Attention to principles of exercise training: an updated systematic review of randomized controlled trials in cancers other than breast and prostate

Abstract

Background The primary objective of this systematic review was to update our previous review on randomized controlled trials (RCTs) of exercise in cancers other than breast or prostate, evaluating: 1) the application of principles of exercise training within the exercise prescription; 2) reporting of the exercise prescription components (i.e., frequency, intensity, time, and type (FITT)); and 3) reporting of participant adherence to FITT. A secondary objective was to examine whether reporting of these interventions had improved over time. Methods MEDLINE, EMBASE, CINAHL and SPORTDiscus databases were searched from 2012 to 2020. Eligible studies were RCTs of at least 4 weeks of aerobic and/or resistance exercise that reported on physiological outcomes relating to exercise (e.g., aerobic capacity, muscular strength) in people with cancer other than breast or prostate. Results Eighty-six new studies were identified in the updated search, for a total of 107 studies included in this review. The principle of specificity was applied by 91%, progression by 32%, overload by 46%, initial values by 72%, reversibility by 7% and diminishing returns by 5%. A significant increase in the percentage of studies that appropriately reported initial values (46 to 80%, p < 0.001) and progression (15 to 37%, p = 0.039) was found for studies published after 2011 compared to older studies. All four FITT prescription components were fully reported in the methods in 58% of all studies, which was higher than the proportion that fully reported adherence to the FITT prescription components in the results (7% of studies). Reporting of the FITT exercise prescription components and FITT adherence did not improve in studies published after 2011 compared to older studies. Conclusion Full reporting of exercise prescription and adherence still needs improvement within exercise oncology RCTs. Some aspects of exercise intervention reporting have improved since 2011, including the reporting of the principles of progression and initial values. Enhancing the reporting of exercise prescriptions, particularly FITT adherence, may provide better context for interpreting study results and improve research to practice translation.

Exercise Interventions During Hospitalization for Stem Cell Transplantation: An Integrative Review

“…Incomplete reporting of FITT prescription components is a persistent problem in exercise oncology. The findings from this review were consistent with a recent systematic review of exercise interventions where only 58% of studies reported all FITT prescription components (Bland et al, 2021). Operationalizing exercise prescriptions using FITT components is needed to allow comparison across interventions and improve intervention designs (Fairman et al, 2020).…”

“…Adherence is frequently associated with other concepts such as attendance or compliance to the prescribed exercise program (Collado-Mateo et al, 2021) because there is no consensus on the definition of adherence to exercise interventions in the literature (Hawley-Hague et al, 2016). Bland et al (2021) suggest a comprehensive method for reporting exercise adherence is to describe the frequency, intensity, time, and type (FITT) of the prescription. Frequency refers to the number of sessions per week; intensity to the level of exertion; time to the duration of exercise sessions; and type to the type of exercise, such as aerobic or resistance training.…”

If exercise is medicine, why don’t we know the dose? An overview of systematic reviews assessing reporting quality of exercise interventions in health and disease

“…The clinician is now uncertain what the ‘effective’ exercise programme was. The same could be said for clinicians working in exercise oncology, where key principles of training (eg, progression and reversibility) and prescriptive components of exercise (eg, frequency, intensity, time and type) are poorly reported 21…”

Correction to: Attention to principles of exercise training: an updated systematic review of randomized controlled trials in cancers other than breast and prostate

“…Following publication of the original article [ 1 ], the authors identified the following typesetting errors: A small number of references were not inserted in-text correctly. As a result, some in-text citations are not correct for specific statements in our results section on pages 4-5.…”

“…Please see below for the corrected Table 2 . The reference list has been corrected in the updated article [ 1 ].…”