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Bettariga F, Taaffe DR, Galvão DA, Newton RU. Effects of short- and long-term exercise training on cancer cells in vitro: Insights into the mechanistic associations. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100994. [PMID: 39370102 DOI: 10.1016/j.jshs.2024.100994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/27/2024] [Accepted: 09/02/2024] [Indexed: 10/08/2024]
Abstract
Exercise is a therapeutic approach in cancer treatment, providing several benefits. Moreover, exercise is associated with a reduced risk for developing a range of cancers and for their recurrence, as well as with improving survival, even though the underlying mechanisms remain unclear. Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro. This suppression is potentially due to altered concentrations of hormones (e.g., insulin) and cytokines (e.g., tumor necrosis factor alpha and interleukin 6) after exercise. These factors, known to be involved in tumorigenesis, may explain why exercise is associated with reduced cancer incidence, recurrence, and mortality. However, the effects of short- (<8 weeks) and long-term (≥8 weeks) exercise programs on cancer cells have been reported with mixed results. Although more research is needed, it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients. Although speculative, these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior, low muscle mass, and excess fat mass in cancer patients. Taken together, such interventions could alter the systemic levels of suppressive circulating factors, leading to a less favorable environment for tumorigenesis. While regular exercise and a healthy diet may establish a more cancer-suppressive environment, each acute bout of exercise provides a further "dose" of anti-cancer medicine. Therefore, integrating regular exercise could potentially play a significant role in cancer management, highlighting the need for future investigations in this promising area of research.
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Affiliation(s)
- Francesco Bettariga
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD 4067, Australia.
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Naumann K, Singh B, Bushaway S, Crane R, Deepak S, Hartland A, Konstantopoulos P, Mansell E, Marinelli V, Pallotta V, Tolfts A, Virieux A, Wall M, Wilksch S, Zhuang M, Atkinson M, Maher C. Investigating the impact of multidisciplinary prehabilitation on deconditioning in patients eligible for haematopoietic allogenic stem cell transplantation: protocol for a feasibility trial. BMJ Open 2024; 14:e084372. [PMID: 39237275 PMCID: PMC11381652 DOI: 10.1136/bmjopen-2024-084372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Assessing multidisciplinary prehabilitation strategies becomes crucial to pre-emptively counter the physical, psychological and social negative impacts experienced during an allogenic haematopoietic stem cell transplant (allo-HSCT) among acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) patients. Current evidence is restricted to studies during induction chemotherapy, omitting rehabilitation interventions and predominantly using exercise-only approaches without a multidisciplinary framework. The aim of this study is to investigate the feasibility, safety and preliminary efficacy of multidisciplinary prehabilitation in adults offered allo-HSCT. METHODS AND ANALYSIS This 8-week single-group pre-post feasibility study aims to pilot a multidisciplinary prehabilitation intervention for participants undergoing allo-HSCT, with a focus on feasibility and safety. Participants, aged 18 or older, diagnosed with AML or MDS, and offered allo-HSCT, will be recruited between June 2023 and July 2024. The multidisciplinary prehabilitation intervention, conducted by the cancer allied health team at the Royal Adelaide Hospital, includes exercise physiology, physiotherapy, dietetics, social work, occupational therapy and psychology interventions. Consistent with a multidisciplinary treatment approach, each component is tailored to address different aspects of patient care, and adherence calculations will assess patient engagement and compliance. In addition, participants will continue to receive usual care from cancer allied health staff. The primary outcome of the study is to assess the feasibility of a multidisciplinary prehabilitation intervention by evaluating intervention uptake, retention, adherence, acceptability and safety. Secondary outcomes are leg strength, upper-body strength, aerobic fitness, falls risk, anthropometry, nutritional status, quality of life, anxiety, depression, self-efficacy for coping with cancer and distress. ETHICS AND DISSEMINATION Ethics approval for this study has been provided by the Central Adelaide Local Health Network (HREC 2022/HRE00284). Recruitment for the study commenced in June 2023 and will continue until July 2024. The methods have been designed and are reported according to the SPIRIT and CONSORT-pilot study checklist. TRIAL REGISTRATION NUMBER The Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12623000052639.
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Affiliation(s)
- Karlee Naumann
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Ben Singh
- University of South Australia, Adelaide, South Australia, Australia
| | - Samuel Bushaway
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Rhiannon Crane
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Swapna Deepak
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amie Hartland
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Ella Mansell
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | | | - Annabel Tolfts
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Alison Virieux
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Michelle Wall
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Sarah Wilksch
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Mabel Zhuang
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Morgan Atkinson
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Carol Maher
- University of South Australia, Adelaide, South Australia, Australia
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Laza-Cagigas R, Seijo M, Swaine I, Rampal T, Naclerio F. Commentary: Key Aspects of Multimodal Prehabilitation in Surgical Patients With Cancer. A Practical Approach to Integrating Resistance Exercise Programs. Eval Health Prof 2024; 47:336-342. [PMID: 38032684 PMCID: PMC11351001 DOI: 10.1177/01632787231218993] [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] [Indexed: 12/01/2023]
Abstract
Surgical prehabilitation aims to optimise patients' physiological reserves to better withstand the stress of surgery, reduce the risk of postoperative complications, and promote a faster and optimal recovery. The purpose of this commentary is to outline the key aspects of prehabilitation before surgery for cancer which seem to impact its effectiveness and wider implementation. Particular attention is paid to the role and integration of resistance training programmes as a key component of multimodal prehabilitation for patients with cancer. We firstly analyse some of the barriers currently hindering the implementation of prehabilitation programmes in the National Health Service (United Kingdom). Later, we describe essential aspects of resistance training design, such as exercise modality and order execution, volume and intensity, rest periods between sets or exercises, and workout frequency. Furthermore, we propose a methodology to use the perception of effort to control patients' progression during a prehabilitation programme.
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Gill SS, Shukla A, Namireddy SR, Moin S. Exercise and recovery after surgery in patients with breast cancer: An analysis of the literature. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108525. [PMID: 38991288 DOI: 10.1016/j.ejso.2024.108525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/20/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024]
Abstract
This review explores the impact of exercise on post-surgical recovery in breast cancer patients. Breast cancer, the most prevalent cancer globally, necessitates treatments beyond conventional modalities such as surgery, chemotherapy, radiotherapy, and immunotherapy. While exercise as an adjuvant therapeutic tool is not novel, it is generally accepted for improving cancer outcomes. Yet, it is not included in current treatment guidelines. This study reviews literature using the FACT-B (Functional Assessment of Cancer Therapy - Breast) tool to evaluate quality of life in breast cancer patients undergoing exercise interventions post-surgery. Despite mixed results, with some studies showing significant improvements and others indicating no notable benefits, the general consensus suggests potential advantages of integrating structured exercise programs into recovery protocols. Standardizing the use of quality of life measures like FACT-B could enhance future research and clinical practices, leading to more effective patient care strategies.
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Affiliation(s)
- Saran S Gill
- Faculty of Medicine, Imperial College London, London, UK.
| | - Anushka Shukla
- Faculty of Medicine, Imperial College London, London, UK
| | | | - Sarah Moin
- The Hillingdon Hospitals Foundation Trust, London, UK
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Toohey K, Mizrahi D, Hart NH, Singh B, Lopez P, Hunter M, Newton RU, Schmitz KH, Adams D, Edbrooke L, Hayes S. Exercise in cancer care for people with lung cancer: A narrative synthesis. J Sci Med Sport 2024:S1440-2440(24)00263-9. [PMID: 39155211 DOI: 10.1016/j.jsams.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/24/2024] [Accepted: 08/02/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES Lung cancer is the second most common cancer diagnosed worldwide, resulting in significant physical and psychological consequences. In this narrative review, we explore the role of exercise as an adjunct therapy to counteract health issues experienced by people before, during and after treatment for lung cancer, and offer recommendations for exercise prescription and future research. DESIGN Narrative cornerstone review. METHODS A narrative review was conducted to explore the role of exercise in cancer care for people diagnosed with lung cancer. RESULTS Improvements in fitness, strength and quality of life have been demonstrated in people with lung cancer following participation in exercise programmes before, during and post treatment. Whilst combined aerobic (50-100 % heart rate maximum) and resistance (50-85 % of 1 repetition maximum) training, 2-5 times per week across the cancer continuum is typically prescribed, few people with lung cancer currently access exercise services. 'Optimal' exercise prescription is unclear, although is likely individual-specific. The immediate priority is to identify a tolerable starting exercise dosage, with the side effects of lung cancer and its treatment on the respiratory system, particularly shortness of breath (dyspnoea), likely driving the initial maximum threshold for session mode, duration and intensity. To date, exercise safety for people with lung cancer has been poorly evaluated and reported - few trials report it, but those that do report small numbers of serious adverse events. CONCLUSIONS Recommendations for health professionals prescribing exercise therapy to people with lung cancer are provided, with consideration of the strengths and limitations of the current evidence base.
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Affiliation(s)
- Kellie Toohey
- Physical Activity, Sport, and Exercise Research Theme, Faculty of Health, Southern Cross University, Australia; Faculty of Health, University of Canberra, Australia.
| | - David Mizrahi
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia; Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Australia; Institute for Health Research, The University of Notre Dame Australia, Australia
| | - Ben Singh
- Allied Health & Human Performance, University of South Australia, Australia
| | - Pedro Lopez
- Grupo de Pesquisa em Exercício para Populações Clínicas (GPCLIN), Universidade de Caxias do Sul, Brazil; Pleural Medicine Unit, Institute for Respiratory Health, Australia; Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Australia
| | | | - Robert U Newton
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Kathryn H Schmitz
- Division of Hematology and Oncology, Hillman Cancer Center, University of Pittsburgh, USA
| | - Diana Adams
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Australia; Department of Health Services Research, The Peter MacCallum Cancer Centre, Australia
| | - Sandi Hayes
- Menzies Health Institute Queensland, Griffith University, Australia; Viertel Cancer Research Centre, Cancer Council Queensland, Australia
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Toohey K, Paterson C, Coltman CE. Barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. J Cancer Surviv 2024; 18:1252-1263. [PMID: 37171718 PMCID: PMC10175906 DOI: 10.1007/s11764-023-01366-5] [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: 09/05/2022] [Accepted: 03/16/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Ovarian cancer is the leading cause of death among gynecological cancers, with low survival rates and a high disease burden. Despite the known benefits, most women reduce their participation in physical activity following diagnosis. Little is known about ovarian cancer survivors' experiences of physical activity. The primary aim of this study was to explore the barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. METHODS A qualitative descriptive study design was conducted via semi-structured interviews with nine women diagnosed with ovarian cancer (stages I-IV; 40-77 years). The interviews took place at the participant's home via telephone or online video conferencing software Coviu©. An inductive thematic approach was used. The organization and coding of data were completed using NVivo computer software (Version 12.6.0, QSR International Pty Ltd.). Weekly discussions occurred among the research team to ensure that themes accurately represented participant views. The consolidated criteria for reporting qualitative studies (COREQ) 32-item checklist were followed. RESULTS The main barriers to physical activity participation that emerged were (i) the lack of referral to an exercise professional within the multidisciplinary cancer team, (ii) fear of injury after surgery and during treatment, and (iii) treatment-related side effects. However, many of the participants perceived benefits of physical activity related to (i) enhanced physical and psychological health, (ii) improved cancer outcomes, and (iii) social benefits as key enablers of physical activity participation. CONCLUSIONS Physical activity interventions for women with ovarian cancer should address the modifiable barriers identified in this study. A key focus should be to streamline timely referral pathways within the multidisciplinary team, including exercise professionals, dietitians, psychologists, and specialists nurses following a diagnosis of ovarian cancer. Further research and service development are needed to optimize supported self-management through (i) education about the importance of physical activity to both healthcare professionals and women alike, (ii) enhanced symptom management for women, which was identified as a barrier to participation, and (iii) the development of shared care plans and patient center goals to address any fears or concerns. IMPLICATIONS FOR CANCER SURVIVORS People diagnosed with ovarian cancer have low participation levels of physical activity. Cancer care professionals' support could increase physical activity uptake and reduce some of the burden of an ovarian cancer diagnosis.
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Affiliation(s)
- Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, UK
- Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Canberra, Australia
| | - Celeste E Coltman
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
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Vear NK, Moon Y, Mielke GI, Skinner TL, Coombes JS, McCarthy AL, Abbott CR, Bailey TG. Efficacy of exercise training for improving vascular dysfunction in people with cancer: a systematic review with meta-analyses. J Cancer Surviv 2024; 18:1309-1324. [PMID: 37079184 PMCID: PMC11324680 DOI: 10.1007/s11764-023-01372-7] [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: 10/13/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Cancer treatments exert vascular toxic effects that can lead to the development of cardiovascular disease. Exercise training has the potential to prevent or reduce cancer treatment-induced damage to vascular structure and function. This systematic review with meta-analyses aimed to determine the isolated effects of exercise training on vascular outcomes in people with cancer. METHODS Seven electronic databases were searched on 20 September 2021 to identify randomised controlled trials, quasi-randomised trials, pilot and cohort studies. Included studies implemented a structured exercise intervention and assessed vascular structure and/or function in people during or following cancer treatment. Meta-analyses examined the effects of exercise training on endothelial function (via brachial artery flow-mediated dilation) and arterial stiffness (via pulse wave velocity). Methodological quality was assessed using the Cochrane Quality Assessment tool and modified Newcastle-Ottawa Quality Appraisal tool. Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence. RESULTS Ten studies (discussed across 11 articles) met the inclusion criteria. Methodological quality of the included studies was moderate (71% average). Exercise improved vascular function when compared to control (standardised mean difference = 0.34, 95% CI (0.01, 0.67); p = 0.044: studies = 5, participants = 171), but not pulse wave velocity (standardised mean difference = - 0.64, 95% CI (- 1.29, 0.02); p = 0.056: studies = 4, participants = 333). The certainty of evidence was moderate for flow-mediated dilation and low for pulse wave velocity. CONCLUSIONS Compared to usual care, exercise training significantly improves flow-mediated dilation (endothelial function) but not pulse wave analysis, in people treated for cancer. IMPLICATIONS FOR CANCER SURVIVORS Exercise may improve vascular health in individuals during and following cancer treatment.
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Affiliation(s)
- Natalie K Vear
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia.
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
| | - Yubin Moon
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Tina L Skinner
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Mater Research Institute, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, Queensland, 4101, Australia
| | - Claudia R Abbott
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Tom G Bailey
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
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Kiss N, Ugalde A, Prado CM, Denehy L, Daly RM, Siva S, Ball D, Fraser SF, Edbrooke L. Living with low muscle mass and its impact throughout curative treatment for lung cancer: A qualitative study. PLoS One 2024; 19:e0304003. [PMID: 39074132 DOI: 10.1371/journal.pone.0304003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/05/2024] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVES To 1) explore the experience of patients with lung cancer with low muscle mass or muscle loss during treatment and the ability to cope with treatment, complete self-care, and 2) their receptiveness and preferences for nutrition and exercise interventions to halt or treat low muscle mass/muscle loss. METHODS This was a qualitative study using individual semi-structured interviews conducted using purposive sampling in adults with a diagnosis of non-small cell lung cancer (NSCLC) or small-cell lung cancer (SCLC), treated with curative intent chemo-radiotherapy or radiotherapy. Patients who presented with computed tomography-assessed low muscle mass at treatment commencement or experienced loss of muscle mass throughout treatment were included. Data were analysed using thematic analysis. RESULTS Eighteen adults (mean age 73 ± SD years, 61% male) with NSCLC (76%) treated with chemo-radiotherapy (76%) were included. Three themes were identified: 1) the effect of cancer and its treatment; 2) engaging in self-management; and 3) impact and influence of extrinsic factors. Although experiences varied, substantial impact on day-to-day functioning, eating, and ability to be physically active was reported. Patients were aware of the overall importance of nutrition and exercise and engaged in self-initiated or health professional supported self-management strategies. Early provision of nutrition and exercise advice, guidance from health professionals, and support from family and friends were valued, albeit with a need for consideration of individual circumstances. CONCLUSION Adults with NSCLC with or experiencing muscle loss described a diverse range of experiences regarding treatment. The types of support required were highly individual, highlighting the crucial role of personalised assessment of needs and subsequent intervention.
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Affiliation(s)
- Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Anna Ugalde
- Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Linda Denehy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
- Physiotherapy Department, University of Melbourne, Parkville, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Shankar Siva
- Lung Service, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - David Ball
- Lung Service, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Lara Edbrooke
- Department of Health Services Research, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
- Physiotherapy Department, University of Melbourne, Parkville, Victoria, Australia
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Schmocker M, Engst R, Wirz M, Bana M. Factors influencing physical activity in individuals with head and neck cancer: a scoping review. BMJ Open 2024; 14:e083852. [PMID: 39019637 PMCID: PMC11331979 DOI: 10.1136/bmjopen-2023-083852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 06/07/2024] [Indexed: 07/19/2024] Open
Abstract
OBJECTIVES Higher physical activity (PA) levels are associated with better quality of life in people with head and neck cancer (HNC). Despite this positive association, most individuals with these cancer types have a sedentary or low-activity lifestyle. Limited knowledge exists regarding the factors that influence PA in this group. Therefore, we reviewed and mapped the available literature on factors that may influence PA in people with HNC. DESIGN We conducted a scoping review based on the framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for scoping reviews. DATA SOURCES CINHAL, the Cochrane Library, EMBASE, PsycINFO, MEDLINE and Scopus were searched from inception to July 2023. ELIGIBILITY CRITERIA We included qualitative and quantitative studies that stated factors such as barriers, facilitators, beliefs, perceptions and views influencing PA in individuals with HNC. Furthermore, views and recommendations of healthcare professionals involved in the care of people affected by HNC and researchers in this domain were eligible for data extraction. DATA EXTRACTION AND SYNTHESIS Data were extracted and synthesised by one reviewer according to the predefined items including characteristics, barriers, facilitators, beliefs, perceptions and views of people being affected and views and recommendations of experts. Quantitative data were charted descriptively, and qualitative data were analysed and summarised using a basic content analysis approach. RESULTS Of the 1351 publications, we included 19 in our review. Publications mainly focused on barriers to PA, with some studies reporting facilitators and collecting data on patients' and healthcare professionals' views on PA. Most research teams made recommendations for promoting PA in people with HNC.Characteristics associated with activity levels included age, cancer type and stage, morbidity level and attitude towards being active. Prevalent barriers consisted of health-related factors, including fatigue, pain and nutritional issues, alongside personal and environmental impediments such as time constraints, lack of interest or motivation. Facilitating factors for PA included perceived or experienced mental and health-related benefits. Consensus among patients, healthcare professionals and researchers highlighted the necessity for enhanced information and education, emphasising individualised approaches to promote PA throughout the cancer continuum. CONCLUSIONS Numerous factors affect PA in individuals with HNC. Future research should concentrate on screening and addressing risk factors for sedentary behaviour and activity barriers and on optimal design and delivery of interventions to incorporate PA promotion into the care pathway.
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Affiliation(s)
- Martina Schmocker
- Institute for Therapies and Rehabilitation, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Ramona Engst
- Institute of Nursing Sciences, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Markus Wirz
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Marika Bana
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
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Zhou S, Zhang Y, Yang G, Huang X, Li W, Lu J. Effect of modified Baduanjin exercise on nutritional status in patients with nasopharyngeal carcinoma: a randomized controlled trial. Support Care Cancer 2024; 32:498. [PMID: 38981883 DOI: 10.1007/s00520-024-08646-5] [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: 06/27/2023] [Accepted: 06/10/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND As a traditional Chinese fitness technique, Baduanjin is a low- to medium-intensity aerobic exercise that has a common regulatory effect on both body and mind and is also an important means of disease prevention and treatment. However, the role of Baduanjin in improving patients' nutritional status and promoting tumor recovery remains to be confirmed. OBJECTIVE This study aims to investigate the effectiveness of the modified Baduanjin exercise on the nutritional status of patients with nasopharyngeal carcinoma. DESIGN This is a randomized controlled trial. SETTING(S) The participants were recruited from patients in the Radiotherapy Department of the First Affiliated Hospital of Guangxi Medical University in China. PARTICIPANTS A total of 121 patients with nasopharyngeal carcinoma were randomly divided into the control group and the Baduanjin group. Finally, 106 patients completed the study (53 cases each in the control group and the Baduanjin group) with the intervention time from the beginning to the end of radiotherapy. METHODS The control group received conventional care (health education and regular conventional exercise), and the Baduanjin exercise group received health education and regularly improved Baduanjin exercise, with the intervention time from the beginning to the end of the radiotherapy. Patient-generated subjective global assessment (PG-SGA) was evaluated before, during (15 times), and at the end of radiotherapy as the main evaluation index to compare nutritional status between the two groups. RESULTS From August 2022 to December 2022, 121 patients with nasopharyngeal carcinoma were randomly divided into the control group and the Baduanjin group. During the intervention, 15 patients withdrew from the study, leading to 53 of 59 patients in the control group and 53 of 62 patients in the Baduanjin group. After the intervention, the PG-SGA score, radioactive oral mucositis, and oropharyngeal pain score were lower (P < 0.05), whereas anorexia scores, the levels of hemoglobin, albumin, prealbumin, and total protein were higher than those in the control group (P < 0.05). CONCLUSIONS Modified Baduanjin exercise can improve the nutritional status of patients with nasopharyngeal carcinoma and deserves further clinical application. TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry under the registration number ChiCTR2200064519, registered on August 27, 2022. The public research topic is the construction and intervention research based on Internet + nasopharyngeal carcinoma.
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Affiliation(s)
- Shufen Zhou
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yanxin Zhang
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guirong Yang
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaojun Huang
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wei Li
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jiamei Lu
- Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
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11
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Bettariga F, Taaffe DR, Galvão DA, Bishop C, Kim JS, Newton RU. Suppressive effects of exercise-conditioned serum on cancer cells: A narrative review of the influence of exercise mode, volume, and intensity. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:484-498. [PMID: 38081360 PMCID: PMC11184317 DOI: 10.1016/j.jshs.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/24/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023]
Abstract
Cancer is a major cause of morbidity and mortality worldwide, and the incidence is increasing, highlighting the need for effective strategies to treat this disease. Exercise has emerged as fundamental therapeutic medicine in the management of cancer, associated with a lower risk of recurrence and increased survival. Several avenues of research demonstrate reduction in growth, proliferation, and increased apoptosis of cancer cells, including breast, prostate, colorectal, and lung cancer, when cultured by serum collected after exercise in vitro (i.e., the cultivation of cancer cell lines in an experimental setting, which simplifies the biological system and provides mechanistic insight into cell responses). The underlying mechanisms of exercise-induced cancer suppressive effects may be attributed to the alteration in circulating factors, such as skeletal muscle-induced cytokines (i.e., myokines) and hormones. However, exercise-induced tumor suppressive effects and detailed information about training interventions are not well investigated, constraining more precise application of exercise medicine within clinical oncology. To date, it remains unclear what role different training modes (i.e., resistance and aerobic training) as well as volume and intensity have on exercise-conditioned serum and its effects on cancer cells. Nevertheless, the available evidence is that a single bout of aerobic training at moderate to vigorous intensity has cancer suppressive effects, while for chronic training interventions, exercise volume appears to be an influential candidate driving cancer inhibitory effects regardless of training mode. Insights for future research investigating training modes, volume and intensity are provided to further our understanding of the effects of exercise-conditioned serum on cancer cells.
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Affiliation(s)
- Francesco Bettariga
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Chris Bishop
- London Sport Institute, School of Science and Technology, Middlesex University, London, NW4 4BT, UK
| | - Jin-Soo Kim
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD 4072, Australia.
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12
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Kennedy MA, Wood KC, Campbell A, Potiaumpai M, Wilson CM, Schwartz AL, Gorzelitz J, Caru M, Schmitz KH. Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants. Cancer Med 2024; 13:e70004. [PMID: 39046221 PMCID: PMC11267632 DOI: 10.1002/cam4.70004] [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: 01/23/2024] [Revised: 05/13/2024] [Accepted: 06/30/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Integration of exercise into standard oncology care requires a highly skilled workforce of exercise professionals; however, competency requirements have not kept pace with advancements in the field. Therefore, the aim of this study was to obtain consensus on core competencies required for an exercise professional to be qualified to work with adults undergoing active cancer treatment. MATERIALS AND METHODS A three-round modified electronic Delphi process was used. In Round 1, an international group of 64 exercise oncology stakeholders (i.e., exercise oncology professionals (n = 29), clinical referrers (n = 21), and people with lived experience (n = 14)) responded to open-ended prompts eliciting perspectives regarding competencies needed for an exercise oncology professional to work with adults receiving active cancer treatment. Subsequently, only exercise oncology professionals participated, ranking the importance of competencies. In Round 2, professionals received summary feedback, ranked new competencies generated from open-ended responses, and reranked competencies not reaching consensus. In the final round, professionals finalized consensus ranking and rated frequency and mastery level for each. RESULTS Consensus was reached on 103 core competencies required for exercise professionals to be qualified to deliver care to adults undergoing active cancer treatment. The core competencies represent 10 content areas and reflect the needs of clinical referrers and people with lived experience of receiving cancer treatment. CONCLUSIONS The core competencies identified reflect significant advancements in the field of exercise oncology. Results will underpin the development of education, certification, and employment requirements for exercise oncology professionals, providing a critical step toward achieving routine integration of exercise into standard oncology care.
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Affiliation(s)
- Mary A. Kennedy
- Nutrition and Health Innovation Research Institute, School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | | | - Anna Campbell
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUK
| | - Melanie Potiaumpai
- Division of Hematology and OncologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Christopher M. Wilson
- Physical Therapy Program, School of Health SciencesOakland UniversityRochesterMichiganUSA
- Founding Residency Program DirectorBeaumont Health Oncology ResidencyTroyMichiganUSA
| | - Anna L. Schwartz
- College of Nursing, University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Jessica Gorzelitz
- Department of Health and Human PhysiologyUniversity of IowaIowa CityIowaUSA
| | - Maxime Caru
- Department of Pediatrics, Division of Hematology and OncologyPennsylvania State Health Children's HospitalHersheyPennsylvaniaUSA
| | - Kathryn H. Schmitz
- Division of Hematology and OncologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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13
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Kim JS, Taaffe DR, Galvão DA, Clay TD, Redfern AD, Gray ES, Newton RU. Enhancing circulatory myokines and extracellular vesicle uptake with targeted exercise in patients with prostate cancer (the MYEX trial): a single-group crossover study. BMC Cancer 2024; 24:784. [PMID: 38951803 PMCID: PMC11218391 DOI: 10.1186/s12885-024-12530-0] [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: 05/27/2024] [Accepted: 06/17/2024] [Indexed: 07/03/2024] Open
Abstract
INTRODUCTION Physical activity is associated with improved disease progression and cancer-specific survival in patients with prostate cancer (PCa). However, the mechanisms underlying these associations remain unclear, while the relative impact of exercise modes is unknown. This study aims to examine the differential impact of exercise mode on tumour-suppressive skeletal muscle-associated systemic molecules as well as their delivery mechanism. This study will compare the effects of the two main exercise modes, aerobic and resistance, on (1) circulatory myokine levels, (2) skeletal muscle-induced extracellular vesicle abundance and cargo contents, and (3) uptake of extracellular vesicles (EVs) in PCa cells in patients with localised or advanced PCa. METHODS A single-group cross-over design will be used for patients at opposite ends of the disease spectrum. A total of 32 patients (localised PCa, n = 16; metastatic castrate-resistant PCa, n = 16) will be recruited while capitalising on two ongoing studies. Ethics amendment has been approved for two ongoing trials to share data, implement the acute exercise sessions, and collect additional blood samples from patients. The patients will undertake two exercise sessions (aerobic only and resistance only) in random order one week apart. Blood will be collected before, after, and 30 min post-exercise. Circulating/EV-contained myokine levels (irisin, IL-6, IL-15, FGF-21, and SPARC) and plasma skeletal muscle-induced EVs will be measured using ELISA and flow cytometry. PCa cell line growth with or without collected plasma will be examined using PCa cell lines (LNCaP, DU-145, and PC-3), while evaluating cellular uptake of EVs. Ethics amendments have been approved for two capitalising studies to share data, implement acute exercise sessions and collect additional samples from the patients. DISCUSSION If findings show a differential impact of exercise mode on the establishment of an anti-cancer systemic environment, this will provide fundamental knowledge for developing targeted exercise prescriptions for patients with PCa across different disease stages. Findings will be reported in peer-reviewed publications and scientific conferences, in addition to working with national support groups to translate findings for the broader community. TRIAL REGISTRATION The registration for the two capitalising studies are NCT02730338 and ACTRN12618000225213.
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Affiliation(s)
- Jin-Soo Kim
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Timothy D Clay
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Department of Medical Oncology, St John of God Subiaco Hospital, Perth, WA, Australia
| | - Andrew D Redfern
- Department of Medical Oncology, Fiona Stanley Hospital, Murdoch, WA, Australia
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Elin S Gray
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia.
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14
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De Lazzari N, Götte M, Kasper S, Meier E, Schuler M, Pogorzelski M, Siveke JT, Tewes M. P-move: a randomized control trial of exercise in patients with advanced pancreatic or biliary tract cancer (aPBC) receiving beyond first-line chemotherapy. Support Care Cancer 2024; 32:437. [PMID: 38879700 PMCID: PMC11180022 DOI: 10.1007/s00520-024-08650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 06/10/2024] [Indexed: 06/19/2024]
Abstract
PURPOSE Patients with advanced pancreatic and biliary tract cancer (aPBC) frequently suffer from high symptom burden. Exercise can reduce treatment side effects and improve patient-related outcomes (PROMs). However, evidence from prospective studies regarding feasibility and efficacy in advanced settings are sparse. The primary aim of this prospective, randomized-controlled study was to evaluate the feasibility and effects of exercise (ET) in patients with aPBC. METHODS Patients with aPBC beyond first-line therapy were randomized according to the minimization procedure with stratification by gender, age, and loss of body weight in the past six months. The intervention group (IG) completed 3 training units/week for 8 weeks (1x supervised strength sessions, 2x individualized home-based sessions). Control group (CG) received recommendations on physical activity during cancer. RESULTS 41 patients (stage IV pancreatic or biliary tract cancer) were included no adverse events related to exercise occurred during the trial. Physical function increased significantly in IG in 5 out of 7 physical domains. Comparison of IG and CG at 8 weeks (t2) showed significant differences in favour of IG in leg press (p=0.001), bench press (p=0.011), sit-to-stand (p=0.001) and crunch (0.006). Constipation revealed a significant difference in favour of IG at t2 (p=0.033). Quality of life stabilized/increased in IG during the study period compared to a decrease in CG. Throughout/Over the 8 weeks, fatigue notably reduced in the IG (p=0.028). CONCLUSION Exercise is safe and feasible in patients with aPBC undergoing further line therapy. Significant improvements in physical functioning and increased quality of life were achieved. German Clinical Trials Register ID: DRKS00021179; Registration date 15.05.2020.
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Affiliation(s)
- Nico De Lazzari
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
- West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Palliative Medicine, West German Cancer Center, University Hospital Essen, Margot-von-Bonin-Haus, 2. Floor, Room 2.017, Hohlweg 8, 45147, Essen, Germany
| | - Miriam Götte
- West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen, a partnership between German Cancer Research Center (DKFZ) and University Hospital Essen, 45147, Essen, Germany
- National Center for Tumor Diseases (NCT) West, Campus Essen, University Hospital Essen, 45147, Essen, Germany
| | - Eileen Meier
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
- Bridge Institute of Experimental Tumor Therapy (BIT) and Division of Solid Tumor Translational Oncology (DKTK), West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Martin Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
- German Cancer Consortium (DKTK), partner site Essen, a partnership between German Cancer Research Center (DKFZ) and University Hospital Essen, 45147, Essen, Germany
- National Center for Tumor Diseases (NCT) West, Campus Essen, University Hospital Essen, 45147, Essen, Germany
| | - Michael Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
| | - Jens T Siveke
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147, Essen, Germany
- Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK Partner Site Essen) and German Cancer Research Center, DKFZ, Heidelberg, Germany
- German Cancer Consortium (DKTK), partner site Essen, a partnership between German Cancer Research Center (DKFZ) and University Hospital Essen, 45147, Essen, Germany
- Bridge Institute of Experimental Tumor Therapy (BIT) and Division of Solid Tumor Translational Oncology (DKTK), West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
- National Center for Tumor Diseases (NCT) West, Campus Essen, University Hospital Essen, 45147, Essen, Germany
| | - Mitra Tewes
- Department of Palliative Medicine, West German Cancer Center, University Hospital Essen, Margot-von-Bonin-Haus, 2. Floor, Room 2.017, Hohlweg 8, 45147, Essen, Germany.
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15
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Chen K, Wong TH, Tan YG, Tay KJ, Tan WC, Chan J, Ho H, Cheng C, Teoh JYC, Chiu PKF, Wang HJ, Saad MB, Kanesvaran R, Li YQ, Ng CT, Tuan JKL, Yuen JSP. Cardio-oncology in advanced prostate cancer. Front Oncol 2024; 14:1386597. [PMID: 38947889 PMCID: PMC11211357 DOI: 10.3389/fonc.2024.1386597] [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: 02/15/2024] [Accepted: 05/28/2024] [Indexed: 07/02/2024] Open
Abstract
Treatment intensification with androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPi) have led to improved survival in advanced prostate cancer. However, ADT is linked to significant cardiovascular toxicity, and ARPi also negatively impacts cardiovascular health. Together with a higher prevalence of baseline cardiovascular risk factors reported among prostate cancer survivors at diagnosis, there is a pressing need to prioritise and optimise cardiovascular health in this population. Firstly, While no dedicated cardiovascular toxicity risk calculators are available, other tools such as SCORE2 can be used for baseline cardiovascular risk assessment. Next, selected patients on combination therapy may benefit from de-escalation of ADT to minimise its toxicities while maintaining cancer control. These patients can be characterised by an exceptional PSA response to hormonal treatment, favourable disease characteristics and competing comorbidities that warrant a less aggressive treatment regime. In addition, emerging molecular and genomic biomarkers hold the potential to identify patients who are suited for a de-escalated treatment approach either with ADT or with ARPi. One such biomarker is AR-V7 splice variant that predicts resistance to ARPi. Lastly, optimization of modifiable cardiovascular risk factors for patients through a coherent framework (ABCDE) and exercise therapy is equally important. This article aims to comprehensively review the cardiovascular impact of hormonal manipulation in metastatic hormone-sensitive prostate cancer, propose overarching strategies to mitigate cardiovascular toxicity associated with hormonal treatment, and, most importantly, raise awareness about the detrimental cardiovascular effects inherent in our current management strategies involving hormonal agents.
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Affiliation(s)
- Kenneth Chen
- Department of Urology, Singapore General Hospital, Singapore, Singapore
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ting Hong Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yu Guang Tan
- Department of Urology, Singapore General Hospital, Singapore, Singapore
| | - Kae Jack Tay
- Department of Urology, Singapore General Hospital, Singapore, Singapore
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Wei Chong Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Johan Chan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Henry Ho
- Department of Urology, Singapore General Hospital, Singapore, Singapore
| | - Christopher Cheng
- Department of Urology, Singapore General Hospital, Singapore, Singapore
| | - Jeremy Yuen-Chun Teoh
- S. H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Peter Ka-Fung Chiu
- S. H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hung Jen Wang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University and College of Medicine, Kaohsiung, Taiwan
| | - Marniza Binti Saad
- Department of Clinical Oncology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Ravindran Kanesvaran
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - You Quan Li
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Choon Ta Ng
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | | | - John Shyi Peng Yuen
- Department of Urology, Singapore General Hospital, Singapore, Singapore
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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16
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Vainshelboim B, Sardesai SD, Bhammar D. Potential Therapeutic Role of Respiratory Muscle Training in Dyspnea Management of Cancer Survivors: A Narrative Review. World J Oncol 2024; 15:337-347. [PMID: 38751708 PMCID: PMC11092410 DOI: 10.14740/wjon1781] [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: 11/29/2023] [Accepted: 03/04/2024] [Indexed: 05/18/2024] Open
Abstract
Dyspnea is a disabling symptom presented in approximately half of all cancer survivors. From a clinical perspective, despite the availability of pharmacotherapies, evidence-based effective treatments are limited for relieving dyspnea in cancer survivors. Preliminary evidence supports the potential of respiratory muscle training to reduce dyspnea in cancer survivors, although large randomized controlled studies are warranted. The aims of this article were to review the relevant scientific literature on the potential therapeutic role of respiratory muscle training in dyspnea management of cancer survivor, and to identify possible mechanisms, strengths and limitations of the evidence as well as important gaps for future research directions.
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Affiliation(s)
- Baruch Vainshelboim
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43214, USA
| | - Sagar D. Sardesai
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43214, USA
| | - Dharini Bhammar
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43214, USA
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17
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Campbell KL, Brown JC, Lee C, Weltzien E, Li J, Sternfeld B, Campbell N, Vaughan M, Fedric R, Meyerhardt JA, Caan BJ, Schmitz KH. Advances in Adherence Reporting of Resistance Training in a Clinical Trial during Adjuvant Chemotherapy for Colon Cancer. Med Sci Sports Exerc 2024; 56:1186-1195. [PMID: 38233992 PMCID: PMC11096063 DOI: 10.1249/mss.0000000000003395] [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] [Indexed: 01/19/2024]
Abstract
PURPOSE Detailed reporting of individually tailored exercise prescriptions (ExR x ) used in clinical trials is essential to describe feasibility, tolerability, and efficacy of the intervention and to inform translation to clinical care. This article outlines the methodology used to develop a resistance training (RT) ExR x for people with colon cancer receiving chemotherapy and reports adherence to the randomized controlled trial testing the impact of RT on relative dose intensity of chemotherapy and patient-reported toxicities. METHODS Participants randomized to the exercise arm ( n = 90) were included. To promote muscle hypertrophy, the ExR x was twice-weekly, moderate to heavy loads (65%-85% one-repetition maximum), high sets (3-5), and intermediate repetitions (6-10) of five large multijoint movements with adjustable dumbbells. Attendance (achieved frequency) and adherence (achieved volume) were calculated. Group-based trajectory modeling was used to identify clusters of individuals with similar adherence patterns and compared baseline characteristics across adherence groups. RESULTS The median attendance was 69.1%. Adherence was 60.6% but higher for those receiving 3 versus 6 months of chemotherapy (80.4 vs 47.4%; P < 0.05 ). Participants engaged in a median of 1.4 d of RT each week, lifting 62% of the one-repetition maximum load, for 3.0 sets and 7.5 repetitions per set. Three distinct adherence groups were identified: 13% "nonstarter," 37% "tapered off," and 50% "consistent exercisers." Females were more likely to be in the nonstarter and tapered-off groups. CONCLUSIONS This article outlines suggested methods for reporting ExR x of RT in oncology clinical trials and provides insight into the tolerance of ExR x of RT during chemotherapy treatment for colon cancer. These findings aim to foster constructive dialogue and offer a premise for designing future research to elucidate the benefits of exercise during chemotherapy.
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Affiliation(s)
| | | | | | | | - Jia Li
- Kaiser Permanente Northern California, Oakland, CA
| | | | | | | | - Regan Fedric
- Kaiser Permanente Northern California, Oakland, CA
| | | | - Bette J Caan
- Kaiser Permanente Northern California, Oakland, CA
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18
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Sandler CX, Gildea GC, Spence RR, Jones TL, Eliadis P, Walker D, Donaghue A, Bettington C, Keller J, Pickersgill D, Shevill M, Biggs V, Morrison B, Jonker F, Foote M, Bashford J, Hayes SC. The safety, feasibility, and efficacy of an 18-week exercise intervention for adults with primary brain cancer - the BRACE study. Disabil Rehabil 2024; 46:2317-2326. [PMID: 37310040 DOI: 10.1080/09638288.2023.2221041] [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: 11/03/2022] [Accepted: 05/27/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE To determine the safety, feasibility, and potential effect of an 18-week exercise intervention for adults with primary brain cancer. MATERIALS AND METHODS Eligible patients were 12-26-weeks post-radiotherapy for brain cancer. The individually-prescribed weekly exercise was ≥150-minutes of moderate-intensity exercise, including two resistance-training sessions. The intervention was deemed "safe" if exercise-related, serious adverse events (SAE) were experienced by <10% of participants, and feasible if recruitment, retention, and adherence rates were ≥75%, and ≥75% compliance rates were achieved in ≥75% of weeks. Patient-reported and objectively-measured outcomes were assessed at baseline, mid-intervention, end-intervention, and 6-month follow-up, using generalized estimating equations. RESULTS Twelve participants enrolled (51 ± 19.5 years, 5 females). There were no exercise-related SAEs. The intervention was feasible (recruitment:80%, retention:92%, adherence:83%). Participants completed a median of 172.8 (min:77.5, max:560.8) minutes of physical activity per week. 17% met the compliance outcome threshold for ≥75% of the intervention. Improvements in quality of life (mean change (95% CI): 7.9 units (1.9, 13.8)), functional well-being (4.3 units (1.4, 7.2)), depression (-2.0 units (-3.8, -0.2)), activity (112.8 min (42.1, 183.4)), fitness (56.4 meters (20.4, 92.5)), balance (4.9 s (0.9, 9.0)), and lower-body strength (15.2 kg (9.3, 21.1)) were observed end-intervention. CONCLUSION Preliminary evidence support that exercise is safe and beneficial to the quality of life and functional outcomes for people with brain cancer.Registration: ACTRN12617001577303.
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Affiliation(s)
- Carolina X Sandler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Gabrielle C Gildea
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Rosalind R Spence
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tamara L Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Eliadis
- Icon Cancer Centre, Brisbane, Queensland, Australia
| | - David Walker
- Newro foundation, Brisbane, Queensland, Australia
| | - Amanda Donaghue
- Queensland Sports Medicine Centre, Brisbane, Queensland, Australia
| | | | - Jacqui Keller
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Deb Pickersgill
- Queensland Sports Medicine Centre, Brisbane, Queensland, Australia
| | - Molly Shevill
- Queensland Sports Medicine Centre, Brisbane, Queensland, Australia
| | - Vivien Biggs
- Newro foundation, Brisbane, Queensland, Australia
| | | | - Fiona Jonker
- Icon Cancer Foundation, Brisbane, Queensland, Australia
| | | | - John Bashford
- Icon Cancer Centre, Brisbane, Queensland, Australia
- Icon Cancer Foundation, Brisbane, Queensland, Australia
| | - Sandra C Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Chen H, Lu H, Zhou H, Wu B, Dong Z, Zhang S, Gu Y, Zhou G, Xiang J, Yang J. Modular multimodal hospital-home chain physical activity rehabilitation programme (3M2H-PARP) in liver cancer: a protocol for a randomised controlled trial. BMJ Open 2024; 14:e083228. [PMID: 38772899 PMCID: PMC11110592 DOI: 10.1136/bmjopen-2023-083228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/17/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION Patients with liver cancer are susceptible to experiencing a decline in muscle mass and function, which can lead to physical frailty and have a negative impact on prognosis. However, there is currently a lack of physical activity interventions specifically tailored for these patients. Therefore, we have developed a modular multimodal hospital-home chain physical activity rehabilitation programme (3M2H-PARP) designed specifically for patients with liver cancer undergoing transarterial chemoembolisation (TACE). We aim to validate the effectiveness and feasibility of this programme through a randomised controlled trial (RCT). METHODS AND ANALYSIS 3M2H-PARP RCT will compare a 12-week, modular, multimodal physical activity rehabilitation programme that includes supervised exercise in a hospital setting and self-management exercise at home. The programmes consist of aerobic, resistance, flexibility and balance exercise modules, and standard survivorship care in a cohort of liver cancer survivors who have undergone TACE. The control group will receive standard care. A total of 152 participants will be randomly assigned to either the 3M2H-PARP group or the control group. Assessments will be conducted at three time points: baseline, after completing the intervention and a 24-week follow-up visit. The following variables will be evaluated: liver frailty index, Functional Assessment of Cancer Therapy-Hepatobiliary subscale, Cancer Fatigue Scale, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale and physical activity level. After the completion of the training programme, semi-structured interviews will be conducted with participants from the 3M2H-PARP group to investigate the programme's impact on their overall well-being. SPSS V.26.0 software will be used for statistical analyses. ETHICS AND DISSEMINATION Ethical approval has been granted by the Jiangnan University School of Medicine Research Ethics Committee. The findings will be disseminated through publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ChiCTR2300076800.
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Affiliation(s)
- Haiyan Chen
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Hanxiao Lu
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Huimin Zhou
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Bo Wu
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Zhixia Dong
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Shuo Zhang
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Yuanlong Gu
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Guangwen Zhou
- Department of General Surgery, Shanghai Sixth People's Hospital, Shanghai, China
| | - Jie Xiang
- Department of Endocrinology, Wuxi Mingci Cardiovascular Hospital, Wuxi, Jiangsu, China
| | - Jun Yang
- Department of General Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
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20
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Burrai F, Ortu S, Rafati S, Micheluzzi V. Effectiveness of Karate in Oncology Patients: A Quasi-Experimental Study. Holist Nurs Pract 2024; 38:151-163. [PMID: 38709131 DOI: 10.1097/hnp.0000000000000644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Cancer is a global health concern and affects patient quality of life, anxiety, depression, and sleep. Physical exercise shows promise in alleviating these effects. Karate is a holistic intervention that could be used to improve several outcomes related to cancer disease, but to date its effect remains unexplored. This quasi-experimental pre-/poststudy evaluated the effects of a 6-month karate program conducted twice a week for 60 minutes each session on quality of life, anxiety, depression, sleep quality, and psychosomatic symptoms in 22 patients with posttherapy oncology. Significant improvements in quality of life (P = .006), anxiety (P < .001), depression (P < .001), and sleep quality (P = .011) were observed. Multidimensional psychophysical evaluation showed significant reductions in symptoms (P < .05). High participant satisfaction was reported across all dimensions. This pilot study shows the potential benefits in oncology patients, but more research is necessary to confirm these findings.
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Affiliation(s)
- Francesco Burrai
- Author Affiliations: Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy (Dr Burrai); Oncology Unit, St Giovanni Paolo II Hospital, Olbia, Italy (Dr Ortu); Social Factors in Health Promotion Research Center, Health Research Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran (Dr Rafati); and Clinical and Interventional Cardiology, University Hospital, Sassari, Italy (Ms Micheluzzi)
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21
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Nuzzo JL, Pinto MD, Kirk BJC, Nosaka K. Resistance Exercise Minimal Dose Strategies for Increasing Muscle Strength in the General Population: an Overview. Sports Med 2024; 54:1139-1162. [PMID: 38509414 PMCID: PMC11127831 DOI: 10.1007/s40279-024-02009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
Many individuals do not participate in resistance exercise, with perceived lack of time being a key barrier. Minimal dose strategies, which generally reduce weekly exercise volumes to less than recommended guidelines, might improve muscle strength with minimal time investment. However, minimal dose strategies and their effects on muscle strength are still unclear. Here our aims are to define and characterize minimal dose resistance exercise strategies and summarize their effects on muscle strength in individuals who are not currently engaged in resistance exercise. The minimal dose strategies overviewed were: "Weekend Warrior," single-set resistance exercise, resistance exercise "snacking," practicing the strength test, and eccentric minimal doses. "Weekend Warrior," which minimizes training frequency, is resistance exercise performed in one weekly session. Single-set resistance exercise, which minimizes set number and session duration, is one set of multiple exercises performed multiple times per week. "Snacks," which minimize exercise number and session duration, are brief bouts (few minutes) of resistance exercise performed once or more daily. Practicing the strength test, which minimizes repetition number and session duration, is one maximal repetition performed in one or more sets, multiple days per week. Eccentric minimal doses, which eliminate or minimize concentric phase muscle actions, are low weekly volumes of submaximal or maximal eccentric-only repetitions. All approaches increase muscle strength, and some approaches improve other outcomes of health and fitness. "Weekend Warrior" and single-set resistance exercise are the approaches most strongly supported by current research, while snacking and eccentric minimal doses are emerging concepts with promising results. Public health programs can promote small volumes of resistance exercise as being better for muscle strength than no resistance exercise at all.
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Affiliation(s)
- James L Nuzzo
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Matheus D Pinto
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Benjamin J C Kirk
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Kazunori Nosaka
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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22
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Hollings M, Gordon N, Redfern J, Thomas L, Singleton A, Tu Q, Zecchin R. Characteristics and Outcomes of Cardiac Rehabilitation Patients With and Without Cancer: Insights From Western Sydney. Heart Lung Circ 2024; 33:730-737. [PMID: 38233306 DOI: 10.1016/j.hlc.2023.11.017] [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: 07/23/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 01/19/2024]
Abstract
AIM Increased cardiovascular events are common in cancer survivors and contribute to an emerging cardio-oncology patient group requiring secondary prevention strategies including cardiac rehabilitation (CR). This study aimed to compare characteristics and outcomes for patients participating in CR with and without an existing cancer diagnosis. METHOD Observational cohort study including consecutive patients enrolled in a single-centre outpatient CR program in Western Sydney between 2018-2022. Clinical history, demographics and CR outcome data were collected as part of standard care at program enrolment and completion. Patients with and without a cancer diagnosis were compared at enrolment and outcomes were analysed in both groups. RESULTS A total of 1,792 patients enrolled in CR, 191 (11%) had a documented history of cancer; prostate (18%), skin (12%), colon (9%) and breast (8%) malignancies were most prevalent. The most common treatments were surgical resection (80%) and chemotherapy or radiotherapy (37%). Cardio-oncology patients were older (68.8±10.6 vs 59.8±13.7yrs, p<0.001), more likely female (33% vs 21%, p<0.001), born in Australia (46% vs 35%, p=0.004), non-partnered (34% vs 25%, p=0.002) and had a prior history of hypertension (65% vs 56%, p=0.010) or stroke (8% vs 5%, p=0.045). After adjusting for age and sex, the overall cohort improved their mean peak exercise capacity and waist circumference after CR, however there were no differences between groups. There were also no between-group differences for adherence and completion of CR program or any other cardiovascular risk factors. Sub-analyses revealed a clinically meaningful improvement in waist circumference for cancer patients with a history of radiation therapy and a blunted peak exercise capacity adaptation for those with a history of chemotherapy treatment. CONCLUSIONS Despite differences in demographic and clinical characteristics of CR patients with and without cancer, all patients showed significant and clinically relevant improvements in peak exercise capacity and waist circumference after CR. Results also highlighted potential associations between specific cancer treatments and changes in fitness outcomes, which warrants further evaluation.
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Affiliation(s)
- Matthew Hollings
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Nicole Gordon
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Liza Thomas
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; South West Clinical School, School of Clinical Medicine, University of NSW, Sydney, NSW, Australia
| | - Anna Singleton
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Qiang Tu
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Robert Zecchin
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
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23
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Zhu W, Geng W, Huang L, Qin X, Chen Z, Yan H. Who could and should give exercise prescription: Physicians, exercise and health scientists, fitness trainers, or ChatGPT? JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:368-372. [PMID: 38176646 PMCID: PMC11116978 DOI: 10.1016/j.jshs.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/06/2024]
Abstract
•There has been a hot debate on who could and should give exercise prescriptions. •While physicians, exercise and health scientists, and fitness trainers each have their role in prescribing exercise, an integrated and interdisciplinary team approach is recommended. •ChatGPT showed great potential to become a smart, interdisciplinary, yet independent, assistant to provide accurate and individualized exercise prescriptions for both general and professional use in the very near future.
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Affiliation(s)
- Weimo Zhu
- Yunnan Plateau Thermal Health Industry Innovation Research Institute, Tengchong 679100, China; Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| | - Wenguang Geng
- Department of Physical Education, Nanjing Agricultural University, Nanjing 210095, China
| | - Lingling Huang
- Yunnan Plateau Thermal Health Industry Innovation Research Institute, Tengchong 679100, China
| | - Xiong Qin
- School of Sports Engineering, Beijing Sport University, Beijing 100084, China
| | - Zezhao Chen
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China
| | - Hai Yan
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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24
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Martínez Aguirre-Betolaza A, Dobaran Amezua A, Yagin FH, Cacicedo J, Olasagasti-Ibargoien J, Castañeda-Babarro A. Do Oncologists Recommend the "Pill" of Physical Activity in Their Practice? Answers from the Oncologist and Patients' Perspectives. Cancers (Basel) 2024; 16:1720. [PMID: 38730668 PMCID: PMC11083921 DOI: 10.3390/cancers16091720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES The purposes of this current questionnaire-based study were to analyse whether oncologists prescribed PA to their patients in Spain, as well as the type of exercise recommended, the variables that influence whether or not to recommend it and to compare these recommendations with the values reported by their patients. METHODS Two online questionnaires were designed for this study. The first one, filled in by the oncologists (n = 93), contained aspects such as the attitude or barriers to promoting PA. The second was designed for patients with cancer (n = 149), which assessed PA levels and counselling received from oncologists, among other facets. RESULTS The majority of oncologists (97%) recommend PA during their consultations. Instead, only 62% of patients reported participating in exercise within the last 7 days. Walking was the most common form of exercise, reported by 50% of participants. Patients who received exercise recommendations from their oncologist walked for more days (p = 0.004; ES = 0.442) and more minutes per day (p = 0.022; ES = 0.410). The barriers most highlighted by patients were lack of time and not knowing how to perform PA. CONCLUSION Oncologists and patients seem to be interested and able to participate in PA counselling and programmes. However, there was a discrepancy between what was reported by oncologists and expressed by patients in terms of recommendations for PA and the modality itself.
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Affiliation(s)
- Aitor Martínez Aguirre-Betolaza
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
| | - Ander Dobaran Amezua
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Jon Cacicedo
- Department of Radiation Oncology, Cruces University Hospital, BioCruces Health Research Institute, Osakidetza, 48903 Barakaldo, Spain;
| | - Jurgi Olasagasti-Ibargoien
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
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25
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Brennan L, Sheill G, Collier S, Browne P, Donohoe CL, O'Neill L, Hussey J, Guinan EM. Personalised exercise rehabilitation in cancer survivorship: the percs triage and referral system study protocol. BMC Cancer 2024; 24:517. [PMID: 38654198 PMCID: PMC11040825 DOI: 10.1186/s12885-024-12266-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: 07/17/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND To effectively embed exercise rehabilitation in cancer survivorship care, a co-ordinated system of acute and community exercise rehabilitation services, forming a stepped model of care, is recommended. Patients can be directed to the exercise rehabilitation service which best meets their needs through a system of assessment, triage and referral. Triage and referral systems are not yet widely applied in cancer survivorship practice and need to be evaluated in real-world contexts. The PERCS (Personalised Exercise Rehabilitation in Cancer Survivorship) study aims to evaluate the real-world application of an exercise rehabilitation triage and referral system in cancer survivors treated during the COVID-19 pandemic. Secondary aims are to evaluate change in physical and psychosocial outcomes, and to qualitatively evaluate the impact of the system and patient experiences, at three months after application of the triage and referral system. METHODS This study will assess the implementation of an exercise rehabilitation triage and referral system within the context of a physiotherapy-led cancer rehabilitation clinic for cancer survivors who received cancer treatment during the COVID-19 pandemic. The PERCS triage and referral system supports decision making in exercise rehabilitation referral by recommending one of three pathways: independent exercise; fitness professional referral; or health professional referral. Up to 100 adult cancer survivors treated during the COVID-19 pandemic who have completed treatment and have no signs of active disease will be recruited. We will assess participants' physical and psychosocial wellbeing and evaluate whether medical clearance for exercise is needed. Participants will then be triaged to a referral pathway and an exercise recommendation will be collaboratively decided. Reassessment will be after 12 weeks. Primary outcomes are implementation-related, guided by the RE-AIM framework. Secondary outcomes include physical function, psychosocial wellbeing and exercise levels. Qualitative analysis of semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) will provide insights on implementation and system impact. DISCUSSION The PERCS study will investigate the real-world application of a cancer rehabilitation triage and referral system. This will provide proof of concept evidence for this triage approach and important insights on the implementation of a triage system in a specialist cancer centre. TRIAL REGISTRATION This study is registered on ClinicalTrials.gov, registration number: NCT05615285, date registered: 21st October 2022.
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Affiliation(s)
- Louise Brennan
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland.
- Trinity St James's Cancer Institute, Dublin, Ireland.
| | - Grainne Sheill
- Trinity St James's Cancer Institute, Dublin, Ireland
- Department of Physiotherapy, St James's Hospital, Dublin, Ireland
| | - Sonya Collier
- Psycho-Oncology Unit, St. James's Hospital, Dublin, Ireland
| | - Peter Browne
- Trinity St James's Cancer Institute Patient Representative Group, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Claire L Donohoe
- Trinity St James's Cancer Institute, Dublin, Ireland
- Department of Surgery, St James's Hospital, Dublin, Ireland
| | - Linda O'Neill
- Trinity St James's Cancer Institute, Dublin, Ireland
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Juliette Hussey
- Trinity St James's Cancer Institute, Dublin, Ireland
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Emer M Guinan
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
- Wellcome-Health Research Board Clinical Research Facility, Trinity College, St James's Hospital, Dublin, Ireland
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26
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Broadbent S, Buhmann R, Kriel Y, Coetzee S, Jones C, Morris M, Wright HH. Study protocol - assessing parkrun for walking rehabilitation for people living with, and beyond, cancer: acceptability, adherence, social support and physical function. BMC Sports Sci Med Rehabil 2024; 16:88. [PMID: 38641624 PMCID: PMC11027354 DOI: 10.1186/s13102-024-00882-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Due to a variety of barriers, the majority of cancer survivors do not do enough physical activity to meet current recommendations. This study will assess the feasibility of participation in parkrun walk-run events as a novel mode of community rehabilitation exercise. METHODS This protocol describes a single-arm intervention study with participants acting as their own controls. The study accepts adults diagnosed with any type of cancer, undergoing treatment or in remission. Participants must be able to walk and have medical clearance to exercise. A sample of 100 participants will be recruited across the Sunshine Coast over two years. Data will be collected over 9-months at 4 time points: Baseline (T1); after 4-weeks of usual daily activities and cancer management prior to parkrun participation(T2); after a 6-month parkrun intervention (T3); at 2-month follow-up (T4). The primary objectives are to assess the acceptability of, and adherence to, parkrun as rehabilitation exercise. Secondary outcomes include wellness, health-related quality of life, anxiety, depression, mood, physical function, parkrun metrics, dietary intake, and diet and exercise behaviour. CONCLUSION This study will be the first to examine the long-term effects of parkrun as a cancer rehabilitation modality with regard to physical function, psychosocial outcomes and dietary intake. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12623000473662 registered 09/05/2023.Approved by UniSC Human Research Ethics Committee (A221828) and the UK parkrun Research Board. Original protocol. Authors SB, RB, HHW, MM, YK.
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Affiliation(s)
- Suzanne Broadbent
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia.
| | - Robert Buhmann
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Yuri Kriel
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Sonja Coetzee
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Christian Jones
- School of Law and Society, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Michelle Morris
- Sunshine Coast University Private Hospital, 4575, Birtinya, QLD, Australia
| | - Hattie H Wright
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
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27
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Munsie C, Ebert J, Joske D, Collins J, Ackland T. The potential impact of exercise upon symptom burden in adolescents and young adults undergoing cancer treatment. Support Care Cancer 2024; 32:293. [PMID: 38632192 PMCID: PMC11023984 DOI: 10.1007/s00520-024-08497-0] [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: 07/21/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Adolescents and young adults (AYAs) experience vast symptom burden resulting from cancer treatment-related toxicities (TRTs). Evidence supports integrated exercise to mitigate several TRTs in other cohorts; however, evidence in AYAs is lacking. Conventional reporting of TRTs adopts a maximum grade approach failing to recognise the trajectory over time, of persistent, or lower grade toxicities. Alternatively, longitudinal analysis of toxicities over time (ToxT) may provide clinically meaningful summaries of this data. We evaluated the longitudinal impact of an exercise intervention on TRTs in AYAs undergoing cancer treatment. METHODS A prospective, randomised trial allocated participants to a 10-week exercise intervention (EG) or control group (CG) undergoing usual care. Detailed information on TRTs was collected throughout the intervention. All TRTs were graded per the Common Terminology Criteria for Adverse Events (CTCAE v5.0). RESULTS Forty-three (43) participants (63% male, mean age 21.1 years) were enrolled. When categorised to reflect the maximal worst grade experienced (Grade 0, Grade 1-2 and ≥ Grade 3), the CG reported an increased incidence of severe fatigue (≥ Grade 3) compared with the EG (p = 0.05). No other differences between groups were evident (p > 0.05). ToxT analysis of the four most common toxicities (fatigue, pain, nausea and mood disturbances) demonstrated no difference in the mean grade of each over time (p > 0.05). CONCLUSION A 10-week exercise intervention reduces the severity of fatigue in AYAs undergoing treatment. While the ToxT approach provided insight into the toxicity profile, adequately powered studies are needed to better understand these differences within a homogenous sample. TRIAL REGISTRATION (ACTRN12620000663954) 10th June 2020.
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Affiliation(s)
- Claire Munsie
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia.
- WA Youth Cancer Service, Locked Bag 2012, Nedlands, Perth, Western Australia, 6009, Australia.
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
| | - Jay Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - David Joske
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Jo Collins
- WA Youth Cancer Service, Locked Bag 2012, Nedlands, Perth, Western Australia, 6009, Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Timothy Ackland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
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28
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Short CE, Rawstorn JC, Jones TL, Edbrooke L, Hayes SC, Maddison R, Nightingale S, Ismail H, De Boer R, Hegi-Johnson F, Sverdlov AL, Bell R, Halligan I, Denehy L. Evaluating a Remotely Delivered Cardio-Oncology Rehabilitation Intervention for Patients With Breast Cancer (REMOTE-COR-B): Protocol for a Single-Arm Feasibility Trial. JMIR Res Protoc 2024; 13:e53301. [PMID: 38578682 PMCID: PMC11031702 DOI: 10.2196/53301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Exercise rehabilitation is a promising strategy for reducing cardiovascular disease risk among patients with breast cancer. However, the evidence is primarily derived from programs based at exercise centers with in-person supervised delivery. Conversely, most patients report a preference for home-based rehabilitation. As such, there is a clear need to explore strategies that can provide real-time supervision and coaching while addressing consumer preferences. Evidence from cardiac rehabilitation has demonstrated the noninferiority of a smartphone-based telerehabilitation approach (REMOTE-CR) to improve cardiorespiratory fitness in people with cardiovascular disease compared to a center-based program. OBJECTIVE This study aims to assess the feasibility, safety, and preliminary efficacy of the REMOTE-CR program adapted for patients with breast cancer at risk of cardiotoxicity (REMOTE-COR-B). We will also assess the satisfaction and usability of REMOTE-COR-B. METHODS We will conduct a single-arm feasibility study of the REMOTE-COR-B program among patients with stage I-III breast cancer who are at risk of cardiotoxicity (taking treatment type and dose, as well as other common cardiovascular disease risk factors into account) and who are within 24 months of completing primary definitive treatment. Participants (target sample size of 40) will receive an 8-week smartphone-based telerehabilitation exercise program involving remotely delivered real-time supervision and behavior change support. The platform comprises a smartphone and wearable heart rate monitor, as well as a custom-built smartphone app and web application. Participants will be able to attend remotely monitored exercise sessions during set operating hours each week, scheduled in both the morning and evening. Adherence is the primary outcome of the trial, assessed through the number of remotely monitored exercise sessions attended compared to the trial target (ie, 3 sessions per week). Secondary outcomes include additional trial feasibility indicators (eg, recruitment and retention), safety, satisfaction, and usability, and objective and patient-reported efficacy outcomes (cardiovascular fitness, quality of life, fatigue, self-reported exercise, self-efficacy, habit strength, and motivation). Adherence, feasibility, and safety outcomes will be assessed during the intervention period; intervention satisfaction and usability will be assessed post intervention; and objective and patient-reported efficacy outcomes will be assessed at baseline, post intervention (2-month postbaseline assessment), and at follow-up (5-month postbaseline assessment). RESULTS Recruitment for this trial commenced in March 2023, and 7 participants had been recruited as of the submission of the manuscript. The estimated completion date for the project is October 2024, with results expected to be published in mid-2025. CONCLUSIONS The REMOTE-COR-B intervention is a novel and promising approach to providing exercise therapy to patients with breast cancer at risk of cardiotoxicity who have unique needs and heightened safety risks. This project will provide important information on the extent to which this approach is satisfactory to patients with breast cancer, safe, and potentially effective, which is necessary before larger-scale research or clinical projects. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621001557820; www.anzctr.org.au/ACTRN12621001557820.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53301.
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Affiliation(s)
- Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jonathan C Rawstorn
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Tamara L Jones
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Sophie Nightingale
- Department of Surgical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Hilmy Ismail
- Department of Anaesthesia, Pain and Perioperative Medicine, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Richard De Boer
- Department of Surgical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Fiona Hegi-Johnson
- Department of Radiation Oncology, The Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Aaron L Sverdlov
- Newcastle Centre of Excellence in Cardio-Oncology, The University of Newcastle, Hunter Medical Research Institute, Calvary Mater Newcastle, Newcastle, Australia
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, Australia
| | - Robyn Bell
- Consumer representative, Melbourne, Australia
| | | | - Linda Denehy
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Australia
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Moraitis AM, Iacob E, Wong B, Beck SL, Echeverria C, Donaldson G, Mooney K. Pairing automated exercise coaching with patient-reported symptom monitoring: A way to nudge exercise uptake during cancer treatment? Support Care Cancer 2024; 32:258. [PMID: 38558321 DOI: 10.1007/s00520-024-08450-1] [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: 11/22/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Symptoms during cancer treatment cause burden, diminished physical functioning, and poor quality of life. Exercise is recommended during treatment to mitigate symptoms; however, interventions are difficult to translate into clinical care due to the lack of patient uptake and clinical implementation barriers. We evaluated the uptake, acceptability, and impact of an automated ePRO exercise module triggered by three patient-reported symptoms: nausea/vomiting, fatigue, and anxiety, during chemotherapy. METHODS We conducted a secondary analysis of an exercise module intervention imbedded in the cancer symptom monitoring and management platform, Symptom Care at Home (SCH). Utilizing behavioral economics principles, the exercise module was triggered when any of the three symptoms were reported. Once triggered, participants were coached on exercise benefits for symptom reduction and then offered the opportunity to set weekly exercise goals plus tracking of the goal outcomes and receive further encouragement. We examined uptake, exercise goal setting and attainment, and symptom impact. RESULTS Of 180 SCH participants receiving the SCH intervention, 170 (94.4%) triggered the exercise module and 102 of the 170 (60%) accepted the module, setting goals on average for 6.3 weeks. Of 102 participants, 82 (80.4%) achieved one or more exercise goals, exercising on average 79.8 min/week. Participants who achieved a higher proportion of goals had statistically significant lower overall symptom severity and lower severity of the triggered symptom. CONCLUSION An automated mHealth exercise coaching intervention, aimed to nudge those receiving chemotherapy to initiate an exercise routine had significant uptake, is acceptable and may reduce symptom severity. TRIAL REGISTRATION NCT01973946.
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Affiliation(s)
- Ann Marie Moraitis
- Dana Farber Cancer Institute, Department of Pediatric Oncology, Boston, MA, USA.
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Susan L Beck
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Gary Donaldson
- Pain Research Center, Department of Anesthesiology, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Kathi Mooney
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
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Li Q, Guo C, Cao B, Zhou F, Wang J, Ren H, Li Y, Wang M, Liu Y, Zhang H, Ma L. Safety and efficacy evaluation of personalized exercise prescription during chemotherapy for lung cancer patients. Thorac Cancer 2024; 15:906-918. [PMID: 38462754 PMCID: PMC11016390 DOI: 10.1111/1759-7714.15272] [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: 01/28/2024] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND To explore the safety and effectiveness of personalized exercise intervention during chemotherapy for lung cancer patients who were relatively weak and with compromised cardiopulmonary function. METHODS Thirty-eight lung cancer patients treated with chemotherapy at Peking University Third Hospital were enrolled in this prospective study. The exercise group (N = 21) received individualized exercise guidance based on personal test results and exercised regularly, while the control group (N = 17) only received exercise education and planed exercise methods according to their own preferences. Both groups underwent three fitness tests and clinical indicator assessments at 0, 6, and 12 weeks after starting the exercise, and the differences in trends of various indicators between the two groups were compared. RESULTS No exercise-related adverse events occurred during the 12-week exercise period. After 12 weeks of exercise training, in terms of fitness, the exercise group showed significant improvements in 6-min walk test (6MWT) (p < 0.001), peak oxygen consumption (VO2peak) (p = 0.005), muscle content (p < 0.001), muscle percentage (p < 0.001), and grip strength (p = 0.008) compared to the control group. In terms of clinical indicators, the exercise group showed significant improvements in vital capacity (p = 0.018), D-dimer (p = 0.031), and C-reactive protein (CRP) (p = 0.01), uric acid (p = 0.003), triglycerides (p < 0.001), functional average score (p < 0.001), and main symptom average score (p = 0.004) compared to the control group in trends over time. CONCLUSION Rehabilitation exercises using individualized exercise prescriptions tailored by exercise prescription specialists during chemotherapy are safe for lung cancer patients. Adhering to exercise can achieve comprehensive improvements in physical fitness and quality of life at 12 weeks.
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Affiliation(s)
- Qian Li
- Department of Medical Oncology and Radiation SicknessPeking University Third HospitalBeijingChina
| | - Chen Guo
- School of Sport ScienceBeijing Sport UniversityBeijingChina
| | - Baoshan Cao
- Department of Medical Oncology and Radiation SicknessPeking University Third HospitalBeijingChina
| | - Fanjie Zhou
- School of Sport ScienceBeijing Sport UniversityBeijingChina
| | - Jiulong Wang
- China Institute of Sports and Health ScienceBeijing Sport UniversityBeijingChina
| | - Hong Ren
- School of Sport ScienceBeijing Sport UniversityBeijingChina
| | - Yanchun Li
- China Institute of Sports and Health ScienceBeijing Sport UniversityBeijingChina
| | - Mopei Wang
- Department of Medical Oncology and Radiation SicknessPeking University Third HospitalBeijingChina
| | - Yane Liu
- Department of Medical Oncology and Radiation SicknessPeking University Third HospitalBeijingChina
| | - Hua Zhang
- Research Center of Clinical EpidemiologyPeking University Third HospitalBeijingChina
| | - Liwen Ma
- Department of Medical Oncology and Radiation SicknessPeking University Third HospitalBeijingChina
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Green A, Newton RU, Smith DP, Tuffaha H, Galvão DA, Heathcote P, Patel MI, Christie D, Egger S, Sara SA, Heneka N, Chambers SK, Dunn J. Prostate Cancer Survivorship Essentials for men with prostate cancer on androgen deprivation therapy: protocol for a randomised controlled trial of a tele-based nurse-led survivorship care intervention (PCEssentials Hormone Therapy Study). BMJ Open 2024; 14:e084412. [PMID: 38521521 PMCID: PMC10961537 DOI: 10.1136/bmjopen-2024-084412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/20/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION Androgen deprivation therapy (ADT) is commonly used to treat men with locally advanced or metastatic prostate cancer. Men receiving ADT experience numerous side effects and frequently report unmet supportive care needs. An essential part of quality cancer care is survivorship care. To date, an optimal effective approach to survivorship care for men with prostate cancer on ADT has not been described. This protocol describes a randomised trial of tele-based nurse-led survivorship that addresses this knowledge gap: (1) determine the effectiveness of a nurse-led survivorship care intervention (PCEssentials), relative to usual care, for improving health-related quality of life (HR-QoL) in men with prostate cancer undergoing ADT and (2) evaluate PCEssentials implementation strategies and outcomes, including cost-effectiveness, compared with usual care. METHODS AND ANALYSIS This is an effectiveness-implementation hybrid (type 1) trial with participants randomised to one of two arms: (1) minimally enhanced usual care and (2) nurse-led prostate cancer survivorship essentials (PCEssentials) delivered over four tele-based sessions, with a booster session 5 months after session 1. Eligible participants are Australian men with prostate cancer commencing ADT and expected to be on ADT for a minimum of 12 months. Participants are followed up at 3, 6 and 12 months postrecruitment. Primary outcomes are HR-QoL and self-efficacy. Secondary outcomes are psychological distress, insomnia, fatigue and physical activity. A concurrent process evaluation with participants and study stakeholders will be undertaken to determine effectiveness of delivery of PCEssentials. ETHICS AND DISSEMINATION Ethics approval was obtained from the Metro South Health HREC (HREC/2021/QMS/79429). All participants are required to provide written informed consent. Outcomes of this trial will be published in peer-reviewed journals. The findings will be presented at conferences and meetings, local hospital departments, participating organisations/clinical services, and university seminars, and communicated at community and consumer-led forums. TRIAL REGISTRATION NUMBER ACTRN12622000025730.
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Affiliation(s)
- Anna Green
- Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - David P Smith
- The Daffodil Centre, a joint venture with Cancer Council NSW, The University of Sydney, Sydney, New South Wales, Australia
| | - Haitham Tuffaha
- The University of Queensland, Saint Lucia, Queensland, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | | | - Manish I Patel
- University of Sydney, Sydney, New South Wales, Australia
| | - David Christie
- Genesiscare, Tugun, Queensland, Australia
- Bond University, Robina, Queensland, Australia
| | - Sam Egger
- The Daffodil Centre, a joint venture with Cancer Council NSW, The University of Sydney, Sydney, New South Wales, Australia
| | - Sally Am Sara
- Prostate Cancer Foundation of Australia, St Leonards, New South Wales, Australia
| | - Nicole Heneka
- Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | | | - Jeff Dunn
- Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
- Prostate Cancer Foundation of Australia, St Leonards, New South Wales, Australia
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Rodrigues B, Encantado J, Franco S, Silva MN, Carraça EV. Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2024:10.1007/s11764-024-01559-6. [PMID: 38448768 DOI: 10.1007/s11764-024-01559-6] [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: 12/10/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. METHODS Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. RESULTS Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. CONCLUSIONS This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. IMPLICATIONS FOR CANCER SURVIVORS Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.
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Affiliation(s)
- Bruno Rodrigues
- Faculty of Sport, University of Porto (Research Centre in Physical Activity, Health and Leisure), R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Jorge Encantado
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Sofia Franco
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Marlene N Silva
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Eliana V Carraça
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
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Western B, Ivarsson A, Vistad I, Demmelmaier I, Aaronson NK, Radcliffe G, van Beurden M, Bohus M, Courneya KS, Daley AJ, Galvão DA, Garrod R, Goedendorp MM, Griffith KA, van Harten WH, Hayes SC, Herrero-Roman F, Hiensch AE, Irwin ML, James E, Kenkhuis MF, Kersten MJ, Knoop H, Lucia A, May AM, McConnachie A, van Mechelen W, Mutrie N, Newton RU, Nollet F, Oldenburg HS, Plotnikoff R, Schmidt ME, Schmitz KH, Schulz KH, Short CE, Sonke GS, Steindorf K, Stuiver MM, Taaffe DR, Thorsen L, Velthuis MJ, Wenzel J, Winters-Stone KM, Wiskemann J, Berntsen S, Buffart LM. Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study. Scand J Med Sci Sports 2024; 34:e14575. [PMID: 38339809 DOI: 10.1111/sms.14575] [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: 09/07/2023] [Revised: 01/04/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. METHODS This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. RESULTS Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2 , performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment. CONCLUSIONS There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.
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Affiliation(s)
- Benedikte Western
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andreas Ivarsson
- Centre of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden
| | - Ingvild Vistad
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Demmelmaier
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gillian Radcliffe
- Lane Fox Respiratory Research Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Marc van Beurden
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
- Heidelberg University, Heidelberg, Germany
- Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Amanda J Daley
- Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Rachel Garrod
- Department of Respiratory Medicine, King's College London, London, UK
| | - Martine M Goedendorp
- Department of Psychology, University of Groningen, Groningen, Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- University of Twente, Enschede, The Netherlands
| | - Sandi C Hayes
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | | | - Anouk E Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Erica James
- School of Medicine & Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam University Medical Centers, Cancer Center Amsterdam and LYMMCARE, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alex McConnachie
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nanette Mutrie
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UK
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Hester S Oldenburg
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ron Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, Callaghan, New South Wales, Australia
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | | | - Karl-Heinz Schulz
- Competence Center for Sports- and Exercise Medicine (Athleticum) and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Cancer and Exercise Recovery Research Group (CanRex), Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabe S Sonke
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Miranda J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Jennifer Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | | | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Clinic, Heidelberg, Germany
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Bowman A, Denehy L, McDonald CE, Edbrooke L. "The Ability to Go Out into the World Is the Most Important Thing"-A Qualitative Study of Important Exercise Outcomes for People with Lung Cancer. Curr Oncol 2024; 31:733-746. [PMID: 38392048 PMCID: PMC10887680 DOI: 10.3390/curroncol31020054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Whilst existing quantitative research identifies outcomes believed to be important by researchers and clinicians, it may neglect outcomes that are meaningful to patients. This study aimed to explore the outcomes of exercise that are important to people with lung cancer and their carers. Data collection involved a qualitative methodology including semi-structured interviews and focus groups. Question guide development was informed by the International Classification of Functioning (ICF) framework. Data were analyzed by two researchers with NVivo (v12) software using a conventional content analysis process, followed by directed content analysis to map outcomes to the ICF. Conduct and reporting adhered to COREQ guidelines. Fifteen participants provided data. Most participants had received their diagnoses 24 months prior to study involvement (n = 9), and one-third had completed treatment (n = 5). Important outcomes were reported by participants across all domains of the ICF: activity and participation (n = 24), body function (n = 19), body structure (n = 5), environmental factors (n = 5), and personal factors (n = 1). Additional code categories pertained to the impacts of non-cancer factors such as age, frailty, and comorbidities; identifying barriers to exercise; and individualizing outcome measures. Clinicians and researchers should consider selecting outcomes from all relevant domains of the ICF, with a focus on the activity and participation domain, in addition to non-cancer factors such as ageing, frailty, and co-morbidities. Feedback should be provided to patients following outcome measures collection and reassessment.
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Affiliation(s)
- Amy Bowman
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC 3053, Australia; (A.B.); (L.D.); (C.E.M.)
- Department of Physiotherapy, Peter Mac Callum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC 3053, Australia; (A.B.); (L.D.); (C.E.M.)
- Department of Health Services Research, Peter Mac Callum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Cassie E. McDonald
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC 3053, Australia; (A.B.); (L.D.); (C.E.M.)
- Allied Health, Alfred Health, Melbourne, VIC 3004, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC 3053, Australia; (A.B.); (L.D.); (C.E.M.)
- Department of Health Services Research, Peter Mac Callum Cancer Centre, Melbourne, VIC 3000, Australia
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Hayes SC, Spence RR, Janda M, Eakin E, Shannon C, Goh J, Beesley VL, Vagenas D, Webb P, Coward J, Gordon LG, O'Neill H, Williams M, Rye S, Newton MJ, Baniahmadi S, Nascimento M, Nicklin J, Garret A, Obermair A. Pre-post feasibility trial of a telephone-delivered exercise intervention for patients during chemotherapy for recurrent ovarian cancer: the ECHO-R trial protocol. BMJ Open 2024; 14:e077158. [PMID: 38238061 PMCID: PMC10806642 DOI: 10.1136/bmjopen-2023-077158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION The benefits of exercise in reducing treatment-related morbidity and improving quality of life following a primary diagnosis of cancer have been well documented and have led to exercise being recommended by oncology societies for all people with a cancer diagnosis. However, these recommendations are derived from research typically involving cohorts with more common cancers and relatively good prognosis, such as breast and prostate. Evidence from these cancers may not apply to women with recurrent ovarian cancer. Therefore, the primary objective of this trial is to evaluate the feasibility and safety of a home-based, telephone-delivered exercise intervention for women undergoing chemotherapy for recurrent ovarian cancer. METHODS AND ANALYSIS The Exercise During Chemotherapy for Recurrent Ovarian Cancer (ECHO-R) trial is a single-arm, phase II, pre/postintervention trial of a 6-month, telephone-delivered exercise intervention (consistent with recommended exercise oncology prescription). The target sample size is 80 women who are currently undergoing (or are scheduled to receive) chemotherapy for recurrent ovarian cancer. Recruitment is through participating hospital sites in Queensland, Australia, or via self-referral. The exercise intervention comprises 12 telephone sessions over a 6-month period delivered by trial-trained exercise professionals and supplemented (where feasible) by five sessions face to face. Exercise prescription is individualised and works towards an overall goal of achieving a weekly target of 150 min of moderate-intensity, mixed-mode exercise. Assessments via self-administered survey and physical fitness and function tests occur at baseline and then at 6 and 9 months postbaseline. Data to inform feasibility and safety are recorded as case notes by the exercise professional during each session. ETHICS AND DISSEMINATION Ethics approval for the ECHO-R trial was granted by the Metro North Human Research Ethics Committee (HREC/2020/QRBW/67223) on 6 November 2020. Findings from the trial are planned to be disseminated via peer-reviewed publications and both national and international exercise and oncology conferences. TRIAL REGISTRATION NUMBER ACTRN12621000042842.
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Affiliation(s)
- Sandra C Hayes
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Rosalind R Spence
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Monika Janda
- Faculty of Medicine, Centre of Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth Eakin
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Catherine Shannon
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
| | - Jeffrey Goh
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
| | - Vanessa L Beesley
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Dimitrios Vagenas
- School of Public Health and Social Work, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
| | - Penny Webb
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Jermaine Coward
- Faculty of Medicine and ICON Cancer Care Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Louisa G Gordon
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Helene O'Neill
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
| | - Merran Williams
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
| | - Sheree Rye
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Melissa J Newton
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Sara Baniahmadi
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
| | | | - James Nicklin
- Gynaecological Cancer, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Andrea Garret
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
| | - Andreas Obermair
- Queensland Centre for Gynaecological Cancer Research, The University of Queensland, Herston, Queensland, Australia
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Morano T, Lancia F, Di Marco A, Viscioni G, Bucci I, Grossi S, Pellegrino R, Cugusi L, Grassadonia A, Manca A, Bullo V, Di Giminiani R, Izzicupo P, Di Baldassarre A, Fusco A, Cortis C, Napolitano G, Di Blasio A. Flexibility and Strength Effects of Adapted Nordic Walking and Myofascial Exercises Practice in Breast Cancer Survivors and Analysis of Differences. Healthcare (Basel) 2024; 12:222. [PMID: 38255109 PMCID: PMC10815343 DOI: 10.3390/healthcare12020222] [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: 12/07/2023] [Revised: 01/07/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
Breast cancer treatments can elicit negative kinesiological side effects concerning both the posture and functional status of breast cancer survivors. As our body is functionally organized in myofascial meridians, physical exercise practice should favor a whole-body approach rather than a local one. The aim of the study was to investigate and compare the effects of two whole-body disciplines, i.e., adapted Nordic Walking and myofascial exercise, on the flexibility and strength performances in BCS. One hundred and sixty breast cancer survivors were trained three times per week for 12 weeks through adapted Nordic Walking or myofascial exercise. Handgrip, sit and reach, back scratch, and single leg back bridge tests and body composition were assessed at the beginning and completion of the training period. Linear mixed models showed no significant changes in body composition, whereas flexibility (p < 0.001), strength (p < 0.001), and muscle quality index (p = 0.003) changed independently from the treatment. When data modification has been analyzed according to sub-sample membership, no significant differences have been observed. Age, radiation therapy, and chemotherapy seem to have independent effects on several investigated variables. Twelve weeks of adapted myofascial exercise and Nordic Walking led to significant changes in flexibility, strength, and muscle quality in breast cancer survivors, with no apparent superiority of one approach over the other.
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Affiliation(s)
- Teresa Morano
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Federica Lancia
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Alessandra Di Marco
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Gianluca Viscioni
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro L.A. 10, 37124 Verona, Italy;
| | - Ines Bucci
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Simona Grossi
- Eusoma Breast Center, “G. Bernabeo” Hospital, ASL02 Lanciano-Vasto-Chieti, c.da S. Liberata, 66026 Ortona, Italy;
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland;
| | - Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy; (L.C.); (A.M.)
| | - Antonino Grassadonia
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy; (L.C.); (A.M.)
| | - Valentina Bullo
- Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy;
| | - Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio, 67100 L’Aquila, Italy;
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo, 03043 Cassino, Italy; (A.F.); (C.C.)
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo, 03043 Cassino, Italy; (A.F.); (C.C.)
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
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Xing R, Wang R, Zopf EM, Rachele JN, Wang Z, Li Y, Zhu W. Effects of qigong exercise on physical fitness and patient-reported health outcomes in lung cancer survivors. Support Care Cancer 2024; 32:99. [PMID: 38214783 DOI: 10.1007/s00520-023-08296-z] [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: 08/28/2023] [Accepted: 12/27/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE The aim of this study was to investigate the effects of a three-month Guolin Qigong (GQ) intervention on physical fitness and patient-reported health outcomes among patients with lung cancer. METHODS This pilot study was a non-randomized controlled trial. Eligible participants who were over 18 years of age and diagnosed with stage I-IV lung cancer were enrolled in the study and received either the GQ intervention or usual care (UC). Participants in the GQ group performed GQ at least twice a week (one hour per session) for three months. Physical fitness (chair stand, arm curl, sit and reach, back scratch, 8-foot up and go, 6-min walk test) was assessed at baseline, post-intervention, six months, and 12 months. Self-reported quality of life and sleep (European Organization for Research and Treatment of Cancer Quality of Life questionnaire and Pittsburgh Sleep Quality Index) were assessed at baseline, post-intervention, and six months. RESULTS Forty-nine participants (65% females, 59.1 ± 7.0 years old, ranging from 39 to 71 years old) were enrolled in the study, and 25 participants completed all tests at 12-month follow-up (13 in GQ vs. 12 in UC; 68% females, 59.3 ± 5.5 years old). Compared to the UC group, results for the chair stand and arm curl tests improved significantly in the GQ group from baseline to post-intervention (P = 0.024 and P = 0.041, respectively). Similarly, the 8-foot up and go test improved in the GQ group from baseline to post-intervention and 12 months (P = 0.004 and P = 0.008, respectively) when compared to the UC group. Between-group analyses also revealed a statistically significant improvement in global health status/quality of life from baseline to six months (P = 0.018) and quality of sleep from baseline to post-intervention (P = 0.034) in favor of the GQ group. CONCLUSION GQ had a beneficial effect on lower and upper body strength, locomotor performance (speed, agility, and balance while moving), quality of sleep, and quality of life among lung cancer survivors, but further randomized controlled trials are warranted to confirm these findings. TRIAL REGISTRATION The trial has been registered in the Chinese Clinical Trial Registry (ChiCTR2200059145).
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Affiliation(s)
- Ruirui Xing
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Renwei Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
| | - Eva M Zopf
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Department of Medical Oncology, Cabrini Cancer Institute, Cabrini Health, Melbourne, Victoria, Australia
| | - Jerome N Rachele
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- College of Sport, Health and Engineering, Victoria University, Melbourne, Australia
| | - Zhen Wang
- School of Martial Arts, Shanghai University of Sport, Shanghai, China.
| | - Yuchao Li
- School of Physical Education, Taiyuan Normal University, Jinzhong, China
| | - Weimo Zhu
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, 61801, USA
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Skouras AZ, Antonakis-Karamintzas D, Tsolakis C, Koulouvaris P. Unraveling the "golden ratio": a pilot study investigating acute-to-chronic workload ratio in breast cancer patients undergoing active treatment. Front Physiol 2024; 14:1273624. [PMID: 38260104 PMCID: PMC10801086 DOI: 10.3389/fphys.2023.1273624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Training load monitoring is a common practice in sports medicine for supporting athletes' health and performance. Despite progress in exercise oncology research for breast cancer patients, training load monitoring is underutilized. This study retrospectively investigated the relationship between maintained training load within a defined range and physical and health outcomes of ten breast cancer patients during active anticancer treatment who underwent a 12-week exercise program. Intervention consisted of endurance and resistance training, three times a week, with each session lasting 30-45 min. Assessments were conducted at baseline, 6 and 12 weeks after enrollment, evaluating physical function (6-min walk test-6MWT, and sit-to-stand), muscle strength, body composition, sleep quality (Pittsburgh Sleep Quality Index-Pittsburgh Sleep Quality Index), quality of life (EORTC-QLQ-C30), heart rate variability and physical activity levels (International Physical Activity Questionnaire-International Physical Activity Questionnaire). The Physiological Cost Index/Energy Expenditure Index (PCI/EEI) was estimated using the 6MWT and Heart rate. Training load monitoring was performed by session rating of perceived exertion (sRPE, relative intensity multiplying with session duration). Acute-to-Chronic Workload Ratio (ACWR) (7:28, rolling average) was calculated accordingly. Analyses were performed within-subjects across time points and between-subjects, comparing those who maintained from weeks 6-12 an ACWR of 0.8-1.3 with those who did not. Adherence rates were similar between groups. Physical function improved in the total sample with large effect sizes (Δ6MWT = 56.5 m [95%CI: 6-100 m], effect size [w] = 0.52, p = 0.006; ΔSit-to-Stand = 1.5 [95%CI: 1-5], effect size [w] = 0.681, p < 0.001), demonstrating greater changes in patients with higher ACWR. Sleep quality improvements were higher in the appropriate ACWR group (p = 0.016). A positive correlation was demonstrated between global health status and 6MWT change from baseline to 12 weeks (ρ = 0.689, p = 0.04). Despite a small sample size, patients maintaining sufficient relative training load presented greater physical fitness and sleep quality improvements. Thus, training load monitoring may enhance exercise program benefits in breast cancer patients under active treatment.
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Affiliation(s)
- Apostolos Z. Skouras
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Antonakis-Karamintzas
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Charilaos Tsolakis
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Koulouvaris
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Murphy K, Kehoe B, Denieffe S, Hacking D, Fairman CM, Harrison M. A comparison of aerobic- and resistance-emphasised exercise on cardiometabolic health and quality of life in men receiving androgen deprivation therapy for prostate cancer: Protocol for a feasibility trial. Contemp Clin Trials 2024; 136:107388. [PMID: 37972755 DOI: 10.1016/j.cct.2023.107388] [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: 06/19/2023] [Revised: 10/15/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Those with intermediate and high-risk prostate cancer typically receive androgen deprivation therapy (ADT) as part of their treatment. ADT often results in extensive side effects including increased risk of cardiometabolic disease. Many ADT side effects can be influenced by exercise, both resistance and aerobic training. Exercise regimes typically combine aerobic and resistance exercise but the appropriate emphasis for achieving the broadest range of therapeutic benefits has yet to be determined. We propose to determine the feasibility of undertaking a larger trial comparing a resistance- vs an aerobic-emphasised exercise intervention in men with prostate cancer undergoing ADT. The trial will also investigate preliminary evidence of difference between arms for cardiometabolic health and quality of life outcomes. METHODS This is a 6-month randomised two-armed feasibility trial. Prostate cancer patients undergoing ADT and radiotherapy will be recruited (n = 24) and randomised to either a resistance- or aerobic-emphasised group. Participants will attend twice-weekly supervised individual or small group sessions, with 75% of exercise time in the primary exercise modality. The primary outcome will be feasibility, determined via assessment of recruitment, retention, adherence, safety, and acceptability. Secondary outcomes will include quality of life, body composition, vascular indices, aerobic and muscular fitness and cardiometabolic health blood biomarkers. CONCLUSION It is envisaged that the trial will provide valuable information and preliminary difference data that will aid in the design of an efficacious larger trial that will adopt a major and minor emphasis approach to the scheduling of resistance and aerobic exercise.
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Affiliation(s)
- Kira Murphy
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland; UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Bróna Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Suzanne Denieffe
- School of Humanities, South East Technological University, Waterford, Ireland
| | - Dayle Hacking
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Ciaran M Fairman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Harrison
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland.
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Bertoni G, Conti V, Testa M, Coppola I, Costi S, Battista S. Physiotherapists' training in oncology rehabilitation from entry-level to advanced education: A qualitative study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2060. [PMID: 37916455 DOI: 10.1002/pri.2060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/14/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND AND PURPOSE Physiotherapy is gaining a central role in oncology. However, the training and competencies needed by physiotherapists in oncology rehabilitation are still unclear. This study aims to articulate the training trajectory of physiotherapists in oncology rehabilitation from entry-level education to advanced education degrees. METHODS Qualitative focus group study following a 'Reflexive Thematic Analysis' for data analysis. Participants were Italian physiotherapists with expertise in Oncology Rehabilitation (either clinically or academically) and Physiotherapy Bachelor of Science (BSc) course leaders, selected through purposive sampling. RESULTS Two focus groups were conducted with 14 participants. Six themes were developed: 1. 'Entry-Level Education in Oncology Rehabilitation: Let's Have a Taste', as the BSc introduces oncology rehabilitation. 2. 'Basic Knowledge: Building up the Library' as students acquire basic knowledge on oncology rehabilitation during their BSc; 3. 'Learning by Experience: The Relevance of the Placement' to answer the question "Is this the right road for me?"; 4. 'Clinical Reasoning and Competencies in Oncology Rehabilitation Embedded in Uncertainty' because oncology physiotherapists need to deal with the uncertainty of their patients' status; 5. 'Advanced Education Degree Skills: from Appetiser to the Main Course', as advanced education degree courses allow for becoming an expert in the field; 6. 'A Call to Action for Physiotherapists: Prevention-Diagnosis-Survivorship & End of Life', to realise their critical role in all the phases of the oncology path. CONCLUSIONS The BSc in Physiotherapy provides a foundation for future physiotherapists to understand oncology rehabilitation, but advanced education is necessary for expertise. The findings of this study have important implications for creating a shared physiotherapy curriculum in oncology rehabilitation. IMPLICATION FOR PHYSIOTHERAPY PRACTICE This study has significant implications for improving physiotherapy curricula in oncology rehabilitation, positively impacting the skills and competencies of practitioners in this paramount field.
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Affiliation(s)
- Gianluca Bertoni
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Genova, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Training Unit, Azienda Sociosanitaria Territoriale di Cremona, Cremona, Italy
| | - Valentina Conti
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Genova, Italy
| | - Ilaria Coppola
- Department of Education Sciences, School of Social Sciences, University of Genova, Genova, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Campus of Savona, Genova, Italy
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Meyer T. The language of science - Selected JSAMS papers now published in Spanish. J Sci Med Sport 2024; 27:1-2. [PMID: 38225059 DOI: 10.1016/j.jsams.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
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Lakicevic N, Ficarra S, Ortega-Gómez S, Jiménez-Pavón D, Asimakopoulou Z, Vantarakis A, Tavares P, Vaz V, Thaller J, Papakonstantinou S, Kirkar M, Glorioso F, Palma A, Bianco A. One more rep! The case for resistance training in young cancer survivors. Front Oncol 2023; 13:1284052. [PMID: 38111526 PMCID: PMC10726118 DOI: 10.3389/fonc.2023.1284052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/06/2023] [Indexed: 12/20/2023] Open
Abstract
Resistance training is now seen as a powerful tool to improve the health and functionality of cancer survivors. Literature shows that it can be implemented both during and after cancer treatment, with the intent of preserving muscle mass in the former and increasing muscle mass in the latter case. However, currently available data on this matter are predominantly derived from adult cancer survivors (ACS), and it is questionable whether the exact same raining regimen should be implemented in young cancer survivors (YCS) given the unique challenges they experience throughout their disease trajectory. Therefore, the goal of this work is to distill the existing evidence on resistance training (RT) interventions in ACS and facilitate discussion on whether the same patterns of RT can be applied in YCS.
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Affiliation(s)
- Nemanja Lakicevic
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Sonia Ortega-Gómez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Zoi Asimakopoulou
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Apostolos Vantarakis
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Paula Tavares
- Faculty of Sport Sciences and Physical Education and ICBR Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Vasco Vaz
- Faculty of Sport Sciences and Physical Education and ICBR Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joshua Thaller
- Department of Health Consulting, Research and Science, Outdoor Against Cancer, Munich, Germany
| | | | - Musa Kirkar
- Centro Internazionale per la Promozione dell’educazione e lo Sviluppo (CEIPES), Palermo, Italy
| | - Francesca Glorioso
- Lega Italiana per la lotta Contro i Tumori (LILT Palermo), Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
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Swaby A, Atallah A, Varol O, Cristea A, Quail DF. Lifestyle and host determinants of antitumor immunity and cancer health disparities. Trends Cancer 2023; 9:1019-1040. [PMID: 37718223 DOI: 10.1016/j.trecan.2023.08.007] [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: 07/05/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023]
Abstract
Lifestyle factors exert profound effects on host physiology and immunology. Disparities in cancer outcomes persist as a complex and multifaceted challenge, necessitating a comprehensive understanding of the interplay between host environment and antitumor immune responses. Determinants of health - such as obesity, diet, exercise, stress, or sleep disruption - have the potential for modification, yet some exert long-lasting effects and may challenge the notion of complete reversibility. Herein we review intersectional considerations of lifestyle immunity and the impact on tumor immunology and disparities in cancer outcomes, with a focus on obesity.
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Affiliation(s)
- Anikka Swaby
- Goodman Cancer Research Institute, Montreal, QC, Canada; Department of Experimental Medicine, McGill University, Montreal, QC, Canada
| | - Aline Atallah
- Goodman Cancer Research Institute, Montreal, QC, Canada; Department of Experimental Medicine, McGill University, Montreal, QC, Canada
| | - Ozgun Varol
- Goodman Cancer Research Institute, Montreal, QC, Canada; Department of Experimental Medicine, McGill University, Montreal, QC, Canada
| | - Alyssa Cristea
- Goodman Cancer Research Institute, Montreal, QC, Canada; Department of Experimental Medicine, McGill University, Montreal, QC, Canada
| | - Daniela F Quail
- Goodman Cancer Research Institute, Montreal, QC, Canada; Department of Experimental Medicine, McGill University, Montreal, QC, Canada; Department of Physiology, McGill University, Montreal, QC, Canada.
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Murray J, Bennett H, Perry R, Bezak E, Davison K. How do practitioners prescribe exercise to patients with breast cancer? Professional perspectives on the key considerations for aerobic exercise in patients with breast cancer undergoing chemotherapy. J Sci Med Sport 2023; 26:650-658. [PMID: 37806824 DOI: 10.1016/j.jsams.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES This study aimed to understand the key factors experienced accredited exercise physiologists (AEPs) and medical professionals consider when prescribing/recommending aerobic exercise to patients with breast cancer undergoing chemotherapy. DESIGN Modified Delphi Survey. METHODS A four-round, two-phase survey was conducted. Following a Delphi approach, four cancer-specific AEPs, four oncologists, and one breast cancer surgeon (median 13-yr breast-cancer-specific experience) completed phase one. Eighty-four AEPs (median 5-yr experience) completed phase two. Phase one participants answered open- and close-ended questions regarding key considerations for aerobic exercise in patients with breast cancer undergoing chemotherapy, and what information should be collected to guide exercise prescription. All questions and considerations agreed upon in phase one (>70 % rating 7-9 on a 0-9 Likert Scale) were rated by AEPs in phase two. RESULTS Key considerations for exercise assessment and prescription aligned closely with exercise guidelines for cancer survivors. Common strategies for exercise individualisation were identified by AEPs, including separating aerobic exercise into 5-to--9-minute bouts when required and avoiding exercising to complete exhaustion. Exercise intensity and duration should be adjusted throughout chemotherapy to improve tolerance and adherence. Novel considerations for subjective questioning and objective assessments to tailor exercise prescription were outlined. CONCLUSIONS This study identifies how professionals approach exercise assessment and prescription in patients with breast cancer undergoing chemotherapy. Findings can guide AEPs in practice when prescribing tailored exercise to breast cancer patients undergoing chemotherapy and inform future guidelines.
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Affiliation(s)
- James Murray
- Allied Health and Human Performance, University of South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia; Cancer Research Institute, University of South Australia, Australia.
| | - Hunter Bennett
- Allied Health and Human Performance, University of South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia.
| | - Rebecca Perry
- Allied Health and Human Performance, University of South Australia, Australia; Cancer Research Institute, University of South Australia, Australia.
| | - Eva Bezak
- Allied Health and Human Performance, University of South Australia, Australia; Cancer Research Institute, University of South Australia, Australia; Department of Physics, University of Adelaide, Australia.
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia.
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Kudiarasu C, Lopez P, Galvão DA, Newton RU, Taaffe DR, Mansell L, Fleay B, Saunders C, Fox-Harding C, Singh F. What are the most effective exercise, physical activity and dietary interventions to improve body composition in women diagnosed with or at high-risk of breast cancer? A systematic review and network meta-analysis. Cancer 2023; 129:3697-3712. [PMID: 37788151 DOI: 10.1002/cncr.35043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/28/2023] [Accepted: 09/07/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Obesity has been recognized as a risk factor in the development and recurrence of breast cancer and is also associated with poor prognostic outcomes. This systematic review and network meta-analysis aimed to identify the most effective exercise, physical activity, and dietary interventions to reduce fat mass, body fat percentage and body weight as well as potentially increase lean mass in women diagnosed with or at high risk of breast cancer. METHODS A systematic search of databases was performed up to May 2022. Eligible randomized controlled trials examined the effects of exercise, physical activity and/or dietary interventions on fat mass and lean mass in women diagnosed with or at high risk of breast cancer. A random-effects network meta-analysis was conducted to determine the effects of different interventions across outcomes when sufficient studies were available. RESULTS Eighty-four studies (n = 6428) were included in this review. Caloric restriction and combined exercise + caloric restriction significantly reduced fat mass (range, -3.9 to -3.7 kg) and body weight (range, -5.3 to -4.7 kg), whereas physical activity + caloric restriction significantly reduced body fat percentage (-2.4%; 95% confidence interval [CI], -3.4% to -13%) and body mass index (-2.2 kg × m-2 ; 95% CI, -3.0 to -1.4 kg × m-2 ) in breast cancer patients. Resistance exercise was the most effective intervention to increase lean mass (0.7 kg; 95% CI, 0.5-1.0 kg) in breast cancer patients. CONCLUSION Multimodal exercise and diet programs were the most effective interventions to reduce fat mass, body fat percentage, and body weight and increase and/or preserve lean mass.
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Affiliation(s)
- Christine Kudiarasu
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Pedro Lopez
- Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lorna Mansell
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Brianna Fleay
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Christobel Saunders
- Department of Surgery, University of Melbourne (Royal Melbourne Hospital), Parkville, Victoria, Australia
| | - Caitlin Fox-Harding
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Favil Singh
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Chan CW, Leung SF, Molassiotis A. Can more be done? - A qualitative study of breast cancer survivors' perspectives on regular walking exercise to improve post-chemotherapy neurotoxicity impairments. Eur J Oncol Nurs 2023; 67:102432. [PMID: 37879196 DOI: 10.1016/j.ejon.2023.102432] [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: 07/21/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Chemotherapy-induced neurotoxicity in breast cancer survivors requires attention as their population are increasing. Limited qualitative study is known about breast cancer survivors' perspectives on regular walking exercise to improve post-chemotherapy neurotoxicity impairments in their free-living setting. This study explored regular walking exercise to improve post-chemotherapy neurotoxicity impairments from breast cancer survivors' perspectives. METHODS A qualitative descriptive study was conducted. A purposive sample of 15 participants experiencing neurotoxicity impairments was invited to semi-structured interviews. Textual interview data were managed in NVivo. Content analysis was performed. RESULTS Participants were aged 39-68 and had received 4-8 cycles of chemotherapy. Most (86.7%, n = 13) reported engaging in regular walking exercise. Four main categories emerged from the data: (1) perceived effects of regular exercise on neurotoxicity impairments, (2) unmet information needs, (3) regular walking habit being self-sustained, and (4) enablers and constraints of regular walking exercise. CONCLUSIONS Walking exercise, as commonly employed by participants in their free-living setting, was the essence in the management of chemotherapy-induced neurotoxic conditions during survivorship. Participants undertaking walking exercise lacked informed and individualized information about the regular walking exercise regime, and vigilance to evaluate post-exercise neurotoxic conditions. These might be the unmet needs of this research area and in clinical practice. Assessing and addressing individualized endeavors in a walking exercise regime will continue to be a vital component of cancer supportive care to fill the unmet information needs in survivorship.
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Affiliation(s)
- Choi Wan Chan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hum, Kowloon, Hong Kong.
| | - Sau Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hum, Kowloon, Hong Kong.
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom.
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Moore M, Northey JM, Crispin P, Semple S, Toohey K. Effects of Exercise Rehabilitation on Physical Function in Adults With Hematological Cancer Receiving Active Treatment: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151504. [PMID: 37743111 DOI: 10.1016/j.soncn.2023.151504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/27/2023] [Accepted: 08/26/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE Evaluate the efficacy of exercise rehabilitation at improving physical function during active treatment for adults diagnosed with a hematological malignancy. DATA SOURCE Systematic review with a multilevel meta-analysis of randomized trails was conducted. Four electronic databases, MEDLINE (EBSCOhost), CINAHL, Scopus, and CENTRAL, were searched using key words and medical subject headings. Articles were screened and assessed against the predetermined eligibility criteria. Data extracted were appraised using the Cochrane risk of bias tool for randomized trials and the GRADE guidelines. A meta-analysis examined four key clinical objectives. CONCLUSION Twelve studies representing a total of 812 participants were included. Analysis of 36 dependent effect sizes from nine studies revealed structured and prescribed exercise interventions improved physical function (SMD = 0.39; 95% CI 0.21-0.57) compared to usual care or an active control. Exercise interventions with a multimodal design consisting of both aerobic and resistance exercise had a statistically significant effect on physical function (P < .001). Exercise intensity also had a statistically significant effect on physical function when prescribed at a moderate (P = .003) and vigorous (P < .001) intensity during active treatment in patients with leukemia or lymphoma. IMPLICATIONS FOR NURSING PRACTICE This review suggests individuals diagnosed with leukemia or lymphoma can optimize physical function during and immediately post-treatment by attending exercise rehabilitation 3-5 times per weeks performing moderate-vigorous aerobic and resistance exercise. While further research is needed to identify optimal prescription guidelines throughout the treatment continuum, this review underscores the importance for hematology nurses to support patient referrals to exercise oncology professionals to gain positive improvements in physical function.
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Affiliation(s)
- Melanie Moore
- Faculty of Health and Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Australia.
| | - Joseph M Northey
- Faculty of Health and Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Philip Crispin
- Haematology Department, Canberra Hospital, Australian and Australian National University Medical School, Canberra, Australia
| | - Stuart Semple
- Faculty of Health, University of Canberra, Australia
| | - Kellie Toohey
- Faculty of Health and Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Australia; Faculty of Health and Research Institute for Sport and Exercise, University of Canberra, Australia; Faculty of Health, Southern Cross University, Queensland, Australia
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48
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Hart NH, Wallen MP, Farley MJ, Haywood D, Boytar AN, Secombe K, Joseph R, Chan RJ, Kenkhuis MF, Buffart LM, Skinner TL, Wardill HR. Exercise and the gut microbiome: implications for supportive care in cancer. Support Care Cancer 2023; 31:724. [PMID: 38012463 DOI: 10.1007/s00520-023-08183-7] [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: 08/09/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE Growing recognition of the gut microbiome as an influential modulator of cancer treatment efficacy and toxicity has led to the emergence of clinical interventions targeting the microbiome to enhance cancer and health outcomes. The highly modifiable nature of microbiota to endogenous, exogenous, and environmental inputs enables interventions to promote resilience of the gut microbiome that have rapid effects on host health, or response to cancer treatment. While diet, probiotics, and faecal microbiota transplant are primary avenues of therapy focused on restoring or protecting gut function in people undergoing cancer treatment, the role of physical activity and exercise has scarcely been examined in this population. METHODS A narrative review was conducted to explore the nexus between cancer care and the gut microbiome in the context of physical activity and exercise as a widely available and clinically effective supportive care strategy used by cancer survivors. RESULTS Exercise can facilitate a more diverse gut microbiome and functional metabolome in humans; however, most physical activity and exercise studies have been conducted in healthy or athletic populations, primarily using aerobic exercise modalities. A scarcity of exercise and microbiome studies in cancer exists. CONCLUSIONS Exercise remains an attractive avenue to promote microbiome health in cancer survivors. Future research should elucidate the various influences of exercise modalities, intensities, frequencies, durations, and volumes to explore dose-response relationships between exercise and the gut microbiome among cancer survivors, as well as multifaceted approaches (such as diet and probiotics), and examine the influences of exercise on the gut microbiome and associated symptom burden prior to, during, and following cancer treatment.
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Affiliation(s)
- Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia.
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.
| | - Matthew P Wallen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Institute for Health and Wellbeing, Federation University, Ballarat, VIC, Australia
| | - Morgan J Farley
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia
- Mental Health Division, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Alexander N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Kate Secombe
- The University of Queensland Diamantina Institute, Faculty of Medicine, The University of Queensland, St. Lucia, QLD, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Ria Joseph
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tina L Skinner
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Hannah R Wardill
- School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
- Supportive Oncology Research Group, Precision Cancer Medicine, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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49
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Wagoner CW, Daun JT, Danyluk J, Twomey R, Murphy L, Peterson M, Gentleman E, Capozzi LC, Francis GJ, Chandarana SP, Hart RD, Matthews TW, McKenzie D, Matthews J, Nakoneshny SC, Schrag C, Sauro KM, Dort JC, Manaloto V, Burnett L, Chisholm A, Lau H, Culos-Reed SN. Multiphasic exercise prehabilitation for patients undergoing surgery for head and neck cancer: a hybrid effectiveness-implementation study protocol. Support Care Cancer 2023; 31:726. [PMID: 38012345 DOI: 10.1007/s00520-023-08164-w] [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: 08/16/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
Head and neck cancer (HNC) treatment often consists of major surgery followed by adjuvant therapy, which can result in treatment-related side effects, decreased physical function, and diminished quality of life. Perioperative nutrition interventions and early mobilization improve recovery after HNC treatment. However, there are few studies on prehabilitation that include exercise within the HNC surgical care pathway. We have designed a multiphasic exercise prehabilitation intervention for HNC patients undergoing surgical resection with free flap reconstruction. We will use a hybrid effectiveness-implementation study design guided by the RE-AIM framework to address the following objectives: (1) to evaluate intervention benefits through physical function and patient-reported outcome assessments; (2) to determine the safety and feasibility of the prehabilitation intervention; (3) to evaluate the implementation of exercise within the HNC surgical care pathway; and (4) to establish a post-operative screening and referral pathway to exercise oncology resources. The results of this study will provide evidence for the benefits and costs of a multiphasic exercise prehabilitation intervention embedded within the HNC surgical care pathway. This paper describes the study protocol design, multiphasic exercise prehabilitation intervention, planned analyses, and dissemination of findings. Trial registration: https://clinicaltrials.gov/NCT04598087.
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Affiliation(s)
- Chad W Wagoner
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada.
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada
| | - Jessica Danyluk
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada
| | - Rosie Twomey
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada
| | - Lisa Murphy
- Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Megan Peterson
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Elaine Gentleman
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada
| | - Lauren C Capozzi
- Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - George J Francis
- Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shamir P Chandarana
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert D Hart
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - T Wayne Matthews
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David McKenzie
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jennifer Matthews
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Steven C Nakoneshny
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christiaan Schrag
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Khara M Sauro
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Joseph C Dort
- Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Vida Manaloto
- Acute Care, Alberta Health Services, Calgary, Canada
| | | | - Alex Chisholm
- Acute Care, Alberta Health Services, Calgary, Canada
| | - Harold Lau
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, T2N IN4, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada
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50
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Edbrooke L, Jones TL. Behavior Change Techniques for the Maintenance of Physical Activity in Cancer. JMIR Cancer 2023; 9:e53602. [PMID: 38015601 DOI: 10.2196/53602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
Ester et al report the findings from a 2-arm cluster randomized controlled trial nested within a hybrid effectiveness-implementation study, which involved a 12-week exercise and behavior change program for rural and remote Canadians (Exercise for Cancer to Enhance Living Well [EXCEL]). The addition of 23 weeks of app-based physical activity monitoring to the EXCEL program did not result in significant between-group differences in physical activity at 6 months. While several behavior change techniques were included in the initial 12-week intervention, additional techniques were embedded within the mobile app. However, there is currently a lack of evidence regarding how many and which behavior change techniques are the most effective for people with cancer and if these differ based on individual characteristics. Potentially, the use of the mobile app was not required in addition to the behavior change support delivered to both groups as part of the EXCEL program. Further research should involve participants who may be in most need of behavioral support, for example, those with lower levels of self-efficacy. Suggestions for future research to tailor behavior change support for people with cancer are discussed.
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Affiliation(s)
- Lara Edbrooke
- The University of Melbourne, Melbourne, Australia
- The Peter MacCallum Cancer Centre, Melbourne, Australia
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