Predictors of follow-up exercise behavior 6 months after a randomized trial of exercise training during breast cancer chemotherapy Main outcomes of the Move More for Life Trial: a randomised controlled trial examining the effects of tailored-print and targeted-print materials for promoting physical activity among post-treatment breast cancer survivors. Supervised physical exercise to improve the quality of life of cancer patients: the EFICANCER randomised controlled trial Design of the Quality of Life in Motion (QLIM) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of a combined physical exercise and psychosocial training program to improve physical fitness in children with cancer Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy The effect of combined aerobic and resistance exercises on quality of life of women surviving breast cancer A modified exercise protocol may promote continuance of exercise after the intervention in lung cancer patients—a pragmatic uncontrolled trial Intervention Components Promoting Adherence to Strength Training Exercise in Breast Cancer Survivors With Bone Loss The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project. Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting A pilot study of a supervised group exercise programme as a rehabilitation treatment for women with breast cancer receiving adjuvant treatment. Effects of a 12-Month Randomized Controlled Trial of Aerobic or Resistance Exercise During and Following Cancer Treatment in Women Impact of a Combined Resistance and Aerobic Exercise Program on Motivational Variables in Breast Cancer Survivors: A Randomized Controlled Trial Five-year follow-up of participants in a randomised controlled trial showing benefits from exercise for breast cancer survivors during adjuvant treatment. Are there lasting effects? Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: A randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue Effects of exercise interventions during different treatments in breast cancer.
Purpose Exercise during breast cancer chemotherapy is beneficial but it needs to be maintained into survivorship to optimize long-term benefits . Here , we report the predictors of follow-up exercise behavior 6 months after a r and omized exercise trial in breast cancer patients . Methods Breast cancer patients ( N = 242 ) initiating adjuvant chemotherapy  were r and omly assigned to usual care ( n = 82 ) , supervised resistance exercise ( n = 82 ) , or supervised aerobic exercise ( n = 78 ) for the duration of their chemotherapy . At baseline and postintervention , data were collected on demographic , medical , behavioral , fitness , psychosocial , and motivational variables . At 6-month follow-up , participants were mailed a question naire that assessed exercise behavior over the past 6 months and were categorized as either meeting both aerobic and resistance exercise guidelines , either exercise guideline , or neither exercise guideline . Results Two hundred one ( 83.1 % ) participants provided 6-month follow-up data with 85 ( 42.3 % ) meeting neither exercise guideline , 74 ( 36.8 % ) meeting either exercise guideline , and 42 ( 20.9 % ) meeting both exercise guidelines . In multivariate regression analysis , seven variables independently predicted the likelihood of meeting exercise guidelines at follow-up including higher pretrial exercise ( β = 0.23 ; P = 0.002 ) , younger age ( β = −0.15 ; P = 0.028 ) , breast conserving surgery ( β = 0.15 ; P = 0.033 ) , strength improvements ( β = 0.15 ; P = 0.028 ) , lower postintervention fatigue ( β = 0.13 ; P = 0.067 ) , a more positive attitude ( β = 0.12 ; P = 0.086 ) , and lower postintervention body mass index ( β = −0.11 ; P = 0.105 ) . Conclusion Exercise behavior 6 months after a r and omized trial was predicted by a wide range of demographic , medical , behavioral , fitness , psychosocial , and motivational variables . These findings may help facilitate the uptake of exercise behavior during the transition from breast cancer patient to survivor BACKGROUND Participation in physical activity can improve the health outcomes of breast cancer survivors . To impact public health , broad-reaching sustainable interventions that promote physical activity are needed . PURPOSE To evaluate the efficacy of two distance-based interventions for promoting physical activity among breast cancer survivors compared with a st and ard recommendation control . METHODS Breast cancer survivors who had finished ' active ' cancer treatment were eligible to participate . Participants ( n = 330 ) were r and omly assigned to receive one of the following mail-delivered interventions : three computer-tailored newsletters , a previously developed breast cancer-specific physical activity booklet or a pamphlet detailing the public health recommendations for physical activity ( control ) . Primary outcomes were self-reported moderate to vigorous aerobic activity and participant 's self-reported resistance training activity at 4 months post-baseline . Secondary outcomes were pedometer step counts , whether or not participants were meeting the physical activity guidelines , time spent in sedentary behaviour , fatigue and health-related quality of life . RESULTS Participants r and omised into the tailored-print intervention group were three times more likely to commence resistance training and meet the resistance-training guidelines immediately after the intervention than participants allocated to the control group . There were no other significant intervention effects . CONCLUSION Computer-tailored newsletters may be an effective strategy for enhancing resistance-based physical activity among breast cancer survivors . The null findings relating to other outcomes may be due to ceiling effects ( in the case of aerobic activity , fatigue and health-related quality of life ) or the sensitivity of the measure used ( in the case of sitting time ) . These issues require further exploration Background The optimal form of exercise for individuals with cancer has yet to be identified , but there is evidence that exercise improves their quality of life . The aim of this study is to assess the efficacy and efficiency of an innovative physical exercise programme , for individuals undergoing chemotherapy for breast , gastrointestinal or non-small cell lung tumours , for improving quality of life , reducing level of fatigue , and enhancing functional capacity over time . Design / Methods We will conduct a clinical trial in 66 patients with stage IV breast , gastrointestinal or non-small cell lung cancer , recruited by the Department of Oncology of the referral hospital from 4 primary care health centres of the Basque Health Service ( Osakidetza ) . These patients will be r and omised to one of two groups . The treatment common to both groups will be the usual care for cancer : optimized usual drug therapies and strengthening of self-care ; in addition , patients in the intervention group will participate in a 2-month exercise programme , including both aerobic and strength exercises , supervised by nurses in their health centre . The principal outcome variable is health-related quality of life , measured blindly with the 30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Question naire and Short Form-36 four times : at baseline , and 2 , 6 and 12 months later . The secondary outcome variables are fatigue ( Functional Assessment of Chronic Illness Therapy-Fatigue question naire ) , functional capacity ( 6-Minute Walk Test and cardiorespiratory test ) , muscle strength ( h and -held dynamometry and sit-to-st and test ) , radiological response to treatment ( Response Evaluation Criteria In Solid Tumors ) and progression-free and overall survival . Age , sex , diagnosis , chemotherapy regimen , Eastern Cooperative Oncology Group performance status and smoking status will be considered as predictive variables . Data will be analysed on an intention-to-treat basis , comparing changes at each time point between groups , adjusting for baseline values by analysis of covariance . Discussion As well as achieving the objectives set , this study will provide us with information on patient perception of the care received and an opportunity to develop a project based on collaborative action between the primary care and oncology professionals . Trial registration Clinical Trials.gov Identifier : NCT01786122 Registration date : 02/05/2013 Background Childhood cancer and its treatment have considerable impact on a child 's physical and mental wellbeing . Especially long-term administration of chemotherapy and /or radiotherapy impairs physical fitness both during and after therapy , when children often present with muscle weakness and /or low cardiorespiratory fitness . Physical exercise can improve these two elements of physical fitness , but the positive effects of physical exercise might be further increased when a child 's wellbeing is simultaneously enhanced by psychosocial training . Feeling better may increase the willingness and motivation to engage in sports activities . Therefore , this multi-centre study evaluates the short and long-term changes in physical fitness of a child with a childhood malignancy , using a combined physical exercise and psychosocial intervention program , implemented during or shortly after treatment . Also examined is whether positive effects on physical fitness reduce inactivity-related adverse health problems , improve quality of life , and are cost-effective . Methods This multi-centre r and omized controlled trial compares a combined physical and psychosocial intervention program for children with cancer , with care as usual ( controls ) . Children with cancer ( aged 8 - 18 years ) treated with chemotherapy and /or radiotherapy , and who are no longer than 1 year post-treatment , are eligible for participation . A total of 100 children are being recruited from the paediatric oncology/haematology departments of three Dutch university medical centres . Patients are stratified according to pubertal stage ( girls : age ≤10 or > 10 years ; boys : ≤11 or > 11 years ) , type of malignancy ( haematological or solid tumour ) , and moment of inclusion into the study ( during or after treatment ) , and are r and omly assigned to the intervention or control group . Discussion Childhood cancer patients undergoing long-term cancer therapy may benefit from a combined physical exercise and psychosocial intervention program since it may maintain or enhance their physical fitness and increase their quality of life . However , the feasibility , patient need , and effectiveness of such a program should be established before the program can be implemented as part of st and ard care . Trial registration numberNTR1531 ( The Netherl and s National Trial Register AIMS AND OBJECTIVES To explore factors influencing exercise adherence  among women with breast cancer while following an exercise programme .  BACKGROUND Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge . Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer . DESIGN This was a qualitative study to explore patient 's perceptions of the challenges to exercise adherence during a r and omised , controlled trial . METHODS Twenty-seven women with early-stage breast cancer were purposively sample d for focus group interviews during 2011 - 2012 from their participation in the exercise intervention group during 2010 - 2012 . Five focus groups were performed , and data analysis was completed using the systematic text condensation method . RESULTS During the focus group study , five main themes were identified , which described factors participants perceived to influence their adherence to exercise during chemotherapy : ' side effects of breast cancer treatment as a barrier to exercise ' , ' restoring and maintaining normality in daily life motivates exercise ' , ' other valued activities compete with exercise ' , ' constructive support enhances exercise ' and ' positive beliefs about efficacy and outcomes motivate exercise ' . CONCLUSION Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing health behaviour . RELEVANCE TO CLINICAL PRACTICE Nurses should be aware that exercise adherence could be a challenge among women with breast cancer . They should help identify obstacles to exercise for women and ways to overcome them , as well as support them in their beliefs that they are capable of changing their health behaviour The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity ; one-repetition maximum ( 1RM ) and maximum oxygen uptake ( VO2Max ) , activity level , general well-being and quality of life in cancer patients undergoing chemotherapy .  The intervention comprised resistance and fitness training , massage , relaxation and body-awareness training .  Eighty-two cancer patients , with or without evidence of residual disease , were included : 66 patients with 13 different types of solid tumours and 16 patients with 6 types of haematological malignancies . The patients trained in mixed groups for 9 h weekly for 6 weeks . Physical capacity , physical activity level and psychosocial well-being as measured by the Medical Outcomes Study 36-item Short-Form Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Question naire C30 were assessed pre- and post-intervention . Highly significant increases were achieved in muscular strength ( p<0.001 ) , physical fitness ( p<0.001 ) and physical activity levels ( p<0.001 ) . The patients reported significant reduction in treatment-related symptoms , i.e. , fatigue ( p=0.006 ) and pain ( p=0.03 ) . Highly significant improvements were observed in physical functioning ( p<0.001 ) and role functioning ( p<0.001 ) . Even patients with advanced disease were able to improve their results after 6 weeks . It is concluded that a multidimensional exercise intervention , including resistance training , may be beneficial for cancer patients undergoing chemotherapy . This study indicates significant clinical meaningful improvements . The exact role of the intervention has to be defined in a r and omized controlled design . A clinical ly controlled trial including 250 patients is currently being carried out Background : Breast cancer is one of the most common cancers amongst women in developed and developing countries . It is associated with the highest mortality rate in low to average-income countries . Breast cancer investigation amongst Iranian women reveals that the number of its incidence is yet the highest in all cancer types . Despite recent longer survival time of women with breast cancer , most of the patients suffer from long term physical and mental distress due to combined treatments . Exercise interventions are among new approaches to promote the better quality of life of the patients , which has only recently been considered by research ers . This study aim ed to investigate the effect of exercise intervention on the quality of life of breast cancer survivors . Material s and Methods : This is a clinical trial conducted on 80 women with I-III breast cancer , at 18 - 55 years of age mostly two years after the completion of their treatment in Seyed al Shohada hospital in Isfahan . They were r and omly divided into two groups of study and control . Exercise intervention went on for 8 weeks in the study group ( three sessions a week , 60 minutes ) . Quality of life in both groups was measured a day before , and at the end of the eight weeks period by the instrument of the National Medical Center and Beckman Research Institute . The data were analyzed by descriptive and inferential statistical tests of X2 , t-test and Mac Hammer test . Findings : Results showed that there was no significant difference in the mean score of the physical dimension of quality of life in the study group before and after intervention while the score of physical health was significantly better in the control group ( p < 0.00).The mean score of mental dimension had increased in the study group , while it had decreased in the control group . The mean score of social health showed no significant difference before and after intervention . The mean score of spiritual health had significantly decreased in the control group , while it had significantly increased in the study group ( p = 0.004 ) . Generally , the total mean score of the quality of life showed no significant difference before and after intervention . However , the percentage of the quality of life score increased in the study group , but decreased in the control group . Conclusions : The results of this study showed that exercise interventions can promote a better quality of life for the patients , and increase the total score of quality of life . Although , the total score of quality of life was not significantly different , it was concluded that exercise can promote the quality of life amongst patients with breast cancer Purpose A previous study investigated the effects of a well-documented COPD exercise protocol in lung cancer patients . The study showed improvements in physical fitness , but poor adherence to continued exercise after intervention . The aim of the present study was to investigate the effect of a modified exercise intervention on post-intervention adherence , and physical fitness in a broad group of lung cancer patients . Methods Fifty-nine patients enrolled in a 9-week exercise program . Eligibility criteria were limited to presence of motivation , and absence of comorbidities that could jeopardize safety . The intervention included three times 3 weeks of exercise ( 3 weeks supervised , 3 weeks home-based and 3 weeks supervised ) . The patient ’s activities were structured by logbooks during the 3 weeks at home . VO2 max was estimated at baseline and at the end of intervention . Self-reported quality of life was recorded before and after the exercise program . Post-intervention exercise activity was assessed by telephone interviews 4 weeks after intervention . Results Fifty-one patients initiated the exercise intervention and 29 patients successfully completed the exercise program .  Full data were available for 25 patients regarding estimated VO2 max . Twenty-six of the 29 were available for follow-up with respect to continuance of physical activity . Among the 26 who completed the 9-week training program , 18 ( 69 % ) continued to be physically active on a daily basis . No change in estimated VO2 max was observed . A trend towards increased quality of life and better symptom control was noted . Conclusions The present study showed an increased level of continuance of physical activity compared to the previous study . The present study could , however , not repeat the significant improvements in estimated VO2 max from the previous study Numerous studies have reported that exercise is safe and beneficial for breast cancer survivors ; however , long-term adherence to exercise programs is not easy to accomplish . This secondary analysis examined the demographic and clinical characteristics , adherence to exercise , and cognitive — behavioral intervention components data collected on 120 postmenopausal women with a history of breast cancer and bone loss who had been r and omized to the exercise group in a 24-month study . Hierarchical regression was used to identify variables that predicted adherence to  exercise . Mean adherence to  exercises  was 61.89 % .  Feedback and support were the most frequently used cognitive — behavioral intervention components . In hierarchical regression , predictors for adherence to exercise were feedback ( β = .40 , p < .001 ) and adherence to exercise  in the previous time period ( β = .31 , p < .001 ) . Participants receiving more frequent feedback had higher adherence to exercise BACKGROUND Exercise is becoming an important component of cancer rehabilitation programs . A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue . However , sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship . OBJECTIVE This study examined self-reported short-term exercise adherence following a 6-week , supervised exercise program ( muscle strength , cardiovascular fitness , relaxation , body awareness , and massage ) in a heterogeneous group of 61 cancer patients ( mean age 42.9 years , 82 % oncological and 18 % haematological ) from the Body & Cancer Project . METHODS Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program . The study furthermore included 3-month follow-up assessment of psychological distress ( Hospital Anxiety and Depression Scale-HADS ) . Patient statements were selected that best illustrated trends found in the statistical material . RESULTS There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks . However , the patients ( half of whom were still undergoing treatment at the time of follow-up ) reported a higher physical activity level postprogram compared to their baseline levels . The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level , treatment , and postprogram changes in depression . SIGNIFICANCE OF RESEARCH Given the significant decrease in postprogram PA level , especially in subjects still undergoing cancer treatment , the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population . However , r and omized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients Observational studies demonstrate an association between physical activity and improved outcomes in breast and colon cancer survivors . To test these observations with a large , r and omized clinical trial , an intervention that significantly impacts physical activity in these patients is needed . The Active After Cancer Trial ( AACT ) was a multicenter pilot study evaluating the feasibility of a telephone-based exercise intervention in a cooperative group setting . Sedentary ( engaging in < 60 min of recreational activity/week ) breast and colorectal cancer survivors were r and omized to a telephone-based exercise intervention or usual care control group . The intervention was delivered through the University of California at San Diego ; participants received ten phone calls over the course of the 16-week intervention . All participants underwent assessment of physical activity , fitness , physical functioning , fatigue and exercise self-efficacy at baseline and after the 16-week intervention . One hundred and twenty-one patients were enrolled through ten Cancer and Leukemia Group B ( CALGB ) institutions ; 100 patients had breast cancer and 21 had colorectal cancer . Participants r and omized to the exercise group increased physical activity by more than 100 versus 22 % in controls ( 54.5 vs. 14.6 min , P = 0.13 ) , and experienced significant increases in fitness ( increased 6-min walk test distance by 186.9 vs. 81.9 feet , P = 0.006 ) and physical functioning ( 7.1 vs. 2.6 , P = 0.04 ) as compared to the control group . Breast and colorectal cancer survivors enrolled in a multicenter , telephone-based physical activity intervention  increased physical activity and experienced significant improvements in fitness and physical functioning . Lifestyle intervention research is feasible in a cooperative group setting This pilot study examined whether exercise as an adjunctive rehabilitation therapy could benefit women who have early stage breast cancer and are currently receiving chemotherapy/radiotherapy . The study was design ed as a r and omised controlled trial ( RCT ) . Physical functioning , fatigue and Quality of Life ( QoL ) outcomes were evaluated pre and post a 12-week intervention . The results showed that after 12 weeks the women who participated in the exercise programme ( n = 12 ) displayed significantly higher levels of physical functioning and reported higher QoL scores than the controls ( n = 10 ) . Changes in fatigue and satisfaction with life favoured the intervention group but did not reach significance . These results are encouraging and suggest that a structured group exercise programme during adjuvant treatment is a safe , well tolerated and effective way of providing physical and psychological health benefits to women during treatment for early stage breast cancer . Since this was a pilot study the numbers did not allow appropriately powered analyses of some variables of interest and favoured relatively young and socio-economically advantaged women . Future studies need to address these issues and determine if these short-term benefits can be sustained Abstract Weight gain is common during and following cancer treatment and contributes to many adverse health consequences and increased risk of recurrence for cancer survivors . The purpose of this longitudinal r and omized controlled trial was to compare differences in weight change and body composition among newly diagnosed cancer survivors receiving chemotherapy who were r and omly assigned to usual care control , aerobic exercise , or resistance exercise interventions .  It was hypothesized that cancer survivors become more sedentary during treatment , leading to positive energy balance that in turn worsens body composition . One hundred one subjects completed the 12-month study . Data collected included body composition ( body weight and dual energy x-ray absorptiometry scan ) , aerobic capacity ( 12-minute walk ) , and muscle strength ( 1 repetition maximum ) . Aerobic exercisers were found to have significant improvements in body composition , aerobic capacity , and muscle strength . Resistance exercisers also benefitted , but were less compliant with the intervention over time . Thus , exercise during and following cancer treatment is an important intervention to maintain and perhaps improve body composition of cancer survivors , which may improve survival , reduce comorbidities , and improve quality of life Background Short term exercise interventions have been shown to be beneficial for breast cancer survivors soon after treatments but longer term adherence is needed . Purpose To examine the effects of a supervised exercise program on motivational variables in breast cancer survivors using Self-Determination Theory ( SDT ) . MethodS ixty breast cancer survivors were r and omized in a cross-over design to either an immediate exercise group  ( IEG ; n = 30 )  that exercised from baseline to week 12 or a delayed exercise group  ( DEG  ; n = 30 )  that exercised from week 12 to 24 .  SDT variables were assessed at baseline , 6 , 12 , 18 and 24 weeks using the  Behavioral Regulation for Exercise Question niare-2 and the Basic Psychological Needs Satisfaction Scale . Results Fifty-eight participants completed the follow-up assessment s and achieved a 61.3 % adherence rate . Analyses of variance revealed significant time by group interactions for almost all psychological needs and motivations that favored the exercise intervention time periods . For example , autonomy increased in the IEG from baseline to 12 weeks by 2.0 points compared to the DEG where scores decreased by 0.1 points ( mean group difference = 2.0 , p < 0.001 ) . The cross-over results further supported the main findings . ConclusionS upervised exercise soon after breast cancer treatments may help to develop a positive exercise motivational profile among breast cancer survivors that could portend longer term adherence Purpose In an earlier r and omised controlled trial , we showed that early stage breast cancer patients who received a supervised exercise programme , with discussion of behaviour change techniques , had psychological and functional benefits 6 months after the intervention . The purpose of this study was to determine if benefits observed at 6 months persisted 18 and 60 months later . Methods Women who were in the original trial were contacted at 18 and 60 months after intervention . Original measures were repeated . Results Of the 148 women from the original study who agreed to be contacted again , 114 attended for follow-up at 18 months and 87 at 60 months . Women in the original intervention group reported more leisure time physical activity and more positive moods at 60 months than women in the original control group . Irrespective of original group allocation , women who were more active consistently reported lower levels of depression and increased quality of life compared to those who were less active . Conclusions We have shown that there are lasting benefits to an exercise intervention delivered during treatment to breast cancer survivors . Regular activity should be encouraged for women with early stage breast cancer as this can have lasting implication s for physical and psychological functioning Background Preliminary studies suggest that physical exercise interventions can improve physical fitness , fatigue and quality of life in cancer patients after completion of chemotherapy . Additional research is needed to rigorously test the effects of exercise programmes among cancer patients and to determine optimal training intensity accordingly . The present paper presents the design of a r and omized controlled trial evaluating the effectiveness and cost-effectiveness of a high intensity exercise programme compared to a low-to-moderate intensity exercise programme and a waiting list control group on physical fitness and fatigue as primary outcomes . Methods After baseline measurements , cancer patients who completed chemotherapy  are r and omly assigned to either a 12-week high intensity exercise programme or a low-to-moderate intensity exercise programme . Next , patients from both groups are r and omly assigned to immediate training or a waiting list ( i.e. waiting list control group ) . After 12 weeks , patients of the waiting list control group start with the exercise programme they have been allocated to . Both interventions consist of equal bouts of resistance and endurance interval exercises with the same frequency and duration , but differ in training intensity . Additionally , patients of both exercise programmes are counselled to improve compliance and achieve and maintain an active lifestyle , tailored to their individual preferences and capabilities . Measurements will be performed at baseline ( t = 0 ) , 12 weeks after r and omization ( t = 1 ) , and 64 weeks after r and omization ( t = 2 ) . The primary outcome measures are cardiorespiratory fitness and muscle strength assessed by means of objective performance indicators , and self-reported fatigue . Secondary outcome measures include health-related quality of life , self-reported physical activity , daily functioning , body composition , mood and sleep disturbances , and return to work . In addition , compliance and satisfaction with the interventions will be evaluated . Potential moderation by pre- and post-illness lifestyle , health and exercise-related attitudes , beliefs and motivation will also be assessed . Finally , the cost-effectiveness of both exercise interventions will be evaluated . Discussion This r and omized controlled trial will be a rigorous test of effects of exercise programmes for cancer patients after chemotherapy , aim ing to contribute to evidence -based practice in cancer rehabilitation programmes . Trial registration This study is registered at the Netherl and s Trial Register ( NTR2153 Previous findings suggest that exercise is a safe and efficacious means of improving physiological and psychosocial outcomes in female breast cancer survivors . To date , most research has focused on post-treatment interventions . However , given that the type and severity of treatment-related adverse effects may be dependent on the type of treatment , and that the effects are substantially more pronounced during treatment , an assessment of the safety and efficacy of exercise during treatment is warranted . In this review , we present and evaluate the results of r and omized controlled trials ( RCTs ) conducted during breast cancer treatment . We conducted literature search es to identify studies examining exercise interventions in breast cancer patients who were undergoing chemotherapy or radiation .  Data were extracted on physiological and psychosocial outcomes . Cohen 's d effect sizes were calculated for each outcome . A total of 17 studies involving 1,175 participants undergoing active cancer therapy met the inclusion criteria . Findings revealed that , on average , exercise interventions result ed in moderate to large improvements in muscular strength : resistance exercise ( RE , 𝑑 = 0.86 ) , aerobic exercise  ( AE , 𝑑 = 0.55 ) , small to moderate improvements in cardiovascular functioning ( RE , 𝑑 = 0.45 ; AE , 𝑑 = 0.17 , combination exercise ( COMB , 𝑑 = 0.31 ) and quality of life ( QoL ; RE , 𝑑 = 0.30 ; AE , 𝑑 = 0.50 ; COMB , 𝑑 = 0.63 ) . The results of this review suggest that exercise is a safe , feasible , and efficacious intervention in breast cancer patients who are undergoing different types of treatment . Additional research addressing the different modes of exercise during each type of treatment is warranted to assess the comparable efficacy of the various exercise modes during established breast cancer treatments
Interventions to promote exercise in cancer survivors who report better levels of adherence share some common behaviour change techniques .
These involve setting programme goals , prompting practise and self-monitoring and encouraging participants to attempt to generalise behaviours learned in supervised exercise environments to other , non-supervised context s. However , expecting most sedentary survivors to achieve current guideline recommendations of at least 150 minutes per week of aerobic exercise is likely to be unrealistic .
BACKGROUND The beneficial effects of regular exercise for people living with or beyond cancer are becoming apparent .
However , how to promote exercise behaviour in sedentary cancer cohorts is not as well understood .
A large majority of people living with or recovering from cancer do not meet exercise recommendations .
Hence , review ing the evidence on how to promote and sustain exercise behaviour is important .
OBJECTIVES To assess the effects of interventions to promote exercise behaviour in sedentary people living with and beyond cancer and to address the following questions : Which interventions are most effective in improving aerobic fitness and skeletal muscle strength and endurance ?
What adverse effects are attributed to different exercise interventions ?
Which interventions are most effective in improving exercise behaviour amongst patients with different cancers ?
Which interventions are most likely to promote long-term ( 12 months or longer ) exercise behaviour ?
What frequency of contact with exercise professionals is associated with increased exercise behaviour ?
What theoretical basis is most often associated with increased exercise behaviour ?
What behaviour change techniques are most often associated with increased exercise behaviour ?