Development of a Risk‐Screening Tool for Cancer Survivors to Participate in Unsupervised Moderate‐ to Vigorous‐Intensity Exercise: Results From a Survey Study. Issue 2 (10th September 2014)

• Record Type: Journal Article
• Authors: Brown, Justin C.; Ko, Emily M.; Schmitz, Kathryn H.
• Is Part Of: PM&R. Volume 7:Issue 2(2015)
• Page Start: 113
• Page End: 122
• Publication Date: 2014-09-10
• Subjects: Medical rehabilitation -- Periodicals; Physical therapy -- Periodicals; Physical Therapy Modalities -- Periodicals; 615.5
• DOI: 10.1016/j.pmrj.2014.09.003
• Languages: English
• ISSNs: 1934-1482

Abstract

Abstract: Background: 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 before they progress from the common recommendation of walking to unsupervised moderate‐ to vigorous‐intensity exercise. Objective: To clarify how to identify cancer survivors who should undergo a pre‐exercise evaluation before they progress from the common recommendation of walking to unsupervised moderate‐ to vigorous‐intensity exercise. Design: Electronic survey. Participants: Forty‐seven (n = 47) experts in the field of exercise physiology, rehabilitation medicine, and cancer survivorship. Setting: Not applicable. Methods: We synthesized peer‐reviewed guidelines for exercise and cancer survivorship and identified 82 health factors that may warrant a pre‐exercise evaluation before a survivor engages in unsupervised moderate‐ to vigorous‐intensity exercise. The 82 health factors were classified into 3 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 before they engaged in moderate‐ to vigorous‐intensity exercise. Main Outcome Measurements: The response rate to our survey was 75% (n = 47). Across the 3 domains of health factors, acute symptoms, comorbidities, and medications related to cardiovascular disease were agreed on to indicate a pre‐exercise evaluation for survivors before they engaged 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 because no 2 patients are alike, and their decisions are made on a case‐by‐case basis. Conclusions: The results from this expert survey will help to identify which cancer survivors should undergo a pre‐exercise evaluation before they engage in unsupervised moderate‐ to vigorous‐intensity exercise.