Translating 2019 ACSM Cancer Exercise Recommendations for a Physiatric Practice: Derived Recommendations from an International Expert Panel

Abstract

In 2018, the American College of Sports Medicine (ACSM) reconvened an international, multi‐disciplinary group of professionals to review pertinent published literature on exercise for people with cancer. The 2018 roundtable resulted in the publication of three articles in 2019. The three articles serve as an important update to the original ACSM Roundtable on Cancer, which convened in 2010. Although the focus of the three 2019 articles is on exercise, which is only one part of comprehensive cancer rehabilitation, the evidence presented in the 2019 ACSM articles has direct implications for physiatrists and other rehabilitation professionals who care for people with cancer. As such, the narrative review presented here has two primary objectives. First, we summarize the evidence within the three ACSM articles and interpret it within a familiar rehabilitation framework, namely the Dietz model of Cancer Rehabilitation, in order to facilitate implementation broadly within rehabilitation practice. Second, via expert consensus, we have tabulated relevant exercise recommendations for specific cancer populations at different points in the cancer care continuum and translated them into text, tables, and figures for ease of reference. Notably, the authors of this article are members of the Cancer Rehabilitation Physician Consortium (CRPC), a group of physicians who subspecialize in cancer rehabilitation medicine (CRM).

Position statement regarding the current standing of exercise therapy in Austria (Positionspapier zur Situation der Trainingstherapie in Österreich)

“…Also in oncology, the importance of physical exercise as a rehabilitation and adjuvant therapy to chemotherapy is becoming increasingly important (Mayr et al, 2022;Stout et al, 2021;Westphal et al, 2018). Current position papers from Australia, the USA, and other countries confirm the importance and the increasing significance of physical exercise in the treatment, follow-up, and palliative care of these diseases (Hayes et al, 2019;Parke et al, 2022;Pollán et al, 2020).…”

Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project

“…Most exercise evidence, however, arises from people with early-stage cancer, often following adjuvant treatment, and far less relates to people with incurable cancer. [27][28][29] Low adherence 30 and high attrition are common in exercise studies for people with incurable disease. 31 The potential gains may be difficult to realise for people with incurable cancer or restricted to physical fitness.…”

The Development of a Multi-Modal Cancer Rehabilitation (including Prehabilitation) Service in Sheffield, UK: Designing the Active Together Service

“…Following the patient's acute clinical treatment, they enter the restorative rehabilitation phase of the Active Together pathway. The restorative phase aims to support the patient in achieving optimal function following acute treatment 49 . At the start of the restorative phase, the patient repeats their initial needs assessment.…”