title: Effects of supervised exercise on motivational outcomes and longer-term behavior.
abstract: BACKGROUND
  Supervised exercise may have positive effects on motivation and continued exercise in cancer survivors, but few randomized controlled trials have examined this issue. Here, we report the motivational outcomes and longer-term exercise behavior from the Healthy Exercise for Lymphoma Patients trial.
  
  
  METHODS
  Lymphoma patients were randomly assigned to 12 wk of supervised aerobic exercise (SUP, n = 60) or usual care (UC, n = 62). Motivational outcomes from the theory of planned behavior were assessed at baseline, after intervention, and at 6-month follow-up using standardized measures. Exercise behavior was self-reported at baseline and 6-month follow-up using the Godin Leisure Time Exercise Questionnaire.
  
  
  RESULTS
  Data were available from 95% of participants after intervention and 90% at 6-month follow-up. SUP attended a median of 92% of the supervised exercise sessions. After intervention, SUP was superior to UC for intention (+0.41 (+0.09 to +0.72), P = 0.012) and perceived behavioral control (+0.36 (+0.01 to +0.72), P = 0.047) and borderline superior for self-efficacy (+0.35 (-0.02 to +0.72), P = 0.060). At 6-month follow-up, SUP reported significantly more exercise minutes compared with UC (+133 (+38 to +227), P = 0.006), and a higher percentage of SUP participants were meeting public health exercise guidelines (+25.6% (+8.2% to +43.0%), P = 0.004). Path analysis showed that perceived behavioral control partially mediated the effects of supervised exercise (group assignment) on exercise behavior at 6-month follow-up (meeting exercise guidelines).
  
  
  CONCLUSIONS
  Supervised exercise has motivational effects in lymphoma patients and improves longer-term exercise behavior. Strategies to further enhance the motivational value of supervised exercise are warranted.
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada. kerry.courneya@ualberta.ca
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.forename: Clare
authors.initials: C
authors.lastname: Stevinson
authors.forename: Margaret L
authors.initials: ML
authors.lastname: McNeely
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Sellar
authors.forename: Christine M
authors.initials: CM
authors.lastname: Friedenreich
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Peddle-McIntyre
authors.forename: Neil
authors.initials: N
authors.lastname: Chua
authors.forename: Tony
authors.initials: T
authors.lastname: Reiman
mesh_terms: D000416:Alberta; D015444:Exercise / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008223:Lymphoma / Q000534:rehabilitation*; D008297:Male; D009042:Motivation; D010349:Patient Compliance; D011788:Quality of Life; D012042:Registries; D011795:Surveys and Questionnaires; D016896:Treatment Outcome