Department of Occupational Therapy, Colorado State University, Occupational Therapy Building, 1573 Campus Delivery, Fort Collins, CO, 80523-1573, USA.
ReVital Cancer Rehabilitation, Select Medical, 4714, Gettysburg Road, Mechanicsburg, PA, 17055, USA.
Support Care Cancer. 2019 Dec;27(12):4435-4450. doi: 10.1007/s00520-019-05022-6. Epub 2019 Aug 16.
Based on randomized controlled trials, exercise is an efficacious strategy to improve quality of life (QOL) among cancer survivors. However, the effectiveness of exercise programs to improve QOL in real-world settings is unknown, as are factors related to external validity. This hinders dissemination and scalability. This scoping review synthesized published research on community-based exercise programs for cancer survivors and reported on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM).
A systematic literature search identified community-based exercise programs for adult cancer survivors (1980-March 2018), that met the following inclusion criteria: at least one face-to-face exercise session, the primary aim of program evaluation (i.e., feasibility/effectiveness), and pre/post measure of QOL. Data were coded using the RE-AIM framework. The effect size was calculated for overall QOL.
Electronic database search yielded 553 articles; 31 studies describing unique programs were included for review. All studies described at least one element of implementation and most (80.6%) reported a significant (p < .05) improvement in at least one subscale, or total QOL. Few studies reported on indicators of reach (16.1%), adoption (6.5%), individual (16.1%), or system-level maintenance (32.3%).
Community-based exercise programs are effective for improving QOL in adult cancer survivors. Recommendations are provided to improve reporting across RE-AIM dimensions, which is an important step to enhance the scalability of programs and thus, the potential for exercise to be fully integrated into system-level standard care for cancer survivors.
Community-based exercise programs are a resource to improve QOL for adult cancer survivors.
基于随机对照试验，运动是提高癌症幸存者生活质量（QOL）的有效策略。然而，在真实环境中，运动计划提高 QOL 的效果以及与外部有效性相关的因素尚不清楚，这阻碍了其传播和可扩展性。本研究通过对社区为基础的癌症幸存者运动项目进行综述，综合已发表的研究，报告了项目的可及性、效果、采用、实施和维持（RE-AIM）情况。
系统文献检索确定了社区为基础的成年癌症幸存者运动项目（1980 年至 2018 年 3 月），其符合以下纳入标准：至少有一次面对面的运动课程、项目评估的主要目的（即可行性/有效性）以及 QOL 的预/后测量。使用 RE-AIM 框架对数据进行编码。计算了整体 QOL 的效应量。
电子数据库检索产生了 553 篇文章；31 项描述独特项目的研究被纳入综述。所有研究都描述了实施的至少一个要素，大多数（80.6%）报告了至少一个亚量表或总 QOL 的显著（p < .05）改善。很少有研究报告了可达性（16.1%）、采用（6.5%）、个体（16.1%）或系统水平维持（32.3%）的指标。
社区为基础的运动项目对提高成年癌症幸存者的 QOL 是有效的。为提高 RE-AIM 各维度的报告提供了建议，这是增强项目可扩展性的重要步骤，从而使运动有可能被充分纳入癌症幸存者的系统水平标准护理中。
社区为基础的运动项目是提高成年癌症幸存者生活质量的资源。
