Publications (3)26.69 Total impact
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Article: Predictors of adherence to supervised exercise in lymphoma patients participating in a randomized controlled trial.
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ABSTRACT: Exercise improves health in lymphoma patients but the determinants of adherence in this population are unknown. The purpose of this study is to examine predictors of exercise adherence in lymphoma patients. In a randomized trial, 60 lymphoma patients were assigned to the exercise group and asked to attend three supervised exercise sessions per week for 12 weeks. Baseline data were collected on demographic, medical, fitness, psychosocial, and motivational variables. Adherence was assessed by objective attendance. Adherence was 77.8% and was significantly predicted by age (beta = 0.29; p = 0.016) and past exercise (beta = 0.27; p = 0.024); and borderline significantly predicted by previous treatments (beta = 0.22; p = 0.053), body mass index (beta = -0.21; p = 0.076), and smoking (beta = -0.19; p = 0.092). Poorer exercise adherence was experienced by lymphoma patients under age 40, insufficiently active at baseline, previously treated with radiation therapy, overweight or obese, and smokers. Findings may facilitate the development of targeted interventions to improve exercise adherence in this understudied patient population.Annals of Behavioral Medicine 08/2010; 40(1):30-9. · 4.20 Impact Factor -
Article: Moderator effects in a randomized controlled trial of exercise training in lymphoma patients.
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ABSTRACT: The Healthy Exercise for Lymphoma Patients trial showed that aerobic exercise training improved important health outcomes in lymphoma patients. Here, we examine potential moderators of the exercise training response. Lymphoma patients were stratified by major disease type and current treatment status and randomly assigned to usual care (n = 62) or aerobic exercise training (n = 60) for 12 weeks. Endpoints were quality of life, cardiovascular fitness, and body composition. Moderators were patient preference for group assignment, age, sex, marital status, disease stage, body mass index, and general health. Patient preference did not statistically moderate the effects of exercise training on quality of life (P for interaction = 0.36), but the interaction effect of 7.8 points favoring patients with no preference was clinically meaningful. Marital status (P for interaction = 0.083), general health (P for interaction = 0.012), and body mass index (P for interaction = 0.010) moderated the effects of aerobic exercise training on quality of life with better outcomes for unmarried versus married patients, patients in poor/fair health versus good-to-excellent health, and normal weight/obese versus overweight patients. Disease stage (P for interaction = 0.056) and general health (P for interaction = 0.012) moderated the effects of aerobic exercise training on body composition with better outcomes for patients with advanced disease versus early disease/no disease and patients in good health versus very good-to-excellent health. No variables moderated intervention effects on cardiovascular fitness. Findings were not explained by differences in adherence. Clinically available variables predicted quality of life and body composition responses to aerobic exercise training in lymphoma patients. If replicated, these results may inform future randomized trials and clinical practice.Cancer Epidemiology Biomarkers & Prevention 10/2009; 18(10):2600-7. · 4.12 Impact Factor -
Article: Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients.
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ABSTRACT: Lymphoma patients commonly experience declines in physical functioning and quality of life (QoL) that may be reversed with exercise training. We conducted a randomized controlled trial in Edmonton, Alberta, Canada, between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and randomly assigned them to usual care (UC; n = 62) or 12 weeks of supervised aerobic exercise training (AET; n = 60). Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia. Secondary end points were overall QoL, psychosocial functioning, cardiovascular fitness, and body composition. Follow-up assessment for our primary end point was 96% (117 of 122) at postintervention and 90% (110 of 122) at 6-month follow-up. Median adherence to the supervised exercise program was 92%. At postintervention, AET was superior to UC for patient-rated physical functioning (mean group difference, +9.0; 95% CI, 2.0 to 16.0; P = .012), overall QoL (P = .021), fatigue (P = .013), happiness (P = .004), depression (P = .005), general health (P < .001), cardiovascular fitness (P < .001), and lean body mass (P = .008). Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning. AET did not interfere with chemotherapy completion rate or treatment response. At 6-month follow-up, AET was still borderline or significantly superior to UC for overall QoL (P = .054), happiness (P = .034), and depression (P = .009) without an increased risk of disease recurrence/progression. AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response. Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients.Journal of Clinical Oncology 08/2009; 27(27):4605-12. · 18.37 Impact Factor
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Institutions
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2009–2010
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University of Alberta
- Faculty of Physical Education and Recreation
Edmonton, Alberta, Canada
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