The Phys-Can study: meaningful and challenging - supervising physical exercise in a community-based setting for persons undergoing curative oncological treatment

Abstract

Introduction: Supervised exercise may improve physical function and quality of life during oncological treatment. Providing supervised exercise to all patients at hospitals may be impractical, with community-based settings (e.g. public gyms) as a possible alternative. To facilitate implementation, knowledge about the experiences of professionals who deliver exercise programs in community-based settings is crucial. Objective: To explore how physical therapists and personal trainers experience supervising exercise in a community-based setting for persons undergoing curative oncological treatment. Methods: Nine physical therapists and two personal trainers (coaches) were interviewed individually. The semi-structured interviews lasted 33-67 minutes and were analyzed using thematic analysis. Results: Two main themes emerged: "A meaningful task" and "A challenging task," with nine sub-themes. The coaches experienced supervising exercise for persons undergoing treatment as meaningful, as they became a link between oncology care and health promotion. They grew more confident in the role and ascertained that exercising during treatment was feasible. Challenges included managing side effects of treatment and contradictory information from oncology care staff at hospitals, advising patients not to exercise. Conclusion: Supervising exercise for persons undergoing oncological treatment in a communitybased setting may be highly rewarding for professionals who deliver exercise programs, which is promising for implementation. However, patients receive contradictory information about exercise, which may prevent physical activity. Also, supervising exercise for persons undergoing oncological treatment requires skills training; this is suggested for inclusion in educational programs for physical therapists and others. Future research should focus on strategies for cooperation between oncology care and health promotion.

Translating Evidence from Dutch Exercise Oncology Trials in Patients with Breast Cancer into Clinical Practice Using the RE-AIM Framework

“…More variation in exercises has also been suggested by other studies, in order to prevent boredom, better tailor exercises to patients' preferences, needs (e.g., functional training), or capabilities, and to add exercise types other than resistance or aerobic exercises, such as balance exercises [65,71]. In addition, physical therapists and personal trainers have reported that guidance of a group of patients can be challenging (e.g., dealing with diferent types of group dynamics; providing sufcient attention to individual patients' abilities and needs) [72,73]. Tis indicates the importance of qualifed trainers and preferably small group sizes although the latter needs to be balanced with afordability.…”