'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': A feasibility study PEACH Trial: Prescribed exercise after chemotherapy

Walsh, Julie; Hussey, Juliette; Guinan, Emer; Donnell, Dearbhaile O'

doi:10.1186/1471-2407-10-42

Cited by 10 publications

(3 citation statements)

References 46 publications

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“…The planned RCTs included three with combined supervised and home-based exercise [24–26], three trials in a rehabilitation setting (described in one publication) [27], and one study each in the health care [28], community fitness [29], and clinical research [30] settings. Aerobic fitness and physical activity levels (e.g., exercise minutes or step counts) were the most common primary outcomes in the planned RCTs (Fig.…”

Section: Resultsmentioning

confidence: 99%

Searching for maintenance in exercise interventions for cancer survivors

et al. 2014

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Purpose Translating evidence-based exercise interventions into practice is important for expanding the capacity to support cancer survivors. Using the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework and scoping study methodology, we addressed the research question, “What is known about the maintenance of exercise interventions for cancer survivors that would inform translation from research to practice and community settings?” Maintenance was investigated at the individual and setting level. Methods Literature searches were performed in the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Sport Discus databases for articles published from January 2009 to June 2012. Abstracts were judged using a priori criteria for the survivor population, exercise intervention, and maintenance on the individual or setting level. We included completed and planned randomized controlled trials (RCTs) and other study designs. Publications meeting the criteria were reviewed and coded. Results Of the 211 abstracts meeting patient and exercise criteria, 24 (19 RCTs) met the maintenance criteria. Nine of the 12 completed RCTs demonstrated maintenance of intervention outcomes after 3 to 14 months of follow-up. The planned RCTs described interventions lasting 2 to 4.5 months and maintenance intervals lasting 3 to 12 months following the active intervention. Maintenance at the setting level was reported in one publication. Conclusions On the individual level, intervention outcomes were maintained in most studies, in a variety of settings and survivor subpopulations. Maintenance on the setting level was scarcely addressed. This scoping study suggests several strategies that could be taken by agencies, clinicians, and researchers to develop more effective and sustainable exercise programs for cancer survivors. Implications for Cancer Survivors Many benefits of exercise training are maintained for months after cancer survivors complete controlled research studies but relatively little is known about how to translate research to sustainable community-based exercise programs. A better understanding of how programs can be sustained in practice beyond short-term research or grant funding is needed to support a growing number of survivors.

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Section: Resultsmentioning

confidence: 99%

Searching for maintenance in exercise interventions for cancer survivors

et al. 2014

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“…In this review, assessments included only exercise logs and class attendance (Bourke et al, 2011; Bourke et al, 2014). Alternative methods of measuring adherence such as heart rate monitors and mobile phone apps have been used previously in trials involving cancer patients (Walsh et al, 2010) and may have a role in adherence monitoring in future exercise trials to ensure patients follow the parameters of prescribed exercise sessions correctly.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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PurposePatients with advanced cancer can experience debilitating physical symptoms, making participation in exercise programs difficult. This systematic review investigated the recruitment, adherence, and attrition rates of patients with advanced cancer participating in exercise interventions and examined components of exercise programs that may affect these rates.MethodsRelevant studies were identified in a systematic search of CINAHL, PubMed, PsycINFO, and EMBASE to December 2017. Two quality assessment tools were used, and levels of evidence were assigned according to the Oxford Centre for Evidence-Based Medicine (CEBM) guidelines.ResultsThe search identified 18 studies published between 2004 and 2017. Recruitment, adherence, and attrition rates varied widely among the studies reviewed. The mean recruitment rate was 49% (standard deviation [SD] = 17; range 15–74%). Patient-reported barriers to recruitment included time constraints and difficulties in traveling to exercise centers. Levels of adherence ranged from 44% to 95%; however, the definition of adherence varied substantially among trials. The average attrition rate was 24% (SD = 8; range 10–42%), with progression of disease status reported as the main cause for dropout during exercise interventions.Significance of resultsConcentrated efforts are needed to increase the numbers of patients with advanced disease recruited to exercise programs. Broadening the eligibility criteria for exercise interventions may improve accrual numbers of patients with advanced cancer to exercise trials and ensure patients recruited are representative of clinical practice.

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“…15,16 Interestingly, results from a pilot study by our research group demonstrated a decrease in waist circumference (WC) (P,0.05) in a group of breast cancer survivors 2-6 months post-chemotherapy who adhered to .90% of a prescribed supervised and home-based moderate intensity aerobic exercise protocol. 17,18 The decrease in WC occurred in the absence of significant change in other anthropometric measures. While there were no accompanying changes in measures of insulin resistance or inflammatory markers, these results provide a meaningful target for designing a larger study and suggest that rigorous adherence to an appropriate aerobic intervention over a short period of time may decrease WC.…”

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confidence: 95%

Response to commentary on: ‘Exercise training in breast cancer survivors: a review of trials examining anthropometric and obesity-related biomarkers of breast cancer risk’

Guinan

Connolly

Hussey

2013

Physical Therapy Reviews

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The authors would like to thank Campbell and Neil for their commentary 1 on a recently published review by Guinan, Connolly and Hussey 2 which explores the effect of exercise training in breast cancer survivors on anthropometric and obesity-related biomakers of breast cancer risk outcomes. We welcome discussion on this topic which, due to the increasing number of breast cancer survivors, is becoming a public health issue that needs to be addressed by physical therapists with proficient skills in prescribing exercise in clinical populations. Of course, the issues addressed explore the impact of physical activity on many diseases where obesity and inactivity are risk factors, e.g. cardiovascular disease. Breast cancer survivors however, characterize a unique group for whom physical activity may impact on not only chronic disease risk factors but also breast cancer-specific outcomes including risk of recurrence and mortality. Data from our research group have described breast cancer survivors, in the first number of years following adjuvant treatment, as largely overweight or obese and/or centrally obese and physical inactive, 3,4 which led to the need to implement exercise interventions in addition to healthy weight strategies early in the cancer trajectory.Campbell and Neil correctly point out that exercise alone, in the absence of diet modification, is not sufficient to produce meaningful, long-lasting weight loss. The end-points examined in the review by Guinan et al. 2 were termed 'obesity-related biomakers' and were therefore inherently related to adiposity. Campbell and Neil discuss the results of a recent four-arm randomized control trial by Foster-Schubert and colleagues, 5 comparing the effect of four different interventions: (i) aerobic exercise; (ii) weight loss (calorie restriction); (iii) exercise and weight loss (calorie restriction); and (iv) usual care control group on selected biomarkers. The results of this trial are similar to others 6-8 in suggesting that the benefits to be gained from exercise combined with weight loss through calorie restriction are superior to those stimulated by either exercise or diet modification alone.In relation to breast cancer, both physical activity and maintenance of a healthy body weight are associated with improved survival and breast cancerrelated outcomes. 9,10

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'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': A feasibility study PEACH Trial: Prescribed exercise after chemotherapy

Cited by 10 publications

References 46 publications

Searching for maintenance in exercise interventions for cancer survivors

Searching for maintenance in exercise interventions for cancer survivors

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

Response to commentary on: ‘Exercise training in breast cancer survivors: a review of trials examining anthropometric and obesity-related biomarkers of breast cancer risk’

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