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Adherence to and satisfaction with low-intensity physical activity and supervised moderate-high intensity exercise during chemotherapy for breast cancer

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Abstract

Purpose

In this study, we investigated factors associated with program adherence and patient satisfaction with a home-based physical activity program (Onco-Move, N = 77) and a supervised exercise program with a home-based component (OnTrack, N = 76).

Methods

We assessed adherence via self-report (home-based program) and attendance records (supervised program). We used logistic regression analysis to identify sociodemographic, clinical and behavioural variables associated with program adherence. Patient satisfaction was assessed with self-report and is reported descriptively.

Results

Fifty-one percent of Onco-Move and 62% of OnTrack participants were adherent to the home-based program, while 59% of OnTrack participants were adherent to the supervised sessions. Higher baseline physical fitness was associated with higher adherence to home-based components. Higher disease stage and having a partner were associated with adherence to OnTrack supervised sessions. Overall satisfaction with the exercise programs was high, but ratings of coaching provided by professionals for the home-based components were low. Patients offered suggestions for improving delivery of the programs.

Conclusions

These findings point to factors relevant to program adherence and suggest ways in which such programs can be improved. Providing additional time and training for health care professionals could improve the quality and hopefully the effectiveness of the interventions. The use of online diaries and smartphone apps may provide additional encouragement to participants. Finally, allowing greater flexibility in the planning and availability of supervised exercise training in order to accommodate the variability in cancer treatment schedules and the (acute) side effects of the treatments could also enhance program adherence.

Trial registration

Netherlands Trial Register, NTR2159.

http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2159

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Acknowledgements

We thank the Netherlands Comprehensive Cancer Organization for the development of the Onco-Move intervention, and the VU University Medical Center in Amsterdam, Motion Physiotherapy in Uithoorn, and The Netherlands Cancer Institute in Amsterdam for the development of the OnTrack intervention. The PACES trial is part of the A-CaRe Program. We thank the A-CaRe Clinical Research Group and all of the patients, oncologists, nurses and physical therapists who participated in the trial. We also thank Marianne de Maaker-Berkhof and Miranda Gerritsma for their contributions to the data collection and entry.

Funding statement

This work was supported by the Alpe d’Huzes/Dutch Cancer Society Grant No. ALPE-2009-4299, the CZ Fund, Zilveren Kruis Achmea, and the Comprehensive Cancer Centre of the Netherlands.

Author information

Authors and Affiliations

  1. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Hanna van Waart, Wim H. van Harten & Neil K. Aaronson

  2. Departments of Epidemiology and Biostatistics and Medical Oncology, the Amsterdam Pubic Health research institute and Cancer Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands

    Laurien M. Buffart

  3. Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia

    Laurien M. Buffart

  4. Center for Quality of Life, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Martijn M. Stuiver

  5. ACHIEVE Center for Applied Research, Faculty of Health, Amsterdam University of Applied Science, Amsterdam, The Netherlands

    Martijn M. Stuiver

  6. Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands

    Wim H. van Harten

  7. Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Gabe S. Sonke

Authors
  1. Hanna van Waart
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  2. Laurien M. Buffart
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  6. Neil K. Aaronson
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Corresponding author

Correspondence to Neil K. Aaronson.

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Competing interests

The authors declare that they have no competing interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (primary: Netherlands Cancer Institute, PTC09.2711) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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van Waart, H., Buffart, L.M., Stuiver, M.M. et al. Adherence to and satisfaction with low-intensity physical activity and supervised moderate-high intensity exercise during chemotherapy for breast cancer. Support Care Cancer 28, 2115–2126 (2020). https://doi.org/10.1007/s00520-019-05019-1

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