Adherence to a remote exercise program and quality of life among patients with cancer: The mediating role of symptom burden.
Notice bibliographique
Résumé
349 Background: Remote exercise interventions are being increasingly employed in oncology, but real-world adherence and its impact on outcomes remain to be established. Understanding whether adherence is associated with better quality of life (QOL), and how symptom burden mediates this relationship, is critical to optimizing supportive care delivery for patients with cancer. Methods: We conducted a longitudinal, single-arm study of a 12-week remote exercise program among adults with cancer receiving systemic treatment. Eligible participants had ECOG ≤2 and access to a smartphone. The intervention included weekly virtual sessions with an exercise physiologist and personalized prescriptions based on the Borg scale, supported by instructional videos and remote guidance via WhatsApp. Participants were encouraged to complete a 30–45-minute exercise session per day. Assessments were conducted at baseline and 12 weeks using the Functional Assessment of Cancer Therapy–General (FACT-G) for QOL and the Edmonton Symptom Assessment Scale (ESAS) for symptom burden. Adherence was defined as high (≥8 weeks) or low (< 8 weeks). Mediation analysis (PROCESS Model 4 with 5,000 bootstrap) tested whether symptom burden at 12 weeks mediated the effect of adherence on QOL. Analyses controlled for baseline FACT-G and ESAS scores. Results: Among 149 participants (median age: 68 years; range: 32–88), 55.0% were female, 67.8% were white, and 56.3% college educated. The most common cancer types were breast (24.8%), genitourinary (17.4%), and gynecological (14.8%); 67.1% had stage IV disease. Treatments included immunotherapy (46.5%), targeted therapy (21.7%), chemotherapy (16.3%), and combination regimens (15.5%). Patients with high adherence (71.1%) showed significantly greater improvement in QOL from baseline to 12 weeks. Adherence had a significant direct effect on QOL at 12 weeks (B = 10.78, SE = 1.33, p < .001; 95% CI: 8.15 to 13.40) and an indirect effect via symptom burden (B = 2.30, Bootstrapped 95% CI: 0.13 to 5.81), indicating partial mediation. These findings suggest that patients who adhered more to the prescribed exercise program had subsequently better QOL, in part due to reduced symptom burden. Conclusions: High adherence to remote exercise programs may lead to meaningful improvements in QOL, partly through reduced symptom burden. Supporting adherence may enhance the effectiveness and scalability of digital exercise interventions in oncology.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».