{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T02:58:55Z","timestamp":1781060335144,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100001943","name":"American Physical Therapy Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001943","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008899","name":"University of South Carolina","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008899","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cancer-related fatigue (CRF) is one of the most common side effects of cancer treatment, yet there is little consensus on best non-pharmacologic practices to manage this debilitating side effect. The purpose of this study was to describe current non-pharmacologic practice patterns for managing CRF and barriers to rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An electronic survey, developed by the authors using the CHERRIES checklist, was piloted via REDCap\u2122 by nine participants. Data collected included demographics, clinical experience, frequency (none of the time, some of the time, and all of the time) of 15 common non-pharmacologic CRF interventions derived by expert consensus, effectiveness of interventions, and barriers to care for CRF. The survey took approximately 7\u00a0min to complete and was distributed via emails or flyers to cancer support groups, listservs, recruitment flyers, and word of mouth. All analyses were descriptive, including frequencies and percentages, and were performed using Microsoft Excel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred ninety-seven rehabilitation providers completed the survey: physical therapy (60%), occupational therapy (20%), speech-language pathology (9%), and exercise physiology (5%). All disciplines indicated frequently applying more than one of the following within their CRF interventions: therapeutic activities (78%), aerobic\/strengthening\/flexibility exercise (73.1%), energy conservation strategies (57.4%), and self-management education (48.2%). All professions measured the effectiveness of their fatigue interventions using patients\u2019 subjective reports (e.g., fatigue severity). Barriers to receiving care were \u201cappointment fatigue\u201d and financial constraints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When developing CRF clinical practice guidelines, current rehabilitation practice patterns and survivors\u2019 barriers to care should be considered along with the highest level of evidence-based interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-10717-8","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T01:35:12Z","timestamp":1778204112000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current non-pharmacological practices for cancer-related fatigue in oncology rehabilitation: results of a national provider survey"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3713-3371","authenticated-orcid":false,"given":"Shana E.","family":"Harrington","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette Q.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Fleischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelley C.","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy C.","family":"Cohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Malone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Insana","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"issue":"1","key":"10717_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-39046-0","volume":"13","author":"Y-E Kang","year":"2023","unstructured":"Kang Y-E, Yoon J-H, Park N-h, Ahn Y-C, Lee E-J, Son C-G (2023) Prevalence of cancer-related fatigue based on severity: a systematic review and meta-analysis. Sci Rep 13(1):12815","journal-title":"Sci Rep"},{"issue":"5","key":"10717_CR2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17050772","volume":"17","author":"ML McNeely","year":"2025","unstructured":"McNeely ML, Shallwani SM, Williamson T, Sellar C, Gobeil E, Joy AA et al (2025) Baseline characteristics of participants in the Alberta cancer exercise hybrid effectiveness-implementation study: a wake-up call for action. Cancers Basel 17(5):772","journal-title":"Cancers Basel"},{"key":"10717_CR3","doi-asserted-by":"publisher","DOI":"10.3322\/caac.70011","author":"NS Wagle","year":"2025","unstructured":"Wagle NS, Nogueira L, Devasia TP, Mariotto AB, Yabroff KR, Islami F et al (2025) Cancer treatment and survivorship statistics, 2025. CA Cancer J Clin. https:\/\/doi.org\/10.3322\/caac.70011","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"10717_CR4","volume":"28","author":"S Akin","year":"2019","unstructured":"Akin S, Kas Guner C (2019) Investigation of the relationship among fatigue, self\u2010efficacy and quality of life during chemotherapy in patients with breast, lung or gastrointestinal cancer. Eur J Cancer Care 28(1):e12898","journal-title":"Eur J Cancer Care"},{"issue":"1","key":"10717_CR5","first-page":"111","volume":"10","author":"D Liu","year":"2023","unstructured":"Liu D, Weng J-S, Ke X, Wu X-Y, Huang S-T (2023) The relationship between cancer-related fatigue, quality of life and pain among cancer patients. Int J Nurs Sci 10(1):111\u2013116","journal-title":"Int J Nurs Sci"},{"issue":"1","key":"10717_CR6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s11764-015-0450-2","volume":"10","author":"JM Jones","year":"2016","unstructured":"Jones JM, Olson K, Catton P, Catton CN, Fleshner NE, Krzyzanowska MK et al (2016) Cancer-related fatigue and associated disability in post-treatment cancer survivors. J Cancer Surviv 10(1):51\u201361","journal-title":"J Cancer Surviv"},{"issue":"2","key":"10717_CR7","doi-asserted-by":"publisher","DOI":"10.1530\/EC-21-0506","volume":"11","author":"Y Maki","year":"2022","unstructured":"Maki Y, Horiuchi K, Okamoto T (2022) Fatigue and quality of life among thyroid cancer survivors without persistent or recurrent disease. Endocr Connect 11(2):e210506","journal-title":"Endocr Connect"},{"issue":"1","key":"10717_CR8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1017\/S1478951522000207","volume":"21","author":"SF Abduljawad","year":"2023","unstructured":"Abduljawad SF, Beckstead JW, Dobbs D, Visovsky C, Rodriguez CS, McMillan SC et al (2023) Fatigue-related symptom clusters and functional status of older adults in hospice. Palliat Support Care 21(1):57\u201364","journal-title":"Palliat Support Care"},{"issue":"7","key":"10717_CR9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0269519","volume":"17","author":"E Chayadi","year":"2022","unstructured":"Chayadi E, Baes N, Kiropoulos L (2022) The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: a systematic review and meta-analysis. PLoS One 17(7):e0269519","journal-title":"PLoS One"},{"issue":"10","key":"10717_CR10","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1136\/bjsports-2016-096422","volume":"52","author":"R Hilfiker","year":"2018","unstructured":"Hilfiker R, Meichtry A, Eicher M, Nilsson Balfe L, Knols RH, Verra ML et al (2018) Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med 52(10):651\u2013658","journal-title":"Br J Sports Med"},{"issue":"2","key":"10717_CR11","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s00520-022-07549-7","volume":"31","author":"GB Penna","year":"2023","unstructured":"Penna GB, Otto DM, Da Silva TC, Pedroni AS, Macagnan FE (2023) Physical rehabilitation for the management of cancer-related fatigue during cytotoxic treatment: a systematic review with meta-analysis. Support Care Cancer 31(2):129","journal-title":"Support Care Cancer"},{"issue":"20","key":"10717_CR12","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1200\/JCO.24.00541","volume":"42","author":"JE Bower","year":"2024","unstructured":"Bower JE, Lacchetti C, Alici Y, Barton DL, Bruner D, Canin BE et al (2024) Management of fatigue in adult survivors of cancer: ASCO\u2013Society for Integrative Oncology guideline update. J Clin Oncol 42(20):2456\u20132487","journal-title":"J Clin Oncol"},{"issue":"6","key":"10717_CR13","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1016\/j.annonc.2020.02.016","volume":"31","author":"A Fabi","year":"2020","unstructured":"Fabi A, Bhargava R, Fatigoni S, Guglielmo M, Horneber M, Roila F et al (2020) Cancer-related fatigue: ESMO clinical practice guidelines for diagnosis and treatment. Ann Oncol 31(6):713\u2013723","journal-title":"Ann Oncol"},{"issue":"1","key":"10717_CR14","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1186\/s12913-023-09377-9","volume":"23","author":"EJ Pearson","year":"2023","unstructured":"Pearson EJ, Denehy L, Edbrooke L (2023) Identifying strategies for implementing a clinical guideline for cancer-related fatigue: a qualitative study. BMC Health Serv Res 23(1):395","journal-title":"BMC Health Serv Res"},{"issue":"Suppl 1","key":"10717_CR15","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","volume":"13","author":"S Cuschieri","year":"2019","unstructured":"Cuschieri S (2019) The STROBE guidelines. Saudi J Anaesth 13(Suppl 1):S31\u2013S34","journal-title":"Saudi J Anaesth"},{"issue":"3","key":"10717_CR16","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.enfcle.2024.06.001","volume":"34","author":"M-C Torrej\u00f3n-Guirado","year":"2024","unstructured":"Torrej\u00f3n-Guirado M-C, San Mart\u00edn-Erice I, San Mart\u00edn-Rodr\u00edguez L, Lima-Serrano M (2024) Methodological and strategic insights for online survey studies: an analysis based on the CHERRIES checklist. Enfermer\u00eda Cl\u00ednica (English Edition) 34(3):207\u2013213","journal-title":"Enfermer\u00eda Cl\u00ednica (English Edition)"},{"key":"10717_CR17","unstructured":"PT Management Support Systems (2018) Appropriate use and documentation of therapeutic activities (97530). Available from: https:\/\/pt-management.com\/blog\/appropriate-use-and-documentation-of-therapeutic-activities-97530\/.\u00a0Accessed 7 Apr 2026"},{"key":"10717_CR18","unstructured":"Services CfMM. Billing and coding: outpatient physical and occupational therapy services. cms.gov2025"},{"issue":"11","key":"10717_CR19","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","volume":"51","author":"KL Campbell","year":"2019","unstructured":"Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS et al (2019) Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc 51(11):2375\u20132390","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"10717_CR20","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa2502760","volume":"393","author":"KS Courneya","year":"2025","unstructured":"Courneya KS, Vardy JL, O\u2019Callaghan CJ, Gill S, Friedenreich CM, Wong RK et al (2025) Structured exercise after adjuvant chemotherapy for colon cancer. N Engl J Med 393(1):13\u201325","journal-title":"N Engl J Med"},{"issue":"11","key":"10717_CR21","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1249\/MSS.0000000000002117","volume":"51","author":"AV Patel","year":"2019","unstructured":"Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL et al (2019) American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Med Sci Sports Exerc 51(11):2391\u20132402","journal-title":"Med Sci Sports Exerc"},{"issue":"6","key":"10717_CR22","first-page":"468","volume":"69","author":"KH Schmitz","year":"2019","unstructured":"Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS et al (2019) Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA Cancer J Clin 69(6):468\u2013484","journal-title":"CA Cancer J Clin"},{"issue":"10","key":"10717_CR23","first-page":"4783","volume":"17","author":"E Sadeghi","year":"2016","unstructured":"Sadeghi E, Gozali N, Tabrizi FM (2016) Effects of energy conservation strategies on cancer related fatigue and health promotion lifestyle in breast cancer survivors: A randomized control trial. Asian Pac J Cancer Prev 17(10):4783","journal-title":"Asian Pac J Cancer Prev"},{"key":"10717_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104206","volume":"129","author":"OA Agbejule","year":"2022","unstructured":"Agbejule OA, Hart NH, Ekberg S, Crichton M, Chan RJ (2022) Self-management support for cancer-related fatigue: A systematic review. Int J Nurs Stud 129:104206","journal-title":"Int J Nurs Stud"},{"issue":"11","key":"10717_CR25","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1002\/pon.5492","volume":"29","author":"SS Spahrk\u00e4s","year":"2020","unstructured":"Spahrk\u00e4s SS, Looijmans A, Sanderman R, Hagedoorn M (2020) Beating cancer\u2010related fatigue with the Untire mobile app: Results from a waiting\u2010list randomized controlled trial. Psychooncology 29(11):1823\u20131834","journal-title":"Psychooncology"},{"issue":"6","key":"10717_CR26","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1002\/pon.5886","volume":"31","author":"SS Spahrk\u00e4s","year":"2022","unstructured":"Spahrk\u00e4s SS, Looijmans A, Sanderman R, Hagedoorn M (2022) How does the Untire app alleviate cancer\u2010related fatigue? A longitudinal mediation analysis. Psychooncology 31(6):970\u2013977","journal-title":"Psychooncology"},{"issue":"9","key":"10717_CR27","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzac120","volume":"102","author":"MI Fisher","year":"2022","unstructured":"Fisher MI, Cohn JC, Harrington SE, Lee JQ, Malone D (2022) Screening and assessment of cancer-related fatigue: a clinical practice guideline for health care providers. Phys Ther 102(9):pzac120","journal-title":"Phys Ther"},{"issue":"9","key":"10717_CR28","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1080\/09593985.2022.2056554","volume":"39","author":"SE Harrington","year":"2023","unstructured":"Harrington SE, Fisher MI, Lee JQ, Cohn J, Malone D (2023) Knowledge regarding cancer-related fatigue: a survey of physical therapists and individuals diagnosed with cancer. Physiother Theory Pract 39(9):1964\u20131973","journal-title":"Physiother Theory Pract"},{"key":"10717_CR29","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.socscimed.2017.01.044","volume":"176","author":"TJ Kim","year":"2017","unstructured":"Kim TJ, Vonneilich N, L\u00fcdecke D, Von Dem Knesebeck O (2017) Income, financial barriers to health care and public health expenditure: a multilevel analysis of 28 countries. Soc Sci Med 176:158\u2013165","journal-title":"Soc Sci Med"},{"issue":"2","key":"10717_CR30","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s00432-023-05555-8","volume":"150","author":"M Milzer","year":"2024","unstructured":"Milzer M, Wagner AS, Schmidt ME, Maatouk I, Hermann S, Baden-W\u00fcrttemberg CRO et al (2024) Patient\u2013physician communication about cancer-related fatigue: a survey of patient-perceived barriers. J Cancer Res Clin Oncol 150(2):29","journal-title":"J Cancer Res Clin Oncol"},{"issue":"9","key":"10717_CR31","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1634\/theoncologist.2009-0048","volume":"14","author":"S-C Shun","year":"2009","unstructured":"Shun S-C, Lai Y-H, Hsiao F-H (2009) Patient-related barriers to fatigue communication in cancer patients receiving active treatment. Oncologist 14(9):936\u2013943","journal-title":"Oncologist"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-10717-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-10717-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-10717-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T02:30:01Z","timestamp":1781058601000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-026-10717-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10717"],"URL":"https:\/\/doi.org\/10.1007\/s00520-026-10717-8","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"assertion":[{"value":"16 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"517"}}