This study employs the Delphi method to develop expert consensus on the optimal parameters of green exercise to be integrated into breast cancer rehabilitation programs, providing clearer guidelines for its use in supporting recovery.
A modified Delphi study was conducted to develop consensus on the parameters of a green exercise protocol for breast cancer patients. Participants, consisting of expert panelists, were asked to evaluate and grade exercise parameters and overall protocol structure using a seven-point Likert scale. These parameters were initially derived from established exercise guidelines for breast cancer patients. The survey was delivered via the Microsoft Forms platform, and the Delphi process included two rounds. Consensus was defined as 80% agreement among participants. Parameters that reached this threshold were considered agreed upon for inclusion in the green exercise protocol.
Thirty-eight experts (20 physiotherapists and 18 medical doctors) participated in the first round, with twenty-nine continuing to the second round. In the first round, consensus was reached on the following elements of the exercise protocol: the setting of the outdoor session, warm-up, resistance training, and recovery phase. In the second round, participants used a 7-point Likert scale to rate the exercise protocol elements that did not reach consensus in the first round, along with additional suggestions they had provided. An 80% agreement level was achieved for a session duration of 45 minutes and for incorporating a variety of aerobic activities from which participants could choose. These findings suggest that a structured green exercise protocol, with sessions lasting 45 minutes and incorporating a diverse range of aerobic options combined with resistance training, could offer significant benefits to breast cancer patients during recovery.
This Delphi study established expert consensus on key parameters for integrating green exercise into breast cancer rehabilitation programs. Consensus was reached on critical aspects such as the outdoor setting, warm-up routines, resistance training, recovery phases, session duration, and the inclusion of varied aerobic activities. The therapeutic potential of green exercise in enhancing physical and emotional well-being is supported by the consensus reached among the expert panel.
This Delphi study provides a framework for integrating green exercise into breast cancer rehabilitation, promoting its adoption in physiotherapy practice. It encourages tailored nature-based interventions to enhance recovery and improve patient outcomes in clinical settings.
breast cancer rehabilitation
exercise oncology
