McNeely Margaret L, Williamson Tanya, Shallwani Shirin M, Ternes Leslie, Sellar Christopher, Joy Anil Abraham, Lau Harold, Easaw Jacob, Brown Adam, Courneya Kerry S, Culos-Reed S Nicole
Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada.
Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada.
Cancers (Basel). 2025 Sep 1;17(17):2873. doi: 10.3390/cancers17172873.
Current guidelines endorse the integration of exercise into cancer care. The diagnosis of cancer and its treatment, however, may introduce factors that make exercise engagement difficult, especially for individuals with advanced stages of disease. In this paper, we describe the baseline screening and triage process implemented for the Alberta Cancer Exercise (ACE) hybrid effectiveness-implementation study and share findings that highlight the multifaceted complexity of the process and the direct role of the clinical exercise physiologist (CEP).
ACE was a hybrid effectiveness-implementation study examining the benefit of 12-week cancer-specific community-based exercise program. The ACE screening process was developed by integrating evidence-based guidelines with oncology rehabilitation expertise to ensure safe and standardized participation across cancer populations. The screening process involved four steps: (1) a pre-screen for high-risk cancers, (2) completion of a cancer-specific intake form and the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+), (3) a CEP-led interview to further evaluate cancer status, cancer-related symptoms and other health issues (performed in-person or by phone), and (4) a baseline fitness assessment that included measurement of vital signs.
A total of 2596 individuals registered and underwent prescreening for ACE with 2570 (86.6%) consenting to participate. After full screening including the baseline fitness testing, 209 participants (8.1%) were identified as requiring further medical clearance. Of these, 191 (91.4%) had either a high-risk cancer, metastatic disease or were in the palliative end-stage of cancer, and 161 (84.3%) reported cancer-related symptoms potentially affecting their ability to exercise. In total, 806 (31.4%) participants were triaged to CEP-supervised in-person programming, 1754 (68.2%) participants to ACE community programming, and 8 (0.3%) specifically to virtual programming (post-COVID-19 option).
The findings highlight the complexity and challenges of the screening and triage process, and the value of a highly trained CEP-led iterative approach that included the application of clinical reasoning.
当前指南支持将运动纳入癌症护理。然而，癌症的诊断及其治疗可能会引入一些因素，使参与运动变得困难，尤其是对于疾病晚期的个体。在本文中，我们描述了为艾伯塔癌症运动（ACE）混合效果-实施研究实施的基线筛查和分诊过程，并分享了突出该过程多方面复杂性以及临床运动生理学家（CEP）直接作用的研究结果。
ACE是一项混合效果-实施研究，旨在检验为期12周的针对癌症患者的社区运动项目的益处。ACE筛查过程通过将循证指南与肿瘤康复专业知识相结合而制定，以确保癌症患者群体安全、规范地参与。筛查过程包括四个步骤：（1）对高危癌症进行预筛查；（2）填写癌症专用的 intake form和通用的身体活动准备情况问卷（PAR-Q+）；（3）由CEP主导进行访谈，以进一步评估癌症状况、癌症相关症状及其他健康问题（面对面或通过电话进行）；（4）进行包括生命体征测量的基线体能评估。
共有2596人注册并接受了ACE的预筛查，其中2570人（86.6%）同意参与。在包括基线体能测试在内的全面筛查后，209名参与者（8.1%）被确定需要进一步的医疗许可。其中，191人（91.4%）患有高危癌症、转移性疾病或处于癌症姑息末期，161人（84.3%）报告有可能影响其运动能力的癌症相关症状。共有806名参与者（31.4%）被分诊到由CEP监督的面对面项目，1754名参与者（68.2%）被分诊到ACE社区项目，8名参与者（0.3%）被特别分诊到虚拟项目（COVID-19疫情后的选项）。
研究结果突出了筛查和分诊过程的复杂性和挑战，以及由训练有素的CEP主导的迭代方法（包括应用临床推理）的价值。
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