Courneya 2003.
| Study characteristics | ||
| Methods | Study design: RCT Study location: Canada Inclusion criteria: 1. surgery for colorectal cancer within the past 3 months 2. recovery from surgery as indicated by an attending physician 3. ability to understand and provide written informed consent in English 4. passed the revised Physical Activity Readiness Questionnaire (rPAR‐Q; Thomas et al. 1992) 5. no contraindications to exercise as determined by a submaximal cardiorespiratory fitness test Exclusion criteria: not reported |
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| Participants | Number randomised: 102; 69 to the exercise group and 33 to a waiting list control group Baseline imbalances: no significant differences at baseline Withdrawals and exclusions: 9 lost to follow‐up in total (7 in intervention group 2 in control group) Age, mean (SD) years: Total; 60.3 years Control; 61.1 (9.93) years Intervention; 59.92 (10.73) years Gender: Control: 64.5% male Intervention: 54.8% male Ethnicity: not reported Comorbidities: not reported SES: Control group: 35% completed university; 53.6% with income > USD 40,000 Intervention group: 46.4% completed university; 65.5% with income > USD 40,000 Cancer type: colorectal cancer Cancer stage: Tumour stage III/IV control; 87.1 % intervention; 77.6 % Node stage 0 control; 61.3% intervention; 58.6% Metastatic control; 0 intervention; 6.9% (4 participants) Type of treatment: 100% had surgery Surgery alone: control 32.3% intervention 34.4% surgery plus RT control 0% intervention 1.6% Surgery plus CT control 51.6% intervention 32.6% surgery plus RT and CT control 16.1% intervention 21.3% Receiving or finished treatment: not reported (most likely a combination of both as surgery had taken place in passed 3 months) Time beyond treatment: surgery within last 3 months Time since diagnosis: not reported |
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| Interventions |
Physical activity description Frequency: 3 to 5 times per week Intensity: to 65% to 75% of heart rate maximum Time: 20 to 30 minutes Type: participants were allowed to choose the mode of exercise they preferred (e.g. swimming, cycling) but if they had no preference they were prescribed walking Length of intervention: 16 weeks Total number of exercise sessions: 48 to 80 Control group: were asked not to initiate any structured exercise over the course of the intervention (wait list) Setting: home based Supervised or self‐directed: self‐directed Co‐interventions: none |
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| Outcomes | 1. Quality of life (FACT‐C scale, FACT‐G, TOI score‐ sum of physical and FWB subscale and colorectal subscale)
2. Satisfaction with life, measured (Satisfaction with Life scale)
3. Depression and anxiety, (CES‐D scale and STAI, respectively)
4. Cardiovascular fitness (Modified Balke Treadmill Test)
5. Body composition (Harpenden callipers)
6. Flexibility, (sit and reach test)
Time points measured: baseline and 16 weeks Time points reported: baseline and 16 weeks Adverse events: not reported |
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| Notes | Funding source: National Cancer Institute of Canada, the Alberta Heritage Foundation for Medical Research and Sociobehavioral Cancer Research Network | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | A random numbers table was used |
| Allocation concealment (selection bias) | Unclear risk | Not described |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Not possible to blind participants and personnel due to the nature of the intervention |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Fitness test conducted by person blinded to the experimental group |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Attrition and exclusions were reported, with reasons. Retention rate was 91.2%. ITT analysis conducted |
| Selective reporting (reporting bias) | Low risk | There appears to be no selective reporting of outcomes |
| Other bias | Low risk | The study appears to be free of other problems that could put it at a high risk of bias |