Abstract
BackgroundDespite the established benefits of regular exercise for patients with cancer to counteract the deleterious effects of the disease itself and treatment-related adverse effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programs that are accessible and generalizable to a large proportion of patients with cancer into routine cancer care.ObjectiveWe intend to examine the effects attributable to the implementation of a community-based exercise program on cardiorespiratory functional capacity and quality of life for patients with cancer.MethodsThis will be a hybrid study. In the first experimental phase, patients diagnosed with any type of cancer will be randomized into two parallel groups. One group immediately performs Bizi Orain, a 3-month supervised exercise program (3 times a week), in addition to behavioral counseling in a primary health care setting; the other is a reference group that starts the exercise program 3 months later (delayed treatment). In the second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the program. The program evaluation involves the uptake, safety, adherence, and effectiveness assessed after completion of the program and with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months. The primary outcomes of the experimental study, to be compared between groups, are improved physical function and quality of life, whereas overall survival is the main objective of the prospective study. To analyze the association between changes in physical activity levels and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures.ResultsA total of 265 patients have been enrolled into the study since January 2019, with 42 patients from the hematology service and 223 from the oncology service.ConclusionsBizi Orain is the first population-based exercise program in Spain that will offer more insight into the implementation of feasible, generalizable, and sustainable supportive care services involving structured exercise to extend survival of patients with cancer, improve their physical function and quality of life, and reverse the adverse effects of their disease and related treatments, thereby reducing the clinical burden.Trial RegistrationClinicalTrials.gov NCT03819595; http://clinicaltrials.gov/ct2/show/NCT03819595International Registered Report Identifier (IRRID)DERR1-10.2196/24835
Highlights
Cancer is one of the diseases that causes major public health problems worldwide
Bizi Orain, which means “live ” in Basque language, is an evidence-based exercise program that adheres to the American College of Sports Medicine guidelines for cancer survivors [6] and is based on the “Life ” exercise program for people with cancer delivered in Australia [22]
Thereafter, a 5-year prospective observational cohort study will be conducted with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months (Figure 1) to (1) examine the long-term clinical effects of physical activity (PA) exposure on overall survival, physical function, and patient-reported outcomes and (2) evaluate the feasibility of Bizi Orain, identifying potential barriers and facilitators for a generalized and sustainable exercise program within standard health care settings
Summary
Bizi Orain, which means “live ” in Basque language, is an evidence-based exercise program that adheres to the American College of Sports Medicine guidelines for cancer survivors [6] and is based on the “Life ” exercise program for people with cancer delivered in Australia [22]. Thereafter, a 5-year prospective observational cohort study will be conducted with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months (Figure 1) to (1) examine the long-term clinical effects of PA exposure on overall survival, physical function, and patient-reported outcomes and (2) evaluate the feasibility of Bizi Orain, identifying potential barriers and facilitators for a generalized and sustainable exercise program within standard health care settings. To address this point, a qualitative research study will be conducted involving clinical, research, administrative, and community staff, and patients with cancer
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