UNDERSTANDING THE INDIVIDUALIZATION OF EXERCISE PRESCRIPTION FOR PEOPLE WITH CANCER: A SYSTEMATIC REVIEW

Abstract

PURPOSE The importance of prescribing individualized exercise for people with cancer to minimize injury risk and optimize outcomes has been echoed internationally in position and consensus statements. However, it is unclear what individualization processes are employed in exercise oncology research and how exercise individualisation is implemented for people with cancer. This study aimed to systematically review the available evidence to elucidate the individualisation methods being employed in exercise oncology research. METHODS A systematic search of PubMed, EMBASE, CINAHL, and Web of Science was performed following the PRISMA guidelines. Eligible randomised controlled trials (RCT), controlled trials (CT), pre-post trials, and comparison trials included men and women aged ≥18 years with a histologically confirmed diagnosis of cancer; undertaking any structured exercise protocol that was ‘individualized’, with or without supervision; and that explored outcomes of intervention fidelity (e.g., recruitment, attendance, adherence, attrition), and/or patient health and wellbeing (i.e., quality of life, symptom improvement, medication use, physical activity). Study quality was assessed using the Delphi list tool. RESULTS Forty-nine studies were found to be eligible and subsequently included in the narrative synthesis. Study quality was on average 49% (range 14 to 100%). Individualization of the exercise prescription most occurred prior to intervention commencement (n=23, 47%), based on physiological results from baseline assessments (n=21, 43%). No study individualized exercise based on participant readiness to train. The exercise prescription was predominantly individualized via modulation of both the intensity and volume of exercise (11, 22%). CONCLUSION Exercise prescription individualization for people with cancer is highly prescriptive and predetermined. Seldom has exercise prescription been individualized based on participant readiness to train. Future exercise oncology studies should include greater detail on the reporting of exercise individualization methods and rationale to enhance our understanding of the relationship between individualization and exercise adherence and attrition in people with cancer.