ACE-Neuro: A tailored exercise oncology program for neuro-oncology patients - Study protocol

Abstract

Background: Patients with primary brain tumours (i.e., neuro-oncology patients) lack access to exercise oncology and wellness resources. The purpose of the Alberta Cancer Exercise - Neuro-Oncology (ACE-Neuro) study is to assess the feasibility of a tailored neuro-oncology exercise program for patients across Alberta, Canada. The primary outcome is to assess the feasibility of ACE-Neuro. The secondary outcome is to examine preliminary effectiveness of ACE-Neuro on patient-reported outcomes and functional fitness.

Methods: Neuro-oncology patients with a malignant or benign primary brain tumour that are pre, on, or completed treatment, are >18 years, and able to consent in English are eligible to participate in the study. Following referral from the clinical team to cancer rehabilitation and the study team, participants are triaged to determine their appropriateness for ACE-Neuro and other cancer rehabilitation services (including physiatry, physiotherapy, occupational therapy, and exercise physiology). In ACE-Neuro, participants complete a tailored 12-week exercise program with pre-post assessments of patient-reported outcomes and functional fitness, and objective physical activity tracked across the 12-week program. ACE-Neuro includes individual and group-based exercise sessions, as well as health coaching.

Conclusion: We are supporting ACE-Neuro implementation into clinical cancer care, with assessment of needs enabling a tailored exercise prescription.

Keywords: Brain Tumour; CCI, Cross Cancer Institute; CSEP, Canadian Society for Exercise Physiology; ECOG, Eastern Cooperative Oncology Group; ESAS-r, Revised Edmonton Symptom Assessment System; Exercise; FACIT-F, Functional Assessment of Chronic Illness Therapy Fatigue Scale; FACT-Br, Functional Assessment of Cancer Therapy-Brain; FACT-Cog, Functional Assessment of Cancer Therapy-Cognition; FITT, Frequency, Intensity, Time, Type; Feasibility; GLTEQ, Godin Leisure-Time Exercise Questionnaire; Implementation; Intervention; KPS, Karnofsky Performance Status; MCID, Minimum Clinically Important Difference; Neuro-Oncology; PAR-Q+, Physical Activity Readiness Questionnaire; PROs, Patient-Reported Outcomes; RE-AIM, Reach, Effectiveness, Adoption, Implementation, Maintenance; REDCap, Research Electronic Data Capture; RPE, Rating of Perceived Exertion; SPPB, Short Physical Performance Battery; TBCC, Tom Baker Cancer Centre; WAT, Wrist-worn Activity Tracker.

Fig. 1

Flow diagram for the multi-site single-arm ACE-Neuro study. Recruitment began in April 2021. Follow-up assessments are expected to conclude in Spring 2024. PROs = patient-reported outcomes.

Fig. 2

Overview of exercise intervention components.