Reporting of Resistance Training Dose, Adherence, and Tolerance in Exercise Oncology

Abstract

Purpose While general guidelines (such as CONSORT or Consensus on Exercise Reporting Template) exist to enhance the reporting of exercise interventions in the field of exercise science, there is inadequate detail facilitating the standardized reporting of resistance training adherence in the oncology setting. The purpose of this study was to apply a novel method to report resistance training dose, adherence, and tolerance in patients with cancer. Methods A total of 47 prostate cancer patients (70.1 ± 8.9 yr, body mass index, 28.6 ± 4.0) with bone metastatic disease completed an exercise program for 12 wk. We assessed traditional metrics of adherence (attendance and loss to follow-up), in addition to novel proposed metrics (exercise-relative dose intensity, dose modification, and exercise interruption). Total training volume in kilograms (repetitions × sets × training load (weight)) was calculated for each patient. Results Attendance assessed from traditional metrics was 79.5% ± 17.0% and four patients (9%) were lost to follow-up. The prescribed and actual cumulative total dose of resistance training was 139,886 ± 69,150 kg and 112,835 ± 83,499 kg, respectively, with a mean exercise-relative dose intensity of 77.4% ± 16.6% (range: 19.4% –99.4%). Resistance training was missed (1–2 consecutive sessions) or interrupted (missed ≥3 consecutive sessions) in 41 (87%) and 24 (51%) participants, respectively. Training dose was modified (reduction in sets, repetitions, or weight) in 40 (85%) of patients. Importantly, using attendance as a traditional metric of adherence, these sessions would have all counted as adherence to the protocol. Conclusions Traditional reporting metrics of resistance training in exercise oncology may overestimate exercise adherence. Our proposed metrics to capture resistance training dose, adherence, and tolerance may have important applications for future studies and clinical practice.

Exercise Adherence and Effect of Self-Regulatory Behavior Change Techniques in Patients Undergoing Curative Cancer Treatment: Secondary Analysis from the Phys-Can Randomized Controlled Trial

“…Studies usually only include participants who did not complete follow-up assessments. 34 , 37 , 41 - 43 However, we believe that including participants who permanently discontinued exercise gives a more accurate picture of the feasibility of such exercise programs during curative treatment, 23 which is valuable information for future interventions.…”

“…Clinical and demographic information was gathered from medical records and study-specific forms. Exercise adherence, defined as the extent to which the participants followed the exercise prescription according to the intervention protocol, 22 , 23 was assessed based on the FITT-principles and dropout rates. Overall adherence (i.e.…”

“…perform exercise according to the intervention protocol). 22 , 23 A detailed description of adherence should include reports of adherence to frequency, intensity, time and type of exercise (FITT-principles). 24 Other metrics such as dropout rates should also be included to provide insight into the efficacy and feasibility of exercise interventions.…”

“… 24 Other metrics such as dropout rates should also be included to provide insight into the efficacy and feasibility of exercise interventions. 23 …”

Rehabilitation strategies following oesophagogastric and Hepatopancreaticobiliary cancer (ReStOre II): a protocol for a randomized controlled trial

“…Adherence to the home-based exercise sessions will be monitored using Polar Heart Rate monitors and an exercise log. Adherence and compliance to resistance exercise component will be calculated using previously reported metrics [28]. Specifically, we will track what was initially prescribed, vs. what was actually achieved for each participant.…”