Factors Associated with Meeting Physical Activity Guideline Recommendations in a Single Community Rehabilitation...

Background: Physical exercise is a vital component of cancer rehabilitation, with demonstrated improvements in cancer health-related outcomes, relapse rates, mortality and overall survival, yet global participation remains low. In Singapore, uptake of community cancer rehabilitation is limited despite high prevalence of treatment-related impairments. Methods: A cross-sectional study was conducted among adults (≥21 years) enrolled in the Singapore Cancer Society Rehabilitation Center between December 2021 and March 2023. Clinical data was collected from medical records and assessments included the Distress Thermometer (DT), Brief Illness Perception Questionnaire (Brief IPQ), and modified Bandura's Exercise Self-Efficacy (ESE) scale. Adequate exercise was defined as ≥150 min/week of moderate intensity aerobic exercise and ≥2 days/week of resistance training. Regression analyses were performed to identify factors associated with meeting recommended moderate-intensity aerobic exercise levels. Results: The median age of our study cohort was 60.0 (IQR: 51.0-66.3) years. Of 132 analyzed participants, only 29.5% met recommended aerobic exercise levels and 9.1% met resistance training level recommendations. The median duration of moderate intensity aerobic exercise per week was 85.0 (30.0-180.0) minutes. The three most common cancer diagnoses amongst the participants were breast (53.8%), gastrointestinal (11.4%) and gynecological (7.6%) cancers. Clinically significant distress (DT ≥ 5) was present in 40.9% of patients. Multivariate regression analyses revealed that having lower ESE was the only significant psychosocial factor associated with a lower likelihood of meeting recommended aerobic exercise activity levels (OR = 0.856; 95% CI = 0.787-0.931; p < 0.001). Conclusions: Our study found a low prevalence of meeting recommended physical activity levels amongst our cohort of Asian cancer survivors enrolled in a community rehabilitation program in Singapore. Reinforcing the need for future longitudinal studies involving Asian cancer survivors to explore additional factors associated with physical inactivity and whether behavioral interventions targeting ESE will improve physical activity participation.