Determinants Of Exercise Adherence Among Breast Cancer Patients Undergoing Chemotherapy: A Systematic Review
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Abstract
Purpose: To systematically explore the determinants of exercise adherence and maintenance in patients undergoing chemotherapy using a socio-ecological approach.
Method: Literature identified in PubMed, Science Direct, SCOPUS, and Cochrane Reviews was searched from January 2010 to the end date restricted to the end of March 2022. We included full-text articles that: 1) were conducted among adult cancer patients undergoing chemotherapy; 2) quantitatively assessed factors associated with the intervention, adherence, and maintenance, and 3) were published in English. The methodological quality of the selected literature was examined using the PEDRO score. Methodological quality ranged from 4 to 8 as rated on the PEDRO scale with a median score of 7 of 10, confirming “high” methodological quality. All literature were rated as high qualitative literature with a score of >4 of which 9 scored high scores.
Results: Nine articles were included and focused on determinants of exercise adherence and evaluated 20 potential determinants: 29 demographic and clinical, 27 psychological, 10 physical, 4 social factors, and 1 environmental factor. We found there is a positive correlation between adherence and many factors which includes location/ centre, VO2 Peak, Disease stage, depression, endocrine symptoms, few exercise limitations, shorter chemotherapy protocols, body-mass index, and high baseline endurance time from the multivariant analysis.
Conclusion: The most prominent determinants of adherence to exercise interventions were location of the rehabilitation centre, VO2 Peak, Disease stage, depression, endocrine symptoms, few exercise limitations, shorter chemotherapy protocols, body mass index, high baseline endurance time from multivariant analysis. To increase the number of cancer patients who will benefit, these results shin developing and implementing implementation of future exercise interventions.