Article

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.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS