title: Exercise motivation in rectal cancer patients during and after neoadjuvant chemoradiotherapy.
abstract: Aerobic exercise is safe and feasible for rectal cancer patients during and after neoadjuvant chemoradiotherapy (NACRT), but their motivation to perform such exercise is unknown. Here, we explore the motivational outcomes, perceived benefits and harms, and perceived barriers to exercise during and after NACRT.
  
  
  
  Rectal cancer patients (n = 18) participated in supervised aerobic exercise during NACRT followed by unsupervised exercise after NACRT. Using the theory of planned behavior, we assessed perceived benefits, harms, enjoyment, support, difficulty, and barriers for exercise both during and after NACRT.
  
  
  
  Patients reported that exercise during NACRT was more enjoyable (p = 0.003) and less difficult (p = 0.037) than initially anticipated. The most common perceived benefits of exercise during NACRT were cardiovascular endurance (75 %), quality of life (75 %), and self-esteem (65 %). After NACRT, the most common perceived benefits were physical functioning (93 %), cardiovascular endurance (86 %), and quality of life (79 %). The most common perceived harms of exercise during NACRT were fatigue (31 %), diarrhea (31 %), and skin irritation (24 %). After NACRT, the most common perceived harms were fatigue (21 %) and hand-foot-syndrome (15 %). Side effects from NACRT were the most common exercise barrier during NACRT (88 %) whereas lack of motivation was the most common barrier after NACRT (79 %).
  
  
  
  Rectal cancer patients reported aerobic exercise during NACRT to be more enjoyable and less difficult than anticipated despite significant barriers. This positive motivational response may facilitate recruitment and adherence in future interventions. Moreover, rectal cancer patients identified potential benefits and harms that should be closely monitored in future interventions.
authors: Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada.
authors: Andria R
authors: AR
authors: Morielli
authors: Department of Oncology, University of Alberta, Edmonton, AB, Canada.
authors: Nawaid
authors: N
authors: Usmani
authors: Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada.
authors: Normand G
authors: NG
authors: Boulé
authors: Department of Oncology, University of Alberta, Edmonton, AB, Canada.
authors: Diane
authors: D
authors: Severin
authors: Department of Oncology, University of Alberta, Edmonton, AB, Canada.
authors: Keith
authors: K
authors: Tankel
authors: Department of Oncology, University of Alberta, Edmonton, AB, Canada.
authors: Tirath
authors: T
authors: Nijjar
authors: Department of Oncology, University of Alberta, Edmonton, AB, Canada.
authors: Kurian
authors: K
authors: Joseph
authors: Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada. kerry.courneya@ualberta.ca.
authors: Kerry S
authors: KS
authors: Courneya
mesh_terms: D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020360:Neoadjuvant Therapy / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cancer survivor; Chemotherapy; Exercise; Motivation; Radiotherapy; Theory of planned behavior