Exercise for survivorship: outcomes associated with a community-based group exercise program for adolescent and young adult cancer survivors.
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BACKGROUND: Adolescent and young adult (AYA) cancer survivors experience persistent physical and psychosocial effects after treatment. Despite evidence supporting exercise in adult cohorts, research specific to AYAs remains limited. This study examined physical and psychosocial outcomes associated with participation in a community-based, group exercise program. METHODS: A pragmatic, single-arm, pre-post study design was used. AYAs aged 15-27 years within 2 years post-treatment completed a 12-week group exercise program in a community setting. Biweekly, individualized sessions incorporated aerobic, resistance, and flexibility training under an accredited exercise physiologist's supervision. The primary outcome was predicted VO₂peak, with secondary outcomes including one-repetition maximum (1RM) strength, physical function, body composition, and quality of life (EORTC QLQ-C30, SF-36). Pre-post changes were analyzed using mixed-effects models adjusted for diagnosis. RESULTS: Of 127 participants (mean age 21.4 ± 3.0 years; 51% male), 93 (73%) completed the program and final assessments. A significant improvement was observed in predicted VO₂peak (3.1 mL·kg⁻1·min⁻1, p < 0.001), all 1RM strength measures (leg press p < 0.001; chest press p < 0.001; seated row p < 0.001), physical function (push ups p < 0.001; sit ups p < 0.001; 5-rep sit-to-stand p < 0.001; grip strength p = 0.028), lean mass (p < 0.001), and quality of life across physical, role, and social domains (p < 0.001). Fat mass percentage (p = 0.002) and fatigue (p < 0.001) decreased. No adverse events occurred. CONCLUSION: Community-based, group exercise was safe and was associated with improvements in fitness, strength, and quality of life among AYA cancer survivors. Findings are consistent with a beneficial association between scalable, real-world exercise models and long-term survivorship outcomes. This trial was retrospectively registered (ACTRN12620000664943) on 10th June 2020.