title: Barriers to supervised exercise training in a randomized controlled trial of breast cancer patients receiving chemotherapy.
abstract: BACKGROUND
  Exercise adherence is a challenge for breast cancer patients receiving chemotherapy but few studies have identified the key barriers.
  
  
  OBJECTIVE
  In this paper, we report the barriers to supervised exercise in breast cancer patients participating in a randomized controlled trial.
  
  
  METHODS
  Breast cancer patients initiating adjuvant chemotherapy (N = 242) were randomly assigned to usual care (n = 82) or supervised resistance (n = 82) or aerobic (n = 78) exercise. Participants randomized to the two exercise groups (n = 160) were asked to provide a reason for each missed exercise session.
  
  
  RESULTS
  The two exercise groups attended 70.2% (5,495/7,829) of their supervised exercise sessions and provided a reason for missing 89.5% (2,090/2,334) of their unattended sessions. The 2,090 reasons represented 36 different barriers. Feeling sick (12%), fatigue (11%), loss of interest (9%), vacation (7%), and nausea/vomiting (5%) accounted for the most missed exercise sessions. Disease/treatment-related barriers (19 of the 36 barriers) accounted for 53% (1,102/2,090) of all missed exercise sessions. Demographic and medical variables did not predict the types of exercise barriers reported.
  
  
  CONCLUSIONS
  Barriers to supervised exercise in breast cancer patients receiving chemotherapy are varied but over half can be directly attributed to the disease and its treatments. Behavioral support programs need to focus on strategies to maintain exercise in the face of difficult treatment side effects.
authors.affiliation: University of Alberta, E-488 Van Vliet Center, Edmonton, Alberta, Canada. kerry.courneya@ualberta.ca
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.forename: Donald C
authors.initials: DC
authors.lastname: McKenzie
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reid
authors.forename: John R
authors.initials: JR
authors.lastname: Mackey
authors.forename: Karen
authors.initials: K
authors.lastname: Gelmon
authors.forename: Christine M
authors.initials: CM
authors.lastname: Friedenreich
authors.forename: Aliya B
authors.initials: AB
authors.lastname: Ladha
authors.forename: Caroline
authors.initials: C
authors.lastname: Proulx
authors.forename: Kirstin
authors.initials: K
authors.lastname: Lane
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Vallance
authors.forename: Roanne J
authors.initials: RJ
authors.lastname: Segal
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology*; D017024:Chemotherapy, Adjuvant / Q000523:psychology*; D017281:Cost of Illness; D015444:Exercise / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D012803:Sick Role
chemical_list: D000970:Antineoplastic Agents