title: Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study.
abstract: OBJECTIVE
  Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation.
  
  
  METHODS
  A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription.
  
  
  RESULTS
  Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals.
  
  
  CONCLUSIONS
  Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care.
authors.affiliation: School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health, VIC, Australia.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Dennett
authors.affiliation: School of Allied Health, La Trobe University and Northern Health, VIC, Australia.
authors.forename: Casey L
authors.initials: CL
authors.lastname: Peiris
authors.affiliation: School of Allied Health, La Trobe University and Northern Health, VIC, Australia.
authors.forename: Nora
authors.initials: N
authors.lastname: Shields
authors.affiliation: Ambulatory and Community Services Program, Eastern Health, VIC, Australia.
authors.forename: Delwyn
authors.initials: D
authors.lastname: Morgan
authors.affiliation: School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health, VIC, Australia.
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
mesh_terms: D001315:Australia; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008495:Medical Oncology / Q000379:methods*; D009369:Neoplasms / Q000534:rehabilitation*; D011795:Surveys and Questionnaires
keywords: cancer; exercise; multidisciplinary care; physiotherapy; rehabilitation