EXCEL will provide online and, where feasible, in-person exercise programs to individuals living with and beyond cancer (ILWBC). Research has shown that targeted programs that include tailored exercise prescriptions are more successful in helping individuals with chronic disease to incorporate physical activity and exercise into their daily routines. While ILWBC are advised by healthcare professionals (HCPs) to engage in exercise, there is a lack of cancer-specific exercise programs and cancer-trained exercise specialists in Canada, outside of the research setting. Considering the negative impact cancer and its treatments have on fitness and physical activity levels, community-based efforts towards improving access, uptake and maintenance of exercise programming are needed. This study will evaluate the benefits of a community-based or online EXCEL exercise program for people living with and beyond cancer across Canada, using a streamlined intake process compared to the original EXCEL Study (HREBA.CC-20-0098, NCT04478851). This 8 to 12-week program (intervention) will be delivered in-person or over virtual platform. It includes twice weekly supervised exercise classes.
Over the past 4.5 years, the EXCEL Study (HREBA.CC-20-0098, NCT04478851) has been implemented across Canada and has recruited over 1500 individuals living with and beyond cancer. This updated study will streamline the program to essential baseline screening and testing (for safe and effective program delivery), simplify outcome assessments (for participants to see changes and for program evaluation), and increase the reach to include more urban centres to encourage more healthcare provider (HCP) buy-in with a simplified referral process (i.e. no patient screening required from HCPs to determine eligibility, based on location). This updated program is based off of the Alberta Cancer Exercise (ACE) Program (HREBA.CC-24-0252). Thus, we are modifying the original EXCEL ethics to will reduce the participant burden with less patient-reported-outcomes and fewer follow-ups, which will allow more focus on program implementation, evaluation, and sustainability. Continued effort and training to establish the clinic-to-community model will be enhanced with stronger relationships and referrals from the cancer care system and the HCPs, which will continue to work towards a 'patient-centered care approach'.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
740
Participants will take part in a combination of aerobic, resistance, balance, and flexibility exercises delivered in a circuit-type class setting, twice weekly for a 8-12-week period (duration of intervention depends on scheduling logistics for the coordinating hubs and their spokes sites). The exercise sessions will be conducted in groups with a ratio of up to 15 participants per instructor. The program follows exercise progression principles (i.e., frequency, intensity, time, type, overload and progression) over the 8-12-weeks, with tailoring of any exercise to meet individual participant needs as required, in order to promote fitness and wellness benefits.
University of Calgary
Calgary, Alberta, Canada
RECRUITINGUniversity of British Columbia
Vancouver, British Columbia, Canada
RECRUITINGNova Scotia Health Authority
Halifax, Nova Scotia, Canada
RECRUITINGUniversity of Toronto
Toronto, Ontario, Canada
RECRUITINGCentre hospitalier de l'Université de Montréal
Montreal, Quebec, Canada
RECRUITINGPhysical Activity Level
The Modified Godin Leisure Time Exercise Questionnaire is used to determine subjective levels of physical activity in each participant.
Time frame: Baseline to one year
Cancer related symptoms
Change in Edmonton Symptom Assessment Scale - revised: cancer. Scale is from 0-10, where 0 means the symptom is absent and 10 means the worst possible severity of the symptom is being experienced.
Time frame: Baseline to one year
Cost-effectiveness
Change in EuroQual - 5Dimensions (EQ-5D) tool - first section is a questionnaire; last section uses a scale from 0-100, where 0 means the worst health imaginable and 100 means the best health imaginable.
Time frame: Baseline to one year
Fatigue
Change in Functional Assessment of Chronic Illness Therapy - Fatigue subscale - scale is from 0-4, where 0 means "not at all" and 4 means "very much".
Time frame: Baseline to one year
Quality of life
Single-item measure on quality of life - scale from 0 to 100, where 100 means the best Quality of Life imaginable and 0 means the worst Quality of Life imaginable.
Time frame: Baseline to one year
Body Composition
Change in body mass index (BMI)
Time frame: Baseline to 12-weeks
Aerobic Capactiy
Change in 6-minute walk test (m) or 2 minute step test (steps) results
Time frame: Baseline to 12-weeks
Lower body strength
Change in sit-to-stand (number of repetitions in 30 seconds)
Time frame: Baseline to 12-weeks
Upper extremity flexibility
Change in active shoulder flexion range of motion (degrees)
Time frame: Baseline to 12-weeks
Balance
Change in one legged stance test (seconds)
Time frame: Baseline to 12-weeks
Exercise adherence
Adherence to exercise programming (attendance at sessions)
Time frame: Duration of the intervention (8-12 week exercise program)
Program implementation and evaluation
RE-AIM: program reach, effectiveness, adoption, implementation and maintenance
Time frame: Baseline to one year
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