Address PA barriers and give patients advice on how to overcome them.40 41 48 49

Physical34 46 52 and psychological50 impairments (eg, distress, anxiety, depression) need to be adequately addressed.

Symptoms or risk factors associated with low PA levels need to be covered.34 35

If necessary, rehabilitation should be recommended;34 ongoing support should be offered by specialist rehabilitation teams.48

Referrals to specialists should be made for individuals with more needs/worries about exercise.52

Give education and training for HCP and patients to be aware of benefits of exercise.40 47 49

Patient education about symptom management should be offered to enhance self-efficacy and PA35; access to resources relevant for recovery should be provided.47

Focus should be put on personal goals and knowledge gaps about benefits and perceived barriers.43

Information on exercise should ideally be given soon after time of diagnosis.40

Blended care or e-health apps can be helpful in providing patient-tailored information on activity level, personal goals and monitoring individual progress.50

Health behaviour change interventions and psychological strength building should be offered to increase patient’s self-efficacy and engagement.46 48

Assistance by medical professionals or exercise specialist should be given to find a suitable type of PA.36 46

Supporting the empowerment process is important.39

Some patients will need professional guidance to help prioritise PA.52

Patient education about exercise benefits should be given to increase confidence, competence, uptake and adherence.49

Attention should be put on dealing with the lack of perceived ability to participate; an expert should guide them.36

HCPs should improve awareness about actual PA levels of individuals.52

Provide access to HCPs at the end of treatment to guide lifestyle decisions.48

Potential intention-behaviour gap needs to be considered.39

Intention might need to be targeted; pedometers or accelerometers might improve awareness of actual PA levels.52

The health behaviour history needs to be included in the survivorship care plan.46

Exercise and PA interventions should be integrated within the oncological care pathway as usual care.40 47 50

There should be a culture shift towards more PA; necessary prescriptions should be provided.47 48

Surgeons should advise and encourage exercise.47 49

All members of the healthcare team should motivate and facilitate exercise as part of recovery.49

Exercise specialists should be involved in the care pathway.47

Exercise and PA interventions should start as early as possible.50

Programmes and interventions should be tailored to each patient’s abilities and preferences.40 43 47 49

Collaborative, flexible, culturally sensitive and individualised approaches are needed.49

Exercise interventions should be tailored and personalised with regard to goal setting, training type, intensity, setting and timing and should be incorporated in ADLs.50

A flexible training programme should be offered with check-in policy after several missed classes at the end stage of treatment.51

Scheduling of exercise sessions need to be flexible around treatment appointments.50

When it is safe: home-based, moderate intensity exercise should be included.36

Training should be at a location to the patients' convenience.50

Supervision: supervision before treatment and remote supervision for home-based training during and shortly after chemoradiotherapy.50

It is assumed that attendance rate and effects are lower for unsupervised training interventions.42

Patients should be monitored before and during exercise.43

The physiotherapist can act as an important facilitator for motivation, mental support and increasing discipline to exercise.50

Exercise/PA should be combined with intensive nutritional support and monitoring.43

Resources need to be built to support exercise into cancer survivorship and in community-based settings.47

Need for funding for exercise programmes (outside of study context).47