Exercise interventions for patients with advanced cancer: A systematic review of recruitment, attrition, and exercise adherence rates

Sheill, Gráinne; Guinan, Emer; Brady, Lauren; Hevey, David; Hussey, Juliette

doi:10.1017/s1478951519000312

Cited by 65 publications

(62 citation statements)

References 55 publications

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“…Similar to our ndings, Morgan et al (41) identi ed program location as a barrier to participation and adherence, while Sheill et al (42) found that di culties travelling to exercise locations were a substantial barrier for individuals with advanced cancer. We found no evidence that the type of exercise program (i.e.,…”

Section: Discussionsupporting

confidence: 88%

Predictors of adherence to prescribed exercise programs for older adults with non-musculoskeletal indications for exercise: a systematic review

Shaw

Pilon

Vierula

et al. 2020

Preprint

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BACKGROUND AND OBJECTIVES: Prescribed exercise to treat medical conditions and to prepare for surgery is a promising intervention to prevent adverse health outcomes for older adults; however, adherence to exercise programs may be low. Our objective was to identify and grade the quality of predictors of adherence to prescribed exercise in older adults. METHODS After registration (CRD42018108242), prospective experimental studies were identified using a peer-reviewed search strategy applied to MEDLINE, EMBASE, Cochrane and CINAHL from inception until April 23, 2019. Following independent and duplicate review of titles, abstracts and full texts, we included prospective studies with an average population age ≥ 65 years, where exercise was formally prescribed for a medical or surgical condition. We excluded studies where exercise was prescribed for a chronic musculoskeletal condition. Risk of bias was assessed using the Quality in Prognostic studies tool or Cochrane risk of bias tool, as appropriate. Predictors of adherence were identified, pooled, and graded for quality using an adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for predictor studies. RESULTS We included 19 observational studies and 4 randomized controlled trials (n = 5785) Indications for exercise included cardiac (n = 6), pulmonary rehabilitation (n = 7), or other (n = 10; surgical, medical, and neurologic). Overall adherence rate was reported in 20 studies (range 21%-93%; mean 68%, standard deviation 23%). Moderate-quality evidence suggested that positive predictors of adherence were self-efficacy and good self-rated mental health; negative predictors were depression (high quality) and distance from the exercise facility. Moderate-quality evidence suggested that comorbidity and age were not predictive of adherence. CONCLUSIONS These findings can inform design of future exercise programs as well as identification of individuals who may require extra support to benefit from prescribed exercise.

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Section: Discussionsupporting

confidence: 88%

Predictors of adherence to prescribed exercise programs for older adults with non-musculoskeletal indications for exercise: a systematic review

Shaw

Pilon

Vierula

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…However, few studies have evaluated what patient-and program-factors predict adherence, and to our knowledge, none have evaluated the strength of this evidence using a standard framework such as GRADE. Similar to our ndings, Morgan et al (46) identi ed program location as a barrier to participation and adherence, while Sheill et al (47) found that di culties travelling to exercise locations were a substantial barrier for individuals with advanced cancer. We found no evidence that the type of exercise program (i.e., interval vs continuous exercise) was predictive of adherence, which is consistent with recommendations that the act of engaging in exercise is likely of greater importance than the speci c type of exercise performed.…”

Section: Discussionsupporting

confidence: 88%

“…We found no evidence that the type of exercise program (i.e., interval vs continuous exercise) was predictive of adherence, which is consistent with recommendations that the act of engaging in exercise is likely of greater importance than the speci c type of exercise performed. (45,47) Some authors have advocated the identi cation of participant-level 'red ags' to adherence as a way to personalize exercise program design and support. (45) However, this approach requires a thorough understanding of what participant characteristics may act as red ags.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Adherence to Prescribed Exercise Programs for Older Adults With Medical or Surgical Indications for Exercise: a Systematic Review

Shaw

Pilon

Vierula

et al. 2020

Preprint

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BACKGROUND AND OBJECTIVES: Prescribed exercise to treat medical conditions and to prepare for surgery is a promising intervention to prevent adverse health outcomes for older adults; however, adherence to exercise programs may be low. Our objective was to identify and grade the quality of predictors of adherence to prescribed exercise in older adults. METHODS: Prospective experimental studies were identified using a peer-reviewed search strategy applied to MEDLINE, EMBASE, Cochrane and CINAHL from inception until October 6, 2020. Following independent and duplicate review of titles, abstracts and full texts, we included prospective studies with an average population age >65 years, where exercise was formally prescribed for a medical or surgical condition. We excluded studies where exercise was prescribed for a chronic musculoskeletal condition. Risk of bias was assessed using the Quality in Prognostic studies tool or Cochrane risk of bias tool, as appropriate. Predictors of adherence were identified, pooled, and graded for quality using an adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for predictor studies.RESULTS: We included 19 observational studies and 4 randomized controlled trials (n=5785) Indications for exercise included cardiac (n=6), pulmonary rehabilitation (n=7), or other (n=10; surgical, medical, and neurologic). Of the 10 studies that reported adherence as the percent of prescribed sessions completed, average adherence was 80% (range 60%-98%; standard deviation (SD) 11%). Of the 10 studies that reported adherence as a categorical threshold demarking adherent vs not adherent, average adherence was 57.5% (range 21%-83%; SD 21%). Moderate-quality evidence suggested that positive predictors of adherence were self-efficacy and good self-rated mental health; negative predictors were depression (high quality) and distance from the exercise facility. Moderate-quality evidence suggested that comorbidity and age were not predictive of adherence.CONCLUSIONS: These findings can inform design of future exercise programs as well as identification of individuals who may require extra support to benefit from prescribed exercise.SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018108242

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“…However, Brandao et al (2017) found that the average of attrition rate in the 34 studies was 22.88; SD=15.31 (Brandao et al, 2017). In addition, Sheill et al, (2019 conducted a systematic review, they reported that the average of attrition rate 24% (Sheill et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Effects of the Educational and Counseling Interventions on Mental Adjustment and Quality of Life in Breast Cancer

2019

IJPHCS

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Background: Education and counselling are widely used independently or as supplementary components in the psychosocial interventions. However, there is a certain level of ambiguity if used separately. In this analysis, we attempted to answer the following question; "Does the education and counseling support improve of the adjustment to cancer in women diagnosed with breast cancer?" Methods: An online search was undertaken in 12 databases for the longitudinal studies for the period from January 2007 to March 2018. The effects of the interventions on the adjustment to breast cancer, were calculated based on the results of the mental adjustment and quality of life (QoL). Three distinct periods were examined; baseline, three months, and six months. The methodological quality, risk of bias, publication bias, and attrition rate were examined. Meta-analysis was carried out using Review Manager 5.3 with the results graphically presented. Results: A comprehensive systematic review was conducted for 5,464 titles, of which 22 studies fulfilled the inclusion criteria, however 14 studies completed the data and included in the qualitative synthesis; included 3,419 patients. The mean of overall attrition rate in both groups was 14.37% (SE= 2.87, median= 12.28). In mental adjustment, the total mean differences for the three trials were statistically significant 0.40 (0.24 to 0.57). For the QoL, the mean differences of the three trials were statistically non-significant 0.18 (-0.48 to 0.84). Conclusion: The educational and/or counseling interventions can be beneficial and useful for patients to adapt with the breast cancer, however, it is less effective on the QoL.

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Exercise interventions for patients with advanced cancer: A systematic review of recruitment, attrition, and exercise adherence rates

Cited by 65 publications

References 55 publications

Predictors of adherence to prescribed exercise programs for older adults with non-musculoskeletal indications for exercise: a systematic review

Predictors of adherence to prescribed exercise programs for older adults with non-musculoskeletal indications for exercise: a systematic review

Predictors of Adherence to Prescribed Exercise Programs for Older Adults With Medical or Surgical Indications for Exercise: a Systematic Review

Meta-Analysis of the Effects of the Educational and Counseling Interventions on Mental Adjustment and Quality of Life in Breast Cancer

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