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Development of a Risk‐Screening Tool for Cancer Survivors to Participate in Unsupervised Moderate‐ to Vigorous‐Intensity Exercise: Results From a Survey Study
Author(s) -
Brown Justin C.,
Ko Emily M.,
Schmitz Kathryn H.
Publication year - 2015
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2014.09.003
Subject(s) - medicine , survivorship curve , physical therapy , comorbidity , cancer , disease , exercise intensity , sports medicine , heart rate , blood pressure
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.