Participation in and adherence to physical exercise after completion of primary cancer treatment

Abstract

BackgroundThe purpose of this study was to identify demographic, clinical, psychosocial, physical and environmental factors that are associated with participation in and adherence to a combined resistance and endurance exercise program among cancer survivors, shortly after completion of primary cancer treatment. Data from the randomized controlled Resistance and Endurance exercise After ChemoTherapy (REACT) study were used for this study.MethodsThe participants of the REACT study were randomly allocated to either a high intensity (HI) or low-to-moderate intensity (LMI) exercise program. Patients’ participation rate was defined as the cancer survivors’ decision to participate in the REACT study. Exercise adherence reflected participants’ attendance to the scheduled exercise sessions and their compliance to the prescribed exercises. High session attendance rates were defined as attending at least 80 % of the sessions. High compliance rates were defined as performing at least of 90 % of the prescribed exercise across all sessions. Correlates of exercise adherence were studied separately for HI and LMI exercise. Demographic, clinical, and physical factors were assessed using self-reported questionnaires. Relevant clinical information was extracted from medical records. Multivariable logistic regression analyses were applied to identify correlates that were significantly associated with participation, high session attendance, high compliance with resistance and high compliance with endurance exercises.ResultsParticipants were more likely to have higher education, be non-smokers, have lower psychological distress, higher outcome expectations, and perceive more exercise barriers than non-participants. In HI exercise, higher self-efficacy was significantly associated with high session attendance and high compliance with endurance exercises, and lower psychological distress was significantly associated with high compliance with resistance exercises. In LMI exercise, being a non-smoker was significantly associated with high compliance with resistance exercises and higher BMI was significantly associated with high compliance with resistance and endurance exercises. Furthermore, breast cancer survivors were less likely to report high compliance with resistance and endurance exercises in LMI exercise compared to survivors of other types of cancer. The discriminative ability of the multivariable models ranged from 0.62 to 0.75.ConclusionSeveral demographic, clinical and psychosocial factors were associated with participation in and adherence to exercise among cancer survivors. Psychosocial factors were more strongly associated with adherence in HI than LMI exercise.Trial registrationThis study was registered at the Netherlands Trial Register [NTR2153] on the 5th of January 2010.

Predictors of adherence to exercise interventions during and after cancer treatment: A systematic review

“…After screening based on title and abstract, 30 papers were potentially eligible for inclusion. Fifteen of these papers met predefined eligibility criteria, of which the oldest paper was published in 2002 …”

“…In total, 2279 cancer patients were included in the 15 studies analyzed . Of these patients, 1383 were assigned to an exercise intervention and these patients had a mean age of 55.5 years.…”

Utility of Regular Management of Physical Activity and Physical Function in Hemodialysis Patients

“…On the other hand, some other studies regarding prevention, e.g., in the general sedentary population, [40] patients with cancer, [41,42] and cardiovascular disease patients, [43][44][45] used the proportion of exerciserelated program attendance as a predictor of outcome. In the present study, the median proportion of attendance at the management program was 75%, which was within the range reported in other studies [41,42,45] (Fig. 3).…”

The effects of exercise on the quality of life of patients with breast cancer (the UMBRELLA Fit study): study protocol for a randomized controlled trial

“…Hence, the study population is in general a selective group of younger or less fatigued patients with breast cancer or patients who had less comorbidity after treatment. In addition, higher-educated patients are more willing to participate in health behavior-change interventions [13,24]. Reasons for the selection may be that trial participation is (unconsciously) not offered to specific subgroups (although fitting the eligibility criteria), that these patients are not willing to participate in an RCT with a 50% chance to be randomized to control or that patients do not want to exercise.…”

“…Positive effects of physical activity on survival and recurrence have been found in observational research [11]. On the contrary, more sedentary behaviour is associated with higher fatigue levels [12], especially in patients with breast cancer with lower levels of physical activity [13,14]. Reported exercise effects on fatigue and QoL are often small and this might be partly explained by shortcomings of the RCT design in evaluating exercise interventions that cannot be blinded [15].…”