Exercise In All Chemotherapy (EnACT) Study: Implementation of Exercise Oncology in a Clinical Setting

Natasha R. Burse, Kathleen Sturgeon, Cathy Bryan, Wayne Foo, Katlynn M. Mathis, Jessica Moyer, Renate Winkels, Joachim Wiskemann, Kathryn Schmitz

Research output: Contribution to journalArticlepeer-review


Purpose: Despite exercise recommendations for cancer patients, exercise counseling is not standard of care in cancer centers across the U.S. Challenges in the field of exercise oncology persist and require strategic approaches to ensure that exercise programming is approached in a manner that is widely acceptable to patients and their clinicians. Therefore, we have conducted an implementation study to assess feasibility, adherence to exercise during chemotherapy, and logistics of operating an exercise intervention program in the infusion suite of a cancer institute.

Methods: The Exercise Medicine Unit at Penn State Cancer Institute (PSCI) is located in the infusion suite of the PSCI and was opened in the Fall of 2017. Staff screened all patient visits to the PSCI infusion suite for study eligibility criteria: ECOG ≤ 2, absence of absolute contraindications for exercise, solid tumor malignancy, and scheduled to receive chemotherapy. Participants completed surveys (physical activity, barriers to exercise, nutrition, work impairment, and quality of life) and physical function testing at baseline and follow up. An ACSM certified cancer exercise trainer prescribed a personalized exercise program that has 5 components: aerobic, strength, balance, stretching, and relaxation.

Results: Of 317 patients screened, 42% were eligible (135), and 104 consented (77%) to the EnACT study. Characteristics of the study population include an average age of 59 years, 62% female, and 40% with metastatic disease. The top 3 cancer sites in the study were breast (23%), colorectal (17%), and pancreatic (16%). Adherence to prescribed exercise programming was 82%, n=39 completers. Overall, barriers to being active were decreased, with fewer participants reporting lack of willpower to exercise (42%, baseline; 19% follow up; p=0.02), and fewer citing influence from others as a barrier to exercise (19%, baseline; 3% follow up; p=0.06).

Conclusion: We report our mid-point analysis of the EnACT study. Thus far, the study is clinically feasible with 77% of eligible participants providing consent and an 82% adherence rate. Qualitative assessment with participants and health care professionals are ongoing. Collectively this study will aid in moving evidence based exercise-oncology practice into routine clinical usage.
Original languageEnglish (US)
Pages (from-to)844
JournalMedicine and Science in Sports and Exercise
Issue number5S
StatePublished - Apr 2018


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