Cardiac Rehabilitation Programs for Cancer Survivors: a Scoping Review

Cuthbertson, Carmen C.; Pearce, Emily; Valle, Carmina G.; Evenson, Kelly R.

doi:10.1007/s40471-020-00235-4

Cited by 11 publications

(17 citation statements)

References 35 publications

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“…is rate is similar to an average completion rate of 60% for the general CR population [38]. e findings are also consistent with completion rates in other studies of cardiac rehabilitation in cancer survivors and are much higher than that reported in a prospective study of breast cancer survivors using a community CR program who had an adherence rate of 30% [39].…”

Section: Discussionsupporting

confidence: 88%

A Cardiac Rehabilitation Program for Breast Cancer Survivors: A Feasibility Study

Zvinovski

Ramaswamy

Reinbolt

et al. 2021

Journal of Oncology

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Purpose. The purpose of this study was to determine the feasibility and preliminary efficacy of a cardiac rehabilitation (CR) intervention in the breast cancer population. Methods. This single-arm feasibility study evaluated a 14-week CR intervention program in breast cancer survivors. Feasibility was defined as completion of at least 30/36 sessions of the program without serious adverse events (SAE) in 80% of patients. Secondary endpoints included the change in VO2 max, cardiovascular disease (CVD) risk factors, Duke Activity Secondary Index (DASI), Brief Fatigue Inventory (BFI), and QLQ-C30. All outcomes were reported as mean change and compared using paired t-tests. Results. A total of 25 patients were enrolled in the study. 18 patients of the 25 enrolled (72%) completed the 14 weeks program without SAE. The overall adherence to the study protocol was 60%. Of the 18 participants who did not withdraw from the program, 15 (83%) adhered to the study protocol and completed 30 or more sessions. There was a nonsignificant improvement in VO2 max (mean Δ0.5, p = 0.6 ). The scores for DASI, BFI, and QLQ-C30 improved from baseline to posttreatment. Conclusion. A CR intervention in breast cancer survivors had high adherence in those who were able to complete the 14-week program. The program significantly improved patient reported physical activity, fatigue, and quality of life (QoL), without significant improvement in CVD risk factors. Implications for cancer patients are that early implementation of a CR program should be considered by practitioners as it improves QoL and exercise tolerance in breast cancer survivors.

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Section: Discussionsupporting

confidence: 88%

A Cardiac Rehabilitation Program for Breast Cancer Survivors: A Feasibility Study

Zvinovski

Ramaswamy

Reinbolt

et al. 2021

Journal of Oncology

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“…Indeed, in trials where participants are allocated to a control group, with no intervention besides usual care, more dropouts could be present, in uencing completion rate. As such, our results in these feasibility outcomes are higher than those reported in other trials, which might be related to study design (namely the presence of an ET intervention in both groups) [21,22,29,32].…”

Section: Discussioncontrasting

confidence: 88%

“…While over the last year's different studies have highlighted the possible bene ts of these programs, the overall effects of a center-based cardiac rehabilitation program (CBCR) have not been fully ascertained [21,22]. Moreover, there is still a need for more data on the feasibility, acceptability, and safety of this approach in speci c subgroups of cancer survivors and in different settings.…”

Section: Introductionmentioning

confidence: 99%

Adherence, safety and satisfaction of a cardio-oncology rehabilitation program framework versus community exercise training for cancer survivors: findings from the CORE trial

Viamonte

Joaquim²,

Alves

et al. 2022

Preprint

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Purpose To assess safety, satisfaction and overall adherence of a cardiac rehabilitation (CR) based framework for cancer patients at increased cardiovascular (CV) risk, compared to a community-based exercise training (CBET) Methods The CORE study (NCT05132998) was a single-center, prospective, randomized controlled trial enrolling cancer survivors exposed to cardiotoxic cancer treatment and/or with previous CV disease. Participants were randomized to an eight-week center-based CR program (CBCR) or CBET, twice a week. Overall feasibility (consent, retention, and completion rates) as well as intervention adherence (percentage of exercise session attended) and safety were assessed. Adverse events (AEs) were registered, and patients’ satisfaction was measured at the end of the study through a 5-item questionnaire. Results Eighty patients were included. The consent rate was 72.4%, and 77 (96.2%) patients started the study (retention rate 100% in CBCR vs 92.5% in CBET). The completion rate was 92.5%. Intervention adherence was higher in CBCR (90.3 ± 11.8% vs 68.4 ± 22.1%, p < 0.001). Exercise-related AEs were mainly musculoskeletal, accounting for exercise prescription modification in 47 sessions, none of them motivating exercise discontinuation. Major CV events were not reported. Patients revealed higher satisfaction in the CBCR (86.8% reported being very satisfied with the program vs 45.9% in CBET, p < 0.001). Conclusion The CORE trial suggests that both exercise-based interventions are feasible and safe in this setting. The higher intervention adherence and patient satisfaction in the CBCR group suggests that this comprehensive approach could be of interest in this patient population.

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“…A scoping review of 9 CR-based studies that included data on 662 cancer survivors reported that participation in CR was associated with favorable effects on multiple health and psychosocial outcomes. 12 Similarly, a recent meta-analysis of 33 studies assessing the impact of both cardiac and pulmonary rehabilitation programs in cancer survivors reported the interventions caused significant and clinically meaningful improvements in CRF, 6-minute walk distance, and quality of life. 13 The magnitude of improvement in V o 2peak -defined CRF (2.58 mL O 2 /kg/min) shown here was similar to that reported by the aforementioned meta-analysis (2.9 mL O 2 /kg/min).…”

Section: Discussionmentioning

confidence: 99%

“…Two prior reviews have described the practical elements (eg, intervention components) of CR-based research in oncology. 12 , 13 However, the reported associations 12 and causal impact 13 of the tested interventions on the evaluated outcomes were either minimally 12 or not 13 discussed in the context of the quality of the evidence (eg, high attrition rates and the majority were single-arm and nonrandomized studies), which has potentially led to biased interpretations of the safety, tolerability, and benefits of CR-based interventions for cancer survivors. 14 …”

mentioning

confidence: 99%