Dealing with lung cancer is traumatic at best. With all the stress of waiting for surgery and the attendant fears and concerns about what happens next, life can be difficult. But would exercise help?
And what would help lung cancer patients stick to an exercise training program?
A secondary analysis of a pilot study, led by behavioural medicine doctoral student Carolyn Peddle, found that not only was there a 73 percent overall adherence to an exercise program among study participants, but those achieving over 80 percent adherence to their exercise training had better perceived behavioural control.
Physical benefits were much in evidence as well. Peddle notes that a previous publication looking at fitness benefits of the exercise regimen in this group of patients found that those with at least 80 percent adherence, experienced improvements in cardiorespiratory fitness.
For this study Peddle and colleagues recruited 19 patients with suspected lung cancer to undergo exercise training while waiting for surgery. This publication examined the correlates - medical, demographic and social-cognitive - of exercise adherence. It's the first study to do so.
"We wanted to see if there was a relationship between theory of planned behaviour variables (such as attitude and intention) or medical and demographic variables and exercise adherence," says Peddle, who is supervised by Kerry Courneya, Canada Research Chair in Physical Activity and Cancer.
Study participants completed a questionnaire based on the Theory of Planned Behaviour (which theorizes that intention is the chief determinant of our behaviours) to help researchers understand participants' attitudes toward exercise, their perceived control over their behaviours, as well as their medical and demographic information.
Participants (six men and 13 women) ranged from 40 to 81 years of age; included smokers and non-smokers; 50 percent had COPD (chronic obstructive pulmonary disease) which can make it difficult to exercise owing to complicating conditions such as muscle-wasting and shortness of breath.
The exercise prescription consisted of coming to the Behavioural Medicine Fitness Centre at the University of Alberta five days a week for about eight weeks in the lead-up to surgery, to a supervised exercise program using the stationery bicycle.
"Perceived behavioural control had the strongest correlation with overall exercise adherence," says Peddle of the study findings.
"We also elicited the control beliefs - what people believed would be the helpful factors for coming to do exercise training. Participants liked making a commitment to the program, and flexible hours in our fitness centre, which made a big difference for people in our study who were working," she says.
Participants said the coaching aspect of the exercise intervention made them feel safe, and the constant monitoring of their health was comforting.
And free parking was a definite plus.
Peddle says parking can be a big concern for study participants. "We have designated parking right outside the fitness centre - it's one less thing people have to worry about."
The biggest barriers to exercise adherence, she says, were "other medical conditions, medical appointments, family matters, work commitments - and transportation"
Peddle says the surprise finding, though this has been borne out in cardiac rehabilitation and other cancer and physical activity studies, was that men in the study adhered to exercise 25 percent better than women did.
That's a big concern, says Peddle.
"In future studies we need to find ways of helping women improve their adherence to exercise"
The study, funded by the Alberta Cancer Board, was published in the May 2009 issue of Oncology Nursing Forum.
More information about the Behavioural Medicine Laboratory at the University of Alberta.