Factors Influencing Participation and Adherence in a Randomized Controlled Trial of Online Exercise Intervention for Cancer Patients in Czechia

Vendula Györiová, Iva Burešová, Jana Halámková, Zora Svobodová, Pavlína Bazalová, Kateřina Kapounková, Iva Hrnčiříková, Karolína Kapounková, Igor Kiss
Purpose:

This study examines factors affecting recruitment, drop-out, and adherence of adult patients with various cancer types undergoing adjuvant chemotherapy in a randomized controlled trial focused on online exercise intervention.  

Methods:

This randomized controlled trial enrolled adult cancer patients (18+) undergoing adjuvant chemotherapy. Patients were randomized into two groups: an intervention group participating in a 12-week online exercise program, and a control group receiving standard care. The exercise program consisted of supervised sessions conducted 3 times a week for 1 hour via Zoom platform. Exercise intensity was monitored using chest strap with a heart rate monitor. Reasons for non-enrollment, drop-out, and exercise adherence were analyzed.  

Results:

Of 442 approached patients, 55.66% (n=246) were not enrolled in the study. The main reasons were failure to meet inclusion criteria (39.84%) and personal reasons such as care for another person, lack of interest in group exercise or demanding job (22.36%), and other reason was failure to attend the initial examination (18.7%). Of the 196 enrolled patients, 56 were excluded during the study, mainly due to personal reasons such as excessive time demands, stress with the technical demands of joining the exercise and  taking care of another person (53.57%) and health complications (19.64%). A higher drop-out rate was observed in the experimental group (64.28%, n=36) compared to the control group (35.71%, n=20). Among the 46 patients who completed the exercise program, the average adherence was 77.15%, with a decrease to 61.67% in the last week of the intervention.

Conclusion(s):

The study revealed significant barriers to participation in online exercise intervention for cancer patients undergoing adjuvant chemotherapy, including personal reasons, and technical obstacles. The higher drop-out rate in the experimental group suggests a need for additional support to maintain participation.

Implications:

Although online interventions are potentially effective tools, it is necessary to consider the possible limitation of insufficient technical equipment for some patients. These findings can contribute to optimizing the design of future studies and improving patient adherence to online exercise interventions.

Funding acknowledgements:
This work was supported by the Ministry of Health of the Czech Republic under Grant number U21-09-00558. All rights reserved.
Keywords:
cancer survivors
physical activity
home-based
Primary topic:
Oncology, HIV and palliative care
Second topic:
Health promotion and wellbeing/healthy ageing/physical activity
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The local ethics committee of Masaryk memorial cancer instute approved the study protocol prior to recruitment (2020/1530/MOU).
Provide the ethics approval number:
(2020/1530/MOU)
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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