A Scoping Review Of Cardiac Rehabilitation Use By Adults With Cancer

Abstract

PURPOSE: Cardiac rehabilitation (CR) improves recovery from cardiac events and may aid in the recovery from cancer. We conducted a scoping review to systematically describe research on CR use by adults with cancer and examined acceptability and benefits of CR for adults with cancer. METHODS: We searched 4 databases through September 16, 2019. Studies were required to have enrolled adults with cancer into CR or into a CR-based rehabilitation program. RESULTS: We identified 780 articles. Ten articles from 9 studies met inclusion criteria. Studies occurred in the United States (n=3), Canada (n=4), and the United Kingdom (n=2). Five studies used a quasi-experimental pre-post design, 3 used a retrospective cohort design, and 1 was a randomized control trial. In total, 662 adults with cancer were included: 74% were female and most had breast cancer (breast 60%, prostate 7%, hematologic 7%, lung 3%, other 23%). The average age at baseline was 55 years for 5 studies and 59, 65, 66, and 74 years for the other studies. Race/ethnicity was reported in 2 studies for 82 adults and the majority of adults were white. Two studies included adults that were post-treatment, 6 included adults that were during treatment or post-treatment, and 1 did not report treatment status. Six studies used an existing CR program, 2 developed a new cancer rehabilitation program based on a CR model, and 1 did not report CR program details. In 2 studies, adults with cancer were interviewed about acceptability of CR. Adults liked the peer support of CR and believed that CR increased their motivation and confidence to be active. Barriers to attending CR were travel distance and lengthy recoveries from surgery/treatment. Seven studies measured changes in outcomes before and after CR. The most frequently measured outcomes were cardiorespiratory fitness (n=4), walking speed (n=3), body composition (n=3), depression (n=3), and quality of life (n=3); in most studies these outcomes improved after rehabilitation. Three studies monitored safety and reported no adverse events. CONCLUSION: CR may safely improve physical and psychosocial health of adults with cancer. Future studies would benefit from the use of more rigorous study designs with a control group, inclusion of a diverse sample of adults with cancer, and more feedback on acceptability of CR from adults with cancer.