Exercise facilitators and barriers following participation in a community-based exercise and education program for cancer survivors

Abstract

Cancer survivors participating in supervised exercise programs learn to exercise safely with oversight from care providers who monitor and facilitate their progress. This study investigated the long-term exercise participation levels and identified exercise barriers for graduates from a specialized cancer exercise and education program. Subjects were graduates from a 12-week supervised exercise program (www.canwellprogram.ca) who participated in a, prospective, long-term evaluation. Measures included: six-minute walk test (6-MWT), STEEP treadmill test, Functional Assessment Cancer Therapy-General (FACT-G), Edmonton Symptom Assessment System (ESAS), Godin Leisure-Time Exercise Questionnaire, and exercise barriers survey. Analysis was performed using the paired t -test. Fifty-seven (55% of eligible cohort) CanWell participants (mean age= 60; 74% females) were included in this study. Post program changes included statistically significant reductions in total min on the treadmill and a trend towards improvements in 6-MWT distance. No significant changes were recorded in total FACT-G or ESAS score, however functional well-being approached statistical significant improvements. The most commonly reported exercise barriers included fatigue, cost, and return to work. While most participants (86%) believed they were able to exercise, only 63% reported being able to progress their exercise. These finding demonstrated that although CanWell graduates have substantial support from exercise specialists and most have early success with exercise, environment-related factors diminish long-term independent adherence to exercise. Providing cancer survivors with the skills needed to monitor and progress their exercise routines, or access to “tune-ups” may increase exercise adherence and maximize benefits.

Effects of the community-based Wellspring Cancer Exercise Program on functional and psychosocial outcomes in cancer survivors

“…Accordingly, public exercise programs for people with cancer are becoming increasingly prevalent, and their effects are becoming more accessible in the academic literature 10,11,15,37 . In the present study, we describe the effects of the wcep, a 30-week community-based exercise program for cancer survivors in southern Ontario.…”

“…Finally, it is worth noting that although the home is a preferred exercise location for cancer survivors 15 , conducting appropriate assessments or providing instructions, demonstrations, and information about safety considerations and behaviour change techniques at each participant's home is often neither pragmatic nor feasible. Such services are therefore likely best delivered in a supervised setting, where cancer-exercise specialists gradually taper supervision to emphasize independent exercise.…”

“…CanWell has demonstrated significant improvements in participant aerobic and functional fitness and in self-reported quality of life 16 . An analysis of CanWell participants approximately 2.5 years after their program discharge found that, although most were likely to continue to exercise in the subsequent 12 months, only 47% reported that they no longer needed supervision 15 . To optimize long-term exercise independence for cancer survivors, it could be that a more subtle transition to independent exercise through tapering of intervention contact hours might facilitate self-efficacy for independent exercise and appropriate progression.…”

Navigating physical activity engagement following a diagnosis of cancer: A qualitative exploration

“…This situation has led to an increased focus on research aiming to understand the complexities of physical activity engagement for cancer survivors (Courneya, Rogers, Campbell, Vallance & Friedenreich, 2015). To date these have tended to: focus primarily on testing the validity of existing models of behaviour change (Pinto & Ciccolo, 2011;Stacey, James, Chapman, Courneya & Lubans, 2015); be mostly focused on breast, prostate or colorectal cancer (Blaney, Lowe-Strong, Rankin-Watt, Campbell & Gracey, 2013;Brawley, Culos-Reed, Angove & Hoffman-Goetz, 2002;Craike, Livingston & Botti, 2010;Gonçalves et al, 2014;Hefferon, Murphy, McLeod, Mutrie & Campbell, 2013;Keogh, Patel, MacLeod & Masters, 2014;Speck et al, 2010); and be largely limited to quantitative research approaches seeking to identify determinants for physical activity (Blaney et al, 2013;Cheifetz, Dorsay & MacDermid, 2015;Hawkes, Patrao, Baade, Lynch & Courneya, 2015;Ottenbacher et al, 2011;Pinto & Ciccolo, 2011;Szymlek-Gay, Richards & Egan, 2011).…”

REMEDY: Remote exercise monitoring using an evaluative data sensing system for cancer

“…Top exercise barriers among breast and prostate cancer survivors include lack of time, no willpower, and bad weather [16]. Other common exercise barriers among cancer survivors include fatigue, cost, return to work, pain, cancer and treatment-related effects, body image issues, lack of exercise knowledge, exercise safety, lack of programs, and lack of priority [17].…”