Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;54(4):377-391.
doi: 10.1177/08445621211062467. Epub 2022 Feb 4.

Considerations of Control Conditions Designs in Randomized Controlled Trials of Exercise Interventions for Cancer Survivors

Affiliations

Considerations of Control Conditions Designs in Randomized Controlled Trials of Exercise Interventions for Cancer Survivors

Wing Lam Tock et al. Can J Nurs Res. 2022 Dec.

Abstract

Background: Given the multifaceted complexity in the nature of randomized controlled trials, identifying an appropriate and comparable control condition is an essential step to ensure methodological rigor, which allows for researchers to draw unambiguous conclusions concerning the efficacy of the intervention being studied.

Objectives: The objectives of this paper are to (a) review the current literature and analyze the control condition designs in exercise interventions targeted for cancer survivors; (b) provide an overview of the benefits and limitations of various types of control conditions used in exercise interventions; (c) discuss the considerations in the design of control conditions for exercise interventions; and (d) suggest recommendations for control condition design in future trials of behavioral interventions.

Results: The review of randomized controlled trials of exercise training interventions for cancer survivors revealed that the design of control conditions varied. The most commonly employed design could be classified into two major categories: (a) active controls including attention control, add-on controls, and dismantling controls; and (b) inactive controls including no-treatment, usual care, and wait-list control. Examples from the literature are presented. Four principal considerations concerning control condition design, including appropriateness, credibility, appeal, and comparability, are discussed. Recommendations on how to avoid some major threats to validity and potential biases are also provided.

Conclusions: Careful planning for the control group design is as important as for the intervention group. Researchers can use the considerations presented in the paper to assist in planning for the most appropriate control condition for their study.

Keywords: control conditions; exercise interventions; methodology; randomized controlled trials; study design.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study selection flow diagram.

References

    1. Arem H., Sorkin M., Cartmel B., Fiellin M., Capozza S., Harrigan M., Ercolano E., Zhou Y., Sanft T., Gross C., Schmitz K., Neogi T., Hershman D., Ligibel J., Irwin M. L. (2016). Exercise adherence in a randomized trial of exercise on aromatase inhibitor arthralgias in breast cancer survivors: The hormones and physical exercise (HOPE) study. Journal of Cancer Survivorship, 10(4), 654–662. 10.1007/s11764-015-0511-6 - DOI - PMC - PubMed
    1. Aycock D. M., Hayat M. J., Helvig A., Dunbar S. B., Clark P. C. (2018). Essential considerations in developing attention control groups in behavioral research. Research in Nursing & Health, 41(3), 320–328. 10.1002/nur.21870 - DOI - PubMed
    1. Berglund G., Bolund C., Gustafsson U.-L., Sjödén P.-O. (1997). Is the wish to participate in a cancer rehabilitation program an indicator of the need? Comparisons of participants and non-participants in a randomized study. Psycho-Oncology, 6(1), 35–46. http://doi/10.1002/(SICI)1099-1611(199703)6:1<35::AID-PON241>3.0.CO;2-J - DOI - PubMed
    1. Boutron I., Altman D. G., Moher D., Schulz K. F., Ravaud P. (2017). CONSORT Statement for randomized trials of nonpharmacologic treatments: A 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Annals of Internal Medicine, 167(1), 40. 10.7326/m17-0046 - DOI - PubMed
    1. Brown J. C., Damjanov N., Courneya K. S., Troxel A. B., Zemel B. S., Rickels M. R., Ky B., Rhim A. D., Rustgi A. K., Schmitz K. H. (2018). A randomized dose-response trial of aerobic exercise and health-related quality of life in colon cancer survivors. Psycho-Oncology, 27(4), 1221–1228. 10.1002/pon.4655 - DOI - PMC - PubMed