Promoting exercise in oncological aftercare Evaluation of Outdoor Against Cancer's 4x4 training programme

Main Article Content

Hannah Pfeifle
https://orcid.org/0009-0009-0452-6222
Tom Degenhardt
Petra Thaller
https://orcid.org/0009-0000-3314-2759

Abstract

Physical exercise is a key non-pharmacological strategy in oncological aftercare, contributing to improvements in physical performance, quality of life, and symptom management. This study evaluates the 4x4 training programme developed by Outdoor Against Cancer (OAC), a supervised high-intensity interval training (HIIT) intervention based on the Norwegian 4x4 protocol, implemented over nine months in Munich. Participants, including individuals with active cancer, survivors in remission, relatives, and health-oriented individuals, completed a structured survey assessing feasibility, safety, adherence, and perceived effects. Results revealed high long-term commitment, with a substantial proportion attending more than sixteen sessions. Participants reported notable benefits, including reduced cancer-related fatigue, enhanced emotional well-being, improved strength and endurance, and increased quality of life. The programme was perceived as safe and well-structured, with individualized supervision playing a crucial role in motivation and adherence. These findings support the feasibility and positive impact of supervised HIIT programmes in oncological exercise therapy and highlight their potential integration into standard cancer aftercare.

Article Details

How to Cite
Pfeifle, H., Degenhardt, T., & Thaller, P. (2026). Promoting exercise in oncological aftercare: Evaluation of Outdoor Against Cancer’s 4x4 training programme. Physical Activity, Exercise and Cancer, 3(1), 20–24. https://doi.org/10.55860/PQCN9371
Section
Physical activity and exercise during cancer treatments

References

Chen, Y., Li, X., Ma, H., Zhang, X., Wang, B., Guo, T., Xiao, Y., Bing, Z., Ge, L., Yang, K., & Han, X. (2020). Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis. Journal of Pain and Symptom Management, 59(3), 734-749.e10. https://doi.org/10.1016/j.jpainsymman.2019.09.010

Herranz-Gómez, A., Suso-Martí, L., Varangot-Reille, C., Barrachina-Gauchia, L., Casaña, J., López-Bueno, L., Calatayud, J., & Cuenca-Martínez, F. (2024). The Benefit of Exercise in Patients With Cancer Who Are Receiving Chemotherapy: A Systematic Review and Network Meta-Analysis. Physical Therapy, 104(2), pzad132. https://doi.org/10.1093/ptj/pzad132

Loughney LA, W. M. A. K. G. J. G. M. P. W., & Jack, S. (2018). Exercise interventions for people undergoing multimodal cancer treatment that includes surgery. Cochrane Database of Systematic Reviews, 12. https://doi.org/10.1002/14651858.CD012280.pub2

Schlüter, K., Schneider, J., Sprave, T., Wiskemann, J., & Rosenberger, F. (2019). Feasibility of Two High-Intensity Interval Training Protocols in Cancer Survivors. Medicine & Science in Sports & Exercise, 51(12). https://doi.org/10.1249/MSS.0000000000002081

Sweegers, M. G., Altenburg, T. M., Chinapaw, M. J., Kalter, J., Verdonck-de Leeuw, I. M., Courneya, K. S., Newton, R. U., Aaronson, N. K., Jacobsen, P. B., Brug, J., & Buffart, L. M. (2018). Which exercise prescriptions improve quality of life and physical function in patients with cancer during and following treatment? A systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 52(8), 505–513. https://doi.org/10.1136/bjsports-2017-097891

Thaller, P. (2025). Physical activity: A future standard in cancer therapy. Physical Activity, Exercise and Cancer, 2(1), 1–3. https://doi.org/10.55860/AOOB6106

Witlox, L., Hiensch, A. E., Velthuis, M. J., Steins Bisschop, C. N., Los, M., Erdkamp, F. L. G., Bloemendal, H. J., Verhaar, M., ten Bokkel Huinink, D., van der Wall, E., Peeters, P. H. M., & May, A. M. (2018). Four-year effects of exercise on fatigue and physical activity in patients with cancer. BMC Medicine, 16(1), 86. https://doi.org/10.1186/s12916-018-1075-x