], and the number of survivors in the action or maintenance stage of change compared to the number of survivors in the precontemplation, contemplation or preparation stage (i.e.…”

Section: Resultsmentioning

confidence: 99%

Determinants of exercise adherence and maintenance among cancer survivors: a systematic review

Kampshoff

Jansen

Mechelen

et al. 2014

Int J Behav Nutr Phys Act

162

173

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For an exercise intervention to be successful, it is important that cancer survivors adhere to the prescribed program. To be able to improve adherence and to preserve achieved beneficial effects, insights into the relevant and modifiable determinants is important. Therefore, we aimed to systematically review determinants of exercise adherence and maintenance in cancer survivors using a socio-ecological approach.Studies were identified in PubMed, Embase, PsycINFO and SPORTDiscus up to July 2013. We included full-text articles that: 1) were conducted among adult cancer survivors; 2) quantitatively assessed factors associated with intervention adherence and maintenance, and 3) were published in English. The methodological quality of the selected studies was examined. A best evidence synthesis was applied.Eighteen studies were included. Median methodological quality was 53% and ranged from 21-78% of maximum score. Twelve studies focused on determinants of exercise adherence and evaluated 71 potential determinants: 29 demographic and clinical, 27 psychological, ten physical, four social factors, and one environmental factor. Six studies focused on determinants of exercise maintenance after completion of an intervention, and investigated 63 factors: 22 demographic and clinical, 28 psychosocial, nine physical, three social and one environmental factor. We found moderate evidence for a positive association between exercise history and exercise adherence. Inconsistent findings were found for age, gender and education as well as for psychological factors such as stage of change, perceived behavioral control, self-efficacy, extraversion, attitude, intention, fatigue, and quality of life, and physical factors including cardiovascular fitness, body mass index, and baseline physical activity.Exercise history is positively associated with exercise adherence. Future trials should further study the influence of social and environmental determinants on exercise adherence and maintenance in addition to demographic, psychological and physical determinants.

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“…Numerous studies have examined the cross-sectional correlates of exercise participation in breast cancer survivors, usually focusing on social cognitive variables and long term breast cancer survivors [[13]-[19]]. Moreover, several studies have examined the prospective correlates of exercise participation in breast cancer survivors [[20],[21]] or the predictors of adherence to a prescribed exercise program in long term breast cancer survivors [[22],[23]]. The determinants of exercise adherence during breast cancer chemotherapy may be quite different than during survivorship because of the known toxicities of these treatments.…”

Section: Discussionmentioning

confidence: 99%

Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy

Courneya

Segal

Gelmon

et al. 2014

Int J Behav Nutr Phys Act

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BackgroundExercise is beneficial for breast cancer patients during chemotherapy but adherence to different types and doses of exercise is a challenge. The purpose of this study was to examine predictors of adherence to different types and doses of exercise during breast cancer chemotherapy in a multicenter randomized controlled trial.MethodsBreast cancer patients in Edmonton, Vancouver, and Ottawa, Canada receiving chemotherapy (N = 301) were randomized to a standard dose of 25–30 minutes of aerobic exercise (STAN), a higher dose of 50–60 minutes of aerobic exercise (HIGH), or a higher dose of 50–60 minutes of combined aerobic and resistance exercise (COMB). Predictors included demographic, medical, fitness, and quality of life variables. Exercise adherence was measured as the percentage of supervised exercise sessions completed.ResultsOverall adherence to the supervised exercise sessions was 73% (SD = 24%). In a multivariate regression model, six independent predictors explained 26.4% (p < 0.001) of the variance in exercise adherence. Higher exercise adherence was achieved by breast cancer patients in Vancouver (p < 0.001), with fewer endocrine symptoms (p = 0.009), randomized to STAN (p = 0.009), with fewer exercise limitations (p = 0.009), receiving shorter chemotherapy protocols (p = 0.015), and with higher VO2peak (p = 0.017). Disease stage (p for interaction = 0.015) and body mass index (p for interaction = 0.030) interacted with group assignment to predict adherence. For disease stage, patients with stage I/IIa disease adhered equally well to all three exercise interventions whereas patients with stage IIb/III disease adhered better to the STAN intervention than the two higher dose exercise interventions. For body mass index, healthy weight patients adhered equally well to all three exercise interventions whereas overweight patients adhered best to STAN and worst to COMB; and obese patients adhered best to STAN and worst to HIGH.ConclusionsDeterminants of exercise adherence in breast cancer patients receiving chemotherapy are multidisciplinary and may vary by the exercise prescription.

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Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study

Abstract: Future studies of exercise and breast cancer prognosis should target obese women for participation, as well as women just beginning to contemplate participation and its benefits after a cancer diagnosis.

Cited by 48 publications

References 38 publications

Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors

Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors

Determinants of exercise adherence and maintenance among cancer survivors: a systematic review

Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy

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