Neoplasms
Conditions
Keywords
cancer, exercise
Brief summary
The primary purpose of this proposed 5-year hybrid effectiveness and implementation study is to evaluate the relative benefit from, and implementation of an Alberta wide clinic-to-community-based cancer and exercise model of care - the Alberta Cancer Exercise (ACE) Program. The investigators hypothesize that the strategy will improve the physical well-being and QoL of survivors (on and off cancer treatment) while preventing the development of secondary cancers.
Detailed description
A total of 2500 adult cancer survivors will be enrolled in the 5-year study. The investigators will build capacity by expanding ACE training and programming to sites beyond the large urban centers. The investigators plan for implementation in 7 Alberta YMCAs and/or City Recreation facilities within 3 years, as well as to formally establish partnerships within AHS to build further capacity across the province within existing AHS programming (e.g., CancerControl Rehab Services, Alberta Healthy Living Program and Primary Care Network). Virtual and supported home-based options will be available as an alternative. Eligible and consenting participants will be screened for exercise safety, and following fitness testing will be triaged to appropriate exercise programming in their home or community. The exercise intervention will take place at the survivor's home, YMCAs and municipal fitness centres across the province. The supported home-based and community-based exercise program will be administered by exercise specialists who have undergone the ACE Cancer and Exercise: Training for Fitness Professionals course. Survivors will take part in a combination of aerobic, resistance, balance, and flexibility exercises delivered in a circuit-type class setting or group personal training format, twice weekly for an 8-to-12-week period. Effectiveness outcomes include physical fitness, physical activity, quality of life, and healthcare utilization. These outcomes are known factors associated with the secondary prevention of cancer. The RE-AIM framework will be used to evaluate program reach, effectiveness, adoption, implementation and maintenance. The Alberta Quality Matrix for Health will serve as a framework to inform program sustainability beyond the funding period. Through this research, the investigators will better understand the effectiveness of the ACE program, and evaluate processes to support future implementation and sustainability.
Interventions
BEHAVIORALExercise
Exercise sessions will include a combination of aerobic, resistance, balance, and flexibility exercises delivered in a circuit-type class setting or group personal training format.
Sponsors
University of Calgary
Alberta Health services
Cross Cancer Institute
Tom Baker Cancer Centre
University of Alberta
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. have a diagnosis of cancer; 2. be over the age of 18 years; 3. be able to participate in low-intensity levels of activity at minimum; 4. be pretreatment, or receiving active cancer treatment (i.e., surgery, systemic therapy and radiation therapy), or have received cancer treatment within the past 3 years; or have ongoing significant cancer or treatment-related impairments (requiring supportive exercise intervention); 5. be able to provide informed written consent in English.
Exclusion criteria
1\) Inability or deemed unsafe to participate in physical activity program \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Physical Activity Minutes Per Week | Baseline to One-year | Change in number of participants meeting Guidelines for Physical Activity of 150 minutes per week of moderate intensity exercise |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Upper extremity flexibility | Baseline to One-year | Change in active shoulder flexion range of motion (degrees) |
| Body Composition | Baseline to One-year | Change in BMI |
| Waist and hip measurements | Baseline to One-year | Change in waist and hip circumference (cm) and change in waist-to-hip ratio |
| Program implementation and evaluation | Baseline to One-year | RE-AIM: program reach, effectiveness, adoption, implementation and maintenance |
| Adverse events | Baseline to One-year | Adverse event rates |
| Aerobic Endurance | Baseline to One-year | Change in 6 minute walk test distance (metres) |
| Quality of Life Cancer Specific | Baseline to One year | Change in Functional Assessment of Cancer Therapy General Scale |
| General Health-related Quality of Life | Baseline to One-year | Change in Rand Short Form (SF)-36 |
| Fatigue | Baseline to One-year | FACT-Fatigue subscale |
| Upper extremity grip strength | Baseline to One-year | Change in hand-grip dynamometry (kg) |
| Functional performance test | Baseline to One-year | Change in sit-to-stand (number in 30 seconds) |
| Lower extremity flexibility | Baseline to One-year | Change in sit-and-reach test (cm) |
| Balance | Baseline to One-year | Change in one legged stance test (seconds) |
| Cost-effectiveness evaluation | Baseline to One-year | EQ-5D questionnaire |
| Exercise adherence | Baseline to 12-weeks | Adherence to exercise programming (attendance at sessions) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Muscular endurance test (optional) | Baseline to One-year | Change in number of push-ups |
| Core endurance test (optional) | Baseline to One-year | Change in plank test (seconds held) |
| Home-based programming stepping test | Baseline to One-year | 2-minute stepping test |
| 1RM or 8RM strength (optional) | Baseline to One-year | Change in bench press, vertical row and leg press strength (kg) |
Countries
Canada
Outcome results
None listed