Exploring The Fidelity of Resistance Training Interventions in Regional, Rural, And Remote Cancer Care: A Systematic...

Resistance-based exercise interventions are an integral part of supportive cancer care, though their high quality and high-fidelity implementation with people with cancer living in non-metropolitan locations is challenging. This systematic scoping review aimed to identify how exercise prescription principles and measures of fidelity are reported in resistance-based exercise interventions delivered to people with cancer living in regional, rural and remote areas. A systematic scoping review was conducted in accordance with the PRISMA-ScR guidelines. Five electronic databases were searched (MEDLINE/PubMed, Embase, CINAHL, SCOPUS and SportDiscus) for peer-reviewed studies published in English, that delivered a resistance-based exercise intervention to adult cancer survivors in regional, rural, or remote areas. Data relating to principles of exercise prescription (specificity, overload, progression, initial values, diminished returns, reversibility), FITT (frequency, intensity, time, time) principles, and fidelity (adherence, dose, quality of delivery, client responsiveness, differentiation) were extracted and summarised descriptively. Of 2490 screened studies, 12 were eligible and retained for analysis. Of the six core principles of exercise prescription, specificity was the most reported (83.3%), and diminished returns and reversibility were least reported (8.3%), with only two studies reporting on more than two principles in total. Similarly, no study reported all four FITT principles. Frequency was the most reported (66.7%), followed by intensity and time (50%). Differentiation (aspects of the intervention that distinguished it from other interventions and contributed to the success) was the most reported aspect of fidelity (100%), with dose (i.e., adherence to prescribed plan) not reported in any study. Exercise prescription principles, FITT principles, and measures of fidelity were poorly reported across included studies. Future research needs to prioritise the quality of reporting of resistance-based exercise interventions to support the replication and translation of clinical research into real world practice within regional, rural, and remote communities.