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THE IMPACT OF A CANCER EXERCISE PROGRAM LOCATED WITHIN A HEALTH SYSTEM ON BODY COMPOSITION, FATIGUE, AND PHYSICAL FUNCTION IN ADULTS WITH CANCER

  • Ciaran M. Fairman(corresponding author)
    ,
  • Shana Harrington
    ,
  • Matthew F. Hudson
    ,
  • Madison M. Kindred
    ,
  • Regina Franco
    ,
  • Jason Morrow
*Corresponding author for this work
  • University of South Carolina
    ,
  • Cancer Institute
    ,
  • Kinesiology
Scholary Output:
Contribution to journal
Article
 Peer-review

Sustainable Development Goals

  • SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well

Abstract

Background Despite exercise being regularly recommended for individuals with cancer, notable and consistent gaps remain in the design, utilization and uptake of cancer exercise services embedded into healthcare. The pur pose of this study was to examine the effectiveness of a longstanding, cancer center-embedded, cancer exercise program (the Moving On Program) within the Prisma Health Cancer Institute, on body composition, fatigue, and physical function in adult survivors of cancer. Materials and Methods Moving On, is a 12-week, thrice weekly, aerobic and resistance exercise program designed for adults who complete their primary treatment for any cancer diagnosis at Prisma Health. In a retrospective analysis of data collected between 2014 and 2020, we assessed changes in body composition, fatigue and physical function (6-minute walk test (6MWT)) at baseline and follow-up using paired t-tests. A Bonferroni adjustment (α=0.05/10=0.005) was used to reduce the chance of committing a type I error. Results Participants who completed both baseline and follow up assessments were included in our analyses (n=369, mean=60.3 10.6 years, male=111, female=258). The most prevalent cancer sites were breast cancer (32%) and blood/lymphoma (9.7%). Individuals exhibited significant improvements in body composition variables (arm lean mass (p=0.003, ES=0.158), total % fat (p<0.001, ES=0.199), total fat mass (p<0.001, ES=0.203), and total lean mass (p=0.005, ES=0.148)), fatigue (p<0.001, ES=0.605), and 6MWT (p<0.001, ES=1.032). Conclusions Though statistically significant improvements were exhibited in a variety of body composition variables; the small effect sizes accompanying these changes suggest that improvements made across 12-weeks are trivial. The medium and large effect sizes accompanying improvements in fatigue and physical function support that participation in an exercise program can attenuate treatment-related side effects after treatment for cancer.

Publication Information

Output type

Scholary Output:
Contribution to journal
Article
 Peer-review

Original language

English (US)

Pages from-to (Number of pages)

Pages 35-40 (6 pages)

Journal (Volume, Issue Number)

Journal of Cancer Rehabilitation (Volume 5, Issue 1)

Publication milestones

  • Published - 2022

Publication status

Published - 2022

Publication IDs

  • Scopus: 85180505928

Access to documents

Publication metrics

Metrics

Fractional count
1
Fractional count
0.14
Fractional count
6
Fractional count
0.86
Fractional count
1
Fractional count
1

Funding Details

The Moving On program consists of a free 12-week, aerobic and resistance exercise program located in an exercise facility, the Prisma Health Life Center, located approximately one mile from the main Cancer Institute. The program is offered three times per week, multiple times throughout the day, between 10am and 4pm. Participant screening, physical assessments and evaluations are conducted by a Nurse Practitioner (NP) with experience in oncology. The Moving On program’s novelty includes billable pre-and post-testing conducted by the NP. However, exercise sessions are not billed to the participant. The exercise sessions were initially funded through philanthropic efforts, and have now been supported through departments operating budget. Moving On’s supervision team includes an oncology certified nurse (OCN) and trained exercise specialists certified by ACSM/ACS as a Certified Exercise Trainer (CET)). Prior to program enrollment, the NP reviews individual’s medical information (medical history, comorbi-dities, oncology treatment history; surgeries, cardiac history, medications, notes from other providers) and evaluates perspective participants/enrollees for fatigue and physical function (6-minute walk test, 6MWT) to determine suitability and program eligibility. Additional criteria include being within three years of the adjuvant therapy completion and the ability to complete the 6WMT without stopping. Individuals with neutropenia (absolute neutrophil count <1,500 cells/ mm3) or anemia (hemoglobin ≤ 10 g/dL) were ineligible to participate. Individuals who were deemed ineligible for the program comprised those receiving negative reports on the criteria outlined above, or individuals who Moving On leadership deemed to require more specialized care (i.e., continued/ exacerbated weight loss, pain that causes limitations, decreases oxygen saturation, lymphedema, cording etc.). Moving On leadership subsequently referred this group to physical/ occupational therapy, cardiac/pulmonary rehab, and/or other CIOS services (e.g., smoking cessation, counseling, nutritional support). Eligible participants were also assessed for and referred to additional services, as appropriate. Individuals challenged to attend the Moving On program’s primary site owing to travel constraints received a referral to local resources (e.g., YMCA’s Livestrong, Exercise Is Medicine-Greenville, Sportsclub’s P.R.E.P (Physical Referred Exercise Program)). Participants who completed the initial screening and were deemed eligible subsequently enrolled in the Moving On program. The program provides for re-entry and program re-initiation if 6 months have lapsed between the last visit/session. Moving On leadership reviews each patient on a case-by-case basis. Figure 1 describes the patient access path to and through the Moving On program.