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Weemaes ATR, Beelen M, Weijenberg MP, van Kuijk SMJ, Lenssen AF. Effects of remote coaching following supervised exercise oncology rehabilitation on physical activity levels, physical fitness, and patient-reported outcomes: a randomised controlled trial. Int J Behav Nutr Phys Act 2024; 21:8. [PMID: 38273361 PMCID: PMC10809633 DOI: 10.1186/s12966-024-01561-2] [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: 05/19/2023] [Accepted: 01/14/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Studies have shown that cancer survivors experience difficulties maintaining physical activity levels after participation in a supervised exercise rehabilitation program. This study aimed to assess the effectiveness of a six-month remote coaching intervention, following a supervised exercise oncology rehabilitation program on maintenance of PA levels; and improvement of aerobic capacity, muscle strength and patient-reported outcomes in cancer survivors. METHODS Ninety-seven participants from a Dutch University Hospital's exercise rehabilitation program were randomised to the COACH group (n = 46), receiving 6 months of remote coaching after completing the exercise program, or the CONTROL group (n = 50), receiving no additional intervention. Assessment of PA levels; sedentary time; aerobic capacity; muscle strength; fatigue; health-related quality of life (HRQoL); level of anxiety and depression; and return to work (RTW) rates were conducted at baseline (T0) and six months later (T1). Multiple linear regression was used for between-group statistical comparisons of all outcomes measures. Mean differences at T1 were estimated with corresponding 95% confidence intervals (95%CI). RESULTS No significant between-group differences were observed for all outcomes at T1. An adjusted mean difference in weekly PA of 45 min (95%CI -50;140) was observed between the COACH group and the CONTROL group, favouring the COACH group, yet lacking statistical or clinical significance. CONCLUSIONS Our six-month remote coaching intervention did not notably improve PA levels; sedentary time; aerobic capacity; muscle strength; HRQoL; fatigue; anxiety and depression symptoms and RTW rates after participation in a supervised exercise oncology program. Although the participants who received coaching showed slightly higher levels of PA, these differences were not significant. More research is needed to identify patients in need for follow-up interventions following supervised exercise program and to investigate the effectiveness of remote coaching interventions in these patients. TRIAL REGISTRATION Dutch Trial Register NL7729, registered 13 may 2019, https://trialsearch.who.int/Trial2.aspx?TrialID=NL7729 .
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Affiliation(s)
- Anouk T R Weemaes
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, Maastricht, AZ, 6202, The Netherlands.
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Milou Beelen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, Maastricht, AZ, 6202, The Netherlands
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Reproduction, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Antoine F Lenssen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, Maastricht, AZ, 6202, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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St-Cyr J, Saint-Onge K, Doré I, Gauvin L. Milestones and turning points in the experience of physical activity throughout cancer care: a qualitative study to inform physical activity promotion. Support Care Cancer 2023; 31:682. [PMID: 37943370 PMCID: PMC10635913 DOI: 10.1007/s00520-023-08093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 09/29/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE Physical activity (PA) is an important supportive care strategy to manage cancer and treatment-related side effects, yet PA participation is low among people diagnosed with cancer. This study examined patients', health professionals', and managers' perspectives on PA throughout cancer care to glean implications for PA promotion. METHODS Random selection and purposeful sampling methods allowed for the recruitment of 21 patients (76.2% women) and 20 health professionals and managers (80% women) who participated in individual semi-structured interviews. Interview questions explored facilitators and barriers to PA participation and promotion across the cancer care continuum. Interviews were audio-recorded and transcribed. Then, qualitative thematic analysis was performed. RESULTS The analysis produced five main themes describing milestones in PA participation throughout cancer care: (1) Getting Started, (2) Discovering PA Resources, (3) Taking Action, (4) Striving for Change, and (5) Returning to a "New Normal." The sub-themes underscored turning points, i.e., tasks and challenges to PA participation that had to be overcome at each milestone. Achieving milestones and successfully navigating turning points were dependent on clinical, social, and community factors. CONCLUSION Cancer patients appear to progress through a series of milestones in adopting and maintaining PA throughout cancer care. Intervention strategies aimed at promoting PA could test whether support in navigating turning points could lead to greater PA participation. These findings require replication and extension, specifically among patients who are men, younger adults, and culturally diverse.
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Affiliation(s)
- Jany St-Cyr
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Kadia Saint-Onge
- Social and Preventive Medicine Department, School of Public Health, Université de Montréal, Montreal, QC, Canada.
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR CHUM), Montreal, QC, Canada.
| | - Isabelle Doré
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR CHUM), Montreal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Lise Gauvin
- Social and Preventive Medicine Department, School of Public Health, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR CHUM), Montreal, QC, Canada
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Weemaes ATR, Sieben JM, Beelen M, Mulder LTMA, Lenssen AF. Determinants of physical activity maintenance and the acceptability of a remote coaching intervention following supervised exercise oncology rehabilitation: a qualitative study. J Cancer Surviv 2023:10.1007/s11764-023-01455-5. [PMID: 37733263 DOI: 10.1007/s11764-023-01455-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE The purpose of the study was to investigate perceived determinants of physical activity (PA) maintenance following supervised exercise oncology rehabilitation and the acceptability of a remote coaching intervention during this period. METHODS A phenomenological qualitative study with semi-structured interviews was conducted. Nineteen participants (16 women, 3 men) were recruited from the intervention (n = 12) and control group (n = 7) of a randomized controlled trial on the effectiveness of remote coaching following hospital-based, supervised exercise oncology rehabilitation. Participants in the intervention group received a 6-month remote coaching intervention after completing the exercise program, aimed at stimulating PA maintenance. The interviews were based on the Capability, Opportunity, and Motivation model of Behaviour (COM-B model) and the framework of acceptability (TFA) and were coded using template analysis. RESULTS Key themes regarding determinants of PA maintenance were self-efficacy, PA habits, accountability, physical complaints, and facilities. Remote coaching was perceived acceptable because it stimulated PA maintenance by offering a source of structure and social support and thereby increased accountability. Moreover, it improved confidence to perform PA, leading to increased levels of self-efficacy. The remote nature of the intervention was perceived as convenient by some of the participants, while others would have preferred additional physical appointments. CONCLUSIONS Cancer survivors considered remote coaching acceptable to stimulate PA maintenance following supervised rehabilitation. Interventions should focus on increasing accountability, self-efficacy, forming habits, and helping cancer survivors to overcome barriers. IMPLICATIONS FOR CANCER SURVIVORS The ability to maintain PA beyond supervised exercise oncology programs depends on many determinants. Remote coaching interventions have potential to target individually relevant determinants following exercise programs in cancer survivors.
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Affiliation(s)
- Anouk T R Weemaes
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Judith M Sieben
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands
| | - Milou Beelen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Louisa T M A Mulder
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Antoine F Lenssen
- Department of Physical Therapy, Maastricht University Medical Center+, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Bultijnck R, Rammant E, Raes A, Vandecasteele N, Decaestecker K, Fonteyne V, Lumen N, Ost P, Deforche B. Experiences of Men With Prostate Cancer Participating in a Clinical Pathway With a Supervised Group-based Exercise Program to Combat Androgen Deprivation-Induced Side Effects: A Qualitative Focus Group Study. Semin Oncol Nurs 2023; 39:151404. [PMID: 36925317 DOI: 10.1016/j.soncn.2023.151404] [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: 09/02/2022] [Revised: 01/30/2023] [Accepted: 02/08/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVES A clinical pathway in daily practice improved implementation of evidence-based strategies for the management of androgen deprivation-induced side effects in men with prostate cancer. This study aimed to explore patients' expectations and reasons to start with the clinical pathway; explore patients' experiences and attitudes toward the pathway; and identify key pathway ingredients and examine patients' attitudes about a possible transition toward the home environment after a hospital-based pathway participation. DATA SOURCES Focus group interviews were conducted through purposeful sampling, consisting of former and current participants of the clinical pathway at Ghent University Hospital. Data was audiotaped and transcribed verbatim, coded in NVivo12, and thematically and inductively analyzed through constant comparisons. CONCLUSION Men with prostate cancer have positive experiences toward the use of a holistic multidisciplinary approach (ie, clinical pathway) to combat androgen deprivation therapy-induced side effects in practice. Patients identified several key ingredients of the pathway, such as peer support, physiotherapist involvement, and availability of a multidisciplinary team. Patients were, however, reluctant to continue the exercise component at home because of negative attitudes toward a public gym, practical issues, absence of known facilitators, and other priorities. IMPLICATIONS FOR NURSING PRACTICE Referral by a health care provider remains an important motivator for pathway participation. Peer support, physiotherapist involvement, and availability of a multidisciplinary team are crucial components of the clinical pathway and should be taken into account when developing and implementing similar pathways to increase program uptake in daily practice.
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Affiliation(s)
- Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium.
| | - Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | | | | | - Karel Decaestecker
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Valérie Fonteyne
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Nicolaas Lumen
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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Ranes M, Wiestad TH, Thormodsen I, Arving C. Determinants of exercise adherence and maintenance for cancer survivors: Implementation of a community-based group exercise program. A qualitative feasibility study. PEC INNOVATION 2022; 1:100088. [PMID: 37213720 PMCID: PMC10194213 DOI: 10.1016/j.pecinn.2022.100088] [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: 04/21/2022] [Revised: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 05/23/2023]
Abstract
Objective Despite verified knowledge that physical exercise plays an important part in recovery after cancer treatment, multiple studies have shown that maintaining a physically active lifestyle after cancer is challenging. There is a need for qualitative studies to increase understanding into patient experiences and perspectives, and facilitate the design of more sustainable exercise program. This qualitative descriptive feasibility study explores experiences from the implementation of a novel four-month community-based group exercise program for cancer survivors within municipality health service after completion of rehabilitation in the specialist health care service. Methods Fourteen cancer survivors participated in focus group interviews after completing Rehabilitation: Physical activity and Coping - feasibility study. Data were analyzed using the systematic text condensation method. Results We identified a main category, Determinants for exercise adherence and maintenance and four subcategories: peer-support, environment, structure and knowledge. Conclusion A social and supportive exercise environment promotes exercise adherence and maintenance among cancer survivors. This knowledge can be useful for further efforts to implement high quality community-based group exercise programs for cancer survivors. Innovation This study adds knowledge of survivors' experience of a novel community-based group exercise program in clinical practice and can promote the implementation of sustainable community-based exercise programs for cancer survivors.
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Affiliation(s)
- Maria Ranes
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
- Corresponding author at: Department of Oncology and Medical Physics, Haukeland University Hospital, Box 1400, 5021 Bergen, PO, Norway
| | - Tor Helge Wiestad
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Inger Thormodsen
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Cecilia Arving
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Roed K, Bjerre ED, Midtgaard J. Easier in Practice Than in Theory: Experiences of Coaches in Charge of Community-Based Soccer Training for Men with Prostate cancer—A Descriptive Qualitative Study. SPORTS MEDICINE - OPEN 2022; 8:28. [PMID: 35239062 PMCID: PMC8892393 DOI: 10.1186/s40798-022-00424-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
Background Evidence suggests that community-based exercise programs and sports participation benefit long-term physical activity adherence and promote health in clinical populations. Recent research shows that community-based soccer can improve mental health and bone health and result in fewer hospital admissions in men with prostate cancer. However, little knowledge exists on what coaches experience, leading to a scarcity of knowledge on how to assist them in promoting and supporting the sustainability of programs. The purpose of this study was to explore the experiences of non-professional soccer coaches in providing community-based soccer training for men with prostate cancer. Results We interviewed 13 out of 21 eligible non-professional soccer coaches in charge of delivering the Football Club Prostate Community program, which is community-based soccer training for men with prostate cancer at 12 local soccer clubs across Denmark. Qualitative content analysis, as described by Graneheim and Lundman, was applied to analyze the data using NVivo 12 software. We identified the five following overall categories with 10 subcategories on what the coaches experienced: (1) enabling training of a clinical population in a community setting, (2) dedication based on commitment, (3) coaching on the players’ terms, (4) navigating the illness, and (5) ensuring sustainability. Collectively, the findings suggest that, while the coaches felt adequately prepared to coach, their coaching role developed and was refined only through interaction with the players, indicating that coaching clinical populations may be easier in practice than in theory and a potentially transformative learning experience. Conclusions Non-professional soccer coaches in charge of delivering soccer training for men with prostate cancer value being educated about specific illness-related issues. Initial concerns about how to coach a clinical population disappeared once the coaches engaged with the players and developed their own team norms and illness management strategies. They also gained a broader perspective on their own lives, which they valued and would not otherwise have achieved by coaching a healthy population. Our study indicates that sustainable implementation and the program’s sustainability can be promoted and supported through additional formal, easily accessible communication with trained health professionals and by networking with peer coaches. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00424-z.
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Exercise Adherence in Men with Prostate Cancer Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14102452. [PMID: 35626058 PMCID: PMC9139246 DOI: 10.3390/cancers14102452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 12/04/2022] Open
Abstract
Androgen deprivation therapy (ADT) for prostate cancer treatment is associated with adverse physiological changes; however, exercise can improve outcomes. This systematic review and meta-analysis aimed to determine exercise intervention adherence and its effects on physiological outcomes in men diagnosed with prostate cancer undergoing ADT. Uniquely, this review incorporated a meta-aggregation of qualitative data, providing perspectives from the men’s experiences. A systematic review and meta-analysis were completed following PRISMA guidelines. Databases (CINAHL, Cochrane, PubMed) were searched for studies using “prostate cancer”, “exercise intervention”, and “androgen deprivation therapy”. Quantitative randomised controlled trials describing adherence to exercise interventions were selected, with qualitative articles selected based on descriptions of experiences around participation. Subgroup meta-analyses of adherence, exercise mode, and intervention duration were completed for quality of life, aerobic fitness, fatigue, and strength. In total, 644 articles were identified, with 29 (n = 23 quantitative; n = 6 qualitative) articles from 25 studies included. Exercise had no effects (p < 0.05) on quality of life and fatigue. Significant effects (all p < 0.05) were observed for aerobic fitness, and upper- and lower-body strength. Adherence to exercise-based interventions was 80.38%, with improvements observed in aerobic fitness and strength. Subgroup analysis revealed exercise adherence impacted fatigue and strength, with greater improvements observed in programs >12-weeks.
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Feasibility of a Remotely Delivered Strength and Balance Training Program for Older Adults with Cancer. Curr Oncol 2021; 28:4408-4419. [PMID: 34898562 PMCID: PMC8628693 DOI: 10.3390/curroncol28060374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
Falls are a major issue among older adults with cancer and lead to interruptions in cancer treatment. Resistance and balance training can prevent falls in older adults, but minimal evidence is available regarding the older cancer population, who often have unique risk factors. We used a pre-post design to assess the feasibility of a remotely delivered exercise program that progressed in difficulty and its efficacy on lower body strength, balance, and falls in older adults with cancer who had prior in-person exercise experience. Twenty-six older adults with cancer completed the intervention. Attendance rate for the virtual component was 97.6% and for the independent component was 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). The median balance score at baseline and end-of-study was 4 (IQR = 0). The median chair-stand time decreased from 9.2 s (IQR = 3.13) to 7.7 s (IQR = 4.6). A statistically significant difference in lower body strength (r = 0.68, p = 0.001) was detected post-intervention. The findings from this study can inform the design of a larger randomized trial.
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Nikolajsen H, Richardson EV, Sandal LF, Juul-Kristensen B, Troelsen J. Fitness for all: how do non-disabled people respond to inclusive fitness centres? BMC Sports Sci Med Rehabil 2021; 13:81. [PMID: 34330328 PMCID: PMC8325230 DOI: 10.1186/s13102-021-00303-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 07/01/2021] [Indexed: 11/17/2022]
Abstract
Background Representation of people with disabilities in fitness centres is lacking, despite initiatives to promote inclusion mainly in the UK and USA. Success creating these inclusive spaces is mixed and few were crafted taking into account attitudes and biases of non-disabled co-members. Inclusive fitness centres have not gained much attention in Denmark, and the campaign ‘Fitness for All - fitness for people with physical disabilities’ was initiated. The aim of this study was shaped by two key questions; 1) what is the ideal fitness space from the perception of non-disabled fitness users? and 2) how might their dis/ableist attitudes negate inclusion in three future pilot inclusive fitness centres across Denmark? Method Three focus groups involving 5–7 (total n = 18) adult non-disabled participants were conducted. Aged ranged between 19 and 75 years, both men and women were involved, with fitness centre experiences ranging from 0 to 20+ years. Interviews were transcribed and analysed using Malterud’s four-step method of systematic text condensation. Results Of most importance was a pleasant atmosphere which should make them feel welcome and comfortable. Good social relations within the space were also highly valued. Participants welcomed people with physical disabilities but predicted many challenges with an inclusive fitness centre and expressed unconscious ableist attitudes. Conclusion The current study adds essential knowledge regarding how non-disabled people perceive the ideal inclusive fitness centre. A welcoming and inviting atmosphere is essential whereas social skills, ableism, ignorance, and preconceptions are important barriers that may hinder inclusion of participants with disabilities in inclusive fitness centres. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00303-2.
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Affiliation(s)
- Helene Nikolajsen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark. .,Department of Physiotherapy, Institute of Health Studies, University College South Denmark, Esbjerg-Haderslev, Denmark.
| | | | - Louise Fleng Sandal
- Research Unit for Physical Activity and Health in Work Life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgit Juul-Kristensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Nikolajsen H, Sandal LF, Juhl CB, Troelsen J, Juul-Kristensen B. Barriers to, and Facilitators of, Exercising in Fitness Centres among Adults with and without Physical Disabilities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147341. [PMID: 34299792 PMCID: PMC8304633 DOI: 10.3390/ijerph18147341] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
Fitness centres are an obvious arena for performing physical activity for the general population but representation of adults with physical disabilities (AwPD) is lacking. To increase possibilities for AwPD to exercise in fitness centres together with adults without physical disabilities (AwoPD), the aim of this study was to identify, synthesise, and compare barriers to, and facilitators of, exercising in fitness centres for each group. A scoping review was conducted and data extraction of the barriers and facilitators was performed independently by two researchers on six categories of contextual factors based on the framework of Di Blasi: (1) The fitness centre setting; (2) The fitness centre user characteristics; (3) The fitness instructor/staff characteristics; (4) The fitness centre user–instructor/management relationship; and (5) The fitness/exercise characteristics. An extra category, (6) Other relationships, was added. The PRISMA Extension for Scoping Reviews was used for reporting. Of the 102 included papers, only 26 (25%) of the papers were on AwPD, which focused mainly on physical barriers (category 1: inaccessible settings). In contrast, the remaining 76 papers involving AwoPD focused primarily on facilitators (category 2: motivational factors and exercising effects). In categories 3–6, the two groups had similar results, as both groups preferred skilled instructors, a welcoming and comfortable fitness centre environment, an ability to exercise at their preferred type and level, and good social connections. Since most data were based on AwoPD, more studies on actual experiences from AwPD are needed, to reveal the facilitators/motivational factors for fitness centre use.
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Affiliation(s)
- Helene Nikolajsen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
- Department of Physiotherapy, Institute of Health Studies, University College South Denmark, 6705 Esbjerg Ø, Denmark
- Correspondence:
| | - Louise Fleng Sandal
- Research Unit for Physical Activity and Health in Work Life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Carsten Bogh Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, 2900 Hellerup, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Birgit Juul-Kristensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
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Sattar S, Haase KR, Bradley C, Papadopoulos E, Kuster S, Santa Mina D, Tippe M, Kaur A, Campbell D, Joshua AM, Rediger C, Souied O, Alibhai S. Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review. Prostate Cancer Prostatic Dis 2021; 24:1007-1027. [PMID: 34108646 DOI: 10.1038/s41391-021-00399-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Prostate cancer (PC) and its treatments lead to significant acute, chronic, or latent adverse effects that result in declines in patients' physical functions, quality of life and reduced sense of masculinities. Robust evidence shows that physical activity (PA) can improve many health outcomes in men with PC; however, less is known about the facilitators, preferences, and barriers to PA engagement in this population. The purpose of this scoping review is to document the nature and extent of literature related to these aspects of PA participation among men with PC. METHODS We conducted a scoping review of PA among men with PC. Databases searched included Medline, CINAHL, Embase, Rehabilitation & Sports Medicine Source, and SportDiscus from inception to June 30, 2020. Multiple reviewers were used in all screening and data abstractions. RESULTS The search yielded 2788 individual citations after duplicates were removed. Following title and abstract screening, 129 underwent full-text review, and 46 articles were included. Quantitative data related to our research question showed that structured group exercise was the most commonly reported facilitator/preference among men with PC, whereas treatment-related effects and lack of time are the most common barriers. In terms of qualitative data, the most prominent theme noted related to masculinities and gender-specific needs within the context of having PC. CONCLUSION Men with PC have unique facilitators and barriers concerning PA. More work is needed from the research and clinical practice perspectives to enable this population to engage and remain in regular PA.
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Affiliation(s)
- S Sattar
- College of Nursing, University of Saskatchewan, Regina, SK, Canada.
| | - K R Haase
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - C Bradley
- Library, University of Regina, Regina, SK, Canada
| | - E Papadopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - S Kuster
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - D Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - M Tippe
- Patient consultant, Toronto, ON, Canada
| | - A Kaur
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - D Campbell
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - A M Joshua
- Department of Medical Oncology, Kinghorn Cancer Centre; Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - C Rediger
- Saskatchewan Health Authority, Regina, SK, Canada
| | - O Souied
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - S Alibhai
- University Health Network, Toronto, ON, Canada.,Department of Medicine, Institute of Health Policy, Management, and Evaluation, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
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12
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Colas C, Goutte J, Creac'h C, Fontana L, Vericel MP, Manzanares J, Peuriere M, Akrour M, Martin C, Presles E, Barth N, Guyot J, Garros M, Trombert B, Massoubre C, Roche F, Féasson L, Marotte H, Cathebras P, Hupin D. Efficiency of an Optimized Care Organization in Fibromyalgia Patients: The From Intent to Move (FIMOUV) Study Protocol of a Randomized Controlled Trial. Front Public Health 2021; 9:554291. [PMID: 34113593 PMCID: PMC8185292 DOI: 10.3389/fpubh.2021.554291] [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: 04/23/2020] [Accepted: 03/29/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Fibromyalgia (FM) is characterized by multiple symptoms including pain, fatigue, and sleep disorders, altering patient's quality of life. In the absence of effective pharmacological therapy, the last European guidelines recommend a multidisciplinary management based on exercise and education. Thus, our main objective was to measure the effectiveness of a healthcare organization offering a specific program of adapted physical activity combined with a therapeutic education program for FM patients. Methods and Analysis: The From Intent To Move (FIMOUV) study will recruit 330 FM patients randomized into two groups: test and control. The test group will benefit from a 1-month mixed exercise training program supervised at the hospital, followed by 2 months in a community-based relay in a health-sport structure. In addition, each of the two groups will benefit from therapeutic patient education sessions. The main endpoint is the measurement of the level of physical activity by accelerometry at 1 year. The secondary endpoints concern adherence to the practice of physical activity, impact on lifestyle, state of health, and physical capacity, as well as an estimate of the budgetary impact of this management strategy. Discussion: This interventional research will allow us to assess the evolution of behaviors in physical activity after an FM syndrome management based solely on patient education or based on a supervised and adapted practice of physical activity associated with this same therapeutic education program. It seems to be the first study evaluating the impact of its intervention on objective data for measuring physical activity and sedentary behavior via accelerometry among FM patients. Trial registration:ClinicalTrials.gov NCT04107948.
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Affiliation(s)
- Claire Colas
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Julie Goutte
- Department of Internal Medicine, University Hospital Center, Saint-Étienne, France
| | - Christelle Creac'h
- Pain Center, University Hospital Center, Saint-Étienne, France.,University Claude Bernard, Central Integration of Pain (NeuroPain) Lab-Lyon Neuroscience Research Center, INSERM U1028, CNRS, Bron, France
| | - Luc Fontana
- Department of Occupational and Environmental Medicine, University Hospital Center, Saint-Étienne, France.,University Lyon, University Lyon 1, University St Etienne, University Gustave Eiffel, IFSTTAR, UMRESTTE, UMR_T9405, Saint-Étienne, France
| | - Marie-Pierre Vericel
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | | | - Marie Peuriere
- Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France
| | - Madjid Akrour
- Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France
| | - Charly Martin
- Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France
| | - Emilie Presles
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Clinical Research, Innovation and Pharmacology Unit, University Hospital Center, Saint-Étienne, France.,Department of Clinical Investigation Center, CIC 1408-INSERM, University Hospital Center, Saint-Étienne, France
| | - Nathalie Barth
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,University Lyon, UJM-Saint-Etienne Chaire Santé des Ainés, Saint-Étienne, France.,Gerontopole Auvergne-Rhone-Alpes, Saint-Étienne, France
| | - Jessica Guyot
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,University Lyon, UJM-Saint-Etienne Chaire Santé des Ainés, Saint-Étienne, France
| | - Maël Garros
- Sport Health House, CDOS 42, Saint-Étienne, France
| | - Béatrice Trombert
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Public Health, University Hospital Center, Saint-Étienne, France
| | | | - Frédéric Roche
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Léonard Féasson
- Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France.,University Lyon, UJM-Saint-Etienne Interuniversity Laboratory of Human Movement Biology, EA 7424, Saint-Étienne, France
| | - Hubert Marotte
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Rheumatology, University Hospital Center, Saint-Étienne, France
| | - Pascal Cathebras
- Department of Internal Medicine, University Hospital Center, Saint-Étienne, France
| | - David Hupin
- University Lyon, UJM-Saint-Etienne Sainbiose Laboratory, INSERM U1059, Saint-Étienne, France.,Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France.,Department of Medicine, K2, Solna Karolinska Institutet, Stockholm, Sweden
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13
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Reliability of graded cycling test with talk test and 30-s chair-stand test in men with prostate cancer on androgen deprivation therapy. Support Care Cancer 2021; 29:4249-4256. [PMID: 33411043 DOI: 10.1007/s00520-020-05918-8] [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: 09/02/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the absolute and relative reliability of the "graded cycling test with talk test" (GCT-TT) and the "30-second chair-stand test" (30s-CST) in men with prostate cancer receiving androgen deprivation therapy (ADT). METHODS Men with prostate cancer on ADT were included in this test-retest study. GCT-TT and 30s-CST were performed twice with 1 hour between test sessions. All tests were conducted by two experienced physiotherapists and all patients were familiar with the tests. Only intra-tester reliability was investigated as the test and retest of each participant were performed by the same physiotherapist. Intraclass correlation coefficient (ICC2.1), standard error of measurement (SEM and SEM95), and smallest real difference (SRD) were calculated. RESULTS Sixty men were included with a mean age of 70.8 ± 6.6 (mean ± SD) years. All performed 30s-CST twice without any problems. Two participants were excluded from the analysis of the GCT-TT results. Relative reliability for 30s-CST (ICC2.1) was 0.97 [95% CI: 0.94-0.98] with low measurement error: SEM95, 1.9 repetitions, and SRD, 2.6 repetitions. The corresponding results for GCT-TT were ICC2.1, 0.90 [95% CI: 0.84-0.94]; SEM95, 19.9 W; and SRD, 28.2 W. CONCLUSIONS The reliability of 30s-CST and GCT-TT is substantial for men with prostate cancer receiving ADT. Overall, an average 30s-CST improvement of 1.9 repetitions on a group level and three repetitions for individual patients are considered real improvements. A GCT-TT improvement exceeding 19.9 W represents a real improvement for a group of patients. Individual patients need to improve two steps (30 W).
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14
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Lam T, Cheema B, Hayden A, Lord SR, Gurney H, Gounden S, Reddy N, Shahidipour H, Read S, Stone G, McLean M, Birzniece V. Androgen deprivation in prostate cancer: benefits of home-based resistance training. SPORTS MEDICINE-OPEN 2020; 6:59. [PMID: 33315154 PMCID: PMC7736381 DOI: 10.1186/s40798-020-00288-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Androgen deprivation therapy (ADT) has detrimental effects on body composition, metabolic health, physical functioning, bone mineral density (BMD) and health-related quality of life (HRQOL) in men with prostate cancer. We investigated whether a 12-month home-based progressive resistance training (PRT) programme, instituted at the start of ADT, could prevent these adverse effects. METHODS Twenty-five patients scheduled to receive at least 12 months of ADT were randomly assigned to either usual care (UC) (n = 12) or PRT (n = 13) starting immediately after their first ADT injection. Body composition, body cell mass (BCM; a functional component of lean body mass), BMD, physical function, insulin sensitivity and HRQOL were measured at 6 weeks and 6 and 12 months. Data were analysed by a linear mixed model. RESULTS ADT had a negative impact on body composition, BMD, physical function, glucose metabolism and HRQOL. At 12 months, the PRT group had greater reductions in BCM by - 1.9 ± 0.8 % (p = 0.02) and higher gains in fat mass by 3.1 ± 1.0 % (p = 0.002), compared to the UC group. HRQOL domains were maintained or improved in the PRT versus UC group at 6 weeks (general health, p = 0.04), 6 months (vitality, p = 0.02; social functioning, p = 0.03) and 12 months (mental health, p = 0.01; vitality, p = 0.02). A significant increase in the Matsuda Index in the PRT versus UC group was noted at 6 weeks (p = 0.009) but this difference was not maintained at subsequent timepoints. Between-group differences favouring the PRT group were also noted for physical activity levels (step count) (p = 0.02). No differences in measures of BMD or physical function were detected at any time point. CONCLUSION A home-based PRT programme instituted at the start of ADT may counteract detrimental changes in body composition, improve physical activity and mental health over 12 months. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12616001311448.
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Affiliation(s)
- Teresa Lam
- School of Medicine, Western Sydney University, Penrith, NSW, Australia. .,Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW, 2148, Australia. .,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia.
| | - Birinder Cheema
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
| | - Amy Hayden
- Department of Radiation Oncology, Blacktown Hospital, Blacktown, NSW, Australia.,Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | - Stephen R Lord
- NeuRA, University of New South Wales, Sydney, NSW, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | - Shivanjini Gounden
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
| | - Navneeta Reddy
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
| | - Haleh Shahidipour
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Translational Health Research Institute, Penrith, NSW, Australia
| | - Scott Read
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
| | - Glenn Stone
- School of Computing, Engineering and Mathematics, Western Sydney University, Penrith, NSW, Australia
| | - Mark McLean
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia
| | - Vita Birzniece
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Translational Health Research Institute, Penrith, NSW, Australia.,Garvan Institute of Medical Research, Sydney, NSW, Australia
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15
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McDonough MH, Beselt LJ, Kronlund LJ, Albinati NK, Daun JT, Trudeau MS, Wong JB, Culos-Reed SN, Bridel W. Social support and physical activity for cancer survivors: a qualitative review and meta-study. J Cancer Surviv 2020; 15:713-728. [PMID: 33128705 DOI: 10.1007/s11764-020-00963-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Physical activity (PA) is important for well-being and coping among cancer survivors. Social support (SS) encourages adoption and maintenance of PA behavior, and PA contexts can provide opportunities for obtaining support for coping with cancer. The qualitative literature examining cancer survivors' experience with SS in and for PA could inform understanding of behaviors experienced as supportive. The purpose of this meta-study was to synthesize the research on adult cancer survivors' experiences with SS related to PA. METHODS Following meta-study guidelines, we searched nine databases and retrieved 39 articles describing intervention and observation studies, and extracted, analyzed, and synthesized information addressing SS and PA in cancer survivors. RESULTS Results emphasized ways that PA contexts facilitate relationships, which are a foundation for obtaining supportive behaviors that enable PA (e.g., providing encouragement and accountability) and assist with coping with cancer (e.g., understanding and talking about cancer). Some themes identified were unique to studies with female breast cancer, advanced cancer, interventions or programs, and that used interviews versus focus groups. CONCLUSIONS Understanding supportive behaviors could improve PA and coping with cancer in interventions. Future research should focus on identifying supportive behaviors, incorporating theory and methods to address the development of supportive relationships, and recruiting more diverse samples of participants in terms of gender, race/ethnicity, and cancer type. IMPLICATIONS FOR CANCER SURVIVORS PA can provide opportunities for positive social connections ranging from loose to close social ties, and this research identifies several behaviors in the PA context that may be supportive of PA behavior (e.g., providing actionable information), and coping with cancer (e.g., opportunities but low obligation to talk about cancer).
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Affiliation(s)
- Meghan H McDonough
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
| | - L Jayne Beselt
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Liam J Kronlund
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Natalia K Albinati
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Melanie S Trudeau
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - Janet B Wong
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
| | - William Bridel
- Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
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16
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Dennett AM, Peiris CL, Shields N, Taylor NF. From Cancer Rehabilitation to Recreation: A Coordinated Approach to Increasing Physical Activity. Phys Ther 2020; 100:2049-2059. [PMID: 32737975 DOI: 10.1093/ptj/pzaa135] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/22/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022]
Abstract
Participation in adequate physical activity improves the health status of cancer survivors, enhances their survival, and reduces their risk of cancer recurrence. However, cancer survivors engage in low levels of physical activity and have limited access to rehabilitation services that could increase their participation. No optimal framework has been developed that supports physical activity participation among cancer survivors. Given the growth in numbers of cancer survivors, development of a framework may provide a pathway to facilitate timely and appropriate care. This perspective paper describes the development of the Cancer Rehabilitation to Recreation (CaReR) Framework and its practical implications. The CaReR Framework uses a tailored, stepped approach to guide health services and clinicians on the design and implementation of interventions to promote physical activity among cancer survivors. Implementation of the CaReR Framework will improve continuity and quality of care for cancer survivors and promote physical activity with the ultimate aim of improving health outcomes.
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Affiliation(s)
- Amy M Dennett
- School of Allied Health, Human Services, and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health, Level 2, 5 Arnold St, Box Hill, Victoria, Australia
| | - Casey L Peiris
- School of Allied Health, Human Services, and Sport, La Trobe University
| | - Nora Shields
- School of Allied Health, Human Services, and Sport, La Trobe University
| | - Nicholas F Taylor
- School of Allied Health, Human Services, and Sport, La Trobe University and Allied Health Clinical Research Office, Eastern Health
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17
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Edmunds K, Tuffaha H, Scuffham P, Galvão DA, Newton RU. The role of exercise in the management of adverse effects of androgen deprivation therapy for prostate cancer: a rapid review. Support Care Cancer 2020; 28:5661-5671. [PMID: 32699997 DOI: 10.1007/s00520-020-05637-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Prostate cancer (PCa) is the most commonly diagnosed cancer in Australia, accounting for one quarter of all new cancer diagnoses for males. Androgen deprivation therapy (ADT) is the standard first-line therapy for metastatic PCa but is also used across much of the spectrum of disease. Unfortunately, debilitating adverse effects are a significant and largely unavoidable feature of ADT. A recent systematic review of adverse effects of ADT identified 19 sub-groups classified according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. The potential for multiple simultaneous adverse effects, their associated management and the impact of adverse effects on cancer outcomes and quality of life are important considerations in the treatment and supportive care of men with PCa. Exercise is increasingly being recognized as an efficacious strategy in managing these adverse effects. METHODS A rapid review was undertaken to examine the role of exercise in the management of the most commonly reported ADT adverse effects classified according to the CTCAE sub-groups. A systematic search was conducted in Medline, PsycINFO, Google Scholar and Google for the years 2010 to September 2019 to identify the benefits of exercise in managing the adverse effects of ADT for PCa. RESULTS There is strong evidence for exercise as medicine in addressing several of the adverse effects of PCa such as loss of muscle mass and strength, fatigue and declining physical function. Moderate level evidence for PCa exists for exercise-induced improvements in depression and anxiety, bone loss, and sexual dysfunction. While evidence of the effectiveness of exercise is lacking for many adverse effects of ADT for PCa, evidence in the cancer population as a whole or other clinical populations is strong, and many clinical guidelines recommend exercise as a fundamental part of their clinical management. With the exception of gynaecomastia and breast pain, there is increasing evidence (PCa, cancer or other clinical populations) to suggest that exercise has the potential to reduce and even prevent many of the adverse effects of ADT, thus improving survivorship outcomes for men with PCa. CONCLUSION Exercise has the potential to reduce and even prevent many of the adverse effects of ADT, thus improving survivorship outcomes for men with PCa. The use of exercise for PCa management has the potential to translate into health and economic benefits in improved quality of life and fewer complications, resulting in savings to the health care system, enhanced productivity and reduced patient and carer burden. Exercise thus has the potential to improve quality of life for this population as well as generate significant cost savings.
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Affiliation(s)
- Kim Edmunds
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia. .,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Haitham Tuffaha
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Paul Scuffham
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
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18
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Outcomes of a text message, Fitbit, and coaching intervention on physical activity maintenance among cancer survivors: a randomized control pilot trial. J Cancer Surviv 2019; 14:80-88. [PMID: 31776849 DOI: 10.1007/s11764-019-00831-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/26/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE We aimed to determine the effect of a health coach, text message, and Fitbit intervention on moderate-to-vigorous physical activity (MVPA) maintenance in cancer survivors following a supervised exercise program compared to provision of a Fitbit alone. METHODS Participants were recruited during the last month of an exercise-based oncology rehabilitation program and randomly assigned to the full intervention (n = 34) or Fitbit-only control groups (n = 32). In total, 59 cancer survivors completed the program (81% female; mean age 61.4 ± 9.0). Group by time differences in accelerometer-measured MVPA was assessed using linear mixed models. Additionally, we examined mean weekly Fitbit-derived MVPA levels. RESULTS Intervention participants maintained weekly MVPA from pre- (295.7 ± 139.6) to post-intervention (322.0 ± 199.4; p = 0.37), whereas those in the Fitbit-only group had a significant decrease in MVPA (305.5 ± 181.1 pre vs 250.7 ± 166.5 post; p = 0.03, effect size 0.57). The intervention participants maintained recommended levels of MPVA for health benefits during the 8-week intervention, whereas the Fitbit-only control group did not. CONCLUSIONS The findings demonstrate that a remote intervention delivered through health coaching, text messages, and Fitbit can promote maintenance of MVPA after a structured program for cancer survivors. However, use of a Fitbit alone was not sufficient to prevent expected decline in MVPA. Additional research is warranted to examine long-term impacts and efficacy in a more diverse population of cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Use of a wearable tracker alone may not be sufficient for exercise maintenance among cancer survivors after transition to an independent program. Additional planning for relapse prevention is recommended.
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19
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Fox L, Wiseman T, Cahill D, Beyer K, Peat N, Rammant E, Van Hemelrijck M. Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review. Psychooncology 2019; 28:2270-2285. [DOI: 10.1002/pon.5240] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Louis Fox
- Translational Oncology and Urology ResearchKing's College London London UK
| | - Theresa Wiseman
- Applied Health ResearchThe Royal Marsden NHS Foundation Trust London UK
- Health SciencesUniversity of Southampton Southampton UK
| | - Declan Cahill
- Urology SurgeryThe Royal Marsden NHS Foundation Trust London UK
| | - Katharina Beyer
- Translational Oncology and Urology ResearchKing's College London London UK
| | - Nicola Peat
- Cancer Exercise PhysiotherapyGuy's and St Thomas' NHS Foundation Trust London UK
| | - Elke Rammant
- Department of Radiation Oncology and Experimental Cancer ResearchUniversity Hospital Ghent Ghent Belgium
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20
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Lam T, McLean M, Hayden A, Poljak A, Cheema B, Gurney H, Stone G, Bahl N, Reddy N, Shahidipour H, Birzniece V. A potent liver-mediated mechanism for loss of muscle mass during androgen deprivation therapy. Endocr Connect 2019; 8:605-615. [PMID: 30991356 PMCID: PMC6510709 DOI: 10.1530/ec-19-0179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/15/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT Androgen deprivation therapy (ADT) in prostate cancer results in muscular atrophy, due to loss of the anabolic actions of testosterone. Recently, we discovered that testosterone acts on the hepatic urea cycle to reduce amino acid nitrogen elimination. We now hypothesize that ADT enhances protein oxidative losses by increasing hepatic urea production, resulting in muscle catabolism. We also investigated whether progressive resistance training (PRT) can offset ADT-induced changes in protein metabolism. OBJECTIVE To investigate the effect of ADT on whole-body protein metabolism and hepatic urea production with and without a home-based PRT program. DESIGN A randomized controlled trial. PATIENTS AND INTERVENTION Twenty-four prostate cancer patients were studied before and after 6 weeks of ADT. Patients were randomized into either usual care (UC) (n = 11) or PRT (n = 13) starting immediately after ADT. MAIN OUTCOME MEASURES The rate of hepatic urea production was measured by the urea turnover technique using 15N2-urea. Whole-body leucine turnover was measured, and leucine rate of appearance (LRa), an index of protein breakdown and leucine oxidation (Lox), a measure of irreversible protein loss, was calculated. RESULTS ADT resulted in a significant mean increase in hepatic urea production (from 427.6 ± 18.8 to 486.5 ± 21.3; P < 0.01) regardless of the exercise intervention. Net protein loss, as measured by Lox/Lra, increased by 12.6 ± 4.9% (P < 0.05). PRT preserved lean body mass without affecting hepatic urea production. CONCLUSION As early as 6 weeks after initiation of ADT, the suppression of testosterone increases protein loss through elevated hepatic urea production. Short-term PRT was unable to offset changes in protein metabolism during a state of profound testosterone deficiency.
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Affiliation(s)
- Teresa Lam
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, New South Wales, Australia
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia
- Correspondence should be addressed to T Lam:
| | - Mark McLean
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, New South Wales, Australia
| | - Amy Hayden
- Department of Radiation Oncology, Blacktown Hospital, Blacktown, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia
| | - Anne Poljak
- Bioanalytical Mass Spectrometry Facility and School of Medical Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - Birinder Cheema
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia
| | - Glenn Stone
- School of Computing, Engineering and Mathematics, Western Sydney University, Penrith, New South Wales, Australia
| | - Neha Bahl
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Navneeta Reddy
- Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, New South Wales, Australia
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Haleh Shahidipour
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, New South Wales, Australia
- School of Medicine, UNSW Sydney, Sydney, New South Wales, Australia
- Translational Health Research Institute, Penrith, New South Wales, Australia
| | - Vita Birzniece
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Department of Diabetes and Endocrinology, Blacktown Hospital, Blacktown, New South Wales, Australia
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- School of Medicine, UNSW Sydney, Sydney, New South Wales, Australia
- Translational Health Research Institute, Penrith, New South Wales, Australia
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Culos-Reed SN, Dew M, Shank J, Langelier DM, McDonough M. Qualitative Evaluation of a Community-Based Physical Activity and Yoga Program for Men Living With Prostate Cancer: Survivor Perspectives. Glob Adv Health Med 2019; 8:2164956119837487. [PMID: 31024755 PMCID: PMC6472160 DOI: 10.1177/2164956119837487] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/08/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose Physical activity (PA) programs for prostate cancer survivors have positive effects on many aspects of health-related quality of life. Translating this research into sustainable community-based settings is necessary to ensure access to programs for survivors. This study examines patient perspectives in the community-based TrueNTH Lifestyle Management (TrueNTH LM) program in Calgary, Canada. Methods Eleven men from programs at civic wellness centers participated in 2 small semistructured focus groups (n = 5 and 6) at the University of Calgary. Motivation for program initiation and adherence, benefits and barriers to participation, and individual satisfaction and feedback on program improvement were discussed. Audio recordings were transcribed and analyzed using thematic methodology guided by a pragmatic philosophy on the patient experience in the program. Results Themes identified included perceived benefits of participating (physical, psychological, and social), facilitators for involvement in the PA program (program design, initial free access, tailored to prostate cancer specific needs, psychosocial environment), and opportunities for improvement and sustainability (exercise as a part of standard care, cost structure, home-based options). Conclusions These findings provide valuable insight into patient perspectives on effective characteristics of prostate cancer and exercise programs. TrueNTH LM has implemented findings, and ensuring needs (benefits and barriers) are addressed for prostate cancer survivors when entering community-based PA programs.
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Affiliation(s)
- S N Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Canada
| | - M Dew
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - J Shank
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - D M Langelier
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Department of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - M McDonough
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
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Dennett AM, Peiris CL, Taylor NF, Reed MS, Shields N. 'A good stepping stone to normality': a qualitative study of cancer survivors' experiences of an exercise-based rehabilitation program. Support Care Cancer 2018; 27:1729-1736. [PMID: 30136023 DOI: 10.1007/s00520-018-4429-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/15/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE Exercise-based rehabilitation is not routinely offered to patients. We explored the experience of cancer survivors completing an exercise-based cancer rehabilitation program with and without motivational interviewing. METHOD A qualitative study using semi-structured interviews and thematic analysis was completed with a purposive sample of 26 cancer survivors (n = 17 female, n = 18 post-treatment) participating in cancer rehabilitation at a tertiary hospital. Interviews were recorded and transcribed verbatim. Coding was completed by two reviewers independently and confirmed by a third reviewer. RESULTS The main theme that emerged was exercise-based rehabilitation facilitated a return to normality after diagnosis which included positive changes in physical activity behaviour. Sub-themes were that rehabilitation is person-centred, challenges expectations, empowering and facilitated by expert staff. Common themes emerged whether participants received additional motivational interviewing or not. However, participants who received motivational interviewing were more likely to report feeling accountable for their physical activity levels. Transition to ongoing independent physical activity remained a challenge for some people who did not feel empowered or socially supported. CONCLUSION Exercise-based cancer rehabilitation is important in facilitating 'return to normal' including increased participation in physical activity. To challenge expectations and to empower cancer survivors, rehabilitation programs should be person-centred and led by expert staff.
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Affiliation(s)
- Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, 3128, Australia.
- School of Allied Health, La Trobe University, Bundoora, Australia.
| | - Casey L Peiris
- Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, 3128, Australia
| | - Nicholas F Taylor
- Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, 3128, Australia
- School of Allied Health, La Trobe University, Bundoora, Australia
| | - Melissa S Reed
- Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, 3128, Australia
| | - Nora Shields
- Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, 3128, Australia
- Allied Health, Northern Health, Epping, Australia
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