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Understanding factors influencing physical activity and exercise in lung cancer: a systematic review

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Abstract

Purpose

Despite evidence and clinical practice guidelines supporting physical activity (PA) for people with lung cancer, this evidence has not translated into clinical practice. This review aims to identify, evaluate and synthesise studies examining the barriers and enablers for patients with lung cancer to participate in PA from the perspective of patients, carers and health care providers (HCPs).

Methods

Systematic review of articles using electronic databases: MEDLINE (1950–2016), CINAHL (1982–2016), EMBASE (1980–2016), Scopus (2004–2016) and Cochrane (2016). Quantitative and qualitative studies, published in English in a peer-reviewed journal, which assessed the barriers or enablers to PA for patients with lung cancer were included. Registered-PROSPERO (CRD4201603341).

Results

Twenty-six studies (n = 9 cross-sectional, n = 4 case series, n = 11 qualitative) including 1074 patients, 23 carers and 169 HCPs were included. Barriers and enablers to PA were identified (6 major themes, 18 sub-themes): Barriers included patient-level factors (physical capability, symptoms, comorbidities, previous sedentary lifestyle, psychological influences, perceived relevance), HCP factors (time/knowledge to deliver information) and environmental factors (access to services, resources, timing relative to treatment). Enablers included anticipated benefits, opportunity for behaviour change and influences from HCPs and carers.

Conclusion

This systematic review has identified the volume of literature demonstrating that barriers and enablers to PA in lung cancer are multidimensional and span diverse factors. These include patient-level factors, such as symptoms, comorbidities, sedentary lifestyle, mood and fear, and environmental factors. These factors should be considered to identify and develop suitable interventions and clinical services in attempt to increase PA in patients with lung cancer.

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Author information

Authors and Affiliations

  1. Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia

    Catherine L. Granger, Linda Denehy, Kuan-Yin Lin & Selina M. Parry

  2. Department of Physiotherapy, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia

    Catherine L. Granger & Kuan-Yin Lin

  3. Institute for Breathing and Sleep, Bowen Centre, 145 Studley Road, Hiedelberg, VIC, 3084, Australia

    Catherine L. Granger & Linda Denehy

  4. Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London National Institute of Health Research Biomedical Research Centre, Strand, London, WC2R 2LS, UK

    Bronwen Connolly & Nicholas Hart

  5. Lane Fox Clinical Respiratory Physiology Research Centre, Guy’s and St. Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK

    Bronwen Connolly & Nicholas Hart

  6. Centre of Human and Aerospace Physiological Sciences, King’s College London, Strand, London, WC2R 2LS, UK

    Bronwen Connolly

  7. Division of Asthma, Allergy and Lung Biology, King’s College London, Strand, London, WC2R 2LS, UK

    Nicholas Hart

  8. Department of Thoracic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia

    Phillip Antippa

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  1. Catherine L. Granger
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  2. Bronwen Connolly
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  3. Linda Denehy
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  4. Nicholas Hart
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  6. Kuan-Yin Lin
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  7. Selina M. Parry
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Corresponding author

Correspondence to Catherine L. Granger.

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Conflict of interest

The work of two authors (CG, LD) was included as a primary study in this review [29].

The authors declare that they have no conflicts of interest.

Funding

This work is supported by Fellowships to the following authors: Dr. Granger is partially funded by a National Health and Medical Research Council Translating Research Into Practice Fellowship co-funded by Cancer Australia. Dr. Parry is funded by a National Health and Medical Research Council Early Career Fellowship. Dr. Connolly is funded by a National Institute of Health Research Postdoctoral Fellowship.

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Granger, C.L., Connolly, B., Denehy, L. et al. Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer 25, 983–999 (2017). https://doi.org/10.1007/s00520-016-3484-8

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  • DOI: https://doi.org/10.1007/s00520-016-3484-8

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