Exercise Program
For the intervention at the CEP Clinic, the American Council of Sports Medicine (ACSM) guidelines and the American Cancer Society’s recommendations for cancer patients are followed. The intervention program is based on the results obtained from all of the tests performed at the oncology office at MidCentral Hospital and the CEP Clinic. Vital signs (HR, BP, SaO2, and ECG) and lactate levels (if necessary) are screened and monitored before, during and after exercise sessions.
To apply for funding contact the ExMed Charity. Refer to the How to Get on The Program part of this website by clicking the button below for more information.
Training Frequency
Twice per week.
Training Intensity
Aerobic exercise is prescribed between 40-70% of the peak VO2 obtained during the CPET. Symptom limits will be taken into consideration (e.g., BP-response, HR, RPE, Angina, dyspnea, etc.)
Resistance training is based on 40-80% of 10 rep max test results obtained during the first assessment at the CEP Clinic.
Flexibility exercises consist of slow static stretching to the point of tension.
Balance or motor control exercises will be prescribed where necessary.
Session Duration
40 - 60 minutes.
Type
Aerobic exercises consist of prolonged, rhythmic activities using the large muscle groups (e.g., walking, cycling or arm ergometer).
Resistance exercises include using either free weights, resistance machines, or weight-bearing functional tasks (e.g., sit to stand), targeting all major muscle groups.
Flexibility exercises include either stretching or ROM exercises of all major muscle groups. These exercises will also address specific areas of joint and/or muscle restrictions that can happen with surgery, chemotherapy or radiation treatment.
Progression
Progression is based on the patient's response to the intervention program. Adjustments are individually based.
Special Considerations
Patients receiving chemotherapy and/or radiation may experience fluctuating periods of sickness and fatigue during treatment cycles. This requires frequent modifications to the exercise prescription, such as reducing the intensity and/or duration of the exercise sessions.
Cancer Patient Journey Timeline
CPET = Cardiopulmonary Exercise Test; BMI = Body Mass Index; RMAX = Repetition Maximum; QoL = Quality of Life; IPAQ = International Physical Activity Questionnaire
How Does the Program Work?
Enrolment/referral
People with cancer are referred to the ExMed funded exercise rehab program through the oncology department at MidCentral Hospital in Palmerston North. General practitioners can refer patients to MidCentral Oncology for eligibility screening. A patient’s eligibility is determined by their overall profile with a focus on the Cardiopulmonary Exercise Test (CPET) performed by the team at MidCentral Oncology. The entry criteria are mostly based on the patient's medical profile (e.g., type of cancer and other co-morbidities), and the results of the CPET test.
CEP consultation/assessment
An ExMed team member will contact you and provide information about the service. You will be scheduled for a consultation/assessment with a registered clinical exercise physiologist.
The initial appointment with an ExMed exercise physiologist
Your exercise physiologist will conduct a pre-activity health screening and assess your health-related physical fitness in order to individualise your exercise prescription. This exercise prescription will be tailored to your type of cancer, treatment history, the severity of any symptoms/side effects, and your general health history, physical abilities and personal preferences. The personalised exercise prescription will be designed using international guidelines for best practice exercise medicine.
Individual exercise session with your ExMed exercise physiologist
Your next appointment will be an instructional exercise session in which the exercise physiologist will take you through your personalised exercise program. The session will help familiarise you with the facilities at the fitness centre and the processes involved with your participation.
Individual/group-based exercise sessions for 6 months at an ExMed location
You will attend 2 x 1 hour exercise sessions each week for up to six months (i.e., a total of 48 exercise sessions). In most cases there will be other patients (maximum of 10 people) with cancer or cardiovascular disease also in the clinic busy with their rehabilitation exercises. The exercise sessions will be supervised by your ExMed exercise physiologist.
Final appointment with your ExMed exercise physiologist
Your exercise physiologist will re-assess your health status and provide feedback on your progress following the completion of the ExMed program. The exercise physiologist will re-evaluate your personalised exercise prescription in light of your progress and develop a plan for you to continue exercising. A variety of options and strategies to continue exercising will be discussed (e.g., supervision options, continued fitness centre membership, home-based exercise, other programs and services available in the local community) and a written exercise plan will be provided.