Western Benedikte, Ivarsson Andreas, Vistad Ingvild, Demmelmaier Ingrid, Aaronson Neil K, Radcliffe Gillian, van Beurden Marc, Bohus Martin, Courneya Kerry S, Daley Amanda J, Galvão Daniel A, Garrod Rachel, Goedendorp Martine M, Griffith Kathleen A, van Harten Wim H, Hayes Sandi C, Herrero-Roman Fernando, Hiensch Anouk E, Irwin Melinda L, James Erica, Kenkhuis Marlou-Floor, Kersten Marie José, Knoop Hans, Lucia Alejandro, May Anne M, McConnachie Alex, van Mechelen Willem, Mutrie Nanette, Newton Robert U, Nollet Frans, Oldenburg Hester S, Plotnikoff Ron, Schmidt Martina E, Schmitz Katie H, Schulz Karl-Heinz, Short Camille E, Sonke Gabe S, Steindorf Karen, Stuiver Martijn M, Taaffe Dennis R, Thorsen Lene, Velthuis Miranda J, Wenzel Jennifer, Winters-Stone Kerri M, Wiskemann Joachim, Berntsen Sveinung, Buffart Laurien M
Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.
Centre of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden.
Scand J Med Sci Sports. 2024 Feb;34(2):e14575. doi: 10.1111/sms.14575.
The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors.
This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree.
Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m , performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m exercising during (5.2%) or post (9.5%) treatment.
There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.
近年来，研究运动对癌症幸存者影响的随机对照试验（RCT）数量有所增加；然而，很少有关于试验参与者退出情况的描述。本研究的目的是评估参与者特征与运动项目特征的哪些组合与癌症幸存者RCT运动组的退出有关。
本研究使用了在“预测最佳癌症康复与支持性护理”（POLARIS）研究中收集的数据，该研究是一个调查运动对癌症幸存者影响的RCT国际数据库。纳入了34项运动试验，共有2467例无转移性疾病的患者被随机分配到运动组。纳入的研究包括一项前测和一项后测，当参与者在干预后测试中缺失所有评估时被归类为退出者。使用条件推断树识别亚组。
总体而言，9.6%的参与者退出。根据与退出的四个显著关联，在条件推断树中识别出五个亚组。BMI>28.4kg/m²、进行有监督的阻力运动或无监督的混合运动的参与者退出率最高（19.8%），或教育程度为中低水平且进行有氧运动或有监督的混合运动的参与者退出率最高（13.5%）。BMI>28.4kg/m²且教育程度高、进行有氧运动或有监督的混合运动的参与者退出率最低（5.1%），以及在治疗期间（5.2%）或治疗后（9.5%）进行运动的BMI≤28.4kg/m²的参与者退出率最低。
完成运动试验和退出运动试验的癌症幸存者之间存在一些系统性差异，这可能会影响运动效果的外部有效性。
