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Liang IJ, Perkin OJ, McGuigan PM, Spellanzon B, Robb M, Liu CY, Lin LL, Thompson D, Western MJ. The effectiveness of unsupervised home-based exercise for improving lower extremity physical function in older adults in Western and Eastern cultures: a systematic review and meta-analysis. BMC Geriatr 2024; 24:800. [PMID: 39354428 DOI: 10.1186/s12877-024-05393-4] [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: 06/05/2024] [Accepted: 09/18/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Ageing leads to decreased physical function, which can impact independent living and raise health risks, increasing demand on healthcare resources. Finding affordable and accessible exercise to improve physical function is necessary for a population seemingly resistant to strength and balance training in leisure settings. This review aimed to evaluate whether unsupervised home-based exercises improve lower extremity function in older adults. METHODS We systematically searched for randomised controlled trials (RCTs) and cluster RCTs investigating unsupervised home-based exercises' effects on physical function in older adults through English and Mandarin databases. Studies' methodological quality was assessed using the Cochrane's Risk of Bias Tool. Meta-analyses were conducted on lower extremity functions outcomes. RESULTS Of the 6791 identified articles, 10 English studies (907 participants) were included, 8 studies (839 participants) were used for final meta-analysis, with no Mandarin studies. Studies were largely based in Europe with mostly moderate risk of bias. Most interventions were multicomponent lasting 10-40 min/session, 3 times/week. Meta-analysis showed no statistically significant differences in 5 sit-to-stand (p = 0.05; I2 = 0%), maximal knee extension strength (p = 0.61; I2 = 71%), 10 m maximal walking speed (p = 0.22; I2 = 30%), timed-up-to-go (p = 0.54; I2 = 0%), and short physical performance battery (p = 0.32; I2 = 98%) between exercise and control groups. CONCLUSIONS This meta-analysis suggests that unsupervised home-based exercise programmes have little impact on lower extremity functions in older adults. This review is limited by the small number of included studies, sample sizes, and high heterogeneity. There is a need to understand why this format lacks efficacy, and design more beneficial home-based exercise programmes.
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Affiliation(s)
- Ian Ju Liang
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Oliver J Perkin
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Polly M McGuigan
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
| | - Bruno Spellanzon
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
| | - Molly Robb
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
| | - Chien-Yu Liu
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Linda L Lin
- Graduate Institute of Physical Education, Health & Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| | - Dylan Thompson
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, UK
| | - Max J Western
- Department for Health, University of Bath, 1 West 5.108, Bath, BA2 7AY, UK.
- Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK.
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Liu X, Xu X, Cheung DST, Chau PH, Ho MH, Takemura N, Lin CC. The effects of exercise with or without dietary advice on muscle mass, muscle strength, and physical functioning among older cancer survivors: a meta-analysis of randomized controlled trials. J Cancer Surviv 2024; 18:1548-1556. [PMID: 37266818 PMCID: PMC10236397 DOI: 10.1007/s11764-023-01396-z] [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: 12/18/2022] [Accepted: 04/28/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To evaluate the effect of exercise with or without dietary advice on muscle mass, muscle strength and physical functioning (including perceived physical functioning and physical performance) in old cancer survivors. METHODS A systematic literature search was undertaken in May 2022 by searching multiple databases. Randomized controlled trials (RCTs) that compared exercise with or without dietary advice to control group among old cancer survivors were screened. Meta-analyses were conducted to evaluate the effects of exercise with or without dietary advice on muscle mass, muscle strength, and physical functioning. RESULTS Data from 21 trials were included in this study, including 16 exercise trials and 5 exercise + dietary advice studies. Regarding exercise, evidence supported its significant benefits on muscle strength among old cancer survivors, while no effect was seen on physical functioning and muscle mass. Concerning exercise combined with dietary advice, meta-analysis showed overall benefits on physical functioning, while limited study examined muscle mass and strength. As for safety and feasibility of interventions, low recruitment rate, moderate compliance, and few adverse events were reported. CONCLUSIONS Exercise combined with dietary advice is a more effective approach for old cancer survivors in improving physical functioning compared with exercise alone. Future study is needed to explore the effects of exercise combined with dietary advice on combating sarcopenia. As recruitment and compliance among old cancer survivors were challenging, strategies to stimulate their motivation and promote habitual healthy behaviour are warranted. IMPLICATIONS FOR CANCER SURVIVORS It is necessary for old cancer survivors to receive exercise and dietary support to improve physical functioning.
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Affiliation(s)
- Xiaohang Liu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
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3
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Hardikar S, Dunston ER, Winn M, Winterton C, Rana A, LoCastro M, Curtis M, Mulibea P, Maslana KE, Kershner K, Hurtado-Orozco J, Simon LH, McFarland MM, Casucci T, Ehlers D, Dolgoy N, Williams G, Loh KP, Coletta AM. A scoping review of diet and exercise interventions for older cancer survivors' physical function. J Geriatr Oncol 2024:102050. [PMID: 39214732 DOI: 10.1016/j.jgo.2024.102050] [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: 01/08/2024] [Revised: 07/12/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
Lifestyle (diet and exercise) interventions across the cancer care continuum among younger cancer survivors (<60 years of age) demonstrate utility in improving physical function, and other cancer relevant health outcomes. However, the impact of lifestyle interventions on physical function in older (≥60 years) cancer survivors is not entirely clear. This scoping review aims to map and characterize the existing literature on the effect of diet and exercise interventions on physical function in older cancer survivors. Conducted to the JBI Manual for Evidence Synthesis and reported to the PRISMA guidelines, the literature search was performed on multiple databases through March 2024. A total of 19,901 articles were identified for screening with 49 articles published between 2006 and 2024 selected for full-text review. Of these, 36 studies included an exercise intervention, two focused on diet intervention, while 11 studies included both diet and exercise intervention. These 49 studies included various cancer types, cancer stages, and timepoints across the cancer care continuum. Most studies described physical function as their primary outcome and demonstrated maintenance or improvement in physical function. We identified several gaps in the current evidence including lack of (adequately powered) trials focused only on older cancer survivors, and trials focused on dietary interventions alone or dietary interventions combined with exercise interventions within this population vulnerable for nutritional inadequacies and declining physical function. Considering the growing population of older cancer survivors, this represents an important area for further research.
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Affiliation(s)
- Sheetal Hardikar
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States of America; Cancer Control and Population Sciences Program, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
| | - Emily R Dunston
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America
| | - Maci Winn
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States of America
| | - Candace Winterton
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States of America
| | - Anish Rana
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester, Rochester, NY, United States of America
| | - Marissa LoCastro
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester, Rochester, NY, United States of America
| | - Maren Curtis
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America
| | - Pendeza Mulibea
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
| | - Kelsey E Maslana
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America
| | - Kyle Kershner
- Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, United States of America
| | - Jaime Hurtado-Orozco
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America
| | - Lea Haverbeck Simon
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
| | - Mary M McFarland
- Spencer S. Eccles Health Sciences Library, University of Utah, Salt Lake City, UT, United States of America
| | - Tallie Casucci
- J. Willard Marriott Library, University of Utah, Salt Lake City, UT, United States of America
| | - Diane Ehlers
- Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, United States of America
| | - Naomi Dolgoy
- Department of Occupational Therapy, University of Alberta, Alberta, Canada
| | - Grant Williams
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester, Rochester, NY, United States of America
| | - Adriana M Coletta
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America.
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Vlachopoulos N, Kontogiannis G, Papageorgiou DI, Symvoulakis E, Haidich AB, Smyrnakis E. Effectiveness and Feasibility of Home-Based Palliative Care Interventions for Geriatric Oncology Patients: A Systematic Review Using Narrative Synthesis. Am J Hosp Palliat Care 2024:10499091241277882. [PMID: 39197821 DOI: 10.1177/10499091241277882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Due to an urgent need to develop palliative care services for geriatric patients with advanced cancer, an overview of available information regarding home-based palliative care interventions would be valuable. AIM To summarize current literature for interventions targeted to homebound, older patients with incurable cancer, and investigate whether these patients can be benefited from home-based palliative care and achieve improved outcomes. DESIGN A search strategy consisting of terms related to home care, palliation, oncology, and geriatrics was employed. A protocol following PRISMA guidelines was prospectively uploaded at PROSPERO (ID = CRD42023404675). DATA SOURCES Pubmed (MEDLINE), Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Epistemonikos.org databases were searched from inception until the present day. Eligibility criteria were selected based on the research question, the population of interest, and the research design. The Risk of Bias Assessment Tool version 2 (RoB-2) was used to appraise study quality. RESULTS A total of 10 articles including 871 patients (out of 1236 titles and 141 fully-reviewed texts) were selected. Four studies assessed exercise interventions, two evaluated multi-component home-care models, two focused on supervision services, and two had nutrition and activity components. Eight studies reported improved outcomes in either specified or mixed cancer geriatric populations. CONCLUSIONS There is a scarcity of clinical trials regarding home-based palliative care for geriatric oncology patients, resulting in poor information and a lack of evidence. At-home interventions seem feasible and have a positive effect on pain management and functional status, but more high-quality studies are required.
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Affiliation(s)
- Nikolaos Vlachopoulos
- Primary Health Care Research Network of the Aristotle University of Thessaloniki, Thessaloniki, Greece
- 251 Hellenic Air Force General Hospital, Athens, Greece
| | | | - Dimitra Iosifina Papageorgiou
- Primary Health Care Research Network of the Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Primary Health Care, General Practice and Health Services Research, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Anna-Bettina Haidich
- Primary Health Care Research Network of the Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Hygiene, Social and Preventive Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Smyrnakis
- Primary Health Care Research Network of the Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Primary Health Care, General Practice and Health Services Research, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ashton RE, Faghy MA, Roscoe CMP, Aning J. Inclusivity in prostate cancer and exercise research: a systematic review. Support Care Cancer 2024; 32:616. [PMID: 39198292 PMCID: PMC11358357 DOI: 10.1007/s00520-024-08793-9] [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: 02/12/2024] [Accepted: 08/07/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Prostate cancer (PCa) is the most prevalent type of cancer in men in the UK. Exercise has been shown to improve the health and quality of life of PCa patients. Exercise should be easily accessible to men with PCa regardless of socioeconomic group or ethnicity. There is a need to better understand whether the current evidence base for exercise interventions is representative and inclusive of racial and ethnic minority men with PCa. METHODS A systematic review of the literature was conducted according to PRISMA guidelines and prospectively registered via Prospero (ID: CRD42022384373). The MEDLINE Ovid, Cochrane Library and PubMed databases were searched from inception to December 2022. The search strategy keywords and MeSH terms used included the following: (1) exercise, (2) training, (3) prostate cancer, (4) ethnic and (5) diversity. RESULTS A total of 778 records were retrieved from database searches, of which 15 records were duplicates. A further 649 were eliminated following the screening of titles and abstracts. After full-text screening of 186 articles, 28 manuscripts were included for review. CONCLUSION This systematic review highlights that there is high heterogeneity in the reporting of participants' ethnicity and there are low numbers of ethnic minority men included in PCa and exercise studies in the UK. Further work is required to understand why representation is lacking within PCa exercise trials in the UK and strategies are needed to achieve representation from all ethnic groups. IMPLICATIONS FOR CANCER SURVIVORS Improved representation and reporting of ethnicity in exercise trials is vital to ensure the results are applicable to all patients.
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Affiliation(s)
- Ruth E Ashton
- Research Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK.
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK.
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Mark A Faghy
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Clare M P Roscoe
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Jonathan Aning
- Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury-On-Trym, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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6
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Raines C, Noorvash B, Posadas EM, Sandler HM, Freedland SJ, Gresham G. Applications of wearable activity monitors for prostate cancer survivors: A systematic scoping review. Contemp Clin Trials 2024; 143:107563. [PMID: 38723860 DOI: 10.1016/j.cct.2024.107563] [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: 12/06/2023] [Revised: 04/04/2024] [Accepted: 05/01/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Wearable technology is used to monitor and motivate physical activity (PA) and provides continuous, objective PA and sleep data outside the clinical setting. We reviewed the literature to understand how wearables are integrated into prostate cancer (PC) investigations in order to identify current practices, gaps, and research opportunities. METHODS We conducted a literature search for articles using wearables, among PC survivors published between 2012 and 2022. We extracted study details, interventions and outcomes, participant baseline characteristics, and device characteristics and grouped them by study type: randomized control trials (RCTs) and non-randomized studies. RESULTS Of 354 articles screened, 44 met eligibility criteria (23 RCTs, and 21 non-randomized). 89% used wearables to monitor PA metrics, 11%, sleep metrics, and 6.8%, both. Most studies involved exercise (70% RCTs, 9% non-randomized studies) or lifestyle interventions (30% RCTs, 9% non-randomized studies). Intervention delivery methods included personalized computer-based (48%), in-person (e.g., trainer) (20%), and education web or print-based (20%). Interventions occurred at the participant's home (48%) or at a gym (20%). 57% of the studies evaluated the feasibility and acceptability of the wearable as an activity-measuring device or as part of a remotely delivered computer-based intervention. Studies used wearables to monitor adherence to PA interventions, motivate behavior change, to assess patient outcomes (e.g., patient function, quality of life, mood), or as data collection tools. CONCLUSIONS Wearables are primarily being used to assess daily activity and monitor adherence to exercise interventions in clinical studies involving PC survivors. Findings suggest that they are feasible for use in this population. More research is needed to understand how to integrate wearables into routine clinical care, expand their use to predict clinical outcomes, or to deliver tailored interventions for PC survivors.
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Affiliation(s)
- Carolina Raines
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
| | - Brandon Noorvash
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
| | - Edwin Melencio Posadas
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
| | - Howard M Sandler
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
| | - Stephen J Freedland
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
| | - Gillian Gresham
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
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Jochems KFT, Menges D, Sanchez D, de Glas NA, Wildiers H, Eberli D, Puhan MA, Bastiaannet E. Outcomes in studies regarding older patients with prostate cancer: A systematic review. J Geriatr Oncol 2024; 15:101763. [PMID: 38575500 DOI: 10.1016/j.jgo.2024.101763] [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: 10/23/2023] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Older patients are often deemed ineligible for clinical research, and many frequently-used endpoints and outcome measures are not as relevant for older patients for younger ones. This systematic review aimed to present an overview of outcomes used in clinical research regarding patients over the age of 65 years with prostate cancer. MATERIALS AND METHODS PubMed and Embase were systematically searched to identify studies on prostate cancer (treatment) in patients aged ≥65 between 2016 and 2023. Data on title, study design, number of participants and age, stage of disease, treatment, and investigated outcomes were synthesized and descriptively analyzed. RESULTS Sixty-eight studies were included. Of these most included patients over 65 years, while others used a higher age. Overall, 39 articles (57.3%) reported on survival-related outcomes, 22 (32.4%) reported on progression of disease and 38 (55.9%) used toxicity or adverse events as an outcome measure. Health-related quality of life and functional outcomes were investigated in 29.4%, and cognition in two studies. The most frequently investigated survival-related outcomes were overall and cancer-specific survival (51.3%); however, 38.5% only studied overall survival. DISCUSSION The main focus of studies included in this review remains survival and disease progression. There is limited attention for health-related quality of life and functional status, although older patients often prioritize the latter. Future research should incorporate outcome measures tailored to the aged population to improve care for older patients with prostate cancer.
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Affiliation(s)
- Kim F T Jochems
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dafne Sanchez
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Nienke A de Glas
- Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans Wildiers
- Oncology, University Hospital Leuven, Leuven, Belgium
| | - Daniel Eberli
- Urology, University Hospital Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Esther Bastiaannet
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
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Hu S, Xiong X, Qiu S, Li J, Xu H, Zhou X, Wang S, Wei Q, Yang L. Comparing Efficacies of Different Exercises on Androgen Deprivation Therapy Adverse Effects in Prostate Cancer Patients: A Network Meta-Analysis. Urol Int 2024; 108:298-313. [PMID: 38432212 DOI: 10.1159/000538114] [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: 12/06/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Previous studies showed exercise have efficacies for androgen deprivation therapy (ADT) adverse effects. To compare the efficacies of different exercises on ADT adverse effects, we conducted the network meta-analysis (NMA). METHODS Literature retrieval was performed in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Nineteen studies (1,184 participants) were included. All analyses were performed in R 4.1.2 or RevMan 5.4.1. RESULTS NMA results showed that compared with the control group, both aerobic + resistance training (ART) (MD = 5.92, 95% CI: 0.38; 11.46) and resistance exercise (RE) (MD = 5.62, 95% CI: 2.70; 8.55) improved quality of life (QoL). ART (P score: 0.72) may have superiority over RE (P score: 0.7). ART (MD = -10.89, 95% CI: -17.67; -4.11) significantly improved the performance of 400-m test. RE could significantly improve leg strength (MD = 118, 95% CI: 78.75; 157.25) and chest strength (MD = 13.30, 95% CI: 4.07; 22.53). RE ranked first for strength improvements of leg and chest. CONCLUSION ART showed better efficacy for the QoL and significantly improved the performance of 400-m test. RE might be superior for the strengths of leg and chest. ART may be appropriate for patients with less significant muscle strength decline but also other adverse effects of ADT, such as decreased cardiopulmonary function.
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Affiliation(s)
- Siping Hu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China,
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China,
| | - Xingyu Xiong
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shi Qiu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, China
| | - Jiakun Li
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Xu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Sheng Wang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
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Brick R, Padgett L, Jones J, Wood KC, Pergolotti M, Marshall TF, Campbell G, Eilers R, Keshavarzi S, Flores AM, Silver JK, Virani A, Livinski AA, Ahmed MF, Kendig T, Khalid B, Barnett J, Borhani A, Bernard G, Lyons KD. The influence of telehealth-based cancer rehabilitation interventions on disability: a systematic review. J Cancer Surviv 2023; 17:1725-1750. [PMID: 35218521 PMCID: PMC8881759 DOI: 10.1007/s11764-022-01181-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To characterize delivery features and explore effectiveness of telehealth-based cancer rehabilitation interventions that address disability in adult cancer survivors. METHODS A systematic review of electronic databases (CINAHL Plus, Cochrane Library: Database of Systematic Reviews, Embase, National Health Service's Health Technology Assessment, PubMed, Scopus, Web of Science) was conducted in December 2019 and updated in April 2021. RESULTS Searches identified 3,499 unique studies. Sixty-eight studies met inclusion criteria. There were 81 unique interventions across included studies. Interventions were primarily delivered post-treatment and lasted an average of 16.5 weeks (SD = 13.1). They were most frequently delivered using telephone calls (59%), administered delivered by nursing professionals (35%), and delivered in a one-on-one format (88%). Risk of bias of included studies was primarily moderate to high. Included studies captured 55 measures of disability. Only 54% of reported outcomes had data that allowed calculation of effect sizes ranging -3.58 to 15.66. CONCLUSIONS The analyses suggest small effects of telehealth-based cancer interventions on disability, though the heterogeneity seen in the measurement of disability makes it hard to draw firm conclusions. Further research using more diverse samples, common measures of disability, and pragmatic study designs is needed to advance telehealth in cancer rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS Telehealth-based cancer rehabilitation interventions have the potential to increase access to care designed to reduce disability across the cancer care continuum.
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Affiliation(s)
- Rachelle Brick
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Lynne Padgett
- VA Central Office, Health Services Research and Development, 1100 1st St NE, Suite 6, Washington, DC, 20002, USA
| | - Jennifer Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, 200 Elizabeth Sr. PMB-B-045, Toronto, ON, M5G 2C4, Canada
| | - Kelley Covington Wood
- ReVital Cancer Rehabilitation, Select Medical, 4714 Gettysburg Road, Mechanicsburg, PA, 17055, USA
| | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, 4714 Gettysburg Road, Mechanicsburg, PA, 17055, USA
| | - Timothy F Marshall
- Ivy Rehab Network, 1311 Mamaroneck Ave, Suite 140, White Plains, NY, 10605, USA
| | - Grace Campbell
- Duquesne University School of Nursing, 600 Forbes Avenue, Pittsburgh, PA, 15282, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences and UPMC Hillman Cancer Center at UPMC Magee, School of Medicine, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, 15213, USA
| | - Rachel Eilers
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA, 15219, USA
| | - Sareh Keshavarzi
- Department of Biostatistics, Princess Margaret Cancer Center, 610 University Ave, Toronto, ON, Canada
- Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, Canada
| | - Ann Marie Flores
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, 60611, USA
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 North Michigan Avenue, 11th Floor, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 North Michigan Avenue, 11th Floor, Chicago, IL, 60611, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA
- Brigham and Women's Hospital, 55 Fruit Street, Boston, MA, USA
- Spaulding Rehabilitation Hospital, 55 Fruit Street, Boston, MA, USA
| | - Aneesha Virani
- Department of Rehabilitation Services, Northside Hospital, 1000 Johnson Ferry Road, Atlanta, GA, 30342, USA
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, OD, NIH, MSC 1150, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Mohammed Faizan Ahmed
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, 200 Elizabeth Sr. PMB-B-045, Toronto, ON, M5G 2C4, Canada
| | - Tiffany Kendig
- ReVital Cancer Rehabilitation, Select Medical, 4714 Gettysburg Road, Mechanicsburg, PA, 17055, USA
| | - Bismah Khalid
- Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1VT, Canada
| | - Jeremy Barnett
- George Washington University School of Medicine and Health Sciences, 2300 I St. NW, Washington, DC, 20052, USA
| | - Anita Borhani
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, 200 Elizabeth Sr. PMB-B-045, Toronto, ON, M5G 2C4, Canada
| | - Graysen Bernard
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, 200 Elizabeth Sr. PMB-B-045, Toronto, ON, M5G 2C4, Canada
| | - Kathleen Doyle Lyons
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown Navy Yard, Building 79/96, 79 13th Street, Boston, MA, 02129, USA
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Sattar S, Papadopoulos E, Smith GVH, Haase KR, Kobekyaa F, Tejero I, Bradley C, Nadler MB, Campbell KL, Santa Mina D, Alibhai SMH. State of research, feasibility, safety, acceptability, and outcomes examined on remotely delivered exercises using technology for older adult with cancer: a scoping review. J Cancer Surviv 2023:10.1007/s11764-023-01427-9. [PMID: 37418170 DOI: 10.1007/s11764-023-01427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION Technology-based exercise is gaining attention as a promising strategy for increasing physical activity (PA) in older adults with cancer (OACA). However, a comprehensive understanding of the interventions, their feasibility, outcomes, and safety is limited. This scoping review (1) assessed the prevalence and type of technology-based remotely delivered exercise interventions for OACA and (2) explored the feasibility, safety, acceptability, and outcomes in these interventions. METHODS Studies with participant mean/median age ≥ 65 reporting at least one outcome measure were included. Databases searched included the following: PubMed, CINAHL, Embase, Cochrane Library Online, SPORTDiscus, and PsycINFO. Multiple independent reviewers completed screening and data abstractions of articles in English, French, and Spanish. RESULTS The search yielded 2339 citations after removing duplicates. Following title and abstract screening, 96 full texts were review, and 15 were included. Study designs were heterogeneous, and sample sizes were diverse (range 14-478). The most common technologies used were website/web portal (n = 6), videos (n = 5), exergaming (n = 2), accelerometer/pedometer with video and/or website (n = 4), and live-videoconferencing (n = 2). Over half (9/15) of the studies examined feasibility using various definitions; feasibility outcomes were reached in all. Common outcomes examined include lower body function and quality of life. Adverse events were uncommon and minor were reported. Qualitative studies identified cost- and time-savings, healthcare professional support, and technology features that encourage engagement as facilitators. CONCLUSION Remote exercise interventions using technology appear to be feasible and acceptable in OACA. IMPLICATIONS FOR CANCER SURVIVORS Some remote exercise interventions may be a viable way to increase PA for OACA.
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Affiliation(s)
- S Sattar
- College of Nursing, University of Saskatchewan, 108-4400 4th Ave, Regina, SK, S4T 0H6, Canada.
| | - E Papadopoulos
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Toronto, ON, M5G 2C4, Canada
- Department of Medicine, University of Toronto, Toronto, 6 Queen's Park Crescent West, 3/F, Toronto, ON, M5S 3H2, Canada
| | - G V H Smith
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - K R Haase
- Faculty of Applied Science, School of Nursing, University of British Columbia, T201-2211, Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - F Kobekyaa
- Faculty of Applied Science, School of Nursing, University of British Columbia, T201-2211, Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - I Tejero
- Department of Geriatric Medicine, Parc de Salut Mar, Pg. Marítim de la Barceloneta, 25, 29, 08003, Barcelona, Spain
| | - C Bradley
- Library, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - M B Nadler
- Department of Medicine, University of Toronto, Toronto, 6 Queen's Park Crescent West, 3/F, Toronto, ON, M5S 3H2, Canada
- Division of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Toronto, ON, M5G 2C4, Canada
| | - K L Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - D Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON, M5S 2W6, Canada
| | - S M H Alibhai
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Toronto, ON, M5G 2C4, Canada
- Department of Medicine, University of Toronto, Toronto, 6 Queen's Park Crescent West, 3/F, Toronto, ON, M5S 3H2, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Ste. 425, Toronto, ON, M5T 3M6, Canada
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11
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Rüth M, Schmelzer M, Burtniak K, Kaspar K. Commercial exergames for rehabilitation of physical health and quality of life: a systematic review of randomized controlled trials with adults in unsupervised home environments. Front Psychol 2023; 14:1155569. [PMID: 37333591 PMCID: PMC10272737 DOI: 10.3389/fpsyg.2023.1155569] [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: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
Background Commercial exergames are widely available tools that can support physical rehabilitation at home. However, the effects of the unsupervised use of commercial exergames in home environments are not yet clear. Hence, we provide a systematic review on the effects of unsupervised commercial exergaming at home on adults' physical health (RQ1) and quality of life (RQ2). We also scrutinize adults' experiences with exergaming at home regarding participant support, adherence, and adverse outcomes (RQ3). Methods We searched Web of Science, PsycINFO, PubMed, Embase, and CINAHL for peer-reviewed randomized controlled trials with adults in need of rehabilitation. Overall, 20 studies (1,558 participants, 1,368 analyzed) met our inclusion criteria. The quality of evidence was assessed with the Cochrane risk of bias tool. Results Effects of unsupervised commercial exergaming at home on physical health were higher in seven studies and similar in five studies regarding the respective comparison or control conditions; eight studies reported non-significant findings. Of the 15 studies that also examined effects on quality of life, improvements were higher in seven studies and similar in two studies regarding the respective comparison or control conditions; results were non-significant in six studies. Participant support consisted of setup of the exergaming system, instructions, training, and contact with participants. Adherence was high in eight studies, moderate in six studies, and low in one study. Adverse outcomes related to exergaming were found in four studies and were at most moderate. Concerning the quality of evidence, six studies were related to a high risk of bias due to outcome reporting bias or ceiling effects in the primary outcome. Additionally, 10 studies yielded some concerns, and four studies were related to a low risk of bias. Discussion This systematic review summarizes promising evidence that the unsupervised use of commercial exergames can support and complement rehabilitation measures in home environments. Still, future studies based on larger samples and using more recent commercial exergames are needed to obtain more high-quality evidence on the effects of different exercise prescriptions. Overall, considering the necessary precautions, the unsupervised use of commercial exergames at home can improve the physical health and quality of life in adults with needs for physical rehabilitation. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341189, identifier: PROSPERO, Registration number: CRD42022341189.
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Wang L, Langlais C, Kenfield SA, Van Loon K, Laffan A, Atreya CE, Chan JM, Zhang L, Allen IE, Miaskowski C, Fukuoka Y, Meyerhardt JA, Venook AP, Van Blarigan EL. Quality of life among colorectal cancer survivors participating in a pilot randomized controlled trial of a web-based dietary intervention with text messages. Support Care Cancer 2023; 31:155. [PMID: 36763183 PMCID: PMC9918568 DOI: 10.1007/s00520-023-07620-x] [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: 09/13/2022] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE We aimed to estimate the effect of a 12-week web-based dietary intervention with text messages on quality of life (QoL) among colorectal cancer (CRC) survivors. METHODS Between 2017 and 2018, 50 CRC survivors were randomized (1:1) to receive a 12-week web-based dietary intervention with daily text messages or wait-list control. Health-related QoL was assessed using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and colorectal quality of life module (QLQ-CR29) at baseline, 12, and 24 weeks. Within- and between-group mean changes in health-related QoL with 95% confidence intervals (CI) were calculated for both arms. RESULTS Compared to the controls, participants receiving the intervention had an improvement in emotional functioning (mean change: 14.3; 95% CI: 3.0, 25.6) at 12 weeks and social functioning (mean change: 13.8; 95% CI: 2.1, 25.5) at 24 weeks. A decrease of fatigue from baseline was also observed in the intervention arm (mean change: - 9.1; 95% CI: - 17.1, - 1.1) at 24 weeks. No other changes in QoL scores were associated with the intervention. CONCLUSION CRC survivors randomized to receive a web-based dietary intervention with text messages experienced higher emotional and social functioning. Further study with a larger population may be warranted. TRIAL REGISTRATION clinicaltrials.gov, NCT02965521. Registered 16 November 2016, https://clinicaltrials.gov/ct2/keydates/NCT02965521.
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Affiliation(s)
- Lufan Wang
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Crystal Langlais
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- IQVIA, Durham, NC, USA
| | - Stacey A Kenfield
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA, USA
| | - Katherine Van Loon
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Angela Laffan
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Chloe E Atreya
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - June M Chan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA, USA
| | - Li Zhang
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Isabel E Allen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Christine Miaskowski
- Department of Physiologic Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Yoshimi Fukuoka
- Department of Physiologic Nursing, University of California, San Francisco, San Francisco, CA, USA
| | | | - Alan P Venook
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erin L Van Blarigan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA, USA.
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Swartz MC, Lewis ZH, Deer RR, Stahl AL, Swartz MD, Christopherson U, Basen-Engquist K, Wells SJ, Silva HC, Lyons EJ. Feasibility and Acceptability of an Active Video Game-Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial. JMIR Cancer 2022; 8:e36889. [PMID: 35994321 PMCID: PMC9446134 DOI: 10.2196/36889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Survivors of breast cancer with functional limitations have a 40% higher mortality rate than those without. Despite the known benefits of physical activity (PA), <40% of survivors of breast cancer meet the recommendations for PA. The combination of active video games (AVGs) and group-based PA counseling may hold potential for motivating PA adoption and improving physical function. However, this method has not been widely studied in survivors of breast cancer. OBJECTIVE We aimed to determine the feasibility and acceptability of a group AVG-based multicomponent PA intervention and estimate its effect size and variability on PA and physical function in female survivors of breast cancer in a clinic setting. METHODS Female survivors of breast cancer (N=60) were recruited through the clinic and randomly assigned to the intervention group (12 weekly sessions) or the control group (existing support group). The intervention group received game-based pedometers and participated in weekly group AVG sessions, PA behavioral coaching, and survivorship navigation discussions. A participant manual with weekly reflection worksheets was provided to reinforce the coaching lessons and promote self-led PA. The control group received conventional pedometers and participated in an existing breast cancer support group. Feasibility was assessed by enrollment rate (≥50%), retention rate (≥80%), group attendance rate (75% attending ≥9 sessions [intervention group]), and the number of technological issues and adverse events. Acceptability was measured by participants' attitudes (from strongly disagree=1 to strongly agree=5) toward the use of AVGs and the overall program. The outcomes included PA (accelerometers) and physical function (Short Physical Performance Battery and gait speed). Analysis of covariance was used to determine differences in PA and physical function between the groups. The Cohen d and its 95% CI determined the effect size and variability, respectively. All the analyses followed the intention-to-treat principle. RESULTS Participants were an average of 57.4 (SD 10.5) years old, 70% (42/60) White, and 58% (35/60) off treatment. The enrollment rate was 55.9% (66/118). Despite substantial long-term hurricane-related disruptions, we achieved an 80% (48/60) retention. The intervention group's attendance rate was 78% (14/18), whereas the control group's attendance rate was 53% (9/17). Of the 26 game-based pedometers, 3 (12%) were damaged or lost. No study-related adverse events occurred. Acceptability items were highly rated. Steps (β=1621.64; P=.01; d=0.72), Short Physical Performance Battery (β=.47; P=.01; d=0.25), and gait speed (β=.12; P=.004; d=0.48) had a significant intervention effect. CONCLUSIONS The intervention was feasible and acceptable in this population despite the occurrence of a natural disaster. Pilot results indicate that group AVG sessions, PA coaching, and survivorship navigation produced moderate effects on PA and physical functioning. AVGs with PA counseling can potentially be used in existing breast cancer support groups to encourage PA and improve physical function. TRIAL REGISTRATION ClinicalTrials.gov NCT02750241; https://clinicaltrials.gov/ct2/show/NCT02750241.
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Affiliation(s)
- Maria C Swartz
- Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Zakkoyya H Lewis
- Department of Kinesiology & Health Promotion, California State Polytechnic University, Pomona, Pomona, CA, United States
| | - Rachel R Deer
- Department of Nutrition, Metabolism and Rehabilitation Sciences, Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States
| | - Anna L Stahl
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Michael D Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Ursela Christopherson
- Department of Nutrition, Metabolism and Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX, United States
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Stephanie J Wells
- Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - H Colleen Silva
- Department of Surgery, The University of Texas Medical Branch, Houston, TX, United States
| | - Elizabeth J Lyons
- Department of Nutrition, Metabolism and Rehabilitation Sciences, Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States
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14
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Toohey K, Hunter M, Paterson C, Mortazavi R, Singh B. Exercise Adherence in Men with Prostate Cancer Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:2452. [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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Affiliation(s)
- Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (M.H.); (C.P.); (R.M.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT 2617, Australia
| | - Maddison Hunter
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (M.H.); (C.P.); (R.M.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT 2617, Australia
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (M.H.); (C.P.); (R.M.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT 2617, Australia
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen AB10 7QB, UK
| | - Reza Mortazavi
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (M.H.); (C.P.); (R.M.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, ACT 2617, Australia
| | - Benjamin Singh
- Allied Health and Human Performance, University of South Australia City East Campus, Adelaide, SA 5001, Australia;
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Loh KP, Sanapala C, Janelsins M, Klepin HD, Schnall R, Culakova E, Sohn MB, Vertino P, Susiarjo M, Jensen-Battaglia M, Becker MW, Liesveld J, Mendler JH, Huselton E, Lin PJ, Mustian K. Protocol for a pilot randomized controlled trial of a mobile health exercise intervention for older patients with myeloid neoplasms (GO-EXCAP 2). J Geriatr Oncol 2022; 13:545-553. [PMID: 34949540 PMCID: PMC9058183 DOI: 10.1016/j.jgo.2021.12.011] [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: 11/09/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION We have shown the Exercise for Cancer Patients (EXCAP©®) exercise program improved physical function and symptoms and reduced inflammatory markers in patients with cancer. However, adherence to exercise was lower in older adults compared to their younger counterparts. We then leveraged a mobile app to deliver EXCAP©® and adapted the intervention [Geriatric-Oncology (GO)-EXCAP] for older patients with myeloid neoplasms. In this pilot randomized trial, the primary goal is to determine effect sizes. We propose to assess the preliminary efficacy of GO-EXCAP compared to a behavioral placebo control on physical function, patient-reported outcomes (fatigue, mood, and quality of life), and inflammatory markers in 100 patients aged ≥60 years with myeloid neoplasms receiving outpatient chemotherapy. METHODS GO-EXCAP consists of the EXCAP©® exercise prescription (daily home-based progressive aerobic walking and resistance exercises with rated perceived exercise of 5-8), EXCAP©® kit (i.e., activity tracker, resistance bands, print manual, bag), a mobile app, and an in-person or virtual session with the exercise physiologist to deliver exercise prescription. The intervention will last for three cycles of chemotherapy (approximately 12 weeks). The primary outcome measure will be physical function (Short Physical Performance Battery). Secondary outcome measures include fatigue (Brief Fatigue Inventory), mood (Center for Epidemiologic Studies Depression Scale), and quality of life (Functional Assessment of Cancer Therapy-Leukemia). Exploratory outcome measures include inflammatory markers. DISCUSSION Older adults with myeloid neoplasms receiving outpatient chemotherapy serve as an ideal model for studying an individually tailored mobile health exercise intervention in vulnerable older patients receiving cancer treatments to prevent physical function decline and improve symptoms.
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Affiliation(s)
- Kah Poh Loh
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Michelle Janelsins
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Heidi D Klepin
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston-Salem, NC, USA.
| | | | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Michael B Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Paula Vertino
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, USA.
| | - Martha Susiarjo
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Michael W Becker
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jane Liesveld
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jason H Mendler
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Eric Huselton
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Po-Ju Lin
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Karen Mustian
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
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16
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Lopez P, Newton RU, Taaffe DR, Singh F, Lyons-Wall P, Buffart LM, Tang C, Hayne D, Galvão DA. Interventions for Improving Body Composition in Men with Prostate Cancer: A Systematic Review and Network Meta-analysis. Med Sci Sports Exerc 2022; 54:728-740. [PMID: 34935706 DOI: 10.1249/mss.0000000000002843] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To perform a systematic review and network meta-analysis to investigate the most effective intervention for improving body composition outcomes in prostate cancer patients during or after treatment. METHODS A systematic search was undertaken in multiple databases from inception to December 2020. Randomized clinical trials examining the effects of exercise/physical activity and/or nutrition interventions on body composition and body weight measures in prostate cancer patients were included. The primary endpoints were both whole-body and regional fat mass and lean mass measures, with body weight and BMI as secondary outcomes. A frequentist random-effects network meta-analysis was undertaken to examine the clustering effect of intervention modalities or control groups on the outcomes of interest. The study protocol is publicly available on PROSPERO (CRD42020202339). RESULTS Fifty articles describing 47 trials (n = 3207) were included. Resistance training and combined resistance and aerobic exercise were the most effective interventions to reduce body fat percentage (-0.9%; 95% confidence interval [CI], -1.4% to -0.3%) and fat mass (-0.5 kg; 95% CI, -0.9 to -0.1 kg), respectively. For whole-body and regional lean mass, combined resistance and aerobic exercise + healthy diet (0.6 kg; 95% CI, 0.1 to 1.0 kg) and resistance training alone (0.7 kg, 95% CI: 0.4 to 1.0 kg) were the best intervention, respectively. A low-fat diet was the most effective for reducing body weight immediately after or at follow-up, while no intervention promoted significant reductions in BMI. CONCLUSIONS These results indicate that a resistance-based exercise program alone or combined with a general healthy diet are the most effective interventions for improving overall body composition in men with prostate cancer.
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Challenges of telemedical exercise management for cancer survivors during the COVID-19 pandemic. Support Care Cancer 2022; 30:9701-9702. [PMID: 35419734 PMCID: PMC9007624 DOI: 10.1007/s00520-022-07055-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/07/2022] [Indexed: 11/02/2022]
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18
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A single-arm pilot study of a mobile health exercise intervention (GO-EXCAP) in older patients with myeloid neoplasms. Blood Adv 2022; 6:3850-3860. [PMID: 35320340 PMCID: PMC9278283 DOI: 10.1182/bloodadvances.2022007056] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Our mobile health exercise intervention adapted for older patients with myeloid neoplasms is feasible, usable, and safe. Geriatric assessment domain impairments are highly prevalent; there is a need for supportive care interventions to mitigate toxicities.
Many older patients with myeloid neoplasms experience treatment-related toxicities. We previously demonstrated that a home-based, progressive aerobic walking and resistance exercise program (EXCAP) improved physical and psychological outcomes in patients with cancer. However, older patients have more difficulty adhering to exercise than younger patients. Reasons may include low motivation, difficulty with transportation, and limited access to exercise professionals. To improve exercise adherence, we integrated a mobile app with EXCAP (GO-EXCAP) and assessed its feasibility and usability in a single-arm pilot study among older patients with myeloid neoplasms undergoing outpatient chemotherapy. GO-EXCAP intervention lasts for 2 cycles of treatment, and the primary feasibility metric was data reporting on the app. Usability was evaluated via the system usability scale (SUS). Patients were interviewed at mid and postintervention to elicit their feedback, and deductive thematic analysis was applied to the transcripts. Twenty-five patients (mean age, 72 years) were recruited. Recruitment and retention rates were 64% and 88%, respectively. Eighty-two percent (18/22) of patients entered some exercise data on the app at least half of the study days, excluding hospitalization (a priori, we considered 70% as feasible). Averaged daily steps were 2848 and 3184 at baseline and after intervention, respectively. Patients also performed resistance exercises 26.2 minutes per day, 2.9 days per week at low intensity (rate of perceived exertion 3.8/10). Usability was above average (SUS, 70.3). In qualitative analyses, 3 themes were identified, including positive experience with the intervention, social interactions, and flexibility. The GO-EXCAP intervention is feasible and usable for older patients with myeloid neoplasms undergoing outpatient chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT04035499.
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Singh B, Zopf EM, Howden EJ. Effect and feasibility of wearable physical activity trackers and pedometers for increasing physical activity and improving health outcomes in cancer survivors: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:184-193. [PMID: 34314878 PMCID: PMC9068515 DOI: 10.1016/j.jshs.2021.07.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/13/2021] [Accepted: 06/24/2021] [Indexed: 05/16/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to evaluate the effect of wearable devices for improving physical activity and health-related outcomes in cancer survivors. METHODS CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, ScienceDirect, and SPORTDiscus databases were searched for randomized controlled trials published before September 1, 2020, that evaluated interventions involving wearable devices in cancer survivors. Standardized mean differences (SMDs) were calculated to assess effects on physical activity and health-related outcomes. Subgroup analyses were conducted to assess whether the effects differed by interventions and cancer characteristics. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS Thirty-five trials were included (breast cancer, n = 15, 43%). Intervention durations ranged between 4 weeks and 1 year. Most trials (n = 25, 71%) involved pedometer-based physical activity interventions. Seven (20%) involved Fitbit-based interventions, and 3 (9%) involved other wearable physical activity trackers (e.g., Polar, Garmin). Compared to usual care, wearable devices had moderate-to-large effects (SMD range 0.54-0.87, p < 0.001) on moderate-intensity physical activity, moderate-to-vigorous-intensity physical activity, total physical activity, and daily steps. Compared to usual care, those in the intervention had higher quality of life, aerobic fitness, physical function, and reduced fatigue (SMD range = 0.18-0.66, all p < 0.05). CONCLUSION Wearable physical activity trackers and pedometers are effective tools that increase physical activity and improve health-related outcomes in individuals with cancer. Identifying how these devices can be implemented for longer-term use with other intervention components remains an area for future research.
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Affiliation(s)
- Benjamin Singh
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD 4120, Australia.
| | - Eva M Zopf
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Erin J Howden
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
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20
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Tao G, Miller WC, Eng JJ, Esfandiari E, Imam B, Lindstrom H, Payne MW. Group-based telerehabilitation intervention using Wii Fit to improve walking in older adults with lower limb amputation (WiiNWalk): A randomized control trial. Clin Rehabil 2021; 36:331-341. [PMID: 34841917 DOI: 10.1177/02692155211061222] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Determine efficacy of the novel WiiNWalk intervention on walking-related outcomes in older adults with lower limb amputation. DESIGN Multi-site, parallel, evaluator-masked randomized controlled trial. SETTING Home-setting in three Canadian cities. PARTICIPANTS Community-dwelling lower limb prosthesis users over 50 years of age. INTERVENTIONS The WiiNWalk group (n = 38) used modified Wii Fit activities for prosthetic rehabilitation. The attention control group (n = 33) used Big Brain Academy: Wii Degree, comprising of cognitive activities. Both groups completed a 4-week supervised phase with three 1-h sessions/week in groups of three overseen by a clinician via videoconferencing and a 4-week unstructured and unsupervised phase. MAIN MEASURES Primary outcome was walking capacity (2 min walk test); secondary outcomes were balance confidence (activities-specific balance confidence scale), dynamic balance (four-step square test), and lower limb functioning (short physical performance battery). Outcomes were compared across time points with repeated measures analysis of covariance, adjusting for baseline and age. RESULTS Mean age was 65.0 (8.4) years, with 179.5 (223.5) months post-amputation and 80% transtibial amputation. No group difference in a 2 min walk test with an effect size: 1.53 95% CI [-3.17, 6.23] m. Activities balance confidence was greater in the WiiNWalk group by 5.53 [2.53, 8.52]%. No group difference in the four-step square test -0.16 [-1.25, 0.92] s, nor short physical performance battery 0.48 [-0.65, 1.61]. A post-hoc analysis showed the greatest difference in balance confidence immediately after an unsupervised phase. CONCLUSIONS The WiiNWalk intervention improved balance confidence, but not walking-related physical function in older adult lower limb prosthesis users. Future rehabilitation games should be specific to the amputation context.Clinical Trial Registration number, NCT01942798.
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Affiliation(s)
- Gordon Tao
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, 8166The University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - William C Miller
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Department of Occupational Science and Occupational Therapy, 8166The University of British Columbia, Vancouver, BC, Canada
| | - Janice J Eng
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Department of Physical Therapy, 8166The University of British Columbia, Vancouver, BC, Canada
| | - Elham Esfandiari
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, 8166The University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Research Lab, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Bita Imam
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, 8166The University of British Columbia, Vancouver, BC, Canada
| | - Heather Lindstrom
- Department of Physical Medicine & Rehabilitation, Faculty of Medicine, 3158University of Alberta, Edmonton, AB, Canada
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
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21
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Loh KP, Sanapala C, Di Giovanni G, Klepin HD, Janelsins M, Schnall R, Culakova E, Vertino P, Susiarjo M, Mendler JH, Liesveld JL, Lin PJ, Dunne RF, Kleckner I, Mustian K, Mohile SG. Developing and adapting a mobile health exercise intervention for older patients with myeloid neoplasms: A qualitative study. J Geriatr Oncol 2021; 12:909-914. [PMID: 33676900 PMCID: PMC8260435 DOI: 10.1016/j.jgo.2021.02.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Older patients with myeloid neoplasms (MN) receiving outpatient chemotherapy are at risk of experiencing treatment-related toxicities such as functional decline. A mobile health (mHealth) exercise intervention may ameliorate these toxicities. This qualitative study aimed to inform the design of a mHealth exercise intervention for this population. METHODS This was a qualitative study of thirteen patients aged ≥60 years receiving hypomethylating agents for MN. EXCAP©® is a home-based walking and progressive resistance exercise program. We combined EXCAP©® with a mobile app; the combination (GO-EXCAP Mobile App) has not been previously tested. A brief verbal description about the intervention was provided to the participants but they did not perform it. Participants were interviewed and inductive thematic analysis was used to analyze the data. RESULTS Mean age was 71.6 (SD 8.5). Three themes were identified: 1) Perceptions of the intervention feasibility, 2) Ways to leverage the app to deliver the exercise intervention, and 3) Personalized exercise goals. Walking and resistance exercises were perceived to be feasible. Patients were comfortable initiating the intervention in cycle 2 of chemotherapy, with exercise increments occurring from week 2-4 of the cycle. Ways to leverage the app to deliver EXCAP©® include 1) Video feature for exercise demonstration and interactions, and 2) Exercise data and symptom surveys to be communicated to the exercise physiologist and primary oncology team. Preservation of existing function and activity was an important goal to participants. CONCLUSIONS Our findings provide insights about the preferences of older adults with MN for a mHealth exercise intervention.
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Affiliation(s)
- Kah Poh Loh
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | | | | | - Heidi D Klepin
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston-Salem, NC, USA.
| | - Michelle Janelsins
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Eva Culakova
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Paula Vertino
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, USA.
| | - Martha Susiarjo
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jason H Mendler
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jane L Liesveld
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Po-Ju Lin
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Richard F Dunne
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Ian Kleckner
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Karen Mustian
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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22
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Viana RB, de Oliveira VN, Dankel SJ, Loenneke JP, Abe T, da Silva WF, Morais NS, Vancini RL, Andrade MS, de Lira CAB. The effects of exergames on muscle strength: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1592-1611. [PMID: 33797115 DOI: 10.1111/sms.13964] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/17/2022]
Abstract
This systematic review and meta-analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand-searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non-randomized exergame intervention studies with or without a non-exercise group and/or a "usual care intervention group" (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty-seven and 25 studies were included in the qualitative review and meta-analysis, respectively. The between-groups meta-analyses showed no significant differences between exergames and non-exercise control groups for handgrip strength in heathy/unhealthy middle-aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.
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Affiliation(s)
- Ricardo Borges Viana
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Scott J Dankel
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS, USA
| | | | - Naiane Silva Morais
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil
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23
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Lin AW, Baik SH, Aaby D, Tello L, Linville T, Alshurafa N, Spring B. eHealth Practices in Cancer Survivors With BMI in Overweight or Obese Categories: Latent Class Analysis Study. JMIR Cancer 2020; 6:e24137. [PMID: 33156810 PMCID: PMC7746487 DOI: 10.2196/24137] [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: 09/05/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 12/11/2022] Open
Abstract
Background eHealth technologies have been found to facilitate health-promoting practices among cancer survivors with BMI in overweight or obese categories; however, little is known about their engagement with eHealth to promote weight management and facilitate patient-clinician communication. Objective The objective of this study was to determine whether eHealth use was associated with sociodemographic characteristics, as well as medical history and experiences (ie, patient-related factors) among cancer survivors with BMI in overweight or obese categories. Methods Data were analyzed from a nationally representative cross-sectional survey (National Cancer Institute’s Health Information National Trends Survey). Latent class analysis was used to derive distinct classes among cancer survivors based on sociodemographic characteristics, medical attributes, and medical experiences. Logistic regression was used to examine whether class membership was associated with different eHealth practices. Results Three distinct classes of cancer survivors with BMI in overweight or obese categories emerged: younger with no comorbidities, younger with comorbidities, and older with comorbidities. Compared to the other classes, the younger with comorbidities class had the highest probability of identifying as female (73%) and Hispanic (46%) and feeling that clinicians did not address their concerns (75%). The older with comorbidities class was 6.5 times more likely than the younger with comorbidities class to share eHealth data with a clinician (odds ratio [OR] 6.53, 95% CI 1.08-39.43). In contrast, the younger with no comorbidities class had a higher likelihood of using a computer to look for health information (OR 1.93, 95% CI 1.10-3.38), using an electronic device to track progress toward a health-related goal (OR 2.02, 95% CI 1.08-3.79), and using the internet to watch health-related YouTube videos (OR 2.70, 95% CI 1.52-4.81) than the older with comorbidities class. Conclusions Class membership was associated with different patterns of eHealth engagement, indicating the importance of tailored digital strategies for delivering effective care. Future eHealth weight loss interventions should investigate strategies to engage younger cancer survivors with comorbidities and address racial and ethnic disparities in eHealth use.
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Affiliation(s)
- Annie Wen Lin
- Department of Nutrition, Benedictine University, Lisle, IL, United States.,Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Sharon H Baik
- Department of Supportive Care Medicine, City of Hope Medical Cancer Center, Duarte, CA, United States.,Department of Medical Social Sciences, Northwestern University, Chicago, IL, United States
| | - David Aaby
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Leslie Tello
- Department of Nutrition, Benedictine University, Lisle, IL, United States
| | - Twila Linville
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Nabil Alshurafa
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
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24
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Mikkelsen MK, Juhl CB, Lund CM, Jarden M, Vinther A, Nielsen DL. The effect of exercise-based interventions on health-related quality of life and physical function in older patients with cancer receiving medical antineoplastic treatments: a systematic review. Eur Rev Aging Phys Act 2020; 17:18. [PMID: 33088348 PMCID: PMC7574419 DOI: 10.1186/s11556-020-00250-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/08/2020] [Indexed: 12/25/2022] Open
Abstract
Older patients with cancer are underrepresented in trials investigating the effect of exercise therapy. The aim of this systematic review was to investigate the effect of exercise therapy during medical antineoplastic treatment in older patients (≥ 65 years) with cancer. A systematic review following the Cochrane guidelines was performed. Randomized controlled trials were identified through a systematic literature search in MEDLINE, EMBASE, CENTRAL, and CINAHL up to December 2019. Study selection was performed independently by two reviewers. Four randomized controlled trials published between 2014 and 2019 were included comprising a total of 412 participants. Most participants were diagnosed with breast, prostate or colorectal cancer. The studies were characterized by large differences in design, interventions and outcomes, which prevented meta-analyses. The interventions ranged from 4 weeks to 12 months and involved both supervised and unsupervised exercise programs. Some evidence of beneficial effects from the interventions were documented on physical function, muscle strength, physical activity and cognitive function. No evidence of effects was found for health-related quality of life, aerobic capacity, body composition, cancer-related symptoms and side effects, or for any clinical outcomes. No adverse events were reported. Exercise therapy seems to be safe and feasible in older patients with cancer. However, due to a limited number of studies, small sample sizes and heterogeneity across study design, the effects of exercise in older patients with cancer receiving medical antineoplastic treatment are inconclusive.
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Affiliation(s)
- Marta Kramer Mikkelsen
- Department of Oncology and Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.,Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Carsten Bogh Juhl
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Cecilia Margareta Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Mary Jarden
- Department of Oncology and Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark.,QD-Research Unit, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Dorte Lisbet Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
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Logan L, Toohey K, Kavanagh PS, Paterson C, McKune AJ. The Effect of Exercise on Body Composition and Physical Performance in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy (ADT): A Narrative Synthesis. Semin Oncol Nurs 2020; 36:151067. [PMID: 33010982 DOI: 10.1016/j.soncn.2020.151067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This review sought to synthesize evidence examining the effect of exercise on prostate cancer patients undergoing androgen deprivation therapy (ADT). DATA SOURCES A systematic literature search was conducted in electronic databases (CINAHL, MEDLINE, APA PsychINFO, Scopus, SPORTDiscus, and Cochrane Library) from their inception to March 31, 2020. Inclusion criteria were randomized controlled trials (RCTs) testing the effect of exercise on body composition, muscle strength and physical performance. Fourteen RCTs were included. Participant numbers within the individual RCTs ranged from 19 to 163 with heterogeneity in prostate cancer stage (localized and locally advanced diagnoses) with age of participants ranging from 43 to 90 years. The length of the interventions ranged from 12 weeks to 12 months, with the number of sessions per week ranging from 2 to 5. Resistance training intensity ranged from 60% to 90% 1RM and the aerobic training ranged from 60% to 90% HRmax. CONCLUSIONS Resistance training and sport (football) in the form of small sided games (SSGs) played an important role in preserving bone mineral density and lean mass as well as improving muscle strength and physical performance outcomes in men affected by prostate cancer undergoing ADT. IMPLICATIONS FOR NURSING PRACTICE Multimodal exercise, including resistance exercise and activity that includes repeated sprints (SSGs), benefit the maintenance of bone mineral density and lean mass as well as increase strength and physical performance in men affected by prostate cancer undergoing ADT. Based on this evidence, nurses should coordinate timely referrals to qualified exercise physiologists or physiotherapist with expertise in cancer care.
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Affiliation(s)
- Lucas Logan
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Kellie Toohey
- Faculty of Health, University of Canberra, Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise, Survivorship (PACES) Research Group, University of Canberra, Canberra, Australia
| | - Phillip S Kavanagh
- Faculty of Health, University of Canberra, Canberra, Australia; Justice and Society, University of South Australia, Magill SA, Australia
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise, Survivorship (PACES) Research Group, University of Canberra, Canberra, Australia
| | - Andrew J McKune
- Faculty of Health, University of Canberra, Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise, Survivorship (PACES) Research Group, University of Canberra, Canberra, Australia; Research Institute for Sport and Exercise (UCRISE), Faculty of Health, University of Canberra, Canberra ACT, Australia; Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
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Schaffer K, Panneerselvam N, Loh KP, Herrmann R, Kleckner IR, Dunne RF, Lin PJ, Heckler CE, Gerbino N, Bruckner LB, Storozynsky E, Ky B, Baran A, Mohile SG, Mustian KM, Fung C. Systematic Review of Randomized Controlled Trials of Exercise Interventions Using Digital Activity Trackers in Patients With Cancer. J Natl Compr Canc Netw 2020; 17:57-63. [PMID: 30659130 DOI: 10.6004/jnccn.2018.7082] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/07/2018] [Indexed: 12/12/2022]
Abstract
Background: Exercise can ameliorate cancer- and treatment-related toxicities, but poor adherence to exercise regimens is a barrier. Exercise interventions using digital activity trackers (E-DATs) may improve exercise adherence, but data are limited for patients with cancer. We conducted a systematic review examining the feasibility of E-DATs in cancer survivors and effects on activity level, body composition, objective fitness outcomes, health-related quality of life (HRQoL), self-reported symptoms, and biomarkers. Methods: We identified randomized controlled trials (RCTs) of E-DATs in adult cancer survivors published in English between January 1, 2008, and July 27, 2017. Two authors independently reviewed article titles (n=160), removed duplicates (n=50), and reviewed the remaining 110 articles for eligibility. Results: A total of 12 RCTs met eligibility criteria, including 1,450 patients (mean age, 50-70 years) with the following cancers: breast (n=5), colon or breast (n=2), prostate (n=1), acute leukemia (n=1), or others (n=3). Duration of E-DATs ranged from 4 to 24 weeks, and the follow-up period ranged from 4 to 52 weeks, with retention rates of 54% to 95%. The technology component of E-DATs included pedometers (n=8); pedometers with smartphone application (n=1), Wii Fit (n=1), heart rate monitor (n=1); and a wireless sensor with accelerometer, gyroscope, and magnetometer (n=1). Adherence by at least one measure to E-DATs was >70% in 8 of 8 RCTs. Compared with controls, E-DATs significantly improved patients' step count in 3 of 5 RCTs, activity level in 6 of 9 RCTs, and HRQoL in 7 of 9 RCTs (all P≤05), with no significant changes in biomarkers (eg, interleukin 6, tumor necrosis factor α, C-reactive protein, c-peptide, lipid panel) in 3 RCTs. Duration of E-DAT was not significantly correlated with adherence or study retention. Conclusions: This systematic review shows that E-DATs are feasible to implement in cancer survivors. Future research should examine the optimal type, dose, and schedule of E-DATs for cancer survivors.
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Farrington N, Richardson A, Bridges J. Interventions for older people having cancer treatment: A scoping review. J Geriatr Oncol 2020; 11:769-783. [DOI: 10.1016/j.jgo.2019.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/24/2019] [Accepted: 09/25/2019] [Indexed: 01/05/2023]
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Loh KP, Kleckner IR, Lin PJ, Mohile SG, Canin BE, Flannery MA, Fung C, Dunne RF, Bautista J, Culakova E, Kleckner AS, Peppone LJ, Janelsins M, McHugh C, Conlin A, Cho JK, Kasbari S, Esparaz BT, Kuebler JP, Mustian KM. Effects of a Home-based Exercise Program on Anxiety and Mood Disturbances in Older Adults with Cancer Receiving Chemotherapy. J Am Geriatr Soc 2020; 67:1005-1011. [PMID: 31034591 DOI: 10.1111/jgs.15951] [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: 01/23/2019] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVE Exercise interventions improve anxiety and mood disturbances in patients with cancer. However, studies are limited in older adults with cancer. We assessed the effects of exercise on anxiety, mood, and social and emotional well-being in older patients with cancer during their first 6 weeks of chemotherapy. DESIGN Exploratory secondary analysis of a randomized controlled trial (RCT). SETTING Community oncology practices. PARTICIPANTS Older patients (aged 60 years or older) undergoing chemotherapy (N = 252). INTERVENTION Patients were randomized to Exercise for Cancer Patients (EXCAP) or usual care (control) for the first 6 weeks of chemotherapy. EXCAP is a home-based, low- to moderate-intensity progressive walking and resistance training program. MEASUREMENTS Analysis of covariance, with study arm as the factor, baseline value as the covariate, and study arm × baseline interaction, was used to evaluate arm effects on postintervention anxiety (State Trait Anxiety Inventory [STAI]), mood (Profile of Mood States [POMS]), and social and emotional well-being (Functional Assessment of Cancer Therapy-General subscales) after 6 weeks. RESULTS Median age was 67 years; 77% had breast cancer. Statistically significant group differences were observed in the STAI score (P = .001), POMS score (P = .022), social well-being (P = .002), and emotional well-being (P = .048). For each outcome, EXCAP patients with worse baseline scores had larger improvements at 6 weeks; these improvements were clinically significant for STAI score and social well-being. CONCLUSIONS Among older cancer patients receiving chemotherapy, a 6-week structured exercise program improved anxiety and mood, especially among those participants with worse baseline symptoms. Additional RCTs are needed to confirm these findings and evaluate the appropriate exercise prescription for managing anxiety, mood, and well-being in this patient population. J Am Geriatr Soc 67:1005-1011, 2019.
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Affiliation(s)
- Kah Poh Loh
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Ian R Kleckner
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Po-Ju Lin
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Supriya G Mohile
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Beverly E Canin
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Marie A Flannery
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Chunkit Fung
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Richard F Dunne
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Javier Bautista
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Eva Culakova
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Amber S Kleckner
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Luke J Peppone
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Michelle Janelsins
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Colin McHugh
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Alison Conlin
- Pacific Cancer Research Consortium National Cancer Institute Community Oncology Research Program (NCORP), Seattle, Washington
| | - Jonathan K Cho
- Hawaii Minority Underserved National Cancer Institute Community Oncology Research Program (NCORP), Honolulu, Hawaii
| | - Sameer Kasbari
- Southeast Clinical Oncology Research Consortium, Winston-Salem, North Carolina
| | - Benjamin T Esparaz
- Heartland National Cancer Institute Community Oncology Research Program (NCORP), Decatur, Illinois
| | - J Philip Kuebler
- Columbus National Cancer Institute Community Oncology Research Program (NCORP), Columbus, Ohio
| | - Karen M Mustian
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
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Geerkens MJM, Pouwels NSA, Beerlage HP. The effectiveness of lifestyle interventions to reduce side effects of androgen deprivation therapy for men with prostate cancer: a systematic review. Qual Life Res 2020; 29:843-865. [PMID: 31832978 PMCID: PMC7142057 DOI: 10.1007/s11136-019-02361-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this review is to systematically review randomized controlled trials on lifestyle interventions on PCa patients undergoing androgen deprivation therapy. METHODS A literature search was conducted using the electronic databases Medline and PubMed. To be eligible, studies had to be randomized controlled trials (RCTs) that focused on side effects of ADT and lifestyle interventions to reduce side effects for men undergoing ADT with PCa. Lifestyle interventions were defined as interventions that included any dietary or behavioral components. RESULTS Twenty-nine trials were included. Most of them focused on exercise interventions, while some investigated the effect of dietary or behavioral interventions. The effect of different lifestyle influencing modalities aimed to improve on the adverse effects of ADT varied greatly. CONCLUSIONS It is not possible to draw one conclusion on the effect of exercise-based interventions, but noted on several adverse effects of ADT improvement. Further studies are necessary to develop personalized lifestyle interventions in order to mitigate the adverse effects.
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Affiliation(s)
- Maud J M Geerkens
- Urology Department, Amsterdam UMC locatie AMC Netherlands, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Nieck S A Pouwels
- Urology Department, Amsterdam UMC locatie AMC Netherlands, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Harry P Beerlage
- Urology Department, Amsterdam UMC locatie AMC Netherlands, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Cormie P, Zopf EM. Exercise medicine for the management of androgen deprivation therapy-related side effects in prostate cancer. Urol Oncol 2020; 38:62-70. [DOI: 10.1016/j.urolonc.2018.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 07/23/2018] [Accepted: 10/03/2018] [Indexed: 12/23/2022]
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Neil-Sztramko SE, Medysky ME, Campbell KL, Bland KA, Winters-Stone KM. Attention to the principles of exercise training in exercise studies on prostate cancer survivors: a systematic review. BMC Cancer 2019; 19:321. [PMID: 30953460 PMCID: PMC6451299 DOI: 10.1186/s12885-019-5520-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/25/2019] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this review is to update previously published reviews on exercise programming in exercise trials in prostate cancer survivors. We evaluated: 1) the application of the principles of exercise training in prescribed programs; 2) the reporting of the components of the exercise prescription; and 3) the reporting of adherence of participants to the prescribed programs. Methods Building upon a previous review, a systematic review was conducted searching OVID Medline, Embase, CINAHL, and SPORTDiscus databases from 2012-2017. Randomized controlled trials of at least four weeks of aerobic and/or resistance exercise in men diagnosed with prostate cancer that reported physical fitness outcomes, including body composition were eligible for inclusion. Results Specificity was appropriately applied by 93%, progression by 55%, overload by 48%, initial values by 55%, and diminishing returns by 28% of eligible studies. No study adequately applied the principle of reversibility. Most (79%) studies reported all components of the exercise prescription in the study methods, but no study reported all components of adherence to the prescribed intervention in the study results. Conclusions Application of standard exercise training principles is inadequate in exercise trials in men with prostate cancer and could possibly lead to an inadequate exercise stimulus. While many studies report the basic components of the exercise prescription in their study methods, full reporting of actual exercise completed is needed to advance our understanding of the optimal exercise dose for men with prostate cancer and promote translation of controlled trials to practice.
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Affiliation(s)
- Sarah E Neil-Sztramko
- School of Nursing, McMaster University, 175 Longwood Road S, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
| | - Mary E Medysky
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelcey A Bland
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Kerri M Winters-Stone
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA.,Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
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Kiss N, Baguley BJ, Ball K, Daly RM, Fraser SF, Granger CL, Ugalde A. Technology-Supported Self-Guided Nutrition and Physical Activity Interventions for Adults With Cancer: Systematic Review. JMIR Mhealth Uhealth 2019; 7:e12281. [PMID: 30747720 PMCID: PMC6390188 DOI: 10.2196/12281] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/08/2018] [Accepted: 11/13/2018] [Indexed: 12/20/2022] Open
Abstract
Background Nutrition and physical activity interventions are important components of cancer care. With an increasing demand for services, there is a need to consider flexible, easily accessible, and tailored models of care while maintaining optimal outcomes. Objective This systematic review describes and appraises the efficacy of technology-supported self-guided nutrition and physical activity interventions for people with cancer. Methods A systematic search of multiple databases from 1973 to July 2018 was conducted for randomized and nonrandomized trials investigating technology-supported self-guided nutrition and physical activity interventions. Risk of bias was assessed using the Cochrane Risk of Bias tool. Outcomes included behavioural, health-related, clinical, health service, or financial measures. Results Sixteen randomized controlled trials representing 2684 participants were included. Most studies were web-based interventions (n=9) and had a 12-week follow-up duration (n=8). Seven studies assessed dietary behaviour, of which two reported a significant benefit on diet quality or fruit and vegetable intake. Fifteen studies measured physical activity behaviour, of which eight studies reported a significant improvement in muscle strength and moderate-to-vigorous physical activity. Four of the nine studies assessing the health-related quality of life (HRQoL) reported a significant improvement in global HRQoL or a domain subscale. A significant improvement in fatigue was found in four of six studies. Interpretation of findings was influenced by inadequate reporting of intervention description and compliance. Conclusions This review identified short-term benefits of technology-supported self-guided interventions on the physical activity level and fatigue and some benefit on dietary behaviour and HRQoL in people with cancer. However, current literature demonstrates a lack of evidence for long-term benefit. Trial Registration PROSPERO CRD42017080346; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=80346
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Affiliation(s)
- Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Brenton James Baguley
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Catherine L Granger
- School of Physiotherapy, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Australia
| | - Anna Ugalde
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Australia
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A Behavioral Physical Activity Intervention to Manage Moderate and Severe Fatigue Among Head and Neck Cancer Patients—Pre-efficacy Study in the National Institutes of Health ORBIT Model. Cancer Nurs 2019; 42:E1-E14. [DOI: 10.1097/ncc.0000000000000568] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Tough D, Robinson J, Gowling S, Raby P, Dixon J, Harrison SL. The feasibility, acceptability and outcomes of exergaming among individuals with cancer: a systematic review. BMC Cancer 2018; 18:1151. [PMID: 30463615 PMCID: PMC6249900 DOI: 10.1186/s12885-018-5068-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 11/08/2018] [Indexed: 11/25/2022] Open
Abstract
Background Individuals with cancer have reduced quality of life, functionality, range of motion, strength, and an increase in pain and fatigue. Exergaming appears to be an effective rehabilitation tool for Parkinson’s disease, multiple sclerosis and post-stroke patients to improve functionality, balance and quality of life; however, the usefulness of exergaming in individuals with cancer is unknown. The aim of this systematic review is to describe exergaming interventions delivered to adults with a current or previous cancer diagnosis and to report the feasibility, acceptability and outcomes of such interventions. Methods Studies reporting on exergaming interventions delivered to individuals with a current or previous cancer diagnosis were included. 12 electronic databases were searched. Eight articles (seven interventions) were identified. Data were extracted and assessed for quality by two reviewers. Results Three interventions were delivered at hospital, two at home, one at a clinical laboratory, and one did not report. Two interventions were delivered by a physiotherapist, two by an occupational therapist, and one by a nurse, research staff and an exercise physiologist. The Nintendo Wii was used in four of seven studies, whilst the remaining three used the IREX system, BrightArm Duo Rehabilitation System or a custom made exergame. Studies showed that most participants enjoyed the exergaming intervention, and would recommend their use, with some preferring exergaming over standard care interventions. Adherence rates and enjoyment appear greater during exergaming than standard care. Exergaming interventions appear to support improvements balance, function, physical activity levels, strength, fatigue, emotions, cognition and pain. Conclusion Exergaming interventions delivered to individuals with cancer show great heterogeneity; differing in duration, frequency and gaming platform. The disease stage and severity of those included, and the outcome measures assessed also vary widely making it difficult to conclude its effectiveness at this time. However, adherence rates and enjoyment appear greater during exergaming compared to standard care, supporting the feasibility and acceptability of this type of intervention delivery for adults with cancer.
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Affiliation(s)
- Daniel Tough
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK.
| | - Jonathan Robinson
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Steven Gowling
- Department of Sport and Exercise Sciences, University of Sunderland, Sunderland, SR1 3SD, UK
| | - Peter Raby
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - John Dixon
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Samantha L Harrison
- School of Health and Social Care, Teesside University, Middlesbrough, TS1 3BX, UK
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Turner RR, Steed L, Quirk H, Greasley RU, Saxton JM, Taylor SJC, Rosario DJ, Thaha MA, Bourke L. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev 2018; 9:CD010192. [PMID: 30229557 PMCID: PMC6513653 DOI: 10.1002/14651858.cd010192.pub3] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND This is an updated version of the original Cochrane Review published in the Cochrane Library 2013, Issue 9. Despite good evidence for the health benefits of regular exercise for people living with or beyond cancer, understanding how to promote sustainable exercise behaviour change in sedentary cancer survivors, particularly over the long term, is not as well understood. A large majority of people living with or recovering from cancer do not meet current exercise recommendations. Hence, reviewing the evidence on how to promote and sustain exercise behaviour is important for understanding the most effective strategies to ensure benefit in the patient population and identify research gaps. OBJECTIVES To assess the effects of interventions designed to promote exercise behaviour in sedentary people living with and beyond cancer and to address the following secondary questions: Which interventions are most effective in improving aerobic fitness and skeletal muscle strength and endurance? Which interventions are most effective in improving exercise behaviour amongst patients with different cancers? Which interventions are most likely to promote long-term (12 months or longer) exercise behaviour? What frequency of contact with exercise professionals and/or healthcare professionals is associated with increased exercise behaviour? What theoretical basis is most often associated with better behavioural outcomes? What behaviour change techniques (BCTs) are most often associated with increased exercise behaviour? What adverse effects are attributed to different exercise interventions? SEARCH METHODS We used standard methodological procedures expected by Cochrane. We updated our 2013 Cochrane systematic review by updating the searches of the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, Embase, AMED, CINAHL, PsycLIT/PsycINFO, SportDiscus and PEDro up to May 2018. We also searched the grey literature, trial registries, wrote to leading experts in the field and searched reference lists of included studies and other related recent systematic reviews. SELECTION CRITERIA We included only randomised controlled trials (RCTs) that compared an exercise intervention with usual care or 'waiting list' control in sedentary people over the age of 18 with a homogenous primary cancer diagnosis. DATA COLLECTION AND ANALYSIS In the update, review authors independently screened all titles and abstracts to identify studies that might meet the inclusion criteria, or that could not be safely excluded without assessment of the full text (e.g. when no abstract is available). We extracted data from all eligible papers with at least two members of the author team working independently (RT, LS and RG). We coded BCTs according to the CALO-RE taxonomy. Risk of bias was assessed using the Cochrane's tool for assessing risk of bias. When possible, and if appropriate, we performed a fixed-effect meta-analysis of study outcomes. If statistical heterogeneity was noted, a meta-analysis was performed using a random-effects model. For continuous outcomes (e.g. cardiorespiratory fitness), we extracted the final value, the standard deviation (SD) of the outcome of interest and the number of participants assessed at follow-up in each treatment arm, to estimate the standardised mean difference (SMD) between treatment arms. SMD was used, as investigators used heterogeneous methods to assess individual outcomes. If a meta-analysis was not possible or was not appropriate, we narratively synthesised studies. The quality of the evidence was assessed using the GRADE approach with the GRADE profiler. MAIN RESULTS We included 23 studies in this review, involving a total of 1372 participants (an addition of 10 studies, 724 participants from the original review); 227 full texts were screened in the update and 377 full texts were screened in the original review leaving 35 publications from a total of 23 unique studies included in the review. We planned to include all cancers, but only studies involving breast, prostate, colorectal and lung cancer met the inclusion criteria. Thirteen studies incorporated a target level of exercise that could meet current recommendations for moderate-intensity aerobic exercise (i.e.150 minutes per week); or resistance exercise (i.e. strength training exercises at least two days per week).Adherence to exercise interventions, which is crucial for understanding treatment dose, is still reported inconsistently. Eight studies reported intervention adherence of 75% or greater to an exercise prescription that met current guidelines. These studies all included a component of supervision: in our analysis of BCTs we designated these studies as 'Tier 1 trials'. Six studies reported intervention adherence of 75% or greater to an aerobic exercise goal that was less than the current guideline recommendations: in our analysis of BCTs we designated these studies as 'Tier 2 trials.' A hierarchy of BCTs was developed for Tier 1 and Tier 2 trials, with programme goal setting, setting of graded tasks and instruction of how to perform behaviour being amongst the most frequent BCTs. Despite the uncertainty surrounding adherence in some of the included studies, interventions resulted in improvements in aerobic exercise tolerance at eight to 12 weeks (SMD 0.54, 95% CI 0.37 to 0.70; 604 participants, 10 studies; low-quality evidence) versus usual care. At six months, aerobic exercise tolerance was also improved (SMD 0.56, 95% CI 0.39 to 0.72; 591 participants; 7 studies; low-quality evidence). AUTHORS' CONCLUSIONS Since the last version of this review, none of the new relevant studies have provided additional information to change the conclusions. We have found some improved understanding of how to encourage previously inactive cancer survivors to achieve international physical activity guidelines. Goal setting, setting of graded tasks and instruction of how to perform behaviour, feature in interventions that meet recommendations targets and report adherence of 75% or more. However, long-term follow-up data are still limited, and the majority of studies are in white women with breast cancer. There are still a considerable number of published studies with numerous and varied issues related to high risk of bias and poor reporting standards. Additionally, the meta-analyses were often graded as consisting of low- to very low-certainty evidence. A very small number of serious adverse effects were reported amongst the studies, providing reassurance exercise is safe for this population.
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Affiliation(s)
- Rebecca R Turner
- Sheffield Hallam UniversityCentre for Sport and Exercise ScienceA124 Collegiate Hall, Collegiate CrescentSheffieldSouth YorkshireUKS10 2BP
| | - Liz Steed
- Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonCentre for Primary Care and Public HealthBlizard Institute, Yvonne Carter Building58 Turner StreetLondonUKE1 2AT
| | - Helen Quirk
- Sheffield Hallam UniversityCentre for Sport and Exercise ScienceA124 Collegiate Hall, Collegiate CrescentSheffieldSouth YorkshireUKS10 2BP
| | - Rosa U Greasley
- Sheffield Hallam UniversityCentre for Sport and Exercise ScienceA124 Collegiate Hall, Collegiate CrescentSheffieldSouth YorkshireUKS10 2BP
| | - John M Saxton
- Northumbria UniversityDepartment of Sport, Exercise, and RehabilitationNewcastle‐upon‐TyneUKNE1 8ST
| | - Stephanie JC Taylor
- Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonCentre for Primary Care and Public Health and Asthma UK Centre for Applied ResearchYvonne Carter Building58 Turner StreetLondonUKE1 2AB
| | - Derek J Rosario
- University of SheffieldDepartment of OncologyBeech Hill RoadRoyal Hallamshire HospitalSheffieldUKS010 2RX
| | - Mohamed A Thaha
- Barts & The London School of Medicine & Dentistry, Queen Mary University LondonAcademic Surgical Unit, National Centre for Bowel Research & Surgical Innovation, Centre for Digestive Diseases, Blizard Institute1st Floor, Abernethy Building, 2 Newark StreetThe Royal London Hospital, WhitechapelLondonEnglandUKE1 2AT
| | - Liam Bourke
- Sheffield Hallam UniversityHealth and Wellbeing Research InstituteSheffieldUKS10 2BP
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Groen WG, van Harten WH, Vallance JK. Systematic review and meta-analysis of distance-based physical activity interventions for cancer survivors (2013-2018): We still haven't found what we're looking for. Cancer Treat Rev 2018; 69:188-203. [PMID: 30077954 DOI: 10.1016/j.ctrv.2018.07.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Physically active cancer survivors have a reduced risk of cancer recurrence and mortality. Given the health advantages of active lifestyles in cancer survivorship, as well as the barriers preventing physical activity (e.g., geography, time) there is a need to develop and evaluate effective physical activity interventions that employ distance-based (i.e., non face-to-face) approaches. The primary objective of this study was to provide a systematic review and meta-analysis of present-day (2013-2018) distance-based physical activity behaviour change interventions for cancer survivors. METHODS PubMed and Embase databases were searched from November 2012 up to June 2018. Studies were included that met the following criteria: (1) written in English, (2) included adult cancer survivors (either undergoing or completed treatment), (3) was a controlled intervention study, and (4) the intervention was distance-based (delivered via distance) with no more than one face-to-face contact. Review Manager 5 (RevMan 5) software was used to perform a meta-analysis on all randomized controlled trials (RCTs) that presented self-reported or objectively measured physical activity post-intervention means and standard deviations. Risk of bias for each study was assessed using The Cochrane Risk of Bias Tool. RESULTS We included 29 RCTs. Across the 29 studies, the total number of participants in these studies was 5218. Median sample size was 95 and ranged from 19 to 463. Thirteen (45%) studies focused on breast cancer survivors and median months since diagnosis was 24 (range 6-79). Moderate-to-vigorous intensity physical activity data from 24 RCTs were included in the meta-analysis and indicated an overall small effect (standardized mean difference) of 0.21 (95% CI 0.11-0.32) favoring the interventions. CONCLUSIONS Intervention effects on physical activity were small. Drawing conclusions from these trials remains challenging given major limitations of these trials included poor methodological design, small sample sizes, lack of statistical power, homogeneous samples (e.g., caucasian, young, well-educated), and poor measures of physical activity (e.g., self-report). Relying on the present landscape of distance-based programs aiming to facilitate physical activity among cancer survivors may not be prudent.
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Affiliation(s)
- Wim G Groen
- Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Wim H van Harten
- Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands; Rijnstate Hospital, Arnhem, The Netherlands.
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Alberta, Canada.
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Finlay A, Wittert G, Short CE. A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer. J Cancer Surviv 2018; 12:571-591. [PMID: 29770953 DOI: 10.1007/s11764-018-0694-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/07/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Men who are survivors of prostate cancer report a variety of psychological and physical factors contributing to a lower quality of life, and physical activity can assist to mitigate these issues. This review aims to provide a summary of physical activity behaviour change trials targeting prostate cancer survivors, assess the feasibility of these interventions and, if possible, identify intervention and study characteristics associated with significant intervention effects. METHOD Four databases (PubMed, CINAHL, PsycINFO and EMBASE) were systematically searched for randomised controlled trials containing at least one behavioural outcome relating to physical activity published up until July 2016. Forward and backwards, hand, key author citation searching and known research were also considered. RESULTS From a total of 13, 828 titles, the search resulted in 12 studies (6 prostate cancer only and 6 mixed cancer interventions), eight of which found positive results most often related immediately to post-intervention aerobic activity. Factors relating to efficacy were not conclusive due to the heterogeneity of studies and lack of cancer-specific data in mixed cancer trials. Future research focusing on intervention reach, maintenance of intervention effects and resistance training outcomes is needed. CONCLUSION There is preliminary evidence to suggest that a variety of physical activity behaviour change interventions targeting men with a history of prostate cancer can be efficacious, at least in the short term. Experimental studies are required to identify key intervention features. IMPLICATIONS FOR CANCER SURVIVORS Physical activity interventions can assist prostate cancer survivors in relation to short-term lifestyle change, though more evidence is required to improve the clarity of factors related to efficacy.
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Affiliation(s)
- A Finlay
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia.
| | - G Wittert
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia
| | - C E Short
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia
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Hallward L, Patel N, Duncan LR. Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review. J Health Psychol 2018; 25:105-122. [PMID: 29446325 DOI: 10.1177/1359105318756501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.
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Yusuf N, Jatoi A. Cancer-associated weight loss: releasing its firm grip on negative clinical outcomes. Curr Opin Support Palliat Care 2017; 11:259-260. [PMID: 28914643 PMCID: PMC5656501 DOI: 10.1097/spc.0000000000000297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Naima Yusuf
- Postbaccalaureate Program, Mayo Clinic, Rochester, Minnesota
| | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, Rochester, Minnesota
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Bridges J, Lucas G, Wiseman T, Griffiths P. Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review. BMJ Open 2017; 7:e016127. [PMID: 28760795 PMCID: PMC5642668 DOI: 10.1136/bmjopen-2017-016127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To provide an overview of the evidence base on the effectiveness of workforce interventions for improving the outcomes for older people with cancer, as well as analysing key features of the workforce associated with those improvements. DESIGN Systematic review. METHODS Relevant databases were searched for primary research, published in English, reporting on older people and cancer and the outcomes of interventions to improve workforce knowledge, attitudes or skills; involving a change in workforce composition and/or skill mix; and/or requiring significant workforce reconfiguration or new roles. Studies were also sought on associations between the composition and characteristics of the cancer care workforce and older people's outcomes. A narrative synthesis was conducted and supported by tabulation of key study data. RESULTS Studies (n=24) included 4555 patients aged 60+ from targeted cancer screening to end of life care. Interventions were diverse and two-thirds of the studies were assessed as low quality. Only two studies directly targeted workforce knowledge and skills and only two studies addressed the nature of workforce features related to improved outcomes. Interventions focused on discrete groups of older people with specific needs offering guidance or psychological support were more effective than those broadly targeting survival outcomes. Advanced Practice Nursing roles, voluntary support roles and the involvement of geriatric teams provided some evidence of effectiveness. CONCLUSIONS An array of workforce interventions focus on improving outcomes for older people with cancer but these are diverse and thinly spread across the cancer journey. Higher quality and larger scale research that focuses on workforce features is now needed to guide developments in this field, and review findings indicate that interventions targeted at specific subgroups of older people with complex needs, and that involve input from advanced practice nurses, geriatric teams and trained volunteers appear most promising.
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Affiliation(s)
- Jackie Bridges
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex
| | - Grace Lucas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Theresa Wiseman
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- The Royal Marsden NHS Foundation Trust
| | - Peter Griffiths
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex
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Maggiore R, Zumsteg ZS, BrintzenhofeSzoc K, Trevino KM, Gajra A, Korc-Grodzicki B, Epstein JB, Bond SM, Parker I, Kish JA, Murphy BA, VanderWalde NA. The Older Adult With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma: Knowledge Gaps and Future Direction in Assessment and Treatment. Int J Radiat Oncol Biol Phys 2017; 98:868-883. [PMID: 28602414 DOI: 10.1016/j.ijrobp.2017.02.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/23/2017] [Accepted: 02/13/2017] [Indexed: 02/06/2023]
Abstract
Older adults with head and neck squamous cell carcinoma (HNSCC) pose unique treatment and supportive care challenges to oncologists and other cancer care providers. The majority of patients with HNSCC present with locoregionally advanced disease, for which combined-modality treatment integrating chemotherapy and radiation therapy is often necessary to maximize tumor control. However, applying these approaches to an older population with concomitant comorbidities and a higher risk of functional impairments remains challenging and is exacerbated by the paucity of studies involving older adults. The purpose of this article is to identify knowledge gaps in the evaluation and management of older adults with HNSCC-particularly those undergoing concurrent chemoradiation therapy-and their caregivers through a review of the literature conducted by clinicians, researchers, and patient advocates. The findings highlight the importance of a geriatric assessment and the therapeutic paradigms and challenges relevant to this population. Furthermore, we identify the need for additional research and interventions related to key supportive care issues that arise during and after treatment in older adults with locoregionally advanced HNSCC. On the basis of our findings, we prioritize these issues to guide future patient-oriented research endeavors to address these knowledge gaps and thus better serve this growing patient population.
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Affiliation(s)
- Ronald Maggiore
- Division of Hematology/Oncology, Department of Medicine, University of Rochester, Rochester, New York
| | - Zachary S Zumsteg
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Kelly M Trevino
- Department of Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Ajeet Gajra
- Division of Hematology/Oncology, Department of Medicine, SUNY Upstate Medical University Cancer Center, Syracuse, New York
| | | | - Joel B Epstein
- Department of Oral Medicine and Diagnostic Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Stewart M Bond
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Ira Parker
- University of California, San Diego School of Medicine, La Jolla, California
| | - Julie A Kish
- Division of Hematology/Oncology, Department of Medicine, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Barbara A Murphy
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Noam A VanderWalde
- Department of Radiation Oncology, University of Tennessee Health Science Center-West Cancer Center, Memphis, Tennessee.
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Yunfeng G, Weiyang H, Xueyang H, Yilong H, Xin G. Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy: An update meta-analysis. Medicine (Baltimore) 2017; 96:e7368. [PMID: 28682886 PMCID: PMC5502159 DOI: 10.1097/md.0000000000007368] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) patients initiating androgen deprivation therapy (ADT) are suffering from adverse effects; exercise has been proposed as a treatment to relieve adverse effects of ADT, available meta-analysis has proved exercise improves quality of life, and therapy caused fatigue; recently, some high-quality trials have been conducted in order to get more assessment; we conduct an updated meta-analysis to evaluate feasibility that exercise relieves adverse effects in PCa patients initiating ADT. MATERIALS AND METHODS A systematic article search was performed from Cochrane Library, MEDLINE, EMBASE, and PubMed databases up to March 10, 2017. Outcomes included changes in body composition, physical function, bone health and cardiometabolic changes. We conduct subgroup analysis to analyze the duration and type of exercise correlated with the effect and calculated using standard mean difference (SMD) and corresponding 95% confidence intervals (CI). RESULT Fifteen studies involving 1135 patients were included in our meta-analysis, and significant positive effects were found in body strength (leg press (SMD: 0.78 (95%CI: 0.57-0.99, P <.00001, I = 0%)), chest press (SMD: 0.71 (95%CI: 0.50-0.92, P <.00001, I = 0%)), exercise tolerance (VO2 peak SMD: 0.35 (95%CI: 0.04-0.66, P = .03, I = 0%) in 6 months and SMD: 0.59 (95%CI: 0.16-1.03, P = .007, I = 0% over 6 months)), fatigue (SMD: 0.84 (95%CI: -1.43 to 3.10, P = .85, I = 51%) in 6 months and SMD: -9.3 (95%CI: -16.22 to -2.39, P = .0030, I = 49%) over 6 months)), ADT-caused obesity (body mass index SMD: -0.33 (95%CI: -0.55 to -0.12, P = .002, I = 38% in 6 months and SMD: -0.59 95%CI: -1.02 to 0.17, P = .006, I = 25% over 6 months)), and sex function (SMD: 0.66 (95%CI: 0.35-0.97, P <.00001, I = 2%). There were no evidence of benefit for cardiometabolic changes and bone health. No systematic difference was observed between resistance exercise training (RET) and aerobic exercise training (AET) in ADT-caused obesity, fatigue, and exercise tolerance CONCLUSION:: Exercise can significantly improve the upper and lower muscle strength, increase exercise tolerance, help PCa patients receiving ADT control their body fat mass, BMI, and keep the sex function. ADT-related fatigue is correlated with exercise duration time. No differences were observed in LBM, bone mineral density, and any other metabolic blood markers. Available data show that there is no difference between AET and RET.
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Affiliation(s)
| | | | - He Xueyang
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chong Qing, China
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O'Neill M, Alibhai SM. Home-based exercise for older men on androgen deprivation therapy: Feasible and safe, but effective? J Geriatr Oncol 2016; 7:68-70. [DOI: 10.1016/j.jgo.2016.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 02/26/2016] [Indexed: 11/16/2022]
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