Table 1. Characteristics of included studies.
Author Location Rurality Study design Sample size (n) Cancer type Treatment Phase Males n (% of sample) Females n (% of sample) Age (years: mean ± SD) Intervention details Outcomes Adverse events
Befort et al. (2012) USA - Kansas 50% large rural, 50% small/ isolated rural One-arm treatment study (non-randomised clinical trial) 31 Breast Cancer n = 31 (100%) Breast Cancer within past 10 years, completed treatment ≥3 months prior (except endocrine therapy) 0 (0%) 31 (100%) 58.9 ± 7.8 Conference calls targeting Behaviour Change, Aerobic, OPTIONAL – light Resistance Training ↓Weight, ↓BMI ↓Waist circumference, ↑Energy expenditure, ↓Insulin, ↓Leptin, ↑Joint pain, ↓Depression, ↑Strength and Health improved significantly, P < 0.001 ↓Social Barriers, ↑Appearance and Sexuality NR
Coletta et al. (2021) USA - Utah 75% of full sample (n=638), 78% of follow-up sample Retrospective cohort study 849 Mixed Bladder n = 4 (0%), Brain n = 24 (3%), Breast n = 288 (34%), Cervical n = 4 (0%), Colorectal n = 34 (4%), Endometrial n = 30 (4%), Fallopian tube n = 3 (0%), Gastrointestinal n = 13 (2%), Kidney n = 13 (2%), Leukemia n = 39 (5%), Liver n = 3 (0%), Lung n = 31 (4%), Lymphoma n = 43 (5%), Melanoma n = 22 (3%), MGUS n = 4 (0%), Multiple myeloma n = 70 (8%), Oral n = 9 (1%), Other n =23 (3%), Ovarian n = 27 (3%), Pancreas n = 18 (2%), Peritoneum n = 4 (0%), Polycythemia vera n = 3 (0%) Cancer survivors (any type, any stage) – Most participants undergoing active treatment 322 (38%) 527 (62%) 61.3 ± 13.5 In-Person, Home Exercise Programs or Hybrid. Aerobic, Resistance Training, Balance, Flexibility ↑GS, ↑CP, ↑LPD, ↑LP, ↑CS, ↑TUG, ↑VO2max, ↑METs, ↑Fatigue, ↑ QoL NR
Hirko et al. (2021) USA - Michigan 100 % Quasi- experimental study 24 Mixed Breast n = 8 (33.3%), Gastrointestinal n = 3 (12.5%), Gynaecological n = 3 12.5%), Prostate = 3 (12.5%), Lung n = 1 (4.2%), Kidney n = 1 (4.2%), Skin n = 2 (8.3%), Multiple myeloma n = 1 (4.2%), Sarcoma n=1 (4.2%), Missing n=1 (3.0%) All stages of treatment and survivorship 6 18 Median 66 (IQR 12.5), Range 31-72 Small group sessions – Aerobic + Resistance Training ↓Fatigue, ↓constipation, ↓ pain, ↑sleep quality NR
Marker et al. (2025) USA – Colorado and surrounding states 100% Single-arm clinical trial 15 Mixed Breast n = 6 (40%) Colorectal n = 1 (7%), Kidney n = 1 (7%), Lung n = 1 (7%), Multiple myeloma n = 2 (13%), non-Hodgkin lymphoma n = 1 (7%), Ovarian n = 1 (7%), Prostate n = 1 (7%), Thyroid n = 1 (7%) Completed treatment with curative intent in the past 12 months or had no planned changes in treatment for the duration of the study 4 11 60.7± 6.7 Home Exercise program – Video conferencing – Aerobic and Resistance Training ↑FACIT-Fatigue ↑FACT-G (QoL) ↓HADS-Anxiety ↓HADS-Depression ↑GLTEQ-MVPA ↑GLTEQ-Resistance ↑30STS 7 in 6 participants
Modesitt et al. (2021) USA – Virginia 100% Prospective trial (non-randomized, single-arm feasibility) 99 Mixed Endometrial n = 58 (58.6%), Breast n = 17 (17.2%), Ovarian n = 23 (23.2%) Post treatment (No current treatment with Chemotherapy or Radiation) 0 99 59.9± 9.4 Aerobic, Resistance Training, Behaviour Change (Home Exercise Program + mailed workbook + exercise bands + telephone motivational coaching) higher baseline mental QOL improved completion and exercise outcomes NR
Wagoner et al. (2023) Canada Alberta, Nova Scotia, Ontario (British Columbia Saskatchewan Northwest Territories - through outreach from the Alberta hub) 84.3% Hybrid effectiveness–implementation study 236 Breast: n = 126 (53.4%), Lung: n = 20 (8.5%), Haematological: n = 19 (8.1%), Gynaecological: n = 16 (6.8%), Prostate: n = 16 (6.8%), Skin: n = 6 (2.5%), Brain: n = 6 (2.5%), Colon: n = 6 (2.5%), Head and Neck: n = 5 (2.1%), Other ‡: n = 16 (6.8%) Pre, during, or up to 3 years post-treatment; 54.2% receiving active treatment 42 192 57.3± 12.5 Online group sessions Aerobic, Resistance Training, Balance Reach - 84.3% rural/remote; Enrol 85.8% (290/338); Female - 82.1%; Breast Cancer 53.4%; On Tx 54.7% Adoption - 163 HCPs; 45 QEPs → 22 classes; 32 fitness partners (19 organsisations, 13 individuals) Implementation - Ret 81.4%; Adh 78.2%; Assess >85%; Fit: BL 98.3% → 12 weeks 89.8%; PRO: BL 96.6% → 12 weeks 87.7% 1 mild.
Wagoner et al. (2024) Canada British Columbia Alberta Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Newfoundland and Labrador Yukon Northwest Territories 71.2% Hybrid effectiveness–implementation study 498 (rural) 201 (urban) Mixed Breast: n = 347 (49.6%) Lung: n = 56 (8.0%) Haematological: n = 56 (8.0%) Gynaecological: n = 47 (6.7%) Prostate: n = 43 (6.2%) Skin: n = 21 (3.0%) Brain: n = 11 (1.6%) Colon: n = 20 (2.9%) Head and Neck: n = 7 (1.0%) Multiple Diagnoses: n = 6 (0.9%) Other: n = 65 (9.3%) No information provided: n = 20 (2.9%) Pre-, during, or post-treatment (up to 3 years); 54.8% receiving active treatment 109 585 57.9± 11.7 Aerobic, Resistance Training, Balance, Flexibility- Small group sessions online and in-person ↑30STS, ↑2MST, ↑6MWT, ↑SL, Balance, ↑Shoulder ROM, ↑Lower Body Flexibility. ↑Fatigue, ↑Wellbeing, ↑Exercise self-efficacy NR
2MST – 2-Minute Step Test, 30STS – 30-Second Sit-to-Stand, 5xSTS – Five-Times Sit-to-Stand Test, 6MWT – Six-Minute Walk Test, AC – Arm Curl, Adh – Adherence, ATPW – Aerobic Training per Week, BL – Baseline, BS – Back Scratch, CP – Chest Press, CS – Chair Stand, DFS – Disease-Free Survival, FACIT-Fatigue – Functional Assessment of Chronic Illness Therapy: Fatigue, FACT-G – Functional Assessment of Cancer Therapy – General (Quality of Life), FIT – Fitness Assessment, GLTEQ-MVPA – Godin Leisure-Time Exercise Questionnaire: Moderate-to-Vigorous Physical Activity, GLTEQ-Resistance – Godin Leisure-Time Exercise Questionnaire: Resistance Training, GS – Grip Strength, HADS-Anxiety – Hospital Anxiety and Depression Scale: Anxiety, HADS-Depression – Hospital Anxiety and Depression Scale: Depression, HCP – Health Care Professional, HCPs – Health-Care Providers, HRQOL – Health-Related Quality of Life, LBD Flexibility – Lower-Body Flexibility, LIPA – Light-Intensity Physical Activity, LP – Leg Press, LPD – Lat Pulldown, METs – Metabolic Equivalents, MVPA – Moderate-to-Vigorous Physical Activity, OS – Overall Survival, PRO – Patient-Reported Outcome, PROMIS-Physical Function – Patient-Reported Outcomes Measurement Information System: Physical Function, QEPs – Qualified Exercise Professionals, QoL – Quality of Life, Ret – Retention, RTPW – Resistance Training per Week, SAR – Sit and Reach, SL Balance – Single-Leg Balance, STS – Sit-to-Stand Test, TUG – Timed Up and Go, Tx – Treatment, VO2max – Maximal Oxygen Uptake.