From Cancer Rehabilitation to Recreation: A Coordinated Approach to Increasing Physical Activity

2020 ◽  
Vol 100 (11) ◽  
pp. 2049-2059 ◽  
Author(s):  
Amy M Dennett ◽  
Casey L Peiris ◽  
Nora Shields ◽  
Nicholas F Taylor
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Recurrence ◽  
Cancer Rehabilitation ◽  
Rehabilitation Services ◽  
Appropriate Care ◽  
Low Levels ◽  
Risk Of Cancer ◽  
Practical Implications

Abstract Participation in adequate physical activity improves the health status of cancer survivors, enhances their survival, and reduces their risk of cancer recurrence. However, cancer survivors engage in low levels of physical activity and have limited access to rehabilitation services that could increase their participation. No optimal framework has been developed that supports physical activity participation among cancer survivors. Given the growth in numbers of cancer survivors, development of a framework may provide a pathway to facilitate timely and appropriate care. This perspective paper describes the development of the Cancer Rehabilitation to Recreation (CaReR) Framework and its practical implications. The CaReR Framework uses a tailored, stepped approach to guide health services and clinicians on the design and implementation of interventions to promote physical activity among cancer survivors. Implementation of the CaReR Framework will improve continuity and quality of care for cancer survivors and promote physical activity with the ultimate aim of improving health outcomes.

scholarly journals Impact of a Tailored Nutrition and Lifestyle Intervention for Overweight Cancer Survivors on Dietary Patterns, Physical Activity, Quality of Life, and Cardiometabolic Profiles

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Colleen K. Spees ◽  
Ashlea C. Braun ◽  
Emily B. Hill ◽  
Elizabeth M. Grainger ◽  
James Portner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Dietary Patterns ◽  
Healthy Eating Index ◽  
Curative Therapy ◽  
Clinical Biomarkers ◽  
Biobehavioral Intervention ◽  
Risk Of Cancer

Survivors of cancer often experience treatment-related toxicity in addition to being at risk of cancer recurrence, second primary cancers, and greater all-cause mortality. The objective of this study was to test the safety and efficacy of an intensive evidence-based garden intervention to improve outcomes for cancer survivors after curative therapy. To do so, a clinical trial of adult overweight and obese cancer survivors within 2 years of completing curative therapy was completed. The 6-month intervention, delivered within the context of harvesting at an urban garden, combined group education with cooking demonstrations, remote motivational interviewing, and online digital resources. Data on dietary patterns, program satisfaction, and quality of life were collected via questionnaires; anthropometrics, physical activity, and clinical biomarkers were measured objectively. Of the 29 participants, 86% were white, 83% were female, and the mean age was 58 years. Compared to baseline, participants had significant improvements in Healthy Eating Index (HEI) scores (+5.2 points, p=0.006), physical activity (+1,208 steps, p=0.033), and quality of life (+16.07 points, p=0.004). Significant improvements were also documented in weight (−3.9 kg), waist circumference (−5.5 cm), BMI (−1.5 kg/m2), systolic BP (−9.5 mmHg), plasma carotenoids (+35%), total cholesterol (−6%), triglycerides (−14%), hs-CRP (−28%), and IGFBP-3 (−5%) (all p<0.010). These findings demonstrate a tailored multifaceted garden-based biobehavioral intervention for overweight and obese cancer survivors after curative therapy is safe and highly effective, warranting larger randomized controlled trials to identify program benefits, optimal maintenance strategies, program value relative to cost, and approaches for integration into a survivor’s oncology management program. This trial is registered on ClinicalTrials.gov NCT02268188.

scholarly journals Cancer Survivors’ Receptiveness to Digital Technology–Supported Physical Rehabilitation and the Implications for Design: Qualitative Study

10.2196/15335 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e15335
Author(s):  
Sine Rossen ◽  
Lars Kayser ◽  
Jette Vibe-Petersen ◽  
Jesper Frank Christensen ◽  
Mathias Ried-Larsen
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Cancer Survivors ◽  
Digital Technology ◽  
Service Providers ◽  
Cancer Rehabilitation ◽  
Rehabilitation Services ◽  
Or Efficiency ◽  
Technology Services ◽  
Readiness Level

Background Physical activity is associated with a positive prognosis in cancer survivors and may decrease the risk of adverse effects of treatment. Accordingly, physical activity programs are recommended as a part of cancer rehabilitation services. Digital technology may support cancer survivors in increasing their level of physical activity and increase the reach or efficiency of cancer rehabilitation services, yet it also comes with a range of challenges. Objective The aim of this qualitative study was to explore cancer survivors’ receptiveness to using digital technology as a mode of support to increase their physical activity in a municipality-based cancer rehabilitation setting. Methods Semistructured interviews were conducted with 11 cancer survivors (3 males, 8 females, age range 32-82 years) who were referred for cancer rehabilitation and had participated in a questionnaire survey using the Readiness and Enablement Index for Health Technology (READHY) questionnaire. Data analysis was based on the content analysis method. Results Two themes were identified as important for the interviewees’ receptiveness to using digital technology services in connection with their physical activity during rehabilitation: their attitude toward physical activity and their attitude toward digital technology–assisted physical activity. Our results indicated that it is important to address the cancer survivors’ motivation for using technology for physical activity and their individual preferences in terms of the following: (1) incidental or structured (eg, cardiovascular and strength exercises or disease-specific rehabilitative exercises) physical activity; (2) social or individual context; and (3) instruction (know-how) or information (know-why). Conclusions The identified preferences provide new insight that complements the cancer survivors’ readiness level and can likely help designers, service providers, and caregivers provide solutions that increase patient receptiveness toward technology-assisted physical activity. Combining digital technology informed by cancer survivors’ needs, preferences, and readiness with the capacity building of the workforce can aid in tailoring digital solutions to suit not only individuals who are receptive to using such technologies but also those reluctant to do so.

Cancer Survivors’ Receptiveness to Digital Technology–Supported Physical Rehabilitation and the Implications for Design: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Sine Rossen ◽  
Lars Kayser ◽  
Jette Vibe-Petersen ◽  
Jesper Frank Christensen ◽  
Mathias Ried-Larsen
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Cancer Survivors ◽  
Digital Technology ◽  
Service Providers ◽  
Cancer Rehabilitation ◽  
Rehabilitation Services ◽  
Or Efficiency ◽  
Technology Services ◽  
Readiness Level

BACKGROUND Physical activity is associated with a positive prognosis in cancer survivors and may decrease the risk of adverse effects of treatment. Accordingly, physical activity programs are recommended as a part of cancer rehabilitation services. Digital technology may support cancer survivors in increasing their level of physical activity and increase the reach or efficiency of cancer rehabilitation services, yet it also comes with a range of challenges. OBJECTIVE The aim of this qualitative study was to explore cancer survivors’ receptiveness to using digital technology as a mode of support to increase their physical activity in a municipality-based cancer rehabilitation setting. METHODS Semistructured interviews were conducted with 11 cancer survivors (3 males, 8 females, age range 32-82 years) who were referred for cancer rehabilitation and had participated in a questionnaire survey using the Readiness and Enablement Index for Health Technology (READHY) questionnaire. Data analysis was based on the content analysis method. RESULTS Two themes were identified as important for the interviewees’ receptiveness to using digital technology services in connection with their physical activity during rehabilitation: their attitude toward physical activity and their attitude toward digital technology–assisted physical activity. Our results indicated that it is important to address the cancer survivors’ motivation for using technology for physical activity and their individual preferences in terms of the following: (1) incidental or structured (eg, cardiovascular and strength exercises or disease-specific rehabilitative exercises) physical activity; (2) social or individual context; and (3) instruction (know-how) or information (know-why). CONCLUSIONS The identified preferences provide new insight that complements the cancer survivors’ readiness level and can likely help designers, service providers, and caregivers provide solutions that increase patient receptiveness toward technology-assisted physical activity. Combining digital technology informed by cancer survivors’ needs, preferences, and readiness with the capacity building of the workforce can aid in tailoring digital solutions to suit not only individuals who are receptive to using such technologies but also those reluctant to do so.

scholarly journals Fee-for-service cancer rehabilitation programs improve health-related quality of life

2016 ◽  
Vol 23 (4) ◽  
pp. 233 ◽  
Author(s):  
A.A. Kirkham ◽  
S.E. Neil-Sztramko ◽  
J. Morgan ◽  
S. Hodson ◽  
S. Weller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Rehabilitation ◽  
Fee For Service ◽  
Health Related Quality ◽  
Rehabilitation Programs ◽  
Related Quality ◽  
Health Related

BackgroundRigorously applied exercise interventions undertaken in a research setting result in improved health related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates.Methods After enrolment and 17 } 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session.Results Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629).Conclusions Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for delivery of exercise to more cancer survivors.

scholarly journals Protocol of a randomized controlled trial of the fear of recurrence therapy (FORT) intervention for women with breast or gynecological cancer

2021 ◽  
Author(s):  
Christine Maheu ◽  
Sophie Lebel ◽  
Christine Courbasson ◽  
Monique Lefebvre ◽  
Mina Singh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Perceived Risk ◽  
Gynecological Cancer ◽  
Cancer Recurrence ◽  
Fear Of Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Control Group ◽  
Risk Of Cancer

Background Clinically significant levels of fear of cancer recurrence (FCR) affect up to 49 % of cancer survivors and are more prevalent among women. FCR is associated with psychological distress, lower quality of life, and increased use of medical resources. Despite its prevalence, FCR is poorly addressed in clinical care. To address this problem, we first developed, and pilot tested a 6-week, 2 h, Cognitive-existential group intervention therapy that targeted FCR in survivors of breast or gynecological cancer. Following the positive outcome of the pilot, we are now testing this approach in a randomized clinical trial (RCT). Goal and hypotheses: This multicenter, prospective RCT aims to test the efficacy of the intervention. The study hypotheses are that, compared to a control group, cancer survivors participating in the intervention (1) will have less FCR, (2) will show more favorable outcomes on the following measures: cancer-specific distress, quality of life, illness uncertainty, intolerance of uncertainty, perceived risk of cancer recurrence, and coping skills. We further postulate that the between-group differences will persist three and 6 months post-intervention. Methods Sixteen groups of seven to nine women are being allocated to the intervention or the control group. The control group receives a 6-week, 2 h, structurally equivalent support group. We are recruiting 144 cancer survivors from four hospital sites in three Canadian cities. The sample size was based on the moderate pre/post-test changes found in our pilot study and adjusted to the drop-out rates. Measurements: The primary outcome, FCR, is measured by the Fear of Cancer Recurrence Inventory. Secondary outcomes measured include cancer-specific distress, perceived risk of cancer recurrence, illness uncertainty, intolerance of uncertainty, coping, and quality of life. We use reliable and recognized valid scales. Participants are to complete the questionnaire package at four times: before the first group session (baseline), immediately after the sixth session, and 3 and 6 months post-intervention. Analysis: In the descriptive analysis, comparison of group equivalent baseline variables, identification of confounding/intermediate variables and univariate analysis are planned. Each participant’s trajectory is calculated using Generalized Estimating Equation models to determine the time and group effects, after considering the correlation structures of the groups. An intent-to-treat analysis approach may be adopted. Discussion Our Fear of Recurrence Therapy (FORT) intervention has direct implications for clinical service development to improve the quality of life for patients with breast (BC) and gynecological cancer (GC). Based on our pilot data, we are confident that the FORT intervention can guide the development of effective psychosocial cancer survivorship interventions to reduce FCR and improve psychological functioning among women with BC or GC.

scholarly journals The Feasibility of Hospital-based Exercise Program on the Level of Physical Activity and Body Composition in Cancer Survivor: An Exploratory Feasibility Study

2020 ◽  
Vol 29 (2) ◽  
pp. 195-200
Author(s):  
Mi Kyung Lee ◽  
Ji Yong Byeon ◽  
Jae Youn Chung ◽  
Justin Y. Jeon
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Exercise Program ◽  
Cancer Recurrence ◽  
Risk Of Cancer ◽  
Counselling Program

PURPOSE: Although physical activity may reduce the risk of cancer recurrence and risk of mortality in cancer patients, majority of cancer survivors are still remained physically inactive. Since most of cancer patients visit their oncologists on a regular basis, it would be ideal to provide exercise counselling program along with their hospital visit. However, the feasibility of hospital based exercise counselling program has not been tested. Therefore, the purpose of this exploratory study was to evaluate the feasibility of hospital-based exercise counselling program on the level of physical activity and body composition in cancer survivors.METHODS: Among 118 cancer survivors underwent exercise counselling program at the cancer prevention center of university affiliated hospital, 47 cancer survivors (mean age, 51.8 years) revisited after an 8-week. At baseline and after 8 weeks, the level of physical activity and body composition were measured.RESULTS: Compared to their baseline value, we observed significant increase in walking (baseline vs. 8 weeks: 170.7±197.8 vs. 362.2±343.4 minutes/week, <i>p</i><.05) and frequency of resistance exercise (baseline vs. 8 weeks: 0.21±1.2 vs. 2.5±2.5 day/week, <i>p</i><.05). Percent body fat was decreased (baseline vs. 8 weeks: 30.3±9.6 vs. 29.7±9.5%, <i>p</i>=.025) and skeletal muscle mass was increased at the 8th week follow up visit compared to their baseline value (baseline vs. 8 weeks: 22.9±3.7 vs. 23.2±3.8 kg, <i>p</i>=.019).CONCLUSIONS: The hospital-based exercise program was feasible intervention to increase the level of physical activity and improve body composition in cancer survivors. Considering that the current study is not a randomized controlled trial and also small portion of cancer survivors returned to the follow up test, the efficacy of this exercise counselling program should be tested with proper study design.

scholarly journals A randomized trial of a clinic-based weight loss intervention in cancer survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 167-167
Author(s):  
Rachel Lynn Yung ◽  
Anita Giobbie-Hurder ◽  
Laura Shockro ◽  
Keelin O'Connor ◽  
Nancy Campbell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Cancer Survivors ◽  
Physical Functioning ◽  
Intervention Group ◽  
Cancer Recurrence ◽  
Weight Loss Intervention ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
The Impact

167 Background: Evidence increasingly links obesity to increased risk of cancer recurrence and mortality in breast and other cancers, but few studies have evaluated weight loss interventions in cancer patients. We evaluated the impact of a group-based weight loss intervention implemented through an oncology clinic on weight and other outcomes in a mixed population of cancer survivors. Methods: Overweight and obese cancer survivors were randomized 1:1 to immediate or delayed participation in a 15-week group-based weight loss program focused on calorie restriction and increased physical activity. Weight, body composition, physical activity, fitness and quality of life were assessed at baseline and 15 weeks. Changes in measurements between baseline and 15 weeks were compared using Wilcoxon rank sum tests. The primary outcome was change in weight between baseline and 15 weeks between groups. Results: 60 participants were randomized; 30 to intervention and 30 to control. Median age was 52, average BMI was 31.8 kg/m2, 97% of participants were women, and 80% had breast cancer. Intervention participants lost 5.3% of baseline weight at 15 weeks vs 0.2% weight gain in controls (P < 0.001) (Table). Improvements in fitness (6-minute walk test) and physical functioning (EORTC QLQ C30) were also observed in the intervention group vs. controls. Conclusions: We found thatparticipation in a 15-week group-based intervention resulted in weight loss and improvements in fitness and physical functioning in overweight and obese cancer survivors. More work is needed to evaluate the feasibility and sustainability of weight loss programs implemented through oncology practices. Clinical trial information: NCT01978899. [Table: see text]

scholarly journals Protocol of a randomized controlled trial of the fear of recurrence therapy (FORT) intervention for women with breast or gynecological cancer

2021 ◽  
Author(s):  
Christine Maheu ◽  
Sophie Lebel ◽  
Christine Courbasson ◽  
Monique Lefebvre ◽  
Mina Singh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Perceived Risk ◽  
Gynecological Cancer ◽  
Cancer Recurrence ◽  
Fear Of Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Control Group ◽  
Risk Of Cancer

Background Clinically significant levels of fear of cancer recurrence (FCR) affect up to 49 % of cancer survivors and are more prevalent among women. FCR is associated with psychological distress, lower quality of life, and increased use of medical resources. Despite its prevalence, FCR is poorly addressed in clinical care. To address this problem, we first developed, and pilot tested a 6-week, 2 h, Cognitive-existential group intervention therapy that targeted FCR in survivors of breast or gynecological cancer. Following the positive outcome of the pilot, we are now testing this approach in a randomized clinical trial (RCT). Goal and hypotheses: This multicenter, prospective RCT aims to test the efficacy of the intervention. The study hypotheses are that, compared to a control group, cancer survivors participating in the intervention (1) will have less FCR, (2) will show more favorable outcomes on the following measures: cancer-specific distress, quality of life, illness uncertainty, intolerance of uncertainty, perceived risk of cancer recurrence, and coping skills. We further postulate that the between-group differences will persist three and 6 months post-intervention. Methods Sixteen groups of seven to nine women are being allocated to the intervention or the control group. The control group receives a 6-week, 2 h, structurally equivalent support group. We are recruiting 144 cancer survivors from four hospital sites in three Canadian cities. The sample size was based on the moderate pre/post-test changes found in our pilot study and adjusted to the drop-out rates. Measurements: The primary outcome, FCR, is measured by the Fear of Cancer Recurrence Inventory. Secondary outcomes measured include cancer-specific distress, perceived risk of cancer recurrence, illness uncertainty, intolerance of uncertainty, coping, and quality of life. We use reliable and recognized valid scales. Participants are to complete the questionnaire package at four times: before the first group session (baseline), immediately after the sixth session, and 3 and 6 months post-intervention. Analysis: In the descriptive analysis, comparison of group equivalent baseline variables, identification of confounding/intermediate variables and univariate analysis are planned. Each participant’s trajectory is calculated using Generalized Estimating Equation models to determine the time and group effects, after considering the correlation structures of the groups. An intent-to-treat analysis approach may be adopted. Discussion Our Fear of Recurrence Therapy (FORT) intervention has direct implications for clinical service development to improve the quality of life for patients with breast (BC) and gynecological cancer (GC). Based on our pilot data, we are confident that the FORT intervention can guide the development of effective psychosocial cancer survivorship interventions to reduce FCR and improve psychological functioning among women with BC or GC.

scholarly journals The Feasibility of Hospital-based Exercise Program on the Level of Physical Activity and Body Composition in Cancer Survivor: An Exploratory Feasibility Study

2020 ◽  
Vol 29 (2) ◽  
pp. 195-200
Author(s):  
Mi Kyung Lee ◽  
Ji Yong Byeon ◽  
Jae Youn Chung ◽  
Justin Y. Jeon
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Exercise Program ◽  
Cancer Recurrence ◽  
Risk Of Cancer ◽  
Counselling Program

PURPOSE: Although physical activity may reduce the risk of cancer recurrence and risk of mortality in cancer patients, majority of cancer survivors are still remained physically inactive. Since most of cancer patients visit their oncologists on a regular basis, it would be ideal to provide exercise counselling program along with their hospital visit. However, the feasibility of hospital based exercise counselling program has not been tested. Therefore, the purpose of this exploratory study was to evaluate the feasibility of hospital-based exercise counselling program on the level of physical activity and body composition in cancer survivors.METHODS: Among 118 cancer survivors underwent exercise counselling program at the cancer prevention center of university affiliated hospital, 47 cancer survivors (mean age, 51.8 years) revisited after an 8-week. At baseline and after 8 weeks, the level of physical activity and body composition were measured.RESULTS: Compared to their baseline value, we observed significant increase in walking (baseline vs. 8 weeks: 170.7±197.8 vs. 362.2±343.4 minutes/week, <i>p</i><.05) and frequency of resistance exercise (baseline vs. 8 weeks: 0.21±1.2 vs. 2.5±2.5 day/week, <i>p</i><.05). Percent body fat was decreased (baseline vs. 8 weeks: 30.3±9.6 vs. 29.7±9.5%, <i>p</i>=.025) and skeletal muscle mass was increased at the 8th week follow up visit compared to their baseline value (baseline vs. 8 weeks: 22.9±3.7 vs. 23.2±3.8 kg, <i>p</i>=.019).CONCLUSIONS: The hospital-based exercise program was feasible intervention to increase the level of physical activity and improve body composition in cancer survivors. Considering that the current study is not a randomized controlled trial and also small portion of cancer survivors returned to the follow up test, the efficacy of this exercise counselling program should be tested with proper study design.

Associations between physical activity and quality of life in ovarian cancer survivors

2007 ◽  
Vol 106 (1) ◽  
pp. 244-250 ◽  
Author(s):  
Clare Stevinson ◽  
Wylam Faught ◽  
Helen Steed ◽  
Katia Tonkin ◽  
Aliya B. Ladha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Ovarian Cancer ◽  
Cancer Survivors
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