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Hollenbach L, Rogahn J, le Coutre P, Schulze S, Muegge LO, Geissler J, Gruen J, Junghanss C, Felser S. Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97). Front Oncol 2024; 14:1345050. [PMID: 38450192 PMCID: PMC10915004 DOI: 10.3389/fonc.2024.1345050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Background Tyrosine kinase inhibitors (TKIs) have significantly lowered mortality of chronic myeloid leukemia (CML) patients adjusting life expectancy to that of the standard population. However, CML and its treatment with TKIs causes a high disease burden. Physical exercise (PE) could be a non-pharmacological approach to reducing these and improving quality of life. Purpose The aim of this study was to determine the individual disease burden as well as PE preferences of CML patients and to deduce thereof specific PE recommendations. Methods This multicenter survey was conducted in cooperation with the LeukaNET/Leukemia-patient network including CML patients aged ≥18 years (German Registry of Clinical Trials, DRKS00023698). The severity of selected symptoms was assessed using the adapted Myeloproliferative Neoplasms Symptom Assessment Form: 0 (absent), 1-30 (mild), 31-70 (moderate), or 71-100 (severe). Information about patients' PE needs and preferences depending on their motivation was recorded. Results A total of 212 questionnaires were analyzed (52% female, median age 54 years). The prevalence of moderate-to-severe symptoms was 49% for fatigue, 40% for musculoskeletal pain, and 37% for concentration problems. Other commonly reported symptoms included skin reactions (42%) and weight gain (24%). The proportion of overweight/obese patients was 52%. Half of all respondents requested more information regarding PE. Patients with CML preferred individual training (82%), located outdoors (71%), at home (47%), or in an indoor swimming pool (31%). Regarding the training frequency, sports-inactive patients preferred a frequency of 1-2 training sessions per week, whereas sports-active patients preferred 3-4 sessions per week (p <0.001). Sports-inactive patients preferred a training time of 15-45 minutes, while sports-active patients preferred 30-60 minutes (p = 0.002). Subsequently, PE recommendations were developed for patients with CML. Combined resistance and endurance training (moderate intensity twice per week for 30 minutes) was recommended for beginners. Obese patients should prioritize joint-relieving sports. To reduce the risk of skin reactions, direct sunlight and possibly water sports should be avoided, and UV protection should be used. Conclusion Counseling and motivation of CML patients to be physically active should be part of the standard of care as well as support for implementation.
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Affiliation(s)
- Lina Hollenbach
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Julia Rogahn
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Philipp le Coutre
- Department of Hematology, Oncology, and Cancer Immunology, Campus Virchow‐Klinikum, Charité ‐ Universitätsmedizin Berlin, Berlin, Germany
| | - Susann Schulze
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Germany
- Department of Medicine, Medical Clinic II, Carl-von-Basedow-Klinikum, Merseburg, Germany
| | - Lars-Olof Muegge
- Department of Internal Medicine III, Heinrich Braun Klinikum Zwickau, Zwickau, Germany
| | - Jan Geissler
- LeukaNET/Leukemia-Online e. V., Riemering, Germany
| | - Julia Gruen
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Christian Junghanss
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Sabine Felser
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
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2
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Hunter H, Qin E, Wallingford A, Hyon A, Patel A. Neurorehabilitation for Adults with Brain and Spine Tumors. Semin Neurol 2024; 44:64-73. [PMID: 38049116 DOI: 10.1055/s-0043-1777407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Central nervous system (CNS) malignancies (i.e. brain and spine tumors) and their treatments can result in a multitude of neurologic deficits. Patients with CNS malignancies experience physical, cognitive, and psychosocial sequelae that can impact their mobility and quality of life. Neurorehabilitation can play a critical role in maintaining independence, preventing disability, and optimizing safety with activities of daily living. This review provides an overview of the neurorehabilitation approaches for patients with CNS malignancies, neurologic impairments frequently treated, and rehabilitation interventions in various health care settings. In addition, we will highlight rehabilitative outcomes between patients with nononcologic neurologic conditions compared to brain and spine tumors. Finally, we address medical challenges that may impact rehabilitation care in these medically complex cancer patients.
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Affiliation(s)
- Hanna Hunter
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Evelyn Qin
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Allison Wallingford
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - April Hyon
- Department of Rehabilitation Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amar Patel
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
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3
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Pieczyńska A, Zasadzka E, Pilarska A, Procyk D, Adamska K, Hojan K. Rehabilitation Exercises Supported by Monitor-Augmented Reality for Patients with High-Grade Glioma Undergoing Radiotherapy: Results of a Randomized Clinical Trial. J Clin Med 2023; 12:6838. [PMID: 37959303 PMCID: PMC10648373 DOI: 10.3390/jcm12216838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Exercise has been shown to improve quality of life (QoL) and even treatment outcomes in cancer patients. However, the evidence to support the benefits of exercise in patients with high-grade glioma (HGG) is limited. Therefore, we performed a randomized clinical trial (RCT) to examine the effect of augmented-reality-based rehabilitation exercises on physical and functional fitness, cognitive function, fatigue, mood, QoL, selected blood parameters, brain derived neurotrophic factor (BDNF), and S100 protein in patients with HGG. METHODS Adult patients with HGG scheduled to undergo radiotherapy after tumor resection were randomized to participate in an exercise program (experimental group, n = 25) or to receive usual care (controls, n = 22). Physical and mental fitness was measured at baseline, after the completion of radiotherapy, and at 3 months. The following tests were administered: Handgrip Strength Test; 6-Minute Walk Test; Time Up and Go test; Functional Independent Measure scale; Addenbrooke's Cognitive Examination III (ACE III); Hospital Anxiety and Depression Scale; Functional Cancer Therapy Assessment-Brain; and Functional Assessment of Chronic Illness Therapy-Fatigue. We also measured blood parameters, BDNF, and S100 protein levels. RESULTS No significant changes were observed in the exercise group. However, the controls experienced a significant decrease in HGS and in the ACE III attention domain. No significant changes were observed in QoL, fatigue, BDNF, or S100 levels in either group. CONCLUSIONS Augmented-reality-based exercise during radiation therapy may prevent loss of muscle strength and attention in patients with HGG.
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Affiliation(s)
- Anna Pieczyńska
- Department of Occupational Therapy, Poznan University of Medical Sciences, 61-781 Poznan, Poland; (A.P.); (K.H.)
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Ewa Zasadzka
- Department of Occupational Therapy, Poznan University of Medical Sciences, 61-781 Poznan, Poland; (A.P.); (K.H.)
| | - Agnieszka Pilarska
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Danuta Procyk
- Central Laboratory, Greater Poland Cancer Centre, 15, 61-866 Poznan, Poland;
| | - Krystyna Adamska
- Chair and Department of Electroradiology, Poznan University of Medical Science, 61-781 Poznan, Poland;
- 3rd Radiotherapy Department, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, 61-781 Poznan, Poland; (A.P.); (K.H.)
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
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van Coevorden-van Loon EMP, Horemans HHLD, Heijenbrok-Kal MH, van den Berg-Emons RJG, Rozenberg R, Vincent AJPE, Ribbers GM, van den Bent MJ. Physical fitness and its association with fatigue in patients with low-grade glioma. Disabil Rehabil 2023; 45:3323-3329. [PMID: 36148487 DOI: 10.1080/09638288.2022.2125084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate physical fitness and its association with fatigue in patients with low grade glioma (LGG). METHODS Cross-sectional study. Muscle strength was measured with a digital dynamometer, cardiorespiratory fitness (peak oxygen uptake (VO2peak), maximal workload (MWL)) by cardiopulmonary-exercise-testing, and fatigue by using the Multidimensional Fatigue Inventory. RESULTS Thirty patients were included, mean age of 44.1 (SD11.2) years, and 67% were men, 31.2 (SD18) months post-diagnosis. Muscle strength (p < 0.01), and cardiorespiratory fitness (VO2peak, MWL) (p < 0.01) were significantly decreased compared to predicted values based on age and gender. Thirty percent of the patients experienced severe physical fatigue, and severe mental fatigue was reported in 57% of the patients. Cardiorespiratory fitness showed weak to moderate (r - 0.46 to r - 0.52) but significant (p < 0.01) correlations with physical fatigue, not with mental and general fatigue. Muscle strength was not associated with fatigue. A lower VO2peak was independently associated with a higher level of physical fatigue, adjusted for Karnofsky Performance Status (R2 0.40). CONCLUSIONS Physical fitness (muscle strength, cardiorespiratory fitness) is reduced in patients with LLG, and a lower level of cardiorespiratory fitness (VO2peak) is independently associated with a higher level of experienced physical fatigue. Trials to explore the benefit of exercise programs to improve cardiorespiratory fitness and, consequently, fatigue are warranted.Implications for rehabilitationPhysical fitness (muscle strength and cardiorespiratory fitness) is reduced in patients with low-grade glioma.Patients with low-grade glioma should be screened for fatigue with the multidimensional fatigue inventory, to differentiate between mental and physical fatigue.Patients with low-grade glioma with severe physical fatigue should be screened for reduced physical fitness, especially cardiorespiratory fitness by objective cardiopulmonary-exercise-testing.Rehabilitation exercise programs to improve cardiorespiratory fitness and, consequently, (physical) fatigue could be warranted in patients with low-grade glioma.
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Affiliation(s)
- Ellen M P van Coevorden-van Loon
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Rehabilitation, Revant Rehabilitation, Goes, The Netherlands
| | - Herwin H L D Horemans
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Majanka H Heijenbrok-Kal
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert Rozenberg
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arnaud J P E Vincent
- The Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Gerard M Ribbers
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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5
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Takemura N, Cheung DST, Fong DYT, Lin CC. Promoting moderate-to-vigorous physical activities in patients with advanced lung cancer: preferences and social cognitive factors, and the mediating roles. Support Care Cancer 2022; 30:7419-7429. [PMID: 35622150 PMCID: PMC9136819 DOI: 10.1007/s00520-022-07149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to assess the prevalence and preferences of moderate-to-vigorous physical activities (MVPA) in patients with advanced lung cancer, explore the social cognitive factors that were associated with MVPA and interest in PA counseling and program, and examine the mediating role of social cognitive factors. METHODS This was a cross-sectional study. Questionnaires on PA levels, PA counseling and programming preferences, and social cognitive variables (social support and self-efficacy) were administered to 105 patients with advanced lung cancer. Linear regression model was used to explore the social cognitive factors associated with MVPA, and logistic regression model was used to explore the factors associated with interest in PA counseling and program. Mediation analysis was used to examine the mediating role of self-efficacy on social support and MVPA. RESULTS Merely 30.5% of patients met the recommended level of MVPA; however, the majority of patients (89.5%) were interested in PA program. Social support (β = 0.60; p = 0.007) and self-efficacy (β = 1.06; p = 0.027) were positively associated with MVPA. Specifically, self-efficacy mediated the relationship between social support and MVPA (β = 0.63, p = 0.004). CONCLUSION The majority of the patients with advanced lung cancer did not meet the recommended level of MVPA; however, they are interested in receiving PA counseling and joining PA programs. Social support was key to promoting higher levels of MVPA, and the association was mediated by self-efficacy. The established mediating model provides insights into designing PA programs and targeting the mediating variable, self-efficacy, to enhance the level of MVPA.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, Hong Kong.
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6
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Fournier B, Delrieu L, Russo C, Terret C, Fervers B, Pérol O. Interest and preferences for physical activity programming and counselling among cancer patients aged over 70 years receiving oncological treatments. Eur J Cancer Care (Engl) 2021; 31:e13527. [PMID: 34668267 DOI: 10.1111/ecc.13527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/23/2021] [Accepted: 10/04/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The objective of this study is to assess the physical activity interest and preferences of cancer patients aged over 70 years during oncological treatments and to explore how demographic characteristics may modulate preferences. METHODS From April to May 2018, this cross-sectional study collected data from self-administered questionnaire regarding physical activity interest and preferences in cancer patients receiving oncological treatments in a regional cancer centre. RESULTS A total of 144 patients completed the questionnaire. Two thirds (n = 95) showed interest in participating in dedicated physical activity programme during oncologic treatments. Patients preferred to exercise in group activities, under the supervision of an exercise instructor, once a week, at a moderate intensity, for 30 min session, in a community fitness centre. Women significantly preferred exercises to improve flexibility (p = 0.03) and to receive counselling in a group (p = 0.03), whereas men preferred to practise strength training (p = 0.02) and to receive counselling with brochures (p = 0.02). As age increases, participants were significantly more inclined to practise physical activity to improve their balance (p = 0.01). CONCLUSION These preliminary results will facilitate the design of programmes considering current physical activity preferences in older adults with cancer, which could ensure better adherence to physical activity programmes and, in turn, improved health outcomes.
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Affiliation(s)
- Baptiste Fournier
- Department Prevention Cancer Environment, Leon Bérard Cancer Center, Lyon, France.,Radiation: Defense, Health, Environment, INSERM UMR1296, Lyon, France
| | - Lidia Delrieu
- Department Prevention Cancer Environment, Leon Bérard Cancer Center, Lyon, France.,Inter-University Laboratory of Human Movement Biology, EA 7424, University of Lyon, UCBL-Lyon 1, Villeurbanne, France
| | - Chiara Russo
- Department of Medical Oncology, Leon Bérard Cancer Center, Lyon, France
| | - Catherine Terret
- Department of Medical Oncology, Leon Bérard Cancer Center, Lyon, France
| | - Béatrice Fervers
- Department Prevention Cancer Environment, Leon Bérard Cancer Center, Lyon, France.,Radiation: Defense, Health, Environment, INSERM UMR1296, Lyon, France
| | - Olivia Pérol
- Department Prevention Cancer Environment, Leon Bérard Cancer Center, Lyon, France.,Radiation: Defense, Health, Environment, INSERM UMR1296, Lyon, France
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7
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Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act 2021; 18:50. [PMID: 33823832 PMCID: PMC8025326 DOI: 10.1186/s12966-021-01116-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients' PA participation. METHODS A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions. RESULTS Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients' PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs. CONCLUSIONS There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
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Affiliation(s)
- Sarah Elshahat
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Charlene Treanor
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
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Gehring K, Stuiver MM, Visser E, Kloek C, van den Bent M, Hanse M, Tijssen C, Rutten GJ, Taphoorn MJB, Aaronson NK, Sitskoorn MM. A pilot randomized controlled trial of exercise to improve cognitive performance in patients with stable glioma: a proof of concept. Neuro Oncol 2021; 22:103-115. [PMID: 31755917 PMCID: PMC6954415 DOI: 10.1093/neuonc/noz178] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Patients with glioma often suffer from cognitive deficits. Physical exercise has been effective in ameliorating cognitive deficits in older adults and neurological patients. This pilot randomized controlled trial (RCT) explored the possible impact of an exercise intervention, designed to improve cognitive functioning in glioma patients, regarding cognitive test performance and patient-reported outcomes (PROs). Methods Thirty-four clinically stable patients with World Health Organization grades II/III glioma were randomized to a home-based remotely coached exercise group or an active control group. Patients exercised 3 times per week for 20–45 minutes, with moderate to vigorous intensity, during 6 months. At baseline and immediate follow-up, cognitive performance and PROs were assessed with neuropsychological tests and questionnaires, respectively. Linear regression analyses were used to estimate effect sizes of potential between-group differences in cognitive performance and PROs at 6 months. Results The exercise group (n = 21) had small- to medium-sized better follow-up scores than the control group (n = 11) on several measures of attention and information processing speed, verbal memory, and executive function, whereas the control group showed a slightly better score on a measure of sustained selective attention. The exercise group also demonstrated small- to medium-sized better outcomes on measures of self-reported cognitive symptoms, fatigue, sleep, mood, and mental health–related quality of life. Conclusions This small exploratory RCT in glioma patients provides a proof of concept with respect to improvement of cognitive functioning and PROs after aerobic exercise, and warrants larger exercise trials in brain tumor patients.
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Affiliation(s)
- Karin Gehring
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.,Department of Cognitive Neuropsychology, Tilburg University, Tilburg, the Netherlands
| | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, the Netherlands.,ACHIEVE, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Eva Visser
- Trauma TopCare, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Corelien Kloek
- Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Martin van den Bent
- Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Monique Hanse
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Cees Tijssen
- Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Geert-Jan Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Margriet M Sitskoorn
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, the Netherlands
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Can Multidisciplinary Inpatient and Outpatient Rehabilitation Provide Sufficient Prevention of Disability in Patients with a Brain Tumor?-A Case-Series Report of Two Programs and A Prospective, Observational Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186488. [PMID: 32899993 PMCID: PMC7559888 DOI: 10.3390/ijerph17186488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/18/2020] [Accepted: 09/01/2020] [Indexed: 12/24/2022]
Abstract
Brain tumor (BT) patients have a high incidence of disability due to the effects of the tumor itself or oncological treatment. Despite the incidence of neurological and functional deficits caused by BT, rehabilitation of those patients is not as properly established as in patients with other neurological conditions. The aim of the research was to evaluate the effectiveness of a multidisciplinary rehabilitation, carried out as an out- or in-patient program, as prevention of disability in BT patients. This was developed as a case-series report of two programs and a prospective, observational clinical study in BT patients who were allocated to inpatient (n = 28) or outpatient (n = 26) rehabilitation programs. The patients were assessed using the Barthel Index, Berg Balance Scale, Functional Independence Measure (FIM), Functional Assessment of Cancer Therapy—Brain and Cognitive Function, and Addenbrooke’s Cognitive Examination III (ACE III) upon admission and after 12 weeks of rehabilitation. Analysis of the results showed that patients in both programs significantly improved their physical functioning scores in daily activities (p < 0.0001). We also observed significant reductions in most post-intervention cognitive complaints (p < 0.05), except for the FIM social functioning and ACE III language functioning in the outpatient group (p > 0.05) in contrast to inpatients (p < 0.001). This is evidence that early multidisciplinary rehabilitation is an effective therapeutic strategy to reduce BT symptoms and disability in this group of patients.
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10
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Luo H, Galvão DA, Newton RU, Fairman CM, Taaffe DR. Sport Medicine in the Prevention and Management of Cancer. Integr Cancer Ther 2020; 18:1534735419894063. [PMID: 31838880 PMCID: PMC6913064 DOI: 10.1177/1534735419894063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Physical inactivity is a major concern in cancer patients despite the established preventative and therapeutic effects of regular physical exercise for this patient group. Sport not only plays an important role in supporting the development and maintenance of a physically active lifestyle but also is increasingly used as a health promotion activity in various populations. Nevertheless, the potential of sport as an effective strategy in the prevention and management of cancer has gained little attention. Based on the scant evidence to date, participation of cancer patients in supervised, well-tailored sport programs appears to be safe and feasible and is associated with an array of physical and psychological benefits. We propose that sport participation may serve as an alternative strategy in the prevention of cancer and sport medicine in the management of cancer. As with the traditional exercise modes, benefits derived from sport participation will be dependent on the sport undertaken and the physical/physiological, motor, and cognitive demands required. To this end, further work is required to develop a solid evidence base in this field so that targeted sport participation can be recommended for cancer patients.
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Affiliation(s)
- Hao Luo
- Guangdong Vocational Institute of Sport, Guangzhou, Guangdong, China.,Edith Cowan University, Joondalup, Western Australia, Australia
| | - Daniel A Galvão
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Robert U Newton
- Edith Cowan University, Joondalup, Western Australia, Australia.,University of Queensland, Brisbane, Queensland, Australia.,The University of Hong Kong, Hong Kong
| | | | - Dennis R Taaffe
- Edith Cowan University, Joondalup, Western Australia, Australia.,University of Queensland, Brisbane, Queensland, Australia
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11
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Feasibility, Safety and Effects of a One-Week, Ski-Based Exercise Intervention in Brain Tumor Patients and Their Relatives: A Pilot Study. J Clin Med 2020; 9:jcm9041006. [PMID: 32252441 PMCID: PMC7231125 DOI: 10.3390/jcm9041006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/23/2020] [Accepted: 04/01/2020] [Indexed: 12/19/2022] Open
Abstract
A brain tumor diagnosis poses a significant psychological burden and it severely impacts quality of life (QOL), both in patients and relatives. However, comprehensive strategies addressing QOL in this setting remain rare. Here, we aim to share our findings of a one-week ski exercise intervention, with emphasis on feasibility, safety, QOL, and physical exercise. The intervention consisted of week-long daily ski sessions with professional ski guides as well as dedicated physicians present. The participants were handed questionnaires, including distress and QOL items before, during, and after the intervention. Using fitness watches, exercise intensity was also tracked at these timepoints. During the intervention, patients were checked for adverse events daily. Fifteen participants, nine patients after multidisciplinary treatment, and six relatives were included in the study. Additionally, 13 children participated in the exercise, but not in the study. All of the participants completed the entire program. No severe adverse events were documented during daily checks. There was a strong increase in quantified activity and QOL with a corresponding decrease in distress during the intervention, and, partly, afterwards. This prospective brain tumor rehabilitation study demonstrates the feasibility and safety of challenging ski exercise in brain tumor patients. The findings also underline the exercise-mediated QOL benefits, emphasizing the need for more comprehensive brain tumor rehabilitation programs.
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Abstract
OBJECTIVES To address the estimated rates of incidence, potential underlying etiologies, and cognitive domains affected from diagnosis and treatment. To describe potential cognitive function interventions. DATA SOURCES PubMed. CONCLUSION Adults with gliomas report that the most distressing, persistent, and greatest negative impact on their lives relates to the cognitive impairment they experience. However, there are several potential interventions that may prevent cognitive decline during treatment or maintain cognitive function long term. IMPLICATIONS FOR NURSING PRACTICE Awareness of cognitive sequela that adults with gliomas face can lead to early identification, full neurocognitive profiling, and implementation of evidence-based interventions for those experiencing cognitive impairments following cancer treatment.
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Wong JN, McAuley E, Trinh L. Physical activity programming and counseling preferences among cancer survivors: a systematic review. Int J Behav Nutr Phys Act 2018; 15:48. [PMID: 29879993 PMCID: PMC5992647 DOI: 10.1186/s12966-018-0680-6] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 05/20/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) participation and adherence among cancer survivors is low, despite research indicating numerous physical, psychological and emotional health benefits of exercise. Tailoring exercise programs specific to the PA preferences in cancer survivors has merit for increasing PA participation and adherence to accrue these benefits. This systematic review identifies and differentiates PA programming and counseling preferences of adult cancer survivors across various cancer survivor groups. METHODS PubMed, SPORTDiscus, Scopus, PsycINFO, EMBASE, Web of Science and CINAHL were electronically searched (inception to Oct 2017) and articles were identified using PRISMA guidelines. Two reviewers independently assessed identified articles to determine eligibility and then individually performed a quality assessment on all final studies. Extracted and analyzed data included participant characteristics, interest in exercise counseling and programming, as well as specific exercise and counseling preferences (e.g. location, timing, intensity). RESULTS Forty-one articles were included in this systematic review. Most studies assessed mixed cancer survivor groups or breast cancer survivors. Most cancer survivors felt able and interested in participating in a PA program, though starting a PA program after or before treatment was preferred. Walking was the strongest PA modality preference, and most cancer survivors preferred moderate intensity PA. Cancer survivors also indicated preferences for home-based PA that could take place in the morning. Slight preferences were found towards physical activity counseling delivered by a fitness expert from a cancer center. Both quantitative and qualitative studies were found to be of moderate to high quality based on the Appraisal Tool for Cross-Sectional Studies (AXIS) and the Consolidated Criteria for Reporting Qualitative Research (COREQ), respectively. CONCLUSION Cancer survivors have an interest in participating in PA programs with walking as the primary modality. Additionally, morning-based PA programs that can be tapered to home-based programs are desirable. However, there was wide variation in other PA preference variables, suggesting multiple program options would be beneficial. Many cancer survivors felt interested and able to participate in PA, and therefore designing PA programs that are tailored to cancer survivors is integral for optimizing recruitment and adherence, as well as enhancing health outcomes in cancer survivors.
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Affiliation(s)
- Jaime N. Wong
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6 Canada
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Wang L, Mårtensson J, Zhao Y, Nygårdh A. Experiences of a health coaching self-management program in patients with COPD: a qualitative content analysis. Int J Chron Obstruct Pulmon Dis 2018; 13:1527-1536. [PMID: 29785102 PMCID: PMC5955048 DOI: 10.2147/copd.s161410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the experiences of patients with COPD participating in a health coaching self-management program. Patients and methods Twenty patients who had participated in a 6-month health coaching self-management program intervention were purposefully selected for a qualitative evaluation of the program using semi-structured interviews. The interviews were analyzed using inductive qualitative content analysis. Results Four categories and 13 subcategories emerged describing the participants’ experiences of the program. Their experiences were expressed as gaining insight into the importance of knowledge and personal responsibilities in the management of COPD, taking action to maintain a healthy lifestyle, feeling supported by the program, and being hindered by individual and program limitations. Conclusion Iterative interactions between patients and health care professionals together with the content of the program are described as important to develop skills to manage COPD. However, in future self-management programs more awareness of individual prerequisites should be considered.
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Affiliation(s)
- Lan Wang
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Nursing, School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China
| | - Jan Mårtensson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Yue Zhao
- Department of Nursing, School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China
| | - Annette Nygårdh
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Abstract
Patients with brain tumor exhibit wide-ranging prognoses and functional implications of their disease and treatments. In general, the supportive care needs of patients with brain tumor, including disabling effects, have been recognized to be high. This review (1) briefly summarizes brain tumor types, treatments, and prognostic information for the rehabilitation clinician; (2) reviews evidence for rehabilitation, including acute inpatient rehabilitation and cognitive rehabilitation, and the approaches to selected common symptom and medical management issues; and (3) examines emerging data about survivorship, such as employment, community integration, and fitness.
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Affiliation(s)
- Mary M Vargo
- Physical Medicine and Rehabilitation, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
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Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, McCarthy AL, Murnane A, Patchell S, Adams D. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 2018; 209:184-187. [DOI: 10.5694/mja18.00199] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Prue Cormie
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC
| | - Morgan Atkinson
- Youth Cancer Services South Australia and Northern Territory, Adelaide, SA
| | - Lucy Bucci
- Peter MacCallum Cancer Centre, Melbourne
| | - Anne Cust
- Cancer Epidemiology and Prevention Research Group, University of Sydney, Sydney, NSW
- Melanoma Institute Australia, Sydney, NSW
| | | | - Sandra Hayes
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD
| | | | | | | | - Diana Adams
- Macarthur Cancer Therapy Centre, South Western Sydney Local Health District, Sydney, NSW
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Mina DS, Sabiston CM, Au D, Fong AJ, Capozzi LC, Langelier D, Chasen M, Chiarotto J, Tomasone JR, Jones JM, Chang E, Culos-Reed SN. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement. ACTA ACUST UNITED AC 2018; 25:149-162. [PMID: 29719431 DOI: 10.3747/co.25.3977] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.
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Affiliation(s)
- D Santa Mina
- Faculty of Kinesiology and Physical Education and.,Faculty of Medicine, University of Toronto, Toronto, ON.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON
| | - C M Sabiston
- Faculty of Kinesiology and Physical Education and
| | - D Au
- Faculty of Kinesiology and Physical Education and.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON
| | - A J Fong
- Faculty of Kinesiology and Physical Education and
| | - L C Capozzi
- Cumming School of Medicine, University of Calgary, Calgary, AB
| | - D Langelier
- Cumming School of Medicine, University of Calgary, Calgary, AB
| | - M Chasen
- Faculty of Kinesiology and Physical Education and
| | - J Chiarotto
- Department of Medicine, Scarborough and Rouge Hospital, Toronto, ON
| | - J R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON
| | - J M Jones
- Faculty of Medicine, University of Toronto, Toronto, ON.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON
| | - E Chang
- Faculty of Medicine, University of Toronto, Toronto, ON.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON.,Toronto Rehabilitation Institute, Toronto, ON
| | - S N Culos-Reed
- Cumming School of Medicine, University of Calgary, Calgary, AB.,Faculty of Kinesiology, University of Calgary, Calgary, AB.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB
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18
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Hansen A, Søgaard K, Minet LR. Development of an exercise intervention as part of rehabilitation in a glioblastoma multiforme survivor during irradiation treatment: a case report. Disabil Rehabil 2018; 41:1608-1614. [PMID: 29382243 DOI: 10.1080/09638288.2018.1432707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION This case report describes the rationale and development of an exercise intervention in a patient with glioblastoma multiforme (GBM ) and discusses potential relations of observed effects in functional performance and quality of life (QOL). METHODS A 54-year-old GBM survivor completed a supervised six-week exercise intervention during irradiation treatment beginning 42 d after resection. Exercise modalities of cardiorespiratory, resistance, and balance training were designed on generic recommendations of various cancer populations and literature review. RESULTS Our case attended all possible sessions without experiencing adverse effects, and improved in aerobe power (24%), muscle strength (0-38%), standing balance (71%), walking ability (9%), and QOL domains of "Global Health Status/QoL" and "Physical functioning." CONCLUSIONS Based on this single case, exercise rehabilitation has the ability to maintain or improve functional performance and QOL domains even during heavy treatments. It also implies that patients with GBM are capable and may be willing to participate in exercise rehabilitation if supervised by physical therapists. Implications for rehabilitation The use of exercise as part of rehabilitation still needs attention in strong methodology studies of patients with gliomas. Exercise rehabilitation may maintain or even improve functional performance and QOL domains during medical treatment regimens. Functional independent patients with GBM are capable to comply with generic exercise recommendations and may be willing to participate in exercise rehabilitation if supervised by physical therapists.
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Affiliation(s)
- Anders Hansen
- a Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.,b OPEN, Odense Patient Data Explorative Network, Odense University Hospital , Odense , Denmark
| | - Karen Søgaard
- a Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.,c Occupational and Environmental Medicine , Odense University Hospital , Odense , Denmark
| | - Lisbeth Rosenbek Minet
- d Department of Clinical Research, Research Unit of Rehabilitation , University of Southern Denmark , Odense , Denmark.,e Research Centre, University College Lillebaelt , Odense , Denmark
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Sheill G, Guinan E, Neill LO, Hevey D, Hussey J. The views of patients with metastatic prostate cancer towards physical activity: a qualitative exploration. Support Care Cancer 2017; 26:1747-1754. [PMID: 29243168 DOI: 10.1007/s00520-017-4008-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/05/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE Patients with metastatic cancer can experience debilitating symptoms, which may influence attitudes towards and engagement in physical activity. This study aimed to examine the attitudes of patients living with metastatic prostate cancer towards physical activity. MATERIALS AND METHODS Semi-structured interviews were completed with male patients living with metastatic prostate cancer. Interviews included eight questions related to patients' attitudes towards physical activity. Content analysis was conducted on the transcribed interview data. Twenty men with metastatic prostate cancer (mean age 71 ± 8.5 years; body mass index 30.19 ± 5.37 kg/cm2) and associated bone metastases (55% with > 2 regions affected) participated in the study. RESULTS Men's views towards physical activity were coded into the following major themes: (1) barriers to physical activity, (2) benefits of physical activity, (3) a reduction in physical activity levels post diagnosis and (4) social support for physical activity. Symptoms of metastatic prostate cancer and treatment side effects including pain and fatigue negatively influenced activity participation. In addition, many generic barriers to physical activity were described such as bad weather and a lack of suitable facilities for exercising in rural areas. CONCLUSION Men living with metastatic prostate cancer have unique needs regarding physical activity related to symptoms of both their cancer and cancer treatment. There is a need to increase prompts that encourage those with metastatic prostate cancer to maintain/increase physical activity levels post diagnosis. Given the individualised needs of this patient group, referral to a cancer exercise specialist should be considered for prescription of tailored physical activity programmes. TRIAL REGISTRATION Clinicaltrials.gov NLM Identifier: NCT02453139.
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Affiliation(s)
- G Sheill
- Discipline of Physiotherapy, School of Medicine, Trinity College Centre for Health Sciences, James's Street, Dublin 8, Ireland.
| | - E Guinan
- School of Medicine, Trinity College Centre for Health Sciences, James's Street, Dublin 8, Ireland
| | - L O Neill
- Discipline of Physiotherapy, School of Medicine, Trinity College Centre for Health Sciences, James's Street, Dublin 8, Ireland
| | - D Hevey
- School of Psychology, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - J Hussey
- Discipline of Physiotherapy, School of Medicine, Trinity College Centre for Health Sciences, James's Street, Dublin 8, Ireland
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20
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Zhu J, Ebert L, Xue Z, Shen Q, Chan SWC. Development of a mobile application of Breast Cancer e-Support program for women with breast cancer undergoing chemotherapy. Technol Health Care 2017; 25:377-382. [PMID: 28085020 DOI: 10.3233/thc-161292] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women with breast cancer undergoing chemotherapy experience a variety of physical and psychosocial symptoms, which have negative effect on women's quality of life and psychological well-being. Although M-health technologies provides innovative and easily accessible option to provide psychosocial support, mobile phone based interventions remain limited for these women in China. OBJECTIVE To develop a new mobile application to offer information as well as social and emotional support to women with breast cancer undergoing chemotherapy to promote their self-efficacy and social support, thus improving symptom management strategies. METHODS Basing on previous theoretical framework which incorporated Bandura's self-efficacy theory and the social exchange theory, a new mobile application, called Breast Cancer e-Support Program (BCS) was designed, with the content and functionality being validated by the expert panel and women with breast cancer. RESULTS BCS App program has four modules: 1) Learning forum; 2) Discussion forum; 3) Ask-the-Expert forum; and 4) Personal Stories forum. BCS program can be applied on both android mobile phones and iPhones to reach more women. CONCLUSIONS This is the first of its kind developed in China for women with breast cancer undergoing chemotherapy. A randomized controlled trial is undertaking to test the effectiveness of BCS program.
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Affiliation(s)
- Jiemin Zhu
- Nursing Department, Medical School, Xiamen University, Xiamen, Fujian, China.,Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, NSW, Australia
| | - Lyn Ebert
- Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, NSW, Australia
| | - Zhimin Xue
- Breast Surgery, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China
| | - Qu Shen
- Nursing Department, Medical School, Xiamen University, Xiamen, Fujian, China
| | - Sally Wai-Chi Chan
- Faculty of Health and Medicine, School of Nursing and Midwifery, University of Newcastle, NSW, Australia
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21
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Gehring K, Kloek CJ, Aaronson NK, Janssen KW, Jones LW, Sitskoorn MM, Stuiver MM. Feasibility of a home-based exercise intervention with remote guidance for patients with stable grade II and III gliomas: a pilot randomized controlled trial. Clin Rehabil 2017; 32:352-366. [PMID: 28882061 DOI: 10.1177/0269215517728326] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In this pilot study, we investigated the feasibility of a home-based, remotely guided exercise intervention for patients with gliomas. DESIGN Pilot randomized controlled trial (RCT) with randomization (2:1) to exercise or control group. SUBJECTS Patients with stable grade II and III gliomas. INTERVENTION The six-month intervention included three home-based exercise sessions per week at 60%-85% of maximum heart rate. Participants wore heart rate monitors connected to an online platform to record activities that were monitored weekly by the physiotherapist. MAIN MEASURES Accrual, attrition, adherence, safety, satisfaction, patient-reported physical activity, VO2 peak (by maximal cardiopulmonary exercise testing) and body mass index (BMI) at baseline and at six-month follow-up. RESULTS In all, 34 of 136 eligible patients (25%) were randomized to exercise training ( N = 23) or the control group ( N = 11), of whom 19 and 9, respectively, underwent follow-up. Mean adherence to prescribed sessions was 79%. Patients' experiences were positive. There were no adverse events. Compared to the control group, the exercise group showed larger improvements in absolute VO2 peak (+158.9 mL/min; 95% CI: -44.8 to 362.5) and BMI (-0.3 kg/m²; 95% CI: -0.9 to 0.2). The median increase in physical activity was 1489 metabolic equivalent of task (MET) minutes higher in the exercise group. The most reported reasons for non-participation were lack of motivation or time. CONCLUSION This innovative and intensive home-based exercise intervention was feasible in a small subset of patients with stable gliomas who were interested in exercising. The observed effects suggest that the programme may improve cardiorespiratory fitness. These results support the need for large-scale trials of exercise interventions in brain tumour patients.
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Affiliation(s)
- Karin Gehring
- 1 Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.,2 Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Corelien Jj Kloek
- 1 Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.,3 Research Group of Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Neil K Aaronson
- 4 Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Kasper W Janssen
- 5 Department of Sports and Exercise Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Lee W Jones
- 6 Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Margriet M Sitskoorn
- 1 Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Martijn M Stuiver
- 7 Department of Physical Therapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,8 ACHIEVE, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, The Netherlands
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Abstract
BACKGROUND Although physical activity (PA) has significant benefits for people living with multiple myeloma (MM), participation rates are low. Examination of PA preferences will provide important information to clinicians and assist in the development of interventions to increase participation in PA for people living with MM. OBJECTIVE The aim of this study is to gain an in-depth understanding of the PA preferences for people living with MM, including the preferred role of clinicians. METHODS Semistructured interviews were conducted with patients treated for MM within the preceding 2 to 12 months. Interviews were analyzed using content analysis, where coding categories were derived directly from the text data. RESULTS Twenty-four interviews were conducted (women, 54%; age: mean [SD], 62 [8.8] years); 16 (67%) participants had an autologous stem cell transplant. Light- to moderate-intensity PA during and after treatment was feasible, with the strongest preference for a program 2 to 8 months after treatment. The timing of information delivery was important, as was input from clinicians and organizations with knowledge of MM. Preferences for location, structure, and timing of programs varied. CONCLUSIONS Low- to moderate-intensity PA after treatment is likely to interest people with MM. Programs need to be flexible and consider individual differences in PA preferences, functional status, and treatment schedules. IMPLICATIONS An individually tailored PA program should form part of clinical care, involving clinicians and organizations with expertise in MM. Options for home-based PA are also important. Further research, including a population-based study of people living with MM, is necessary to further quantify PA preferences.
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Liljehult MM, Buus L, Liljehult J, Rasmussen BK. Walking ability in patients with glioblastoma: prognostic value of the Berg Balance Scale and the 10 meter walk test. J Neurooncol 2017; 135:335-342. [DOI: 10.1007/s11060-017-2579-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/23/2017] [Indexed: 11/24/2022]
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Baima J, Omer ZB, Varlotto J, Yunus S. Compliance and safety of a novel home exercise program for patients with high-grade brain tumors, a prospective observational study. Support Care Cancer 2017; 25:2809-2814. [DOI: 10.1007/s00520-017-3695-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/31/2017] [Indexed: 11/24/2022]
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Exercise preferences and associations between fitness parameters, physical activity, and quality of life in high-grade glioma patients. Support Care Cancer 2016; 25:1237-1246. [PMID: 27988867 DOI: 10.1007/s00520-016-3516-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 11/28/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE Exercise has numerous benefits for cancer survivors, but very limited research to date has exclusively examined brain cancer patients, specifically those diagnosed with high-grade glioma (HGG). This study examined (1) the feasibility of recruiting HGG patients to an exercise-based study and performing fitness assessments; (2) exercise counseling and programming preferences; and (3) associations between fitness, physical activity (PA), and quality of life (QOL). METHODS Participants completed assessments prior to starting Temozolamide chemotherapy with radiation (T1), at 2 months and 8 months. Fitness was measured with an incremental cycling exercise test to volitional exhaustion (VO2peak) and hand grip dynamometry. The Godin leisure time questionnaire measured PA and the functional assessment for cancer therapy, brain cancer module (FACT-Br) measured QOL. RESULTS Of the 35 approached, N = 16 participated. Due to safety concerns, the aerobic fitness test protocol was altered. Participants preferred to exercise during treatment, alone and unsupervised, at home, and at a moderate intensity. Few participants (<25%) met guidelines for PA at any time point. At T1, aerobic capacity was associated with the FACT Trial Outcome Index (TOI) (r = 0.619, p < 0.05). At 2 months, PA minutes were associated with FACT-TOI (r = 0.653, p = 0.057), FACT-G (r = 0.711, p < 0.05), and FACT-Br scores (r = 0.722, p < 0.05). CONCLUSIONS Recruitment rate was similar to a previous study in HGG populations, but study completion rate was lower. Most exercise counseling and programming preferences were similar to previous brain cancer patients. Assessing aerobic fitness to VO2peak was not feasible. Aerobic fitness and PA were positively associated with QOL.
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Lowe SS, Danielson B, Beaumont C, Watanabe SM, Courneya KS. Physical activity interests and preferences of cancer patients with brain metastases: a cross-sectional survey. BMC Palliat Care 2016; 15:7. [PMID: 26786579 PMCID: PMC4719740 DOI: 10.1186/s12904-016-0083-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity has been shown to positively impact cancer-related fatigue, physical functioning and quality of life outcomes in early stage cancer patients, however its role at the end stage of cancer has yet to be determined. Brain metastases are amongst the most common neurological complications of advanced cancer, with significant deterioration in fatigue and quality of life. The purpose of the present study was to examine the physical activity interests and preferences of cancer patients with brain metastases initiating palliative whole brain radiotherapy. METHODS Thirty-one patients aged 18 years or older, cognitively intact, diagnosed with brain metastases, and with Palliative Performance Scale scores of greater than 30%, were recruited from a multidisciplinary outpatient brain metastases clinic. An interviewer-administered survey was used to assess physical activity interests and preferences of participants who were embarking upon palliative whole brain radiotherapy. RESULTS 87% (n = 27) of participants felt that physical activity was important, however there was limited interest in participating in a structured program at the onset of palliative whole brain radiotherapy. Lung cancer diagnosis was associated with being less interested in participating in a physical activity program, and feeling less able to participate in a physical activity program at the onset of palliative whole brain radiotherapy. CONCLUSIONS Cancer patients with brain metastases demonstrate limited interest and varied preferences for physical activity during palliative whole brain radiotherapy. Additional pilot work with this patient population is needed before physical activity interventions can be tested in clinical research.
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Affiliation(s)
- Sonya S Lowe
- Department of Symptom Control and Palliative Care, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Brita Danielson
- Division of Radiation Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Crystal Beaumont
- Department of Symptom Control and Palliative Care, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Sharon M Watanabe
- Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta, T6G 1Z2, Canada.
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, Alberta, T6G 2H9, Canada.
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Abstract
Disabling sequelae occur in a majority of patients diagnosed with brain tumor, including glioma, such as cognitive deficits, weakness, and visual perceptual changes. Often, multiple impairments are present concurrently. Healthcare staff must be aware of the "biographic disruption" the patient with glioma has experienced. While prognostic considerations factor into rehabilitation goals and expectations, regardless of prognosis the treatment team must offer cohesive support, facilitating hope, function, and quality of life. Awareness of family and caregiver concerns plays an important role in the overall care. Inpatient rehabilitation, especially after surgical resection, has been shown to result in functional improvement and homegoing rates on a par with individuals with other neurologic conditions, such as stroke or traumatic brain injury. Community integration comprises a significant element of life satisfaction, as has been shown in childhood glioma survivors. Employment is often affected by the glioma diagnosis, but may be ameliorated, when appropriate, by addressing modifiable factors such as depression, fatigue, or sleep disturbance, or by workplace accommodations. Further research is needed into many facets of rehabilitation in the setting of glioma, including establishing better care models for consistently identifying and addressing functional limitations in this population, measuring outcomes of various levels of rehabilitation care, identifying optimal physical activity strategies, delineating the long-term effects of rehabilitation interventions, and exploring impact of rehabilitation interventions on caregiver burden. The effective elements of cognitive rehabilitation, including transition of cognitive strategies to everyday living, need to be better defined.
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Affiliation(s)
- Mary Vargo
- Department of Physical Medicine and Rehabilitation, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
| | | | - Pär Salander
- Department of Social Work, Umeå University, Umeå, Sweden
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Santa Mina D, Petrella A, Currie KL, Bietola K, Alibhai SMH, Trachtenberg J, Ritvo P, Matthew AG. Enablers and barriers in delivery of a cancer exercise program: the Canadian experience. ACTA ACUST UNITED AC 2015; 22:374-84. [PMID: 26715869 DOI: 10.3747/co.22.2650] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Exercise is an important therapy to improve well-being after a cancer diagnosis. Accordingly, cancer-exercise programs have been developed to enhance clinical care; however, few programs exist in Canada. Expansion of cancer-exercise programming depends on an understanding of the process of program implementation, as well as enablers and barriers to program success. Gaining knowledge from current professionals in cancer-exercise programs could serve to facilitate the necessary understanding. METHODS Key personnel from Canadian cancer-exercise programs (n = 14) participated in semistructured interviews about program development and delivery. RESULTS Content analysis revealed 13 categories and 15 subcategories, which were grouped by three organizing domains: Program Implementation, Program Enablers, and Program Barriers. ■ Program Implementation (5 categories, 8 subcategories) included Program Initiation (clinical care extension, research project expansion, program champion), Funding, Participant Intake (avenues of awareness, health and safety assessment), Active Programming (monitoring patient exercise progress, health care practitioner involvement, program composition), and Discharge and Follow-up Plan.■ Program Enablers (4 categories, 4 subcategories) included Patient Participation (personalized care, supportive network, personal control, awareness of benefits), Partnerships, Advocacy and Support, and Program Characteristics.■ Program Barriers (4 categories, 3 subcategories) included Lack of Funding, Lack of Physician Support, Deterrents to Participation (fear and shame, program location, competing interests), and Disease Progression and Treatment. CONCLUSIONS Interview results provided insight into the development and delivery of cancer-exercise programs in Canada and could be used to guide future program development and expansion in Canada.
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Affiliation(s)
- D Santa Mina
- Princess Margaret Cancer Centre, Toronto, ON; ; University of Guelph-Humber, Toronto, ON; ; University of Toronto, Toronto, ON
| | - A Petrella
- Princess Margaret Cancer Centre, Toronto, ON
| | - K L Currie
- Princess Margaret Cancer Centre, Toronto, ON
| | - K Bietola
- University of Guelph-Humber, Toronto, ON
| | - S M H Alibhai
- University of Toronto, Toronto, ON; ; University Health Network, Toronto, ON
| | - J Trachtenberg
- Princess Margaret Cancer Centre, Toronto, ON; ; University of Toronto, Toronto, ON
| | - P Ritvo
- School of Kinesiology and Health Science, York University, Toronto, ON; ; Cancer Care Ontario, Toronto, ON
| | - A G Matthew
- Princess Margaret Cancer Centre, Toronto, ON; ; University of Toronto, Toronto, ON
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Update on Brain Tumors: New Developments in Neuro-oncologic Diagnosis and Treatment, and Impact on Rehabilitation Strategies. PM R 2015; 8:678-89. [PMID: 26548964 DOI: 10.1016/j.pmrj.2015.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/22/2015] [Accepted: 10/27/2015] [Indexed: 11/21/2022]
Abstract
Brain tumors can be a source of functional impairment to patients due to neurologic sequelae associated with the tumor itself as well as treatment side effects. As a result, many of these patients may require rehabilitation services. Surgery, chemotherapy, and radiation therapy have been longstanding, primary treatment modalities in the management of brain tumors, though these treatments continue to evolve given new developments in research and technology. A better understanding of the diagnostic workup and current treatment standards helps the physiatrist and rehabilitation team identify rehabilitation services needed, recognize potential side-effects from anticipated or concurrent treatments, and coordinate care with referral sources. The purpose of this article is to review these new advances in diagnosis and treatment of patients with brain tumors, as well as discuss the rehabilitation implications for this population, including factors such as rehabilitation approach, timing of concomitant treatment, cost management, and coordination of care.
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Cormie P, Nowak AK, Chambers SK, Galvão DA, Newton RU. The potential role of exercise in neuro-oncology. Front Oncol 2015; 5:85. [PMID: 25905043 PMCID: PMC4389372 DOI: 10.3389/fonc.2015.00085] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 03/23/2015] [Indexed: 12/24/2022] Open
Abstract
Patients with brain and other central nervous system cancers experience debilitating physical, cognitive, and emotional effects, which significantly compromise quality of life. Few efficacious pharmacological strategies or supportive care interventions exist to ameliorate these sequelae and patients report high levels of unmet needs in these areas. There is strong theoretical rationale to suggest exercise may be an effective intervention to aid in the management of neuro-oncological disorders. Clinical research has established the efficacy of appropriate exercise in counteracting physical impairments such as fatigue and functional decline, cognitive impairment, as well as psychological effects including depression and anxiety. While there is promise for exercise to enhance physical and psychosocial wellbeing of patients diagnosed with neurologic malignancies, these patients have unique needs and research is urgently required to explore optimal exercise prescription specific to these patients to maximize safety and efficacy. This perspective article is a discussion of potential rehabilitative effects of targeted exercise programs for patients with brain and other central nervous system cancers and highlights future research directions.
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Affiliation(s)
- Prue Cormie
- Edith Cowan University Health and Wellness Institute, Edith Cowan University , Joondalup, WA , Australia
| | - Anna K Nowak
- School of Medicine and Pharmacology, University of Western Australia , Nedlands, WA , Australia ; Department of Medical Oncology, Sir Charles Gairdner Hospital , Nedlands, WA , Australia
| | - Suzanne K Chambers
- Edith Cowan University Health and Wellness Institute, Edith Cowan University , Joondalup, WA , Australia ; Griffith Health Institute, Griffith University , Southport, QLD , Australia ; Cancer Council Queensland , Brisbane, QLD , Australia ; Prostate Cancer Foundation of Australia , Sydney, NSW , Australia
| | - Daniel A Galvão
- Edith Cowan University Health and Wellness Institute, Edith Cowan University , Joondalup, WA , Australia
| | - Robert U Newton
- Edith Cowan University Health and Wellness Institute, Edith Cowan University , Joondalup, WA , Australia ; The University of Hong Kong , Hong Kong , China
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Harrington JM, Schwenke DC, Epstein DR. Exercise preferences among men with prostate cancer receiving androgen-deprivation therapy. Oncol Nurs Forum 2014; 40:E358-67. [PMID: 23989028 DOI: 10.1188/13.onf.e358-e367] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To investigate acceptability of and preferences for physical activity participation in men receiving androgen-deprivation therapy (ADT) for prostate cancer, to identify influencing clinical and demographic factors, and to determine the percentage meeting national exercise guidelines. DESIGN Cross-sectional, descriptive. SETTING Ambulatory care clinic of a large medical center. SAMPLE 135 men receiving ADT. METHODS A structured interview with a systematic procedure was used to elicit preferences for physical activity. MAIN RESEARCH VARIABLES Exercise preferences and acceptability; evidence-based exercise intervention. FINDINGS Participants expressed high levels of acceptability of and willingness to participate in aerobic (64% and 79%) and muscle-strengthening (79% and 81%) programs. Preferences were expressed for muscle-strengthening activities performed at home, either alone or in the company of a family member. Flexible, spontaneous, and self-paced programs were preferred. Significant associations were identified for distance, age, obesity, duration of ADT, and meeting American College of Sports Medicine (ACSM) and American Heart Association (AHA) guidelines. Nineteen percent of the study population met the guidelines for weekly physical activity. CONCLUSIONS High levels of expressed acceptance of and willingness to participate in physical activity programs as well as the small number of participants meeting ACSM and AHA guidelines suggest feasibility of and support the need for the development of exercise programs in this population. IMPLICATIONS FOR NURSING Incorporating patient preferences and evidence-based practice is integral to providing high-quality patient-centered care and is the foundation for appropriate intervention programs. Insight from this study will facilitate the design of programs that better reflect actual preferences of prostate cancer survivors. KNOWLEDGE TRANSLATION ADT-induced changes in body composition are believed to contribute to a reduction in insulin sensitivity and dyslipidemia that contribute to increased cardiovascular risk profile. Exercise has the potential to mitigate the harmful effects of ADT.
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Affiliation(s)
- Joanne M Harrington
- Division of Hematology/Oncology, Phoenix Veterans Affairs Health Care System, Phoenix, AZ
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Piil K, Juhler M, Jakobsen J, Jarden M. Controlled rehabilitative and supportive care intervention trials in patients with high-grade gliomas and their caregivers: a systematic review. BMJ Support Palliat Care 2014; 6:27-34. [PMID: 24890014 PMCID: PMC4789693 DOI: 10.1136/bmjspcare-2013-000593] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 04/30/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients diagnosed with high-grade gliomas experience a varying and complex symptom burden, and face a high mortality rate. As a consequence, patients with high-grade gliomas and their caregivers have imminent and changing rehabilitative and supportive care needs. OBJECTIVES To give a detailed overview of non-pharmacological rehabilitative and supportive care interventions for patients with high-grade gliomas and/or their caregivers, and provide an appraisal of the methodological quality of these studies. METHOD PubMed, Cumulative Index of Nursing and Allied Health Literature and Embase were searched for literature published from 1995 to May 2013. Data from eight studies were reviewed for substantive methods and results. Methodological quality was described and assessed using the scoring system for appraising mixed methods research and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed study reviews. RESULTS The search yielded 914 unique publications, of which 9 were classified eligible for this review. There is preliminary evidence that cognitive group therapy improves memory skills in patients with high-grade gliomas, early physical training improves functional outcome and massage therapy reduces stress. Patients and caregivers found that telephone follow-up and a specialist nurse function was an effective and useful way to achieve information and support. Finally, psycho-education increased feelings of mastery among caregivers. CONCLUSIONS As evidence is beginning to emerge, there is a need for well-designed longitudinal and randomised controlled trials of non-pharmacological interventions in high-grade glioma patients and their caregivers in order to develop clinical guidelines for supportive and rehabilitative approaches in this unique population.
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Affiliation(s)
- K Piil
- Department of Neurosurgery, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark The University Hospitals Center for Health Research (UCSF), Center for Integrated Rehabilitation for Patients with Cancer (CIRE), Copenhagen, Denmark
| | - M Juhler
- Department of Neurosurgery, The University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark Department of Clinical Medicine, Section of Neurology, Psychiatry and Sensory Sciences, The University of Copenhagen, Copenhagen K, Denmark
| | - J Jakobsen
- The University Hospital of Copenhagen; Rigshospitalet, Neuroscience Center, Copenhagen, Denmark
| | - M Jarden
- The University Hospitals Center for Health Research (UCSF), Center for Integrated Rehabilitation for Patients with Cancer (CIRE), Copenhagen, Denmark
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Lee MK, Yun YH, Park HA, Lee ES, Jung KH, Noh DY. A Web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial. Int J Nurs Stud 2014; 51:1557-67. [PMID: 24856854 DOI: 10.1016/j.ijnurstu.2014.04.012] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/23/2014] [Accepted: 04/22/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND Regular exercise and dietary practices have been shown to affect the health-related quality of life (HRQOL) and survival of breast cancer patients. OBJECTIVE The current study aimed to investigate whether the WSEDI was a feasible and primarily effective method for promoting exercise and dietary behaviours for breast cancer patients. DESIGN A 12-week randomized, controlled trial. SETTING Oncology outpatient treatment clinics at 3 university hospitals and 1 National Cancer Center in South Korea. PARTICIPANTS Fifty-nine breast cancer patients who had received curative surgery and completed primary cancer treatment within 12 months prior to the study and who had been diagnosed with stage 0-III cancers within 2 years prior to the study were recruited. METHODS Participants were randomly assigned to either the intervention group, which used a Web-based self-management exercise and diet intervention program incorporating transtheoretical model (TTM)-based strategies (n=29), or to the control group, which used a 50-page educational booklet on exercise and diet (n=28). The intervention efficacy was measured at the baseline and 12 weeks via a Web-based survey that addressed the promotion of exercise and consumption of 5 servings of fruits and vegetables (F&V) per day, dietary quality, HRQOL, anxiety, depression, fatigue, motivational readiness, and self-efficacy. RESULTS The proportion of subjects who performed at least moderate-intensity aerobic exercise for at least 150 min per week; ate 5 servings of F&V per day; and had overall improvements in dietary quality, physical functioning and appetite loss (HRQOL), fatigue, and motivational readiness was greater in the intervention group than in the control group. The self-efficacy with respect to exercise and F&V consumption was greater in the intervention group than in the control group. A Web-based program that targets changes in exercise and dietary behaviours might be effective for breast cancer survivors if the TTM theory has been used to inform the program strategy, although further research with a larger sample size is required to enable definitive conclusions.
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Affiliation(s)
- Myung Kyung Lee
- Kyungpook National University, College of Nursing, Daegu, South Korea
| | - Young Ho Yun
- Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, South Korea; Research Institute and Hospital, National Cancer Center, Goyang-si, South Korea.
| | - Hyeoun-Ae Park
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Eun Sook Lee
- Research Institute and Hospital, National Cancer Center, Goyang-si, South Korea
| | - Kyung Hae Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dong-Young Noh
- Cancer Research Institute, Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
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Buffart LM, Galvão DA, Brug J, Chinapaw MJM, Newton RU. Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 2013; 40:327-40. [PMID: 23871124 DOI: 10.1016/j.ctrv.2013.06.007] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/20/2013] [Accepted: 06/25/2013] [Indexed: 01/22/2023]
Abstract
Physical activity during and after cancer treatment has beneficial effects on a number of physical and psychosocial outcomes. This paper aims to discuss the existing physical activity guidelines for cancer survivors and to describe future research directions to optimize prescriptions. Studies on physical activity during and after cancer treatment were searched in PubMed, Clinicaltrials.gov, Australian New Zealand Clinical Trials Registry, and Dutch Trial registry. Physical activity guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for all cancer survivors. However, the development of these guidelines has been limited by the research conducted. To be able to develop more specific guidelines, future studies should focus on identifying clinical, personal, physical, psychosocial, and intervention moderators explaining 'for whom' or 'under what circumstances' interventions work. Further, more insight into the working mechanisms of exercise interventions on health outcomes in cancer survivors is needed to improve the efficacy and efficiency of interventions. Finally, existing programs should embrace interests and preferences of patients to facilitate optimal uptake of interventions. In conclusion, current physical activity guidelines for cancer survivors are generic, and research is needed to develop more personalized physical activity guidelines.
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Affiliation(s)
- L M Buffart
- EMGO Institute for Health and Care Research and the VU University Medical Center, Department of Epidemiology and Biostatistics, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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Craike MJ, Hose K, Courneya KS, Harrison SJ, Livingston PM. Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study. BMC Cancer 2013; 13:319. [PMID: 23815855 PMCID: PMC3702408 DOI: 10.1186/1471-2407-13-319] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 06/24/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM. METHODS This was a qualitative study that used a grounded theory approach. Semi-structured interviews were conducted in Victoria, Australia by telephone from December 2011-February 2012 with patients who had been treated for MM within the preceding 2-12 months. Interviews were transcribed and analysed using the constant comparison coding method to reduce the data to themes. Gender differences and differences between treatment groups were explored. RESULTS Twenty-four interviews were completed. The sample comprised 13 females (54%), with a mean age of 62 years (SD = 8.8). Sixteen (67%) participants had received an autologous stem cell transplant (ASCT). All participants currently engaged in a range of light to moderate intensity physical activity; walking and gardening were the most common activities. Recovery from the symptoms of MM and side effects of therapy, psychological benefits, social factors and enjoyment were important benefits of physical activity. Barriers to physical activity predominately related to the symptoms of MM and side effects of therapy, including pain, fatigue, and fear of infection. Low self- motivation was also a barrier. Women participated in a more diverse range of physical activities than men and there were gender differences in preferred type of physical activity. Women were more likely to report psychological and social benefits; whereas men reported physical activity as a way to keep busy and self-motivation was a barrier. Patients treated with an ASCT more often reported affective benefits of participation in physical activity and fatigue as a barrier. Patients treated with other therapies (e.g., chemotherapy, radiotherapy) were more likely to report pain as a barrier. CONCLUSIONS Patients with MM experience debilitating effects of their condition and therapy, which influences their level and intensity of physical activity participation. Physical activity programs should be individualised; take into consideration gender differences and the impact of different types of therapy on physical activity; and focus on meeting the psychological, coping and recovery needs of patients.
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McGowan EL, Speed-Andrews AE, Blanchard CM, Rhodes RE, Friedenreich CM, Culos-Reed SN, Courneya KS. Physical activity preferences among a population-based sample of colorectal cancer survivors. Oncol Nurs Forum 2013; 40:44-52. [PMID: 23269769 DOI: 10.1188/13.onf.44-52] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify the key physical activity (PA) programming and counseling preferences of colorectal cancer (CRC) survivors. DESIGN Population-based, cross-sectional mailed survey. SETTING Alberta, Canada. SAMPLE 600 CRC survivors. METHODS CRC survivors randomly identified through the Alberta Cancer Registry in Canada completed a mailed survey (34% response rate). MAIN RESEARCH VARIABLES Self-reported PA, medical and demographic variables, and PA preferences. FINDINGS Most CRC survivors indicated that they were interested and able to participate in a PA program. The most common PA preferences of CRC survivors were to receive PA counseling from a fitness expert at a cancer center, receive PA information in the form of print materials, start a PA program after cancer treatment, do PA at home, and walk in both the summer and winter. In addition, oncologists and nurses were identified as preferences from whom CRC survivors would like to receive PA information. Chi-square analyses identified that age, education, annual family income, and current PA were the demographic variables most consistently associated with PA preferences. CONCLUSIONS The majority of CRC survivors expressed an interest in participating in a PA program and key PA preferences were identified. Those preferences may be useful for developing and implementing successful PA interventions for CRC survivors. IMPLICATIONS FOR NURSING Oncology nurses are in a unique position to promote PA for CRC survivors. Therefore, understanding CRC survivor PA preferences is essential to assist nurses in making appropriate PA recommendations or referrals. KNOWLEDGE TRANSLATION Although CRC survivors' PA participation rates are low, they may have an interest in receiving PA programming and counseling. CRC survivors have indicated a preference to receive PA information from individuals within their cancer support team (e.g., fitness specialist at a cancer center, oncologist, nurses). The PA preferences identified by CRC survivors are important for the development of successful PA interventions.
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Affiliation(s)
- Erin L McGowan
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Canada
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Lee MK, Park HA, Yun YH, Chang YJ. Development and formative evaluation of a web-based self-management exercise and diet intervention program with tailored motivation and action planning for cancer survivors. JMIR Res Protoc 2013; 2:e11. [PMID: 23612029 PMCID: PMC3628152 DOI: 10.2196/resprot.2331] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 11/16/2012] [Accepted: 11/17/2012] [Indexed: 01/23/2023] Open
Abstract
Background Most dietary and exercise interventions developed to date for cancer survivors have employed intensive clinic-based face-to-face counseling sessions. However, when the clinic-based face-to-face intervention ends, the participants cannot receive feedback from the experts, and the motivation for regular exercise and diet practices decreases. One way to overcome the shortcomings of clinic-based face-to-face intervention is to employ the Internet to this end. To maximize effectiveness when providing Web-based interventions, action planning should be able to start at the right time, education should be tailored to motivational readiness, and self-efficacy should be enhanced at appropriate intervals. Objective The aim of this study was to develop a Web-based self-management diet and exercise intervention program with the aid of the transtheoretical model (TTM) and to conduct formative evaluations. Methods The Web-based self-management exercise and diet intervention program was developed employing a 5-phase system development life-cycle (SDLC) method. The 5 phases were 1) identification of user requirements, 2) system design, 3) system development, 4) system evaluation, and 5) system application. An expert group composed of 3 content experts, a Web developer, and 2 Web designers, evaluated the usability and accuracy of the content. The program was evaluated by 30 breast cancer survivors for perceived ease of use. Results The Web-based self-managed exercise and diet intervention program contained 5 components differing in screen layout. These components are introduction, assessment, education (tailored information provision), action planning (goal setting, scheduling, keeping a diary), and automatic feedback. Education, action planning, and automatic feedback were tailored to each participant through the assessment. The processes of change, self-efficacy, and decisional balance, which are the principal strategies encouraging behavioral change according to the TTM theory, were reflected in the education, and self-efficacy was also reflected in the automatic feedback. After iterative testing by experts on problems that arose in terms of usability and content accuracy during system operation, the perceived ease of use of the program was evaluated by 29 breast cancer survivors. The end users rated the program as being easy to understand and use (a total usability score of 81.3 points). In addition, program feasibility was evaluated using the percentage of patients (27/30, 90%) who consistently used the program. Conclusions The use of Internet technology allowed immediate and easy access to interventions, real-time monitoring of progress, online education, tailored action planning, and tailored short message services using mobile phones.
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Affiliation(s)
- Myung Kyung Lee
- Department of Nursing, Dong-A University, Busan, Korea, Republic Of
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Patterns of physical activity participation across the cancer trajectory in colorectal cancer survivors. Support Care Cancer 2013; 21:1605-12. [PMID: 23292698 DOI: 10.1007/s00520-012-1703-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 12/20/2012] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of the present study was to explore the participation in physical activity (PA) by colorectal cancer survivors across cancer trajectories and based on selected demographic and medical variables. METHODS A total of 431 participants were surveyed individually at the Shinchon Severance Hospital, Seoul, Korea, to determine their PA levels before diagnosis, during treatment and after completion of cancer treatment. RESULTS Percentage of survivors meeting American College of Sports Medicine guideline significantly reduced from 27% before diagnosis to 10% during treatment due to reduced strenuous intensity PA (28.8 ± 106.2 vs. 11.8 ± 95.9 min, p = 0.042), while total PA and mild intensity PA did not change. Total (187.2 ± 257.7 vs. 282.6 ± 282.0 min, p < 0.001) and mild (99.1 ± 191.5 vs. 175.1 ± 231.2 min, p < 0.001) intensity PA significantly increased after the completion of treatments compared with their PA level before diagnosis. Further analyses showed that age (more vs. equal or less than 60 years) and chemotherapy (chemotherapy vs. no chemotherapy) significantly influenced the level of physical activity (p = 0.004). Survivors who were older or received chemotherapy increased their total PA and mild intensity PA after the completion of treatment more than those who did not receive chemotherapy. CONCLUSIONS The level and the pattern of physical activity by colorectal cancer survivors differed across cancer trajectories, which were significantly influenced by age and adjuvant chemotherapy.
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A randomized trial of aerobic versus resistance exercise in prostate cancer survivors. J Aging Phys Act 2012; 21:455-78. [PMID: 23238110 DOI: 10.1123/japa.21.4.455] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Androgen-deprivation therapy (ADT) for prostate cancer (PCa) has side effects that significantly impair health-related quality of life (HRQOL). Exercise ameliorates many side effects of ADT, but different modalities, particularly in the home-based setting, have not been well studied. In this study the authors randomly assigned 66 PCa survivors receiving ADT to 6 mo of home-based aerobic or resistance training. Psychosocial well-being and physical fitness were measured at baseline, 3 and 6 mo, and then 6 mo postintervention. Intention-to-treat analyses showed that fatigue and HRQOL were not significantly different between groups; however, in a per-protocol analysis the resistance-exercise training group demonstrated clinically significant improvements in HRQOL. Differential within-group effects on physical fitness were also observed at various time points. At all time points, the aerobic-training group engaged in significantly more physical activity than the resistance-training group, a finding that should be further examined given evidence-based guidelines for activity volume in cancer survivors.
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Vallance J, Lavallee C, Culos-Reed N, Trudeau M. Rural and Small Town Breast Cancer Survivors’ Preferences for Physical Activity. Int J Behav Med 2012; 20:522-8. [DOI: 10.1007/s12529-012-9264-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Santa Mina D, Alibhai SMH, Matthew AG, Guglietti CL, Steele J, Trachtenberg J, Ritvo PG. Exercise in clinical cancer care: a call to action and program development description. ACTA ACUST UNITED AC 2012; 19:e136-44. [PMID: 22670103 DOI: 10.3747/co.19.912] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A large and convincing body of evidence demonstrates the benefits of exercise for cancer survivors during and after treatment. Based on that literature, more cancer survivors should be offered exercise support and programming. Unfortunately, exercise programs remain an exception rather than the norm in cancer care. Not surprisingly, common barriers to the implementation of exercise programs in oncology include limited resources, expertise, and awareness of benefits on the part of patients and clinicians. To improve the accessibility and cost-effectiveness of cancer exercise programs, one proposed strategy is to combine the resources of hospital and community-based programs with home-based exercise instruction. The present paper highlights current literature regarding exercise programming for cancer survivors, describes the development of an exercise program for cancer patients in Toronto, Canada, and offers experiential insights into the integration of exercise into oncologic care.
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Affiliation(s)
- D Santa Mina
- Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON.
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McGowan EL, Speed-Andrews AE, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, Courneya KS. Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity. Support Care Cancer 2012; 21:139-47. [PMID: 22639138 DOI: 10.1007/s00520-012-1501-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 05/14/2012] [Indexed: 12/14/2022]
Abstract
PURPOSE Physical activity improves health outcomes in colorectal cancer (CRC) survivors, but participation rates are low. One understudied strategy for increasing physical activity in CRC survivors may be sport participation. Here, we report the sport participation rate, sport preferences, and correlates of sport participation among CRC survivors. METHODS A provincial, population-based mailed survey of CRC survivors in Alberta, Canada was performed and included measures of sport participation, sport preferences, sport benefits and barriers, and medical and demographic variables. RESULTS A total of 600 CRC survivors completed the survey (34 % response rate). Almost a quarter (23.0 %) of CRC survivors reported participating in a sport in the past month, with the most common sport being golf (58.7 %). In multivariate regression analysis, 33.0 % (p = 0.001) of the variance in sport participation was explained by being male (β = 0.12; p = 0.006), in better general health (β = 0.12; p = 0.006), and ≥ 5 years post-diagnosis (β = 0.09; p = 0.031). The most common barriers to sport participation were time, age/agility, and no interest/dislike of sports. The most common anticipated benefits of sport participation were improved physical fitness, meeting people, and improved health. Over half (57.2 %) of CRC survivors were possibly interested in learning about sport participation opportunities. CONCLUSIONS Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.
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Affiliation(s)
- Erin L McGowan
- Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, Alberta, Canada, T6G 2H9
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A survey of physical activity programming and counseling preferences in young-adult cancer survivors. Cancer Nurs 2012; 35:48-54. [PMID: 21558852 DOI: 10.1097/ncc.0b013e318210220a] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Few research studies have focused on physical activity in young-adult cancer survivors despite the potential long-term health consequences of inactivity in this population. OBJECTIVE Understanding the unique physical activity programming and counseling preferences of young-adult cancer survivors may inform future research as well as nursing practice. METHODS Participants were 588 young-adult cancer survivors (20-44 years old) who completed a mailed survey in the province of Alberta, Canada, that assessed physical activity preferences and standard demographic and medical variables. RESULTS Most young-adult cancer survivors indicated that they were interested (78%) and able (88%) to participate in an activity program. Young-adult cancer survivors also preferred receiving activity counseling from a fitness expert at the cancer center (49.6%), information by brochure (64%), starting activity after treatment (64%), walking (51%), doing activity with others (49%), and doing activity at a community fitness center (46%). The χ analyses indicated that younger cancer survivors (20-29 vs 30-39 vs 40-44 years) were less likely to prefer walking (P < .001), more interested in receiving information (P = .002), and more likely to prefer receiving information by e-mail (P = .044) or Internet (P = .006). CONCLUSIONS Young-adult cancer survivors show interest in receiving physical activity counseling. There were some consistent programming preferences, although other preferences varied by demographic and medical factors. IMPLICATIONS FOR PRACTICE Nurses may play a key role in promoting physical activity in young-adult cancer survivors. Understanding the physical activity preferences of young-adult cancer survivors may help nurses make practical recommendations and referrals.
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Robertson L, Richards R, Egan R, Szymlek-Gay EA. Promotion and support of physical activity among cancer survivors: a service provider perspective. Psychooncology 2012; 22:441-6. [DOI: 10.1002/pon.3032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 11/03/2011] [Accepted: 12/16/2011] [Indexed: 11/10/2022]
Affiliation(s)
- Lindsay Robertson
- Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; Dunedin School of Medicine; University of Otago; Dunedin; New Zealand
| | - Rosalina Richards
- Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; Dunedin School of Medicine; University of Otago; Dunedin; New Zealand
| | - Richard Egan
- Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; Dunedin School of Medicine; University of Otago; Dunedin; New Zealand
| | - Ewa A. Szymlek-Gay
- Department of Clinical Sciences, Pediatrics; Umeå University; Umeå; Sweden
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Santa Mina D, Ritvo P, G. Matthew A, Rampersad A, Stein H, M. Cheung A, Trachtenberg J, M. H. Alibhai S. Group Exercise versus Personal Training for Prostate Cancer Patients: A Pilot Randomized Trial. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/jct.2012.32020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Brain and other central nervous system tumors have a very high likelihood of producing long-term disabling effects owing to the tumor itself and the effects of treatment, including surgical complications, neurotoxic effects of radiation, and debility caused by chemotherapy. Even benign or low-grade brain tumors can cause significant disability. Brain tumors occur over the life span, showing progressively higher incidence with advancing age. The common types of primary brain tumor differ between pediatric and adult age groups. Evidence for effectiveness of rehabilitation is favorable. Brain tumor patients treated in acute rehabilitation settings improve comparably with individuals with stroke or traumatic brain injury. Although patients with primary brain tumors have been better studied than those with metastatic disease, significant gains with inpatient rehabilitation have been reported in the latter group also. Outpatient programs to address cognitive deficits in brain tumor survivors, including cognitive therapy and pharmacologic strategies, have found benefit. While the patient is receiving rehabilitation care, physiatrists, in interdisciplinary collaboration with the pertinent oncology-related services, assist with managing symptoms including fatigue, headache, and sleep disturbance and medical complications including depression, seizures, and thromboembolic disease. Better methods are needed to identify patients for rehabilitation services when appropriate over the course of the disease process.
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Blaney JM, Lowe-Strong A, Rankin-Watt J, Campbell A, Gracey JH. Cancer survivors' exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire-survey. Psychooncology 2011; 22:186-94. [PMID: 23296635 DOI: 10.1002/pon.2072] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 08/23/2011] [Accepted: 08/24/2011] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the exercise barriers, facilitators and preferences of a mixed sample of cancer survivors as well as fatigue levels, quality of life (QoL) and the frequency and intensity of exercise that cancer survivors typically engage in. METHODS An anonymous, postal questionnaire-survey with a convenience sample of 975 cancer survivors was used. Standardised measures were used to establish fatigue (Multidimensional Fatigue Symptom Inventory-Short Form), QoL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30), exercise frequency and intensity (Leisure Score Index). RESULTS A 52.3% response rate (n = 456) was achieved. A total of 76.0% were female, with stage I (18.3%) or stage II (21.0%) breast cancer (64.4%), and 62.3% were ≥ 3 years post treatment. A total of 73.5% reported fatigue with 57.2% experiencing fatigue on a daily basis. A total of 68.1% had never been given any advice on how to manage fatigue. A total of 9.4% reported to engage in strenuous physical activity, 43.5% in moderate physical activity and 65.5% in mild physical activity. Respondents experienced difficulties with emotional, cognitive and social functioning and the symptoms of fatigue, insomnia and pain. Barriers that interfered with exercise 'often/very often' were mainly related to respondents' health and environmental factors. A total of 50.2% were interested in exercise and 52.5% felt able to exercise. Exercise facilitators, preferences and motivators provide some insight into cancer survivors' needs in terms of becoming more physically active. CONCLUSIONS Although cancer survivors continue to experience fatigue and QoL issues long after treatment completion, over half are willing and feel able to participate in exercise. Exercise barriers were mainly health related or environmental issues, however, the main barriers reported were those that had the potential to be alleviated by exercise.
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Affiliation(s)
- J M Blaney
- Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, Co. Antrim, UK
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Physical activity preferences in a population-based sample of kidney cancer survivors. Support Care Cancer 2011; 20:1709-17. [PMID: 21947412 DOI: 10.1007/s00520-011-1264-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 09/06/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE Physical activity (PA) improves quality of life in kidney cancer survivors (KCS), but PA participation rates are low. Behavior change interventions to increase PA in KCS should take into account PA preferences. The purpose of this study was to identify the PA preferences of KCS and determine any associations with selected demographic and medical variables. METHODS All 1,985 KCS diagnosed between 1996 and 2010 identified through a Canadian provincial registry in Alberta, Canada were mailed a survey that consisted of the Godin Leisure-Time Exercise Questionnaire and various PA preference variables. Standard demographic and medical variables were also collected. RESULTS Completed surveys were received from 703 of 1,654 (43%) eligible KCS. Over 80% of KCS felt they were able or may be able to participate in a PA program designed for KCS and over 70% were interested or may be interested in doing so. The most common PA preferences were to receive PA information from a fitness expert at a cancer center (55.7%), receive information via print material (50.0%), start a PA program after treatment (36.5%), exercise with a spouse (39.6%), exercise at home (52.0%), do moderate-intensity PA (58.4%), and walk in both the summer (69.4%) and winter (48.2%). Chi-square analyses uncovered that age, sex, and current PA were the personal variables most consistently associated with PA preferences. CONCLUSION The majority of KCS expressed an interest in doing a PA program and important preferences were identified. These preferences may be used to inform PA interventions to enhance motivation and adherence in KCS.
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Karvinen KH, Raedeke TD, Arastu H, Allison RR. Exercise Programming and Counseling Preferences of Breast Cancer Survivors During or After Radiation Therapy. Oncol Nurs Forum 2011; 38:E326-34. [DOI: 10.1188/11.onf.e326-e334] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gjerset GM, Fosså SD, Courneya KS, Skovlund E, Jacobsen AB, Thorsen L. Interest and preferences for exercise counselling and programming among Norwegian cancer survivors. Eur J Cancer Care (Engl) 2011; 20:96-105. [PMID: 20345456 DOI: 10.1111/j.1365-2354.2009.01161.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To be able to make suitable exercise intervention programmes for cancer survivors, we need more information about exercise preferences. The primary aim of the study was to investigate the interest and preferences for exercise among Norwegian cancer survivors. A secondary aim was to identify demographic and medical characteristics associated with interest in exercise counselling. A questionnaire was completed by 1284 cancer survivors. Overall, 76% of participants were interested or maybe interested in receiving exercise counselling at some point during their cancer experience. Logistic regression analyses indicated that the interest in exercise counselling in men was associated with younger age, presence of comorbidity and having received chemotherapy. In women, the interest was associated with younger age, higher education and change in physical activity level. The participants preferred face-to-face exercise counselling with an exercise specialist from a cancer centre, at a hospital, immediately after treatment. Most cancer survivors were interested in an exercise programme, walking as activity, at moderate intensity and they wanted to start immediately after treatment. The knowledge from this study can contribute to make suitable physical rehabilitation available to cancer patients in the future.
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Affiliation(s)
- G M Gjerset
- Department of Clinical Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
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