Investigating the feasibility of introducing personalised exercise prescription from point-of-diagnosis in individuals receiving treatment for early-stage breast or colon cancer in Christchurch, New Zealand.

This single centre, multidisciplinary study aims to explore the feasibility of introducing supervised, personalised exercise prescription, any time from point-of-diagnosis for 12-weeks in individuals receiving treatment for early-stage breast or colon cancer in Christchurch, New Zealand. Exercises will be individualised and prescribed by an accredited Exercise Physiologist with more than 5-years-experience. Sessions will be a combined approach of aerobic and resistance training, delivered in a hospital-based gym 1-3 x / week for up to 60 mins per session. Adherence will be assessed to investigate feasibility of the programme. There will be two options for people to self-select to participate in the research study, either in the exercise group or the non-exercise group. Once details of participation have been communicated and consent recorded, all participants will undergo a baseline assessment. From the baseline assessment, individuals in the exercise group will have an individualised exercise programme prescribed one-on-one. The aim will be to reach a combined moderate-to-high intensity resistance and cardiovascular-based programme during each session if this is possible based on how each participant presents. Cardiovascular exercises may include running, walking or biking and resistance exercises may include squats, lunges, balance and modified upper limb exercises. Participants in the non-exercise group will be advised to continue with their usual daily routines. All participants will be asked to keep a journal of their activity and to bring this journal to each assessment. Participants may be referred at any time within the preoperative phase, and therefore the number of sessions completed prior to surgery will vary. Following surgery the exercise will not recommence until approval is received from the treating surgeon. Exercise reassessments and interventions will commence gradually and progressively to allow the participant to recover. The aim will be to reach a combined moderate-to-high intensity resistance and cardiovascular-based programme during each session. Following surgery, exercise prescription will be modified and scaled based on the participant’s mobility, pain and energy levels. The goal of this programme is to individualise the programme to the participant so adaptions to frequency, intensity, time and type will be frequent to ensure the participant is supported and the exercise programme is responsive to the needs of the participant. Reassessments will occur every 4-weeks to assess the progress of the participant’s exercise capacity throughout their treatment. The exercise programme will continue supervised for 12 weeks. Following this, participants will either be transitioned into an independent programme, to a community-based class or continue with the exercise intervention if it is required. The intensity of sessions will be based on the participant’s heart rate at lactate threshold. In addition, an adapted ‘Readiness to be Active’ scale will be used prior to each exercise session. This ‘Readiness to be Active’ scale will take account of the participant’s sleep, mood, energy levels and motivation for the day. Sessions will be adapted based on this ‘Readiness to be Active’ scale on a daily basis. Rate of perceived exertion using the Borg scale will be used throughout each session to verify how the participant is experiencing each session. The resistance training will involve six to eight exercises targeting the major muscle groups and functional movement capacities. The intensity of each session will be assessed through the participant’s previous exercise history and assessment outcomes. If participants have not been doing any resistance training over the past 12-weeks then the training load will commence slowly and progressively, commencing with lower loads and higher repetitions around 50-80% of the participants estimated one-repetition maximum (1RM), around 8-12RM. Exercises will be adapted to assist participants with musculoskeletal discomforts and range of motion restrictions. Flexibility and mobility is important to achieve for activities of daily living and functional movements. Each participant’s range of motion will be assessed during the initial assessment. Exercises will be prescribed to assist with their movement and improve their musculoskeletal discomfort. Shoulder range of motion may be affected following breast cancer surgery and exercises will be gradual and progressive to allow for this return to function.