The purpose of this trial was to determine the feasibility and effectiveness of a novel implementation strategy that includes institution-based exercise plus self-management (SM) or SM alone versus usual care in improving outcomes for individuals with BC receiving treatment.
A hybrid implementation-effectiveness study was conducted in Ontario, Canada. Eligible participants included adult females with a current diagnosis of stage 1-3 BC undergoing treatment and cleared for exercise by their oncology care team. Participants were randomized to one of three groups: 1) Exercise and self-management (EXSM; 8 in person sessions of moderate intensity aerobic exercise and self-management education, led by a physiotherapist, and 4 telephone booster sessions), 2) SM only (8 virtual sessions of self-management education with a physiotherapist and 4 telephone booster sessions), or 3) usual care (UC; no physiotherapy intervention). Feasibility (recruitment, retention, and adherence rates) and effectiveness (exercise knowledge and behaviour, perception of health status, quality of life (QOL), physical functioning, cardiovascular outcomes) were assessed pre and post intervention. Descriptive statistics described feasibility outcomes and an ANCOVA was used to assess effectiveness within and between groups over time.
Eighty-five participants enrolled in this study. Most participants were 40-60 years of age (56%), living with stage 2 BC (46%), and receiving chemotherapy treatment (68%). Fifty-seven percent had comorbidities. Only 27% were considered ‘sufficiently active’ prior to joining the trial. Feasibility outcomes demonstrated a recruitment rate of 72%, retention rates of 75% (EXSM) and 93% (SM), and adherence rates of 76% (EXSM) and 93% (SM). Clinically significant changes in physical function (as measured by the six-minute walk test) were seen within the EXSM group post treatment (47.55m). Improvements in physical activity levels post treatment were evident in the EXSM and SM only groups when compared to usual care. No other between group differences were noted.
Overall, institution-based exercise and virtual self-management is feasible for individuals with BC during treatment and is effective in improving physical activity level and physical functioning. Future research should consider assessing this implementation strategy at multiple institutions across Canada, and triaging exercise strategies based on an individual’s cancer and personal characteristics.
Result of this trial support the use of exercise and physiotherapy for individuals with cancer during treatment. Findings will be used to inform exercise programming strategies at a cancer institution in Ontario, Canada. Overall, exercise implementation strategies should work towards maximizing availability and accessibility for all individuals with BC undergoing treatment.
oncology
implementation science
