Abstract
Purpose
Based on randomized controlled trials, exercise is an efficacious strategy to improve quality of life (QOL) among cancer survivors. However, the effectiveness of exercise programs to improve QOL in real-world settings is unknown, as are factors related to external validity. This hinders dissemination and scalability. This sco** review synthesized published research on community-based exercise programs for cancer survivors and reported on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM).
Methods
A systematic literature search identified community-based exercise programs for adult cancer survivors (1980–March 2018), that met the following inclusion criteria: at least one face-to-face exercise session, the primary aim of program evaluation (i.e., feasibility/effectiveness), and pre/post measure of QOL. Data were coded using the RE-AIM framework. The effect size was calculated for overall QOL.
Results
Electronic database search yielded 553 articles; 31 studies describing unique programs were included for review. All studies described at least one element of implementation and most (80.6%) reported a significant (p < .05) improvement in at least one subscale, or total QOL. Few studies reported on indicators of reach (16.1%), adoption (6.5%), individual (16.1%), or system-level maintenance (32.3%).
Conclusions
Community-based exercise programs are effective for improving QOL in adult cancer survivors. Recommendations are provided to improve reporting across RE-AIM dimensions, which is an important step to enhance the scalability of programs and thus, the potential for exercise to be fully integrated into system-level standard care for cancer survivors.
Implications for Cancer survivors
Community-based exercise programs are a resource to improve QOL for adult cancer survivors.
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The authors are grateful to Samantha M. Harden for her critique of the manuscript.
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Dr. Pergolotti is the Director of Research for ReVital Cancer Rehabilitation, Select Medical. Kelley Covington is a Research Assistant for ReVital Cancer Rehabilitation, Select Medical.
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Covington, K.R., Hidde, M.C., Pergolotti, M. et al. Community-based exercise programs for cancer survivors: a sco** review of practice-based evidence. Support Care Cancer 27, 4435–4450 (2019). https://doi.org/10.1007/s00520-019-05022-6
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DOI: https://doi.org/10.1007/s00520-019-05022-6