Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Sport Science and Physical Education, University of Agder, Norway.
Integr Cancer Ther. 2020 Jan-Dec;19:1534735420946834. doi: 10.1177/1534735420946834.
Adherence to exercise interventions in patients with cancer is often poorly described. Further, it is unclear if self-regulatory behavior change techniques (BCTs) can improve exercise adherence in cancer populations. We aimed to (1) describe exercise adherence in terms of frequency, intensity, time, type (FITT-principles) and dropouts, and (2) determine the effect of specific self-regulatory BCTs on exercise adherence in patients participating in an exercise intervention during curative cancer treatment.
This study was a secondary analysis using data from a Swedish multicentre RCT. In a 2×2 factorial design, 577 participants recently diagnosed with curable breast, colorectal or prostate cancer were randomized to 6 months of high (HI) or low-to-moderate intensity (LMI) exercise, or self-regulatory BCTs (e.g., goal-setting and self-monitoring). The exercise program included supervised group-based resistance training and home-based endurance training. Exercise adherence (performed training/prescribed training) was assessed using attendance records, training logs and heart rate monitors, and is presented descriptively. Linear regression and logistic regression were used to assess the effect of self-regulatory BCTs on each FITT-principle and dropout rates, according to intention-to-treat.
For resistance training (groups vs self-regulatory BCTs), participants attended on average 52% vs 53% of prescribed sessions, performed 79% vs 76% of prescribed intensity, and 80% vs 77% of prescribed time. They adhered to exercise type in 71% vs 68% of attended sessions. For endurance training (groups vs self-regulatory BCTs), participants performed on average 47% vs 51% of prescribed sessions, 57% vs 62% of prescribed intensity, and 71% vs 72% of prescribed time. They adhered to exercise type in 79% vs 78% of performed sessions. Dropout rates (groups vs self-regulatory BCTs) were 29% vs 28%. The regression analysis revealed no effect of the self-regulatory BCTs on exercise adherence.
An exercise adherence rate ≥50% for each FITT-principle and dropout rates at ~30% can be expected among patients taking part in long-term exercise interventions, combining resistance and endurance training during curative cancer treatment. Our results indicate that self-regulatory BCTs do not improve exercise adherence in interventions that provide evidence-based support to all participants (e.g., supervised group sessions).
NCT02473003.
癌症患者的运动干预依从性往往描述不足。此外，尚不清楚自我调节行为改变技术（BCTs）是否可以提高癌症人群的运动依从性。我们旨在：（1）根据频率、强度、时间、类型（FITT 原则）和辍学情况描述运动依从性；（2）确定特定的自我调节 BCTs 对接受癌症治疗期间的运动干预的患者的运动依从性的影响。
这是一项使用瑞典多中心 RCT 数据的二次分析。在 2×2 析因设计中，577 名最近被诊断为可治愈的乳腺癌、结直肠癌或前列腺癌的患者被随机分为 6 个月的高强度（HI）或低到中等强度（LMI）运动，或自我调节 BCTs（例如，目标设定和自我监测）。运动方案包括监督的小组基础阻力训练和家庭基础耐力训练。使用出勤记录、训练日志和心率监测器来评估运动依从性（进行的训练/规定的训练），并进行描述性呈现。根据意向治疗，使用线性回归和逻辑回归来评估自我调节 BCTs 对每个 FITT 原则和辍学率的影响。
对于阻力训练（组 vs 自我调节 BCTs），参与者平均参加规定课程的 52% vs 53%，进行规定强度的 79% vs 76%，以及规定时间的 80% vs 77%。他们在参加的课程中，有 71% vs 68%坚持运动类型。对于耐力训练（组 vs 自我调节 BCTs），参与者平均进行规定课程的 47% vs 51%，规定强度的 57% vs 62%，以及规定时间的 71% vs 72%。他们在进行的课程中，有 79% vs 78%坚持运动类型。辍学率（组 vs 自我调节 BCTs）为 29% vs 28%。回归分析显示，自我调节 BCTs 对运动依从性没有影响。
在接受包括阻力和耐力训练的癌症治疗期间，参加长期运动干预的患者可以预期每个 FITT 原则的依从率≥50%，辍学率约为 30%。我们的结果表明，自我调节 BCTs 并不能提高为所有参与者提供循证支持的干预措施中的运动依从性（例如，监督的小组课程）。
NCT02473003。
