Exercise during and after cancer treatment is often prescribed in line with best-practice evidence, yet patients experience fluctuating symptoms, treatment effects, and psychosocial stressors which can make exercise difficult to follow consistently and may limit the dose patients actually complete. Yet, there is no established understanding about how to adjust exercise in response to these challenges. A practical response is to use autoregulation based on readiness-to-train assessments to adapt prescriptions session by session.
This presentation will translate empirical evaluation of autoregulation into practical guidance for clinicians and services. It will first summarise how exercise is currently individualised in oncology trials, drawing on a systematic review and meta-analysis that characterised why, when, and how exercise is adjusted and examined how different individualisation approaches relate to fatigue outcomes. Particular emphasis will be placed on adjustments informed by subjective patient-reported symptoms, which were associated with larger reductions in fatigue than using objective measurement-based approaches.
The session will then introduce a brief readiness-to-train tool as a practical method for capturing daily readiness at exercise sessions. Using validation data, it will show how simple domains (mood, sleep, energy, soreness, stress) can be used to guide decisions about whether to progress, maintain, or regress intensity and volume. Findings from a randomised trial in people with multiple myeloma will be used to illustrate real-world application of an autoregulated exercise intervention guided by daily readiness scores, which led to higher completed exercise doses and improved sit-to-stand performance compared with standard prescription, with readiness scores predicting both volume and proximity to failure (intensity) as intended.
Finally, Delphi consensus recommendations from international exercise oncology professionals will be integrated to outline practical steps for application. These include what to monitor, how to adjust intensity, volume, type, and frequency, and which clinical reasoning skills support autoregulation. The aim of the presentation is to provide a clear, practice-oriented understanding of how to accommodate individual fluctuations based on readiness-informed prescription that is more likely to be adhered to, tolerated, and effective in everyday cancer care.