Development of a Risk-Screening Tool for Cancer Survivors to Participate in Unsupervised Moderate- to Vigorous-Intensity Exercise: Results from a Survey Study
Identifieur interne : 003568 ( Pmc/Curation ); précédent : 003567; suivant : 003569Development of a Risk-Screening Tool for Cancer Survivors to Participate in Unsupervised Moderate- to Vigorous-Intensity Exercise: Results from a Survey Study
Auteurs : Justin C. Brown ; Emily M. Ko ; Kathryn H. SchmitzSource :
- PM & R : the journal of injury, function, and rehabilitation [ 1934-1482 ] ; 2014.
Abstract
The health-benefits of exercise increase in dose-response fashion among cancer survivors. However, it is unclear how to identify cancer survivors who may require a pre-exercise evaluation prior to progressing from the common recommendation of walking, to unsupervised moderate- to vigorous-intensity exercise.
To clarify how to identify cancer survivors who should undergo a pre-exercise evaluation prior to progressing from the common recommendation of walking, to unsupervised moderate- to vigorous-intensity exercise.
Electronic survey.
Forty seven (n=47) experts in the field of exercise physiology, rehabilitation medicine, and cancer survivorship.
Not Applicable.
We synthesized peer-reviewed guidelines for exercise and cancer survivorship and identified 82 health-factors that may warrant a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise. The 82 health-factors were classified into three domains: 1) clinical health-factors; 2) comorbidity and device health-factors; and 3) medications. We surveyed a sample of experts asking them to identify which of the 82 health-factors among cancer survivors would indicate the need for a pre-exercise evaluation prior to engaging in moderate- to vigorous-intensity exercise.
The response rate to our survey was 75% (n=47). Across the three domains of health-factors, acute symptoms, comorbidities, and medications related to cardiovascular disease were agreed to indicate a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise. Other health-factors in the survey included hematologic, musculoskeletal, systemic, gastrointestinal, pulmonary, and neurological symptoms and comorbidities. Eighteen experts (38%) said it was difficult to provide absolute answers since no two patients are alike, and their decisions are made on a case-by-case basis.
The results from this expert survey will help to identify which cancer survivors should undergo a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise.
Url:
DOI: 10.1016/j.pmrj.2014.09.003
PubMed: 25217819
PubMed Central: 4391374
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<author><name sortKey="Ko, Emily M" sort="Ko, Emily M" uniqKey="Ko E" first="Emily M." last="Ko">Emily M. Ko</name>
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<author><name sortKey="Schmitz, Kathryn H" sort="Schmitz, Kathryn H" uniqKey="Schmitz K" first="Kathryn H." last="Schmitz">Kathryn H. Schmitz</name>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">The health-benefits of exercise increase in dose-response fashion among cancer survivors. However, it is unclear how to identify cancer survivors who may require a pre-exercise evaluation prior to progressing from the common recommendation of walking, to unsupervised moderate- to vigorous-intensity exercise.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To clarify how to identify cancer survivors who should undergo a pre-exercise evaluation prior to progressing from the common recommendation of walking, to unsupervised moderate- to vigorous-intensity exercise.</p>
</sec>
<sec id="S3"><title>Design</title>
<p id="P3">Electronic survey.</p>
</sec>
<sec id="S4"><title>Participants</title>
<p id="P4">Forty seven (n=47) experts in the field of exercise physiology, rehabilitation medicine, and cancer survivorship.</p>
</sec>
<sec id="S5"><title>Setting</title>
<p id="P5">Not Applicable.</p>
</sec>
<sec id="S6"><title>Methods</title>
<p id="P6">We synthesized peer-reviewed guidelines for exercise and cancer survivorship and identified 82 health-factors that may warrant a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise. The 82 health-factors were classified into three domains: 1) clinical health-factors; 2) comorbidity and device health-factors; and 3) medications. We surveyed a sample of experts asking them to identify which of the 82 health-factors among cancer survivors would indicate the need for a pre-exercise evaluation prior to engaging in moderate- to vigorous-intensity exercise.</p>
</sec>
<sec id="S7"><title>Main Outcome Measurements</title>
<p id="P7">The response rate to our survey was 75% (n=47). Across the three domains of health-factors, acute symptoms, comorbidities, and medications related to cardiovascular disease were agreed to indicate a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise. Other health-factors in the survey included hematologic, musculoskeletal, systemic, gastrointestinal, pulmonary, and neurological symptoms and comorbidities. Eighteen experts (38%) said it was difficult to provide absolute answers since no two patients are alike, and their decisions are made on a case-by-case basis.</p>
</sec>
<sec id="S8"><title>Conclusions</title>
<p id="P8">The results from this expert survey will help to identify which cancer survivors should undergo a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101491319</journal-id>
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<contrib-group><contrib contrib-type="author"><name><surname>Brown</surname>
<given-names>Justin C.</given-names>
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<degrees>MA</degrees>
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<contrib contrib-type="author"><name><surname>Ko</surname>
<given-names>Emily M.</given-names>
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<degrees>MD, MSCR</degrees>
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<contrib contrib-type="author"><name><surname>Schmitz</surname>
<given-names>Kathryn H.</given-names>
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<degrees>PhD, MPH</degrees>
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<aff id="A1">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA</aff>
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<author-notes><corresp id="cor1">Corresponding Author: Kathryn H. Schmitz, University of Pennsylvania School of Medicine, 423 Guardian Drive, 8th Floor, Blockley Hall, Philadelphia, PA 19104, Phone: 215–898–6604, Fax: 251–573–5311, <email>schmitz@mail.med.upenn.edu</email>
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<pub-date pub-type="nihms-submitted"><day>1</day>
<month>4</month>
<year>2015</year>
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<pub-date pub-type="epub"><day>10</day>
<month>9</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub"><month>2</month>
<year>2015</year>
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<pub-date pub-type="pmc-release"><day>09</day>
<month>4</month>
<year>2015</year>
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<volume>7</volume>
<issue>2</issue>
<fpage>113</fpage>
<lpage>122</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.pmrj.2014.09.003</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">The health-benefits of exercise increase in dose-response fashion among cancer survivors. However, it is unclear how to identify cancer survivors who may require a pre-exercise evaluation prior to progressing from the common recommendation of walking, to unsupervised moderate- to vigorous-intensity exercise.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To clarify how to identify cancer survivors who should undergo a pre-exercise evaluation prior to progressing from the common recommendation of walking, to unsupervised moderate- to vigorous-intensity exercise.</p>
</sec>
<sec id="S3"><title>Design</title>
<p id="P3">Electronic survey.</p>
</sec>
<sec id="S4"><title>Participants</title>
<p id="P4">Forty seven (n=47) experts in the field of exercise physiology, rehabilitation medicine, and cancer survivorship.</p>
</sec>
<sec id="S5"><title>Setting</title>
<p id="P5">Not Applicable.</p>
</sec>
<sec id="S6"><title>Methods</title>
<p id="P6">We synthesized peer-reviewed guidelines for exercise and cancer survivorship and identified 82 health-factors that may warrant a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise. The 82 health-factors were classified into three domains: 1) clinical health-factors; 2) comorbidity and device health-factors; and 3) medications. We surveyed a sample of experts asking them to identify which of the 82 health-factors among cancer survivors would indicate the need for a pre-exercise evaluation prior to engaging in moderate- to vigorous-intensity exercise.</p>
</sec>
<sec id="S7"><title>Main Outcome Measurements</title>
<p id="P7">The response rate to our survey was 75% (n=47). Across the three domains of health-factors, acute symptoms, comorbidities, and medications related to cardiovascular disease were agreed to indicate a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise. Other health-factors in the survey included hematologic, musculoskeletal, systemic, gastrointestinal, pulmonary, and neurological symptoms and comorbidities. Eighteen experts (38%) said it was difficult to provide absolute answers since no two patients are alike, and their decisions are made on a case-by-case basis.</p>
</sec>
<sec id="S8"><title>Conclusions</title>
<p id="P8">The results from this expert survey will help to identify which cancer survivors should undergo a pre-exercise evaluation prior to engaging in unsupervised moderate- to vigorous-intensity exercise.</p>
</sec>
</abstract>
<kwd-group><kwd>adverse event</kwd>
<kwd>screening</kwd>
<kwd>comorbidity</kwd>
<kwd>safety</kwd>
<kwd>cancer</kwd>
<kwd>exercise</kwd>
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