RESISTANCE training in rural cancer care is poorly reported, limiting replication of supportive oncology interventions.
Resistance Training in Rural Cancer Care
Resistance training is a core component of supportive cancer care, yet new findings suggest that studies conducted in regional, rural, and remote settings often do not report enough detail for clinicians to reproduce interventions safely or consistently.
The systematic scoping review assessed resistance-based exercise interventions delivered to adult cancer survivors living outside metropolitan areas. Investigators screened 2,490 studies and included 12, examining how exercise prescription principles, FITT components, and program fidelity were reported.
The evidence base was limited and heterogeneous. Studies were conducted in the USA, Australia, and Canada, with sample sizes ranging from 19 to 849 participants. Most included people with cancer only, while cancer type, disease stage, and position along the cancer care continuum varied widely.
Exercise Prescription Details Were Often Missing
No included study reported all six core exercise prescription principles: specificity, overload, progression, initial values, diminished returns, and reversibility. Specificity was the most commonly reported principle, appearing in 83.3% of studies, while diminished returns and reversibility were reported in only one study each.
Reporting of progression and overload was also limited. Progression appeared in 33.3% of studies, and overload in 16.7%, but the parameters and rationale were generally insufficiently described. This gap matters because resistance training interventions must be tailored to baseline function, cancer status, treatment effects, and individual capacity to support safe adaptation.
FITT reporting was similarly incomplete. Frequency was reported in 66.7% of studies, while intensity and time were each reported in 50%. Although all studies included resistance-based exercise, only half described the type of resistance training used, such as bands, free weights, or body weight. Just one study reported all four FITT principles.
Fidelity Gaps Limit Clinical Translation
Program fidelity reporting also varied. Adherence was reported in 58.3% of studies, but this often reflected the full intervention rather than the resistance training component specifically. Completion and withdrawal were reported more consistently, while uptake ranged from 0.6% to 85.8%.
Notably, no study reported the prescribed exercise dose or deviations from the intended plan. Without this information, clinicians cannot determine the actual volume of resistance training performed or whether outcomes reflect the intervention itself.
For rural oncology practice, the findings point to a clear need for more transparent reporting of exercise principles, FITT parameters, adherence, dose, and delivery quality. Better detail would support replication, improve clinical translation, and help extend high-quality resistance training to cancer survivors in communities with fewer specialist resources.
Reference
Rowe CW et al. Exploring the fidelity of resistance training interventions in regional, rural, and remote cancer care: A systematic scoping review. Journal of Sports Science and Medicine. 2026;25:487-501.
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