Design and implementation of a standard care programme of therapeutic exercise and education for breast cancer survivors

Abstract

Background Breast cancer survivors (BCS) face several symptoms and are at higher risk of weight gain following diagnosis. Current literature shows that both exercise and diet play a key role in recovery of BCS. However, there is a gap between current guidelines and the real-world context. The aim of this article is to describe the process behind a free, not-for-profit community-based therapeutic exercise and education programme (TEEP) for BCS in the clinical setting. Methods The “Onco-Health Club” (OHC) consists of therapeutic exercise (TE) intervention aimed at ameliorating cancer-related fatigue (CRF) and improving QoL and physical function. TE is supplemented with nutritional education, providing information about the Mediterranean diet. To this end, patients are recruited from an oncologist and are referred to a physiotherapist and a nutritionist for baseline assessment. TEEP consists of a 3-month intervention, delivered twice a week in a group format with 1 h of TE and 30 min of nutritional education. BCS then have a final assessment and are advised to continue with a healthy lifestyle. Data about referral, compliance and assessment were collected. Results From May 2017 to February of 2020, a total of 158 patients were recruited from 8 cohorts and 142 initially started the OHC. From 119 that joined the program, 96 patients were considered to have finished it with good adherence (assistance > 80%). BCS significantly improved their QoL, as well as upper and lower limb’s function, and increased their level of physical activity. CRF tended to decrease (p = 0.005). Conclusions This study obtained data on recruitment, compliance, and possible limitations of these kinds of programmes in a real-world context. Further research is needed in order to optimize patient engagement and compliance, as well as to determine the transferability of these programmes in the clinical setting. Trial registration NCT03879096, Registered 18th March 2019. Retrospectively registered.

Acupuncture for Managing Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis

“…Several randomized controlled trials (RCTs) have been conducted to test the efficacy and safety of AT for the treatment of CRF [ 12 ]. However, these treatments often require the patient’s subjective cooperation and active participation in activities, the clinical implementation is not strong, and compliance seems to be problematic [ 13 , 14 ].…”

Implementation of a Standard Care Program of Therapeutic Exercise in Metastatic Breast Cancer Patients

“…Similar interventions in BCS have shown compliance of 67%, and drop-outs and lack of attendance were mainly related to personal matters (incompatibility with work and family life), health problems and transport barriers [ 21 ]. Data from other randomized studies in metastatic patients report higher rates of completion (64–70%) [ 11 , 42 ], but recent reports from other hospital distance-based PA programs prescribed at home are around 35–52% [ 44 ], with abandonment due mainly to tumor progression [ 42 ].…”

“…The present program started in May 2017 as The School of Healthy Habits for Women Operated for Breast Cancer, known colloquially as The Onco-Health Club (OHC), providing TE and educational interventions in BCS that have been surgically treated for their primary tumor with no evidence presence of tumor or metastatic disease [ 21 ]. Later, TE intervention was offered to patients diagnosed with MBC: The Therapeutic Exercise program in MBC (TEP-MBC).…”

Responsiveness of the new index muscular echotexture in women with metastatic breast cancer: an exercise intervention study

“…A previously described 12-week therapeutic exercise program 35 was performed in groups, including aerobic exercise and strength training led by a physical therapist. The program aimed to generate neuromuscular and cardiovascular adaptations, and took into account the current recommendations in the oncology field 20 .…”