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Guillamó E, Travier N, Oviedo GR, Fonseca-Nunes A, Alamo JM, Cos F, Roca A, Niño O, Agudo A, Javierre C. Physical Test to Estimate Suitable Workloads for an Exercise Program in Breast Cancer Survivors. J Strength Cond Res 2021; 34:3593-3599. [PMID: 29579014 DOI: 10.1519/jsc.0000000000002337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Guillamó, E, Travier, N, Oviedo, GR, Fonseca-Nunes, A, Alamo, JM, Cos, F, Roca, A, Niño, O, Agudo, A, and Javierre, C. Physical test to estimate suitable workloads for an exercise program in breast cancer survivors. J Strength Cond Res 34(12): 3593-3599, 2020-Epidemiologic studies suggest that patients with breast cancer who gain weight after diagnosis have a higher risk of recurrence and death. Regular physical exercise can help minimize postdiagnosis weight gain. The objective of the study was to assess the effectiveness of a physical test for individualizing the workloads used during a fitness program. To continuously individualize the intensity of the training, a test was designed and integrated into the sessions. The test consisted in monitoring heart rate and workload during 2 bouts of cycling at moderate intensity. The workload parameters recorded during the tests were later used as reference values to plan the intensity of the next in-person training sessions. The 5 tests conducted during the 12 weeks of the intervention showed significant differences in intensity (F = 3.034, p = 0.047). Compared with the first evaluation, the intensities measured during the third, fourth, and fifth tests presented increases of 9.9% (p = 0.02), 13.2% (p = 0.019), and 17.5% (p = 0.002), respectively. A significant increase in workload with respect to body weight was observed in the physical assessment performed after the program (t = 13.2, p = 0.0001). The peak oxygen consumption with respect to body weight (peak V[Combining Dot Above]O2) achieved by the subjects during the assessment at the end of the program had also increased (t = 9.72, p = 0.0001). The intensity test, introduced in the training sessions along with the physical exercise program, was an easy-to-use, practical tool for monitoring intensity. It allows an adjustment of the workload over the program period that respects the individual progression of each patient.
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Affiliation(s)
- Elisabet Guillamó
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Noemie Travier
- Breast Cancer Screening Unit, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Guillermo R Oviedo
- Department of Physical Activity and Sports Sciences. Faculty of Psychology, Education and Sport Sciences Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Ana Fonseca-Nunes
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain; and
| | - Juan-Mariano Alamo
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Francesc Cos
- Health and Applied Sciences Department, National Institute for Physical Education of Catalonia, Barcelona, Spain
| | - Ariadna Roca
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Oscar Niño
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain; and
| | - Casimiro Javierre
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
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Acceptability and Usefulness of a Dyadic, Tailored, Web-Based, Psychosocial and Physical Activity Self-Management Program (TEMPO): A Qualitative Study. J Clin Med 2020; 9:jcm9103284. [PMID: 33066225 PMCID: PMC7650635 DOI: 10.3390/jcm9103284] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022] Open
Abstract
Caregivers of men with prostate cancer report high burden, and there is a need to develop cost-effective programs to support them in their roles. This study reports on the acceptability of a dyadic, Tailored, wEb-based, psychosocial and physical activity (PA) self-Management PrOgram called TEMPO. TEMPO was accessed by a convenience sample of 19 men with prostate cancer and their caregivers (n = 18), as well as six health care professionals (HCPs). User feedback was gathered via semi-structured qualitative interviews. Data were analyzed using thematic analysis. Most dyads were satisfied with TEMPO, particularly with the dyadic feature of TEMPO, the focus on goal setting to integrate self-management, and the extensive health library. The patients and caregivers motivated each other as they worked through TEMPO. Most goals to achieve during TEMPO pertained to increasing PA, followed by learning physical symptom management. One unanticipated benefit of TEMPO for the dyads was improved communication. HCPs agreed that TEMPO was a novel approach to online cancer self-management and they echoed the benefits reported by dyads. Key suggestions for improving TEMPO were to reduce repetition, tailor content, add more exercise ideas, and have more printing options. This study provides a strong foundation on which to plan a larger trial.
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Quinn L, Macpherson C, Long K, Shah H. Promoting Physical Activity via Telehealth in People With Parkinson Disease: The Path Forward After the COVID-19 Pandemic? Phys Ther 2020; 100:1730-1736. [PMID: 32734298 PMCID: PMC7454884 DOI: 10.1093/ptj/pzaa128] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/08/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE There is mounting evidence in support of exercise and physical activity as a first-line approach to managing symptoms and potentially altering disease progression in people with Parkinson disease (PD). For many patients, a critical gap is the need for expert guidance to overcome barriers, set realistic goals, and provide personalized advice to optimize exercise uptake and adherence. The purpose of this case report is to describe a physical activity coaching program (Engage-PD) for individuals newly diagnosed with PD and to highlight rapid modifications made to this program in response to the COVID-19 pandemic. METHODS (CASE DESCRIPTION) Engage-PD is a single cohort implementation study of a coaching intervention grounded in self-determination theory being conducted at Columbia University Parkinson's Foundation Center of Excellence in New York City, NY (USA), the early epicenter of the COVID-19 pandemic in the United States. The project was uniquely positioned to be adapted to telehealth delivery and to address an immediate need for support and guidance in the home environment, including people with early-mid-stage PD. Participants completed baseline and follow-up (3 months) assessments and participated in up to 4 coaching sessions, all delivered via a telehealth platform. The intervention incorporated 1:1 coaching, goal-setting, physical activity monitoring, and use of a disease-specific workbook to promote and support safe exercise uptake. RESULTS While the program is ongoing, 52 referrals were received and 27 individuals with PD enrolled in the first 2 months of the pandemic for a recruitment rate of 52%. Although direct comparisons with pre-coronavirus recruitment are difficult due to the recency of the Engage-PD implementation study, this recruitment rate was larger than expected, which may have been due to several factors (eg, most patients had limited, if any, access to in-person programs and therapy services during this time, so the Engage program filled an immediate need to provide exercise and activity guidance). There was a wide range of scores for both baseline physical activity and self-efficacy measures. CONCLUSION Remotely delivered interventions may serve as a sustainable platform for physical activity coaching programs for people with PD as well as other neurodegenerative diseases. IMPACT With the uncertainty brought about by the current pandemic, this case report highlights the opportunity to shift the current model of care for individuals with neurodegenerative diseases such as PD.
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Affiliation(s)
- Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, and Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, 525 W 120th St, Box 199, New York City, NY 10027 USA,Address all correspondence to Dr Quinn at:
| | - Chelsea Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University
| | - Katrina Long
- Department of Biobehavioral Sciences, Teachers College, Columbia University
| | - Hiral Shah
- Department of Neurology, Columbia University Irving Medical Center
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Steegmann J, Bartella AK, Kloss-Brandstätter A, Kamal M, Hölzle F, Lethaus B. A randomized clinical trial on the efficacy of a patient-adapted autonomous exercise regime for patients with head and neck cancer. J Craniomaxillofac Surg 2019; 48:187-192. [PMID: 32113882 DOI: 10.1016/j.jcms.2019.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 11/29/2019] [Accepted: 12/05/2019] [Indexed: 01/01/2023] Open
Abstract
Patients undergoing surgical therapy of head and neck malignancies are known to exhibit a high number of comorbidities and frequently present a high nosocomial morbidity. Physiotherapy (PT) improves the clinical course of patients after extensive surgery. The aim of this study was to establish and then compare an additional individualized autonomous exercise plan with standard physiotherapy. 69 consecutive patients undergoing surgical treatment of head and neck cancer were randomized into two groups. The control group received standard clinical physiotherapy, the intervention group an additional autonomous exercise plan, adapted to the patient's performance profile. The patients randomized to the intervention group showed significantly fewer signs of fatigue (5.5 ± 3.5 vs. 3.7 ± 2.7, p = 0.048) and fewer digestive problems (4.7 ± 3.3 vs. 2.3 ± 2.7; p = 0.009) compared with the patients of the control group. In addition, a significantly shorter hospital stay was observed (17.7 ± 6.3 vs. 13.4 ± 3.4 days, p = 0.005), which was positively influenced by the early start of the exercises (r = 0.623, p = 0.001) and frequent practice (r = 0.432, p = 0.031). Patients with head and neck cancer therapy can benefit from an autonomous, individualized exercise plan. In coordination with the physiotherapists, mobilization should be as early and intensive as possible.
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Affiliation(s)
- Julius Steegmann
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelstr 30, 52074 Aachen, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstr 12, 04103 Leipzig, Germany
| | - Anita Kloss-Brandstätter
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelstr 30, 52074 Aachen, Germany
| | - Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, P. O. Box 24923, Safat 13110, Kuwait
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelstr 30, 52074 Aachen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstr 12, 04103 Leipzig, Germany.
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Signorelli GR, Lehocki F, Mora Fernández M, O'Neill G, O'Connor D, Brennan L, Monteiro-Guerra F, Rivero-Rodriguez A, Hors-Fraile S, Munoz-Penas J, Bonjorn Dalmau M, Mota J, Oliveira RB, Mrinakova B, Putekova S, Muro N, Zambrana F, Garcia-Gomez JM. A Research Roadmap: Connected Health as an Enabler of Cancer Patient Support. J Med Internet Res 2019; 21:e14360. [PMID: 31663861 PMCID: PMC6914240 DOI: 10.2196/14360] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/07/2019] [Accepted: 08/25/2019] [Indexed: 12/30/2022] Open
Abstract
The evidence that quality of life is a positive variable for the survival of cancer patients has prompted the interest of the health and pharmaceutical industry in considering that variable as a final clinical outcome. Sustained improvements in cancer care in recent years have resulted in increased numbers of people living with and beyond cancer, with increased attention being placed on improving quality of life for those individuals. Connected Health provides the foundations for the transformation of cancer care into a patient-centric model, focused on providing fully connected, personalized support and therapy for the unique needs of each patient.
Connected Health creates an opportunity to overcome barriers to health care support among patients diagnosed with chronic conditions. This paper provides an overview of important areas for the foundations of the creation of a new Connected Health paradigm in cancer care. Here we discuss the capabilities of mobile and wearable technologies; we also discuss pervasive and persuasive strategies and device systems to provide multidisciplinary and inclusive approaches for cancer patients for mental well-being, physical activity promotion, and rehabilitation.
Several examples already show that there is enthusiasm in strengthening the possibilities offered by Connected Health in persuasive and pervasive technology in cancer care. Developments harnessing the Internet of Things, personalization, patient-centered design, and artificial intelligence help to monitor and assess the health status of cancer patients. Furthermore, this paper analyses the data infrastructure ecosystem for Connected Health and its semantic interoperability with the Connected Health economy ecosystem and its associated barriers. Interoperability is essential when developing Connected Health solutions that integrate with health systems and electronic health records.
Given the exponential business growth of the Connected Health economy, there is an urgent need to develop mHealth (mobile health) exponentially, making it both an attractive and challenging market. In conclusion, there is a need for user-centered and multidisciplinary standards of practice to the design, development, evaluation, and implementation of Connected Health interventions in cancer care to ensure their acceptability, practicality, feasibility, effectiveness, affordability, safety, and equity.
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Affiliation(s)
- Gabriel Ruiz Signorelli
- Oncoavanze, Seville, Spain.,Sport & Society Research Group, Faculty of Educational Sciences, University of Seville, Seville, Spain.,Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Belfield Campus, Dublin, Ireland
| | - Fedor Lehocki
- Slovak University of Technology in Bratislava, Bratislava, Slovakia.,National Centre of Telemedicine Services, Bratislava, Slovakia
| | - Matilde Mora Fernández
- Sport & Society Research Group, Faculty of Educational Sciences, University of Seville, Seville, Spain
| | - Gillian O'Neill
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Belfield Campus, Dublin, Ireland
| | - Dominic O'Connor
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Belfield Campus, Dublin, Ireland
| | - Louise Brennan
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Belfield Campus, Dublin, Ireland.,Beacon Hospital, Dublin, Ireland
| | - Francisco Monteiro-Guerra
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Belfield Campus, Dublin, Ireland.,Salumedia Tecnologías, Seville, Spain
| | | | - Santiago Hors-Fraile
- Salumedia Tecnologías, Seville, Spain.,Maastricht University, Maastricht, Netherlands.,Architecture and Computer Technology Department, University of Seville, Seville, Spain
| | | | | | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Ricardo B Oliveira
- Laboratory of Active Living, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Bela Mrinakova
- First Department of Oncology, Comenius University, Bratislava, Slovakia
| | - Silvia Putekova
- Faculty of Health Care and Social Work, University of Trnava, Trnava, Slovakia
| | - Naiara Muro
- Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-Santé, Sorbonne Universités, Paris, France.,eHealth and Biomedical Applications, Vicomtech, Donostia-San Sebastian, Spain.,Biodonostia, Donostia-San Sebastián, Spain
| | - Francisco Zambrana
- Department of Oncology, Infanta Sofia University Hospital, Madrid, Spain
| | - Juan M Garcia-Gomez
- Biomedical Data Science Lab, The Institute of Information and Communication Technologies, Universitat Politecnica de Valencia, Valencia, Spain
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6
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Peng L, Huang W, Zhang W, Xu Y, Lu F, Zhong L, Chen X, Xu S, Chen W, Li M. Psychometric Properties of the Short Form of the Fear of Cancer Recurrence Inventory (FCRI) in Chinese Breast Cancer Survivors. Front Psychiatry 2019; 10:537. [PMID: 31447709 PMCID: PMC6692428 DOI: 10.3389/fpsyt.2019.00537] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/10/2019] [Indexed: 02/06/2023] Open
Abstract
Objective: Currently, fear of cancer recurrence (FCR) is emerging as an important issue for long-term breast cancer survivors and is associated with lower quality of life and functional impairment. Given that there is a dearth of research regarding the FCR of Chinese breast cancer survivors, this study investigated whether the short form of the Fear of Cancer Recurrence Inventory (FCRI) could detect high FCR and explored the level and characteristics of FCR in breast cancer survivors. Methods: Two hundred forty patients who had undergone successful breast cancer surgery in China submitted their survey through a website. The participants' demographic and medical data, level of FCR, anxiety, depression, and quality of life were assessed. Results: Two hundred seven patients with ages ranging from 19 to 60 years completed the questionnaires. The mean FCR score of the total sample was 18.39. A cutoff score of 12 or higher on the short form of the FCRI was optimal for the detection of high FCR with a sensitivity of 98.6% and a specificity of 35%, and the PPV (positive predictive values) and NPV (negative predictive values) were 44% and 98%, respectively. The area under the curve of the receiver operating characteristics (ROC) analysis was 83%. A total of 159 breast cancer survivors (76.81%) experienced high FCR levels (FCR score > 12), characterized by lower functional and overall health than survivors with a low FCR (P < 0.01). Conclusions: The short form of the FCRI is capable of detecting high FCR and is therefore able to assist Chinese breast cancer survivors in receiving appropriate care for reducing FCR.
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Affiliation(s)
- Li Peng
- Department of Military Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Weirong Huang
- Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wenmo Zhang
- Department of Fundamental, Army Logistical University of PLA, Chongqing, China
| | - Yuanyuan Xu
- Department of Military Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Fang Lu
- Department of Military Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Ling Zhong
- Breast Center of Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xianchun Chen
- Breast Center of Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Song Xu
- Psychiatry Department, No.991 Hospital of Chinese Liberation Army, Xiangyang, China
| | - Wenjun Chen
- Psychiatry Department, No.991 Hospital of Chinese Liberation Army, Xiangyang, China
| | - Min Li
- Department of Military Psychology, School of Psychology, Third Military Medical University, Chongqing, China
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7
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Decline in tongue pressure during perioperative period in cancer patients without oral feeding. Clin Nutr ESPEN 2018; 29:183-188. [PMID: 30661685 DOI: 10.1016/j.clnesp.2018.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/05/2018] [Accepted: 10/17/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Systemic muscle wasting during perioperative periods has a major impact on postoperative morbidity. However, data on oropharyngeal muscle weakness after surgery are scarce. We examined whether maximum tongue pressure (MTP) and hand grip strength (HGS) diminished during the perioperative period without and with oral feeding in patients receiving cancer surgery. METHODS A total of 258 patients undergoing cancer surgery who had visited a hospital dental clinic were prospectively recruited between October 2015 and February 2016. MTP and HGS were measured on the day before and 4 days after surgery. Data on age, sex, tumor location, surgical procedure, and oral feeding status were obtained from patient medical records. We analyzed for differences in the perioperative changes of MTP and HGS according to surgical procedure, oral feeding, and tumor location using ANOVA. RESULTS Neither MTP nor HGS differed significantly among tumor locations before surgery. The proportion of patients with an oral diet at 4 days after surgery was 36.7% and 34.5% for upper GI and colorectum groups versus 89.2% and 86.4% for genitourinary and lung groups, respectively. During the perioperative period, MTP decreased more significantly in patients without oral feeding than in those with oral feeding at 4 days after surgery (P < 0.01). HGS was not affected by postoperative oral feeding status. Both MTP and HGS decreased more significantly in the upper gastrointestinal group than in the genitourinary and lung groups (P < 0.05), except for MTP between upper GI and genitourinary groups (P = 0.10). CONCLUSIONS MTP, but not HGS, diminishes significantly during the perioperative period without oral feeding. As tongue muscle disuse after surgery may adversely impact postoperative oropharyngeal muscle decline, perioperative tongue muscle strengthening exercises may assist in maintaining muscle strength and good oral feeding.
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8
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Kim K, Gu MO, Jung JH, Hahm JR, Kim SK, Kim JH, Woo SH. Efficacy of a Home-Based Exercise Program After Thyroidectomy for Thyroid Cancer Patients. Thyroid 2018; 28:236-245. [PMID: 29258382 DOI: 10.1089/thy.2017.0277] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The objective of this study was to determine the effect of a home-based exercise program on fatigue, anxiety, quality of life (QoL), and immune function of thyroid cancer patients taking thyroid hormone replacement after thyroidectomy. METHOD This quasi-experimental study with a non-equivalent control group included 43 outpatients taking thyroid hormone replacement after thyroidectomy (22 in the experimental group and 21 in the control group). After education about the home-based exercise program, subjects in the experimental group underwent 12 weeks of aerobic, resistance, and flexibility exercise. A comparative analysis was conducted between the two groups. RESULTS Patients in the experimental group were significantly less fatigued or anxious (p < 0.01). They reported significantly improved QoL (p < 0.05) compared to those in the control group. Natural killer cell activity was significantly higher in the exercise group compared to that in the control group (p < 0.05). CONCLUSION A home-based exercise program is effective in reducing fatigue and anxiety, improving QoL, and increasing immune function in patients taking thyroid hormone replacement after thyroidectomy. Therefore, such a home-based exercise program can be used as an intervention for patients who are taking thyroid hormone replacement after thyroidectomy.
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Affiliation(s)
- Kyunghee Kim
- 1 Department of Otolaryngology, Gyeongsang National University , Jinju, Korea
- 2 Department of Nursing Graduate School, Gyeongsang National University , Jinju, Korea
| | - Mee Ock Gu
- 3 College of Nursing, Gyeongsang National University , Jinju, Korea
- 4 Institute of Health Sciences, Gyeongsang National University , Jinju, Korea
| | - Jung Hwa Jung
- 4 Institute of Health Sciences, Gyeongsang National University , Jinju, Korea
- 5 Department of Internal Medicine, Gyeongsang National University , Jinju, Korea
| | - Jong Ryeal Hahm
- 4 Institute of Health Sciences, Gyeongsang National University , Jinju, Korea
- 5 Department of Internal Medicine, Gyeongsang National University , Jinju, Korea
| | - Soo Kyoung Kim
- 4 Institute of Health Sciences, Gyeongsang National University , Jinju, Korea
- 5 Department of Internal Medicine, Gyeongsang National University , Jinju, Korea
| | - Jin Hyun Kim
- 6 Biomedical Research Institute, Gyeongsang National University , Jinju, Korea
| | - Seung Hoon Woo
- 1 Department of Otolaryngology, Gyeongsang National University , Jinju, Korea
- 5 Department of Internal Medicine, Gyeongsang National University , Jinju, Korea
- 7 Beckman Laser Institute, University of California , Irvine, California
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9
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Gerrand C, Furtado S. Issues of Survivorship and Rehabilitation in Soft Tissue Sarcoma. Clin Oncol (R Coll Radiol) 2017; 29:538-545. [DOI: 10.1016/j.clon.2017.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 03/29/2017] [Accepted: 04/05/2017] [Indexed: 12/31/2022]
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10
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Wilkinson WM, Rance J, Fitzsimmons D. Understanding the importance of therapeutic relationships in the development of self-management behaviours during cancer rehabilitation: a qualitative research protocol. BMJ Open 2017; 7:e012625. [PMID: 28096252 PMCID: PMC5253542 DOI: 10.1136/bmjopen-2016-012625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Cancer is a growing health, social and economic problem. 1 in 3 people in the UK will develop cancer in their lifetime. With survival rates rising to over 50%, the long-term needs of cancer survivors are of growing importance. Cancer rehabilitation is tailored to address the physical or psychosocial decline in ability to engage in daily activities. Its use is supported by high-quality international, multicentre research. Incorporating strategies for self-management behaviour development into rehabilitation can prepare individuals for cancer survivorship. However, healthcare professionals will need to adjust their therapeutic interactions accordingly. Research is yet to clarify the impact of the therapeutic relationship on rehabilitation outcomes in cancer. This study aims to explore the impact of therapeutic relationships on self-management behaviours after cancer. METHODS AND ANALYSIS This qualitative study aims to understand cancer rehabilitation participants' beliefs regarding the importance of therapeutic relationships in developing self-management behaviours. A sample representative of a local cancer rehabilitation cohort will be asked to complete a semistructured interview to identify their perspectives on the importance of therapeutic relationships in cancer rehabilitation. Data obtained from the interviews will be analysed, coded and entered into a Delphi questionnaire for circulation to a local cancer rehabilitation population to determine if the views expressed by the interviewees are supported by group consensus. ETHICS AND DISSEMINATION This study was approved by Wales Research Ethics Committee 6 (15/WA/0331) in April 2016. Findings will be disseminated through the first author's doctoral thesis; peer-reviewed journals; local, national and international conference presentations; and public events involving research participants and the general public.
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Affiliation(s)
- Wendy M Wilkinson
- Abertawe Bro Morgannwg University Health Board, Port Talbot, UK
- Wales Cancer Network
- Swansea University, Swansea, UK
| | - Jaynie Rance
- College of Human and Health Sciences, Swansea University, Swansea, UK
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Liao KYH, Yeung NC, Wong CCY, Warmoth K, Lu Q. Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness. Support Care Cancer 2016; 25:1141-1149. [DOI: 10.1007/s00520-016-3504-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
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12
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Beehler GP, Novi J, Kiviniemi MT, Steinbrenner L. Military veteran cancer survivors' preferences for a program to address lifestyle change and psychosocial wellness following treatment. J Psychosoc Oncol 2016; 35:111-127. [PMID: 27901404 DOI: 10.1080/07347332.2016.1265623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to understand military veteran cancer survivors' preferences regarding the delivery of post-treatment wellness services. Thirty-three military veteran cancer survivors were interviewed about their perceptions of three models of health service delivery (home-, primary care-, and oncology-based services). Conventional qualitative content analysis revealed strengths and weaknesses of each service delivery model's content and structure (e.g., program location, inclusion of emotional support, access to clinical experts). All service delivery programs had strengths, with clinic-based programs offering the greatest breadth of services deemed important for wellness by cancer survivors.
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Affiliation(s)
- Gregory P Beehler
- a VA Center for Integrated Healthcare , VA Western New York Healthcare System , Buffalo , NY , USA.,b School of Nursing , University at Buffalo, The State University of New York , Buffalo , NY , USA.,c School of Public Health and Health Profession , University at Buffalo, The State University of New York , Buffalo , NY , USA
| | - Jonathan Novi
- d Behavioral Health Careline , New Mexico VA Health Care System , Albuquerque , NM , USA
| | - Marc T Kiviniemi
- c School of Public Health and Health Profession , University at Buffalo, The State University of New York , Buffalo , NY , USA
| | - Lynn Steinbrenner
- e Medical VA Careline, VA Western New York Healthcare System , Buffalo , NY , USA
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13
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The Effect of Self-Efficacy and Outcome Expectations Training on the Enhancement of Physical Activities Among Women Suffering From Breast Cancer: An Evidence-Based Intervention. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.28081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dąbrowska-Bender M, Michałowicz B, Pączek L. Assessment of the Quality of Life in Patients After Liver Transplantation as an Important Part of Treatment Results. Transplant Proc 2016; 48:1697-702. [DOI: 10.1016/j.transproceed.2015.12.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/26/2015] [Accepted: 12/30/2015] [Indexed: 10/21/2022]
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15
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Wood WA, Phillips B, Smith-Ryan AE, Wilson D, Deal AM, Bailey C, Meeneghan M, Reeve BB, Basch EM, Bennett AV, Shea TC, Battaglini CL. Personalized home-based interval exercise training may improve cardiorespiratory fitness in cancer patients preparing to undergo hematopoietic cell transplantation. Bone Marrow Transplant 2016; 51:967-72. [PMID: 26999467 PMCID: PMC4935591 DOI: 10.1038/bmt.2016.73] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 01/30/2023]
Abstract
Impaired cardiorespiratory fitness is associated with inferior survival in patients preparing to undergo hematopoietic cell transplantation (HCT). Exercise training based on short, higher-intensity intervals has the potential to efficiently improve cardiorespiratory fitness. We studied home-based interval exercise training (IET) in 40 patients prior to autologous (N=20) or allogeneic (N=20) HCT. Each session consisted of 5, three-minute intervals of walking, jogging, or cycling at 65-95% maximal heart rate (MHR) with 3 minutes of low intensity exercise (<65% MHR) between intervals. Participants were asked to perform sessions at least 3 times weekly. The duration of the intervention was at least 6 weeks, depending on each patient’s scheduled transplantation date. Cardiorespiratory fitness was assessed from a peak oxygen consumption test (VO2peak) and a 6 minute walk (6MWD) before and after the intervention period. For the autologous HCT cohort, improvements in VO2peak (p=0.12) and 6MWD (p=0.19) were not statistically significant. For the allogeneic cohort, the median VO2peak improvement was 3.7ml/kg*min (p=0.005) and the median 6MWD improvement was 34 meters (p=0.006). Home-based, interval exercise training can be performed prior to HCT and has the potential to improve cardiorespiratory fitness.
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Affiliation(s)
- W A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - B Phillips
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - A E Smith-Ryan
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - D Wilson
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - A M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - C Bailey
- Cedars Sinai Medical Center, Los Angeles, CA, USA
| | | | - B B Reeve
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - E M Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - A V Bennett
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - T C Shea
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - C L Battaglini
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Lai YT, Hsieh CC, Huang LS, Liu WS, Lin SH, Wang LL, Chen SF, Lin CC. The Effects of Upper Limb Exercise Through Yoga on Limb Swelling in Chinese Breast Cancer Survivors - A Pilot Study. Rehabil Nurs 2015; 42:46-54. [PMID: 25980790 DOI: 10.1002/rnj.217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Breast cancer is the most common female cancer. The aim of this study was to assess the impact of yoga on lymphedema in breast cancer survivors. DESIGN Repeated measures before and after the intervention. We enrolled 15 women with breast cancer who had not previously worn elastic clothing to treat lymphedema. METHODS The program was led by a certified trainer and consisted of 60-minute sessions, three times a week for 12 weeks. The volumes of the affected and normal limbs were measured. A self-assessed edema score was also recorded. FINDINGS Fifteen patients completed the program, none of whom suffered from complications related to exercise. There was no significant edema after exercise. No significant differences were noted in subgroup analysis by age or the affected arm. CONCLUSIONS Yoga does not induce lymphedema. CLINICAL RELEVANCE Lymphedema is usually treated with uncomfortable elastic clothing, and high-resistance exercise may induce edema. Yoga may be suitable for these patients.
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Affiliation(s)
- Yen-Ting Lai
- 1 Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan2 Department of Nursing, Yuanpei University, Hsinchu, Taiwan3 Department of Health and Leisure Management, Yuanpei University, Hsinchu, Taiwan4 Department of Physical Education, National Hsinchu University of Education, Hsinchu, Taiwan5 Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan6 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan7 Fu-Jen University, New Taipei City, Taiwan8 Division of Nephrology, Department of Medicine, General Hospital, Taipei, Taiwan
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Santa Mina D, Matthew AG, Hilton WJ, Au D, Awasthi R, Alibhai SMH, Clarke H, Ritvo P, Trachtenberg J, Fleshner NE, Finelli A, Wijeysundera D, Aprikian A, Tanguay S, Carli F. Prehabilitation for men undergoing radical prostatectomy: a multi-centre, pilot randomized controlled trial. BMC Surg 2014; 14:89. [PMID: 25394949 PMCID: PMC4246547 DOI: 10.1186/1471-2482-14-89] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 10/02/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND An emerging field of research describes the role of preoperative health behaviours, known as prehabilitation. The preoperative period may be a more physically and emotionally salient time to introduce and foster chronic adherence to health behaviours, such as exercise, in patients compared to post-treatment during recovery. Moreover, physical and psychosocial improvements during the preoperative period may translate into an enhanced recovery trajectory with reduced operative complications and postoperative adverse effects. No studies have assessed prehabilitation for men with prostate cancer undergoing radical prostatectomy. METHODS/DESIGN This is a multi-centre, pilot randomized control trial conducted at two Canadian urban teaching hospitals. 100 men undergoing radical prostatectomy for prostate cancer with no contraindications to exercise will be recruited and randomized to the prehabiliation program or usual care. Prehabilitation participants will engage in a preoperative, individualized exercise program including pelvic floor muscle strengthening instructions and a healthy lifestyle guide for men with prostate cancer. These participants will be asked to engage in 60 minutes of home-based, unsupervised, moderate-intensity exercise on 3-4 days per week. Usual care participants will receive the same pelvic floor muscle strengthening instructions and healthy lifestyle guide only. We will assess the feasibility of conducting an adequately powered trial of the same design via recruitment rate, programmatic adherence/contamination, attrition, and safety. Estimates of intervention efficacy will be captured through measurements at baseline (4-8 weeks preoperatively), within 1 week prior to surgery, and postoperatively at 4, 12, and 26 weeks. Efficacy outcomes include: fatigue, quality of life, urinary incontinence, physical fitness, body composition, aerobic fitness, pain, and physical activity volume. DISCUSSION The primary outcome of this study is to determine the feasibility of conducting a full-scale, randomized controlled trial of prehabilitation versus usual care and to estimate effect sizes that will inform sample size determinations for subsequent trials in this field. To our knowledge, this is the first study to examine a structured presurgical exercise program for men undergoing radical prostatectomy for prostate cancer. This trial will advance our understanding of strategies to efficiently and effectively use the preoperative period to optimize postoperative recovery. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT02036684.
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Affiliation(s)
- Daniel Santa Mina
- />Kinesiology Program, University of Guelph-Humber, Toronto, ON Canada
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Guelph, Guelph, ON Canada
| | - Andrew G Matthew
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Toronto, Toronto, ON Canada
| | - William J Hilton
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Guelph, Guelph, ON Canada
| | - Darren Au
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Guelph, Guelph, ON Canada
| | | | - Shabbir MH Alibhai
- />University of Toronto, Toronto, ON Canada
- />University Health Network, Toronto, ON Canada
| | - Hance Clarke
- />University of Toronto, Toronto, ON Canada
- />University Health Network, Toronto, ON Canada
| | - Paul Ritvo
- />Kinesiology and Health Sciences Department, York University, Toronto, ON Canada
- />Cancer Care Ontario, Toronto, ON Canada
| | - John Trachtenberg
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Toronto, Toronto, ON Canada
| | - Neil E Fleshner
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Toronto, Toronto, ON Canada
| | - Antonio Finelli
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Toronto, Toronto, ON Canada
| | - Duminda Wijeysundera
- />Prostate Centre, Princess Margaret Cancer Centre, Toronto, ON Canada
- />University of Toronto, Toronto, ON Canada
| | | | - Simon Tanguay
- />McGill University Health Centre, Montreal, QC Canada
| | - Franco Carli
- />McGill University Health Centre, Montreal, QC Canada
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De Cocker K, Charlier C, Van Hoof E, Pauwels E, Lechner L, Bourgois J, Spittaels H, Vandelanotte C, De Bourdeaudhuij I. Development and usability of a computer-tailored pedometer-based physical activity advice for breast cancer survivors. Eur J Cancer Care (Engl) 2014; 24:673-82. [DOI: 10.1111/ecc.12225] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2014] [Indexed: 11/29/2022]
Affiliation(s)
- K. De Cocker
- Department of Movement and Sport Sciences; Ghent University; Ghent Belgium
- Research Foundation Flanders; Brussels Belgium
| | - C. Charlier
- Department of Movement and Sport Sciences; Ghent University; Ghent Belgium
- School of Psychology; Open University of the Netherlands; Heerlen the Netherlands
| | - E. Van Hoof
- Experimental and Applied Psychology; Free University of Brussels; Brussels Belgium
| | - E. Pauwels
- Department of Movement and Sport Sciences; Ghent University; Ghent Belgium
| | - L. Lechner
- School of Psychology; Open University of the Netherlands; Heerlen the Netherlands
| | - J. Bourgois
- Department of Movement and Sport Sciences; Ghent University; Ghent Belgium
| | | | - C. Vandelanotte
- Institute for Health and Social Science Research; Central Queensland University; Rockhampton Qld Australia
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Fatigue after liver transplantation: effects of a rehabilitation program including exercise training and physical activity counseling. Phys Ther 2014; 94:857-65. [PMID: 24557657 DOI: 10.2522/ptj.20130402] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND It is hypothesized that increasing physical fitness and daily physical activity can lead to a reduction in fatigue. However, standard medical care following liver transplantation seldom includes rehabilitation that focuses on physical fitness and physical activity. OBJECTIVE The aim of this study was to explore whether a rehabilitation program can reduce fatigue in recipients of liver transplants. Furthermore, effects on physical fitness, physical activity, and cardiovascular risk were studied, and adherence, satisfaction, and adverse events were assessed. DESIGN This was an uncontrolled intervention study. SETTING The study took place in an outpatient rehabilitation clinic. PATIENTS Eighteen recipients of a liver transplant who were fatigued participated in a 12-week rehabilitation program including physical exercise training and counseling on physical activity. The primary outcome measure was fatigue. Other outcome measures were: aerobic capacity, muscle strength, body fat, daily physical activity, lipid profile, and glycemic control. All measurements were performed before and after the rehabilitation program. Adherence, satisfaction, and adverse events were registered. RESULTS After the program, participants were significantly less fatigued, and the percentage of individuals with severe fatigue was 22% to 53% lower than before the program. In addition, aerobic capacity and knee flexion strength were significantly higher, and body fat was significantly lower after the program. Participants were able to perform physical exercise at the target training intensity, no adverse events were registered, and attendance (93%) and mean patient satisfaction (8.5 out of 10, range=7-10) were high. LIMITATIONS No control group was used in the study. CONCLUSIONS A rehabilitation program consisting of exercise training and physical activity counseling is well tolerated and seems promising in reducing fatigue and improving fitness among recipients of liver transplants.
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O'Hanlon É, Kennedy N. Exercise in cancer care in Ireland: a survey of oncology nurses and physiotherapists. Eur J Cancer Care (Engl) 2014; 23:630-9. [DOI: 10.1111/ecc.12206] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2014] [Indexed: 12/12/2022]
Affiliation(s)
- É. O'Hanlon
- Department of Clinical Therapies; Faculty of Education and Health Sciences; University of Limerick; Limerick Ireland
| | - N. Kennedy
- Department of Clinical Therapies; Faculty of Education and Health Sciences; University of Limerick; Limerick Ireland
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Buffart LM, Ros WJG, Chinapaw MJM, Brug J, Knol DL, Korstjens I, van Weert E, Mesters I, van den Borne B, Hoekstra-Weebers JEHM, May AM. Mediators of physical exercise for improvement in cancer survivors' quality of life. Psychooncology 2013; 23:330-8. [DOI: 10.1002/pon.3428] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 08/01/2013] [Accepted: 09/12/2013] [Indexed: 11/12/2022]
Affiliation(s)
- L. M. Buffart
- Department of Epidemiology and Biostatistics; VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research; Amsterdam the Netherlands
| | - W. J. G. Ros
- Julius Center for Health Sciences and Primary Care; University Medical Centre Utrecht; Utrecht the Netherlands
| | - M. J. M. Chinapaw
- Department of Public and Occupational Health; VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research; Amsterdam the Netherlands
| | - J. Brug
- Department of Epidemiology and Biostatistics; VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research; Amsterdam the Netherlands
| | - D. L. Knol
- Department of Epidemiology and Biostatistics; VU University Medical Center Amsterdam, EMGO Institute for Health and Care Research; Amsterdam the Netherlands
| | - I. Korstjens
- Research Department Midwifery Science, Faculty of Midwifery Education and Studies; Zuyd University; Maastricht the Netherlands
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI); Maastricht University; Maastricht the Netherlands
| | - E. van Weert
- Centre for Rehabilitation; University of Groningen, University Medical Center Groningen; Groningen the Netherlands
| | - I. Mesters
- Department Epidemiology, School for Public Health and Primary Care (CAPHRI); Maastricht University; Maastricht the Netherlands
| | - B. van den Borne
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI); Maastricht University; Maastricht the Netherlands
| | - J. E. H. M. Hoekstra-Weebers
- Comprehensive Cancer Center Netherlands; Groningen the Netherlands
- Wenckebach Institute; University of Groningen, University Medical Centre Groningen; Groningen the Netherlands
| | - A. M. May
- Julius Center for Health Sciences and Primary Care; University Medical Centre Utrecht; Utrecht the Netherlands
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Hojan K, Milecki P. Opportunities for rehabilitation of patients with radiation fibrosis syndrome. Rep Pract Oncol Radiother 2013; 19:1-6. [PMID: 24936313 DOI: 10.1016/j.rpor.2013.07.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 05/23/2013] [Accepted: 07/08/2013] [Indexed: 11/18/2022] Open
Abstract
This review discusses the pathophysiology, evaluation, and treatment of neuromuscular, musculoskeletal, and functional disorders that can result as late effects of radiation treatment. Although radiation therapy is often an effective method of killing cancer cells, it can also damage nearby blood vessels that nourish the skin, ligaments, tendons, muscles, nerves, bones and lungs. This can result in a progressive condition called radiation fibrosis syndrome (RFS). It is generally a late complication of radiotherapy which may manifest clinically years after treatment. Radiation-induced damage can include "myelo-radiculo-plexo-neuro-myopathy," causing muscle weakness and dysfunction and contributing to neuromuscular injury. RFS is a serious and lifelong disorder which, nevertheless, may often be decremented when identified and rehabilitated early enough. This medical treatment should be a complex procedure consisting of education, physical therapy, occupational therapy, orthotics as well as medications.
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Affiliation(s)
- Katarzyna Hojan
- Department of Rehabilitation, Greater Poland Cancer Centre, Poznan, Poland
| | - Piotr Milecki
- Department of Electroradiology, Poznan University of Medical Sciences, Poland ; Department of Radiotherapy, Greater Poland Cancer Centre, Poznan, Poland
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23
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Eickmeyer SM, Gamble GL, Shahpar S, Do KD. The role and efficacy of exercise in persons with cancer. PM R 2013; 4:874-81. [PMID: 23174553 DOI: 10.1016/j.pmrj.2012.09.588] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 09/19/2012] [Indexed: 12/25/2022]
Abstract
Improvements in cancer screening, diagnosis, and treatment have resulted in an increasing population of cancer survivors with impairments in physical function, cancer-related symptoms, and reduced quality of life. Exercise and physical activity have therapeutic value at multiple points along the cancer disease continuum, spanning disease prevention, treatment, survivorship, prognostic outcomes, and end-of-life issues. Molecular mechanisms for the influence of exercise in persons with cancer include altering tumor initiation pathways and affecting hormonal, inflammatory, immune, and insulin pathways. Physical activity has been found to play a role in the prevention of certain malignancies, including breast, colon, and other cancers. An increasing amount of evidence indicates that physical activity may affect prognostic outcomes in certain cancer diagnoses, especially breast cancer. Structured exercise and physical activity interventions can be helpful in addressing specific survivorship issues, including overall quality of life, cardiorespiratory impairment, cancer-related fatigue, and lymphedema. Exercise also may be helpful during the palliative care phase to alleviate symptoms and increase physical well-being. This article will familiarize physiatrists with the current state of evidence regarding the role and efficacy of exercise in persons with cancer.
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Affiliation(s)
- Sarah M Eickmeyer
- Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin and Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA.
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24
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A 1,408 km bicycle tour with prostate cancer patients—results of a pilot study. Eur Rev Aging Phys Act 2013. [DOI: 10.1007/s11556-012-0119-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Negative psychological and physical effects of prostate cancer and its medical treatment may persist many years after diagnosis. The influence of a long cycling tour on rehabilitative or health-related effects with prostate cancer patients has not yet been studied. In practice, physicians and therapists rarely recommend cycling to prostate cancer. In May 2010, eight prostate cancer patients rode their bikes for over 1,408 km from Cologne to Marseille within 5 weeks. Endurance test, blood examinations (prostate-specific antigen (PSA), total testosterone, interleukin-6, oxidative stress, and antioxidant capacity) and quality of life questionnaires were completed before and after the tour. All eight subjects reached Marseille. Significant improvements could be observed in physical performance and certain quality of life scores (p = 0.008), as well as a reduction of total testosterone (p = 0.19). PSA levels did not change. This pilot study suggests that long bicycle tours with prostate cancer patients are feasible. Due to the missing control group and the small sample size, the results of this pilot study are limited.
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25
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Chinapaw MJM, Buffart LM, van Mechelen W, Schep G, Aaronson NK, van Harten WH, Stuiver MM, Kersten MJ, Nollet F, Kaspers GJL, van Dulmen-den Broeder E, Huisman J, Takken T, van Tulder M, Brug J. Alpe d'HuZes cancer rehabilitation (A-CaRe) research: four randomized controlled exercise trials and economic evaluations in cancer patients and survivors. Int J Behav Med 2012; 19:143-56. [PMID: 21556821 PMCID: PMC3358561 DOI: 10.1007/s12529-011-9158-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Previous studies showed that exercise in cancer patients is feasible and may reduce fatigue and improve physical fitness and quality of life. However, many previous studies had methodological weaknesses related to trial design, sample size, comparison group, outcome measures, short follow-up durations and programme content. Purpose This paper aims to present the rationale and design of the clinical research subprogramme of the Alpe d’HuZes Cancer Rehabilitation (A-CaRe) programme. Method A-CaRe Clinical Research includes four randomized controlled trials in patients: (a) after chemotherapy, (b) during chemotherapy, (c) after stem cell transplantation and (d) during childhood cancer. These trials compare high-intensity resistance and endurance exercise interventions with usual care or a waiting list control group. In two studies, a second intervention arm consisting of low-to-moderate intensity exercise is included. All four A-CaRe trials use similar methods. Results Outcome measures are carefully chosen based on the International Classification of Functioning Disability and Health model. Measurements will be performed prior to randomization (T0), after completion of the intervention (T1) and at follow-up (T2). The primary outcome measures are cardiorespiratory fitness, muscle strength and fatigue. Secondary outcome measures include health-related quality of life and psychosocial functioning. Furthermore, cost-effectiveness and cost-utility analyses are performed from a societal perspective. Conclusion We hypothesize that exercise is more effective at improving physical fitness and thereby reducing fatigue and more cost-effective compared with usual care or a waiting list control group. If so, the programmes will be implemented in the Dutch clinical practice.
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Affiliation(s)
- Mai J M Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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26
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Charlier C, Van Hoof E, Pauwels E, Lechner L, Spittaels H, Bourgois J, De Bourdeaudhuij I. Treatment-related and psychosocial variables in explaining physical activity in women three weeks to six months post-treatment of breast cancer. PATIENT EDUCATION AND COUNSELING 2012; 89:171-177. [PMID: 22841589 DOI: 10.1016/j.pec.2012.06.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 06/15/2012] [Accepted: 06/29/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study examined treatment-related and psychosocial variables in explaining total and leisure time physical activity in breast cancer survivors three weeks to six months post-treatment. METHODS A questionnaire was used to measure total and leisure time physical activity and relevant determinants among 464 breast cancer survivors (aged 18-65 years). RESULTS Personal control was an important overall determinant in explaining physical activity in breast cancer survivors. The impact of treatment-related variables and psychological functioning depended on the working status of the women. Fatigue and poor body image prevented non-working women from being sufficiently physically active. In working women, chemotherapy and arm problems negatively influenced physical activity, whereas therapy side-effects (headaches, hot flashes, feeling unwell) and poor body image positively influenced physical activity. Social support and coping strategies could not explain post-treatment physical activity levels. CONCLUSION Personal control, treatment-related variables and psychological functioning influenced physical activity after cancer treatment. Relations depended on the working status of the women. PRACTICE IMPLICATIONS Incorporating self-control methods in physical activity interventions after breast cancer could be helpful. Furthermore, interventions should be tailored to the experienced symptoms (fatigue, arm-problems, body image) and working status of women.
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Affiliation(s)
- Caroline Charlier
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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27
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Abstract
With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community.
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Affiliation(s)
- Patrick T McGowan
- Centre on Aging, University of Victoria, Victoria, British Columbia, Canada.
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McMillan EM, Newhouse IJ. Exercise is an effective treatment modality for reducing cancer-related fatigue and improving physical capacity in cancer patients and survivors: a meta-analysis. Appl Physiol Nutr Metab 2011; 36:892-903. [DOI: 10.1139/h11-082] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The use of exercise interventions to manage cancer-related fatigue (CRF) is a rapidly developing field of study. However, results are inconsistent and difficult to interpret across the literature, making it difficult to draw accurate conclusions regarding the true effectiveness of exercise interventions for CRF management. The aims of this study were to apply a meta-analysis to quantitatively assess the effects of exercise intervention strategies on CRF, and to elucidate appropriate exercise prescription guidelines. A systematic search of electronic databases and relevant journals and articles was conducted. Studies were eligible if subjects were over the age of 18 years, if they had been given a diagnosis of or had been treated for cancer, if exercise was used to treat CRF as a primary or secondary endpoint, and if the effects of the intervention were evaluated quantitatively and presented adequate statistical data for analysis. A total of 16 studies, representing 1426 participants (exercise, 759; control, 667) were included in a meta-analysis using a fixed-effects model. The standardized mean difference effect size (SMD) was used to test the effect of exercise on CRF between experimental and control groups. The results indicate a small but significant effect size in favour of the use of exercise interventions for reducing CRF (SMD 0.26, p < 0.001). Furthermore, aerobic exercise programs caused a significant reduction in CRF (SMD 0.21, p < 0.001) and overall, exercise was able to significantly improve aerobic and musculoskeletal fitness compared with control groups (p < 0.01). Further investigation is still required to determine the effects of exercise on potential underlying mechanisms related to the pathophysiology of CRF.
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Affiliation(s)
- Elliott M. McMillan
- School of Kinesiology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L3G1, Canada
| | - Ian J. Newhouse
- School of Kinesiology, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
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Hanssens S, Luyten R, Watthy C, Fontaine C, Decoster L, Baillon C, Trullemans F, Cortoos A, De Grève J. Evaluation of a Comprehensive Rehabilitation Program for Post-Treatment Patients With Cancer. Oncol Nurs Forum 2011; 38:E418-24. [DOI: 10.1188/11.onf.e418-e424] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Clinical exercise interventions in prostate cancer patients--a systematic review of randomized controlled trials. Support Care Cancer 2011; 20:221-33. [PMID: 21989678 DOI: 10.1007/s00520-011-1271-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 09/06/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Urinary incontinence, erectile dysfunction, fatigue as well as fears and depression rank among the most common complaints in patients with prostate cancer, resulting in a reduced participation in daily life and social isolation. Consequently, the quality of life of prostate cancer patients is strongly affected in a negative way. Numerous studies focusing on physical exercise interventions in prostate cancers patients demonstrate positive physiological and psychological effects. Our objective was to evaluate the evidence of randomized controlled studies which examined exercise during medical treatment and in the aftercare of a prostate cancer disease. METHODS Twenty-five randomized controlled trials regarding physical activities in patients with prostate cancer were obtained by systematic literature research (Medpilot). Twenty-one studies examined clinical exercise interventions during the phase of medical treatment (irradiation, pre- and/or post-op, androgen deprivation therapy) and four studies during the aftercare. In order to evaluate the evidence of the included studies, the evaluation system of the Oxford Centre for Evidence-Based Medicine was used. Within this systematic review, we differentiated between "supervised clinical exercise" and "non-supervised clinical exercise." RESULTS AND DISCUSSION Current data suggest that incontinence, fitness, fatigue, body constitution, and also quality of life can be improved by clinical exercise in patients during and after prostate cancer. Studies were mostly ranked evidence level "2b." Only four studies, all conducted during medical treatment, reached the level "1b." It seems to be that "supervised exercise" is more effective than "non-supervised exercise." For future research, further randomized controlled trials with high methodological quality need to be conducted in order to establish evidence-based recommendations particularly for prostate cancer patients.
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Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy. Am J Clin Oncol 2011; 34:350-5. [PMID: 20686404 DOI: 10.1097/coc.0b013e3181e841ec] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate tolerability and compliance to a walking exercise program and its effect on fatigue during and after radical external beam radiation therapy (EBRT) for prostate cancer. METHODS A total of 50 subjects with prostate cancer undergoing EBRT over 6 to 8 weeks were prospectively accrued to an exercise intervention group, matched for age and clinical characteristics to 30 subjects in a historical control group who underwent EBRT with no specific exercise intervention. Starting 1 week before EBRT, exercise participants performed moderate-intensity walking targeting 60% to 70% age-predicted maximum heart rate, at least 20 min/d, 3 d/wk over 12 weeks. The Brief Fatigue Inventory was administered at baseline, mid-EBRT (week 3-4), end-EBRT (week 6-8), and 6 months post-EBRT. RESULTS Of 50, 42 (84%) of exercise participants completed the walking program. There were no cardiovascular complications, musculoskeletal injuries, or other adverse events. A total of 89% subjects reported "Good-Excellent" satisfaction during and up to 6 months post-EBRT. Fatigue in control subjects escalated from baseline to end-EBRT, remaining high at 6 months post-EBRT (P[r] = 0.03). In contrast, mean total fatigue scores in exercise subjects were stable from baseline up to 6 months post-EBRT (P = 0.52). Trends for higher fatigue interference with quality of life were observed in the control group as compared with the exercise group. CONCLUSIONS Moderate-intensity walking exercise during radical EBRT is safe and feasible. The high convenience and satisfaction ratings, in conjunction with the observed fatigue trends, indicate that this activity has the potential to attenuate fatigue and improve quality of life for patients with localized prostate cancer undergoing curative therapy.
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Neubert S, Sabariego C, Stier-Jarmer M, Cieza A. Development of an ICF-based patient education program. PATIENT EDUCATION AND COUNSELING 2011; 84:e13-e17. [PMID: 20705411 DOI: 10.1016/j.pec.2010.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 07/12/2010] [Accepted: 07/15/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To describe the development of an ICF-based patient education program, to present the results of its pilot test and to present the adaptations and final version of the program. METHODS The education program was developed in five steps: (1) definition of relevant areas of functioning, (2) development of strategies to enhance self-efficacy in these areas, (3) development of material and instructions, (4) definition of modules and setting and (5) performance of a pilot test targeting acceptability and feasibility of the program. RESULTS Eleven stroke patients were enrolled in the pilot test. The intervention was well accepted on the part of participants. The developed patient education program is structured in three modules. Module 1 targets to increase patients' understanding of their current level of functioning. Module 2 targets to identify concrete problems and corresponding solutions regarding limited areas. Module 3 is a refresher session. CONCLUSION Feasibility and acceptability of the intervention were verified and a final version of the patient education program was developed. The effectiveness of the program will be evaluated in a randomized controlled trial. PRACTICE IMPLICATIONS Due to the universality of the ICF and availability of ICF tools, it is possible to adapt the intervention to different chronic conditions.
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Affiliation(s)
- Silvia Neubert
- Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-University, Munich, Germany
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Benzo R, Wigle D, Novotny P, Wetzstein M, Nichols F, Shen RK, Cassivi S, Deschamps C. Preoperative pulmonary rehabilitation before lung cancer resection: results from two randomized studies. Lung Cancer 2011; 74:441-5. [PMID: 21663994 DOI: 10.1016/j.lungcan.2011.05.011] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 05/02/2011] [Accepted: 05/04/2011] [Indexed: 11/19/2022]
Abstract
Complete surgical resection is the most effective curative treatment for lung cancer. However, many patients with lung cancer also have severe COPD which increases their risk of postoperative complications and their likelihood of being considered "inoperable." Preoperative pulmonary rehabilitation (PR) has been proposed as an intervention to decrease surgical morbidity but there is no established protocol and no randomized study has been published to date. We tested two preoperative PR interventions in patients undergoing lung cancer resection and with moderate-severe COPD in a randomized single blinded design. Outcomes were length of hospital stay and postoperative complications. The first study tested 4 weeks of guideline-based PR vs. usual care: that study proved to be very difficult to recruit as patients and providers were reluctant to delay surgery. Nine patients were randomized and no differences were found between arms. The second study tested ten preoperative PR sessions using a customized protocol with nonstandard components (exercise prescription based on self efficacy, inspiratory muscle training, and the practice of slow breathing) (n=10) vs. usual care (n=9). The PR arm had shorter length of hospital stay by 3 days (p=0.058), fewer prolonged chest tubes (11% vs. 63%, p=0.03) and fewer days needing a chest tube (8.8 vs. 4.3 days p=0.04) compared to the controlled arm. A ten-session preoperative PR intervention may improve post operative lung reexpansion evidenced by shorter chest tube times and decrease the length of hospital stay, a crude estimator of post operative morbidity and costs. Our results suggest the potential for short term preoperative pulmonary rehabilitation interventions in patients with moderate-severe COPD undergoing curative lung resection. 4 weeks of conventional preoperative PR seems non feasible.
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Affiliation(s)
- Roberto Benzo
- Pulmonary Division, Mayo Clinic, Rochester, MN, USA.
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Okamura H. Importance of Rehabilitation in Cancer Treatment and Palliative Medicine. Jpn J Clin Oncol 2011; 41:733-8. [PMID: 21622762 DOI: 10.1093/jjco/hyr061] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hitoshi Okamura
- Graduate School of Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
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Korstjens I, Mesters I, May AM, van Weert E, van den Hout JH, Ros W, Hoekstra-Weebers JE, van der Schans CP, van den Borne B. Effects of cancer rehabilitation on problem-solving, anxiety and depression: A RCT comparing physical and cognitive-behavioural training versus physical training. Psychol Health 2011; 26 Suppl 1:63-82. [DOI: 10.1080/08870441003611569] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hayes S, Rye S, Battistutta D, Yates P, Pyke C, Bashford J, Eakin E. Design and implementation of the Exercise for Health trial -- a pragmatic exercise intervention for women with breast cancer. Contemp Clin Trials 2011; 32:577-85. [PMID: 21463707 DOI: 10.1016/j.cct.2011.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 03/22/2011] [Accepted: 03/29/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exercise for Health was a pragmatic, randomised, controlled trial comparing the effect of an eight-month exercise intervention on function, treatment-related side effects and quality of life following breast cancer, compared with usual care. The intervention commenced six weeks post-surgery, and two modes of delivering the same intervention was compared with usual care. The purpose of this paper is to describe the study design, along with outcomes related to recruitment, retention and representativeness, and intervention participation. METHODS Women newly diagnosed with breast cancer and residing in a major metropolitan city of Queensland, Australia, were eligible to participate. Consenting women were randomised to a face-to-face-delivered exercise group (FtF, n = 67), telephone-delivered exercise group (Tel, n = 67) or usual care group (UC, n = 60) and were assessed pre-intervention (5-weeks post-surgery), mid-intervention (6 months post-surgery) and 10 weeks post-intervention (12 months post-surgery). Each intervention arm entailed 16 sessions with an Exercise Physiologist. RESULTS Of 318 potentially eligible women, 63% (n = 200) agreed to participate, with a 12-month retention rate of 93%. Participants were similar to the Queensland breast cancer population with respect to disease characteristics, and the randomisation procedure was mostly successful at attaining group balance, with the few minor imbalances observed unlikely to influence intervention effects given balance in other related characteristics. Median participation was 14 (min and max: 0 and 16) and 13 (min and max: 3 and 16) intervention sessions for the FtF and Tel, respectively, with 68% of those in Tel and 82% in FtF participating in at least 75% of sessions. DISCUSSION Participation in both intervention arms during and following treatment for breast cancer was feasible and acceptable to women. Future work, designed to inform translation into practice, will evaluate the quality of life, clinical, psychosocial and behavioural outcomes associated with each mode of delivery.
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Affiliation(s)
- Sandra Hayes
- School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, Queensland, Australia.
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McQuestion M, Fitch M, Howell D. The changed meaning of food: Physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 2011; 15:145-51. [DOI: 10.1016/j.ejon.2010.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 06/25/2010] [Accepted: 07/16/2010] [Indexed: 10/19/2022]
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Ashing-Giwa KT, Lim JW, Gonzalez P. Exploring the relationship between physical well-being and healthy lifestyle changes among European- and Latina-American breast and cervical cancer survivors. Psychooncology 2011; 19:1161-70. [PMID: 20101673 DOI: 10.1002/pon.1687] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cancer and its treatments have a lingering and often negative impact on survivors' physical well-being. The physical sequelae impinge on daily functioning and overall HRQOL, and perhaps influence lifestyle changes post-cancer. This study aims to examine: (1) physical well-being items that are associated with low overall health-related quality of life; and (2) the relationship between physical well-being outcomes and healthy lifestyle changes by cancer type. METHODS This study employed a cross-sectional design with mixed sampling methods. In total 922 European- (n=452) and Latina-American (n=470) breast (BCS) or cervical cancer survivors (CCS) were recruited from the California Cancer Surveillance Program and Los Angeles area hospital registries. Item responses from survivors in the lowest quartile of total quality of life scores and percentages reflecting low physical well-being levels were calculated. RESULTS A statistical approach to individual items provides unique and valuable measurement and clinical information above and beyond physical well-being total scores. Physical well-being item responses varied according to ethnicity, income, and education. BCS and CCS showed different patterns in the relationship between physical well-being items and lifestyle changes. Specifically, exercise was significantly related to physical well-being items for BCS, while diet changes were significantly associated with physical well-being for CCS. CONCLUSIONS Results reveal unique correlates of physical well-being items by cancer type, ethnicity, and lifestyle changes. Clinically, this study highlights the need for greater consideration of individual and medical characteristics in developing culturally sensitive and patient responsive interventions to promote healthy lifestyles and improve survivorship outcomes.
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Affiliation(s)
- Kimlin T Ashing-Giwa
- Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope, Duarte, CA 91010-3000, USA.
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Kampshoff CS, Buffart LM, Schep G, van Mechelen W, Brug J, Chinapaw MJM. Design of the Resistance and Endurance exercise After ChemoTherapy (REACT) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of exercise interventions after chemotherapy on physical fitness and fatigue. BMC Cancer 2010; 10:658. [PMID: 21118564 PMCID: PMC3009679 DOI: 10.1186/1471-2407-10-658] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 11/30/2010] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Preliminary studies suggest that physical exercise interventions can improve physical fitness, fatigue and quality of life in cancer patients after completion of chemotherapy. Additional research is needed to rigorously test the effects of exercise programmes among cancer patients and to determine optimal training intensity accordingly. The present paper presents the design of a randomized controlled trial evaluating the effectiveness and cost-effectiveness of a high intensity exercise programme compared to a low-to-moderate intensity exercise programme and a waiting list control group on physical fitness and fatigue as primary outcomes. METHODS After baseline measurements, cancer patients who completed chemotherapy are randomly assigned to either a 12-week high intensity exercise programme or a low-to-moderate intensity exercise programme. Next, patients from both groups are randomly assigned to immediate training or a waiting list (i.e. waiting list control group). After 12 weeks, patients of the waiting list control group start with the exercise programme they have been allocated to.Both interventions consist of equal bouts of resistance and endurance interval exercises with the same frequency and duration, but differ in training intensity. Additionally, patients of both exercise programmes are counselled to improve compliance and achieve and maintain an active lifestyle, tailored to their individual preferences and capabilities.Measurements will be performed at baseline (t = 0), 12 weeks after randomization (t = 1), and 64 weeks after randomization (t = 2). The primary outcome measures are cardiorespiratory fitness and muscle strength assessed by means of objective performance indicators, and self-reported fatigue. Secondary outcome measures include health-related quality of life, self-reported physical activity, daily functioning, body composition, mood and sleep disturbances, and return to work. In addition, compliance and satisfaction with the interventions will be evaluated. Potential moderation by pre- and post-illness lifestyle, health and exercise-related attitudes, beliefs and motivation will also be assessed. Finally, the cost-effectiveness of both exercise interventions will be evaluated. DISCUSSION This randomized controlled trial will be a rigorous test of effects of exercise programmes for cancer patients after chemotherapy, aiming to contribute to evidence-based practice in cancer rehabilitation programmes. TRIAL REGISTRATION This study is registered at the Netherlands Trial Register (NTR2153).
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Affiliation(s)
- Caroline S Kampshoff
- EMGO Institute for Health and Care Research, department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.
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Cancer-related fatigue and rehabilitation: a randomized controlled multicenter trial comparing physical training combined with cognitive-behavioral therapy with physical training only and with no intervention. Phys Ther 2010; 90:1413-25. [PMID: 20651011 DOI: 10.2522/ptj.20090212] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Research suggests that cancer rehabilitation reduces fatigue in survivors of cancer. To date, it is unclear what type of rehabilitation is most beneficial. OBJECTIVE This randomized controlled trial compared the effect on cancer-related fatigue of physical training combined with cognitive behavioral therapy with physical training alone and with no intervention. DESIGN In this multicenter randomized controlled trial, 147 survivors of cancer were randomly assigned to a group that received physical training combined with cognitive-behavioral therapy (PT+CBT group, n=76) or to a group that received physical training alone (PT group, n=71). In addition, a nonintervention control group (WLC group) consisting of 62 survivors of cancer who were on the waiting lists of rehabilitation centers elsewhere was included. SETTING The study was conducted at 4 rehabilitation centers in the Netherlands. PATIENTS All patients were survivors of cancer. INTERVENTION Physical training consisting of 2 hours of individual training and group sports took place twice weekly, and cognitive-behavioral therapy took place once weekly for 2 hours. MEASUREMENTS Fatigue was assessed with the Multidimensional Fatigue Inventory before and immediately after intervention (12 weeks after enrollment). The WLC group completed questionnaires at the same time points. RESULTS Baseline fatigue did not differ significantly among the 3 groups. Over time, levels of fatigue significantly decreased in all domains in all groups, except in mental fatigue in the WLC group. Analyses of variance of postintervention fatigue showed statistically significant group effects on general fatigue, on physical and mental fatigue, and on reduced activation but not on reduced motivation. Compared with the WLC group, the PT group reported significantly greater decline in 4 domains of fatigue, whereas the PT+CBT group reported significantly greater decline in physical fatigue only. No significant differences in decline in fatigue were found between the PT+CBT and PT groups. CONCLUSIONS Physical training combined with cognitive-behavioral therapy and physical training alone had significant and beneficial effects on fatigue compared with no intervention. Physical training was equally effective as or more effective than physical training combined with cognitive-behavioral therapy in reducing cancer-related fatigue, suggesting that cognitive-behavioral therapy did not have additional beneficial effects beyond the benefits of physical training.
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Syrjala KL, Yi JC, Artherholt SB, Stover AC, Abrams JR. Measuring musculoskeletal symptoms in cancer survivors who receive hematopoietic cell transplantation. J Cancer Surviv 2010; 4:225-35. [PMID: 20454867 PMCID: PMC3288113 DOI: 10.1007/s11764-010-0126-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 04/16/2010] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Beyond documentation of high prevalence rates, research has not examined the qualities and characteristics of musculoskeletal symptoms in cancer survivors, possibly because measures have not been validated specifically for the assessment of these symptoms in survivors. We report here on a new measure of muscle and joint symptoms for survivors of hematologic malignancies and hematopoietic cell transplantation (HCT). METHODS In a cross-sectional design, 130 adults, 5-20 years after HCT, completed patient-reported outcomes. Assessment included musculoskeletal symptoms on the Muscle and Joint Measure (MJM), as well as health-related quality of life and treatments. RESULTS Principal components analysis using promax rotation revealed four subscales for the MJM with item factor loadings above 0.50: muscle aches or stiffness (myalgias), joint pain, stiffness or swelling (arthralgias), muscle cramps, and muscle weakness. Variance explained by the total score was 77%. Internal consistency reliabilities of the subscales and total score ranged from 0.86 to 0.93. Validity was confirmed by correlations with the Short Form-36 bodily pain, physical function and vitality subscales, the Fatigue Symptom Inventory, and the Symptom Checklist-90-R depression (all P < .001). CONCLUSIONS Musculoskeletal symptoms in survivors who received HCT can be measured reliably and validly with the MJM. The measure requires testing to establish its psychometric properties with other diagnostic and treatment groups. IMPLICATIONS FOR CANCER SURVIVORS The MJM has potential research and clinical value for addressing the musculoskeletal symptoms of survivors. The measure may assist with examining the mechanisms as well as treatments for these symptoms, which are among the most prevalent in long-term cancer survivors.
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Affiliation(s)
- Karen L Syrjala
- Biobehavioral Sciences Department, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Velthuis MJ, May AM, Koppejan-Rensenbrink RA, Gijsen BCM, van Breda E, de Wit GA, Schröder CD, Monninkhof EM, Lindeman E, van der Wall E, Peeters PHM. Physical Activity during Cancer Treatment (PACT) Study: design of a randomised clinical trial. BMC Cancer 2010; 10:272. [PMID: 20534147 PMCID: PMC2927992 DOI: 10.1186/1471-2407-10-272] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 06/09/2010] [Indexed: 01/27/2023] Open
Abstract
Background Fatigue is a major problem of cancer patients. Thirty percent of cancer survivors report serious fatigue three years after finishing treatment. There is evidence that physical exercise during cancer treatment reduces fatigue. This may also lead to an improvement of quality of life. Such findings may result in a decrease of healthcare related expenditures and societal costs due to sick leave. However, no studies are known that investigated these hypotheses. Therefore, the primary aim of our study is to assess the effect of exercise during cancer treatment on reducing complaints of fatigue and on reducing health service utilisation and sick leave. Methods/Design The Physical Activity during Cancer Treatment study is a multicentre randomised controlled trial in 150 breast and 150 colon cancer patients undergoing cancer treatment. Participants will be randomised to an exercise or a control group. In addition to the usual care, the exercise group will participate in an 18-week supervised group exercise programme. The control group will be asked to maintain their habitual physical activity pattern. Study endpoints will be assessed after 18 weeks (short term) and after 9 months (long term). Validated questionnaires will be used. Primary outcome: fatigue (Multidimensional Fatigue Inventory and Fatigue Quality List) and cost-effectiveness, health service utilisation and sick leave. Secondary outcome: health related quality of life (European Organisation Research and Treatment of Cancer-Quality of Life questionnaire-C30, Short Form 36 healthy survey), impact on functioning and autonomy (Impact on functioning and autonomy questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), physical fitness (aerobic peak capacity, muscle strength), body composition and cognitive-behavioural aspects. To register health service utilisation and sick leave, participants will keep diaries including the EuroQuol-5D. Physical activity level will be measured using the Short Questionnaire to Assess Health-Enhancing Physical Activity and will be monitored with an exercise log and a pedometer. Discussion This study investigates the (cost)-effectiveness of exercise during adjuvant treatment of patients with breast or colon cancer. If early physical exercise proves to be (cost) effective, establishing standardised physical exercise programmes during cancer treatment will be planned. Trial registration Current Controlled trials ISRCTN43801571, Dutch Trial Register NTR2138
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Affiliation(s)
- Miranda J Velthuis
- Comprehensive Cancer Center Middle Netherlands, Utrecht, the Netherlands.
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Mitchell SA. Cancer-Related Fatigue: State of the Science. PM R 2010; 2:364-83. [DOI: 10.1016/j.pmrj.2010.03.024] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/21/2010] [Indexed: 01/17/2023]
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Monitoring training progress during exercise training in cancer survivors: a submaximal exercise test as an alternative for a maximal exercise test? Arch Phys Med Rehabil 2010; 91:351-7. [PMID: 20298823 DOI: 10.1016/j.apmr.2009.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 11/18/2009] [Accepted: 11/20/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the use of a submaximal exercise test in detecting change in fitness level after a physical training program, and to investigate the correlation of outcomes as measured submaximally or maximally. DESIGN A prospective study in which exercise testing was performed before and after training intervention. SETTING Academic and general hospital and rehabilitation center. PARTICIPANTS Cancer survivors (N=147) (all cancer types, medical treatment completed > or =3 mo ago) attended a 12-week supervised exercise program. INTERVENTIONS A 12-week training program including aerobic training, strength training, and group sport. MAIN OUTCOME MEASURES Outcome measures were changes in peak oxygen uptake (Vo(2)peak) and peak power output (both determined during exhaustive exercise testing) and submaximal heart rate (determined during submaximal testing at a fixed workload). RESULTS The Vo(2)peak and peak power output increased and the submaximal heart rate decreased significantly from baseline to postintervention (P<.001). Changes in submaximal heart rate were only weakly correlated with changes in Vo(2)peak and peak power output. Comparing the participants performing submaximal testing with a heart rate less than 140 beats per minute (bpm) versus the participants achieving a heart rate of 140 bpm or higher showed that changes in submaximal heart rate in the group cycling with moderate to high intensity (ie, heart rate > or =140 bpm) were clearly related to changes in VO(2)peak and peak power output. CONCLUSIONS For the monitoring of training progress in daily clinical practice, changes in heart rate at a fixed submaximal workload that requires a heart rate greater than 140 bpm may serve as an alternative to an exhaustive exercise test.
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Hirsch MA. Community-based rehabilitation for Parkinson's disease: from neurons to neighborhoods. Parkinsonism Relat Disord 2010; 15 Suppl 3:S114-7. [PMID: 20082969 DOI: 10.1016/s1353-8020(09)70795-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This paper describes a model for developing early, community-based exercise interventions for people with Parkinson's disease (PD). The model being described is novel in that it advocates collaborative development of the program by multiple stakeholders (i.e., researchers, people with Parkinson's disease, caregivers, Parkinson's associations and healthcare providers), utilizing a community-based participatory research (CBPR) approach, and peer-to-peer training by caregivers and person's with PD. Opportunities and challenges of creating community-based exercise programs are discussed.
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Affiliation(s)
- Mark A Hirsch
- Carolinas Rehabilitation, Carolinas Medical Center, Department of Physical Medicine and Rehabilitation, Charlotte, NC 28203, USA.
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Motor disability in malignant hematology: An epidemiological study on Italian hospitalized patients. Leuk Res 2010; 34:e66. [DOI: 10.1016/j.leukres.2009.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 07/31/2009] [Accepted: 08/03/2009] [Indexed: 11/23/2022]
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Physiotherapy management of cancer-related fatigue: a survey of UK current practice. Support Care Cancer 2009; 18:817-25. [DOI: 10.1007/s00520-009-0715-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 07/27/2009] [Indexed: 11/26/2022]
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Palacio A, Calmels P, Genty M, Le-Quang B, Beuret-Blanquart F. Oncology and physical medicine and rehabilitation. Ann Phys Rehabil Med 2009; 52:568-78. [PMID: 19720573 DOI: 10.1016/j.rehab.2009.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Accepted: 05/29/2009] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cancer patients are living longer with deficiencies and functional impairments requiring often typically a care in physical medicine and rehabilitation (PMR). OBJECTIVE To examine the care of cancer patients in PMR. METHOD Investigation made with a questionnaire diffused from the e-mail listing of the Société Française de Médecine Physique et de Réadaptation. RESULTS Sixty-seven answers received. Fifty-seven centers take care of cancer patients. On average, 4% of cancer patients are hospitalised in PMR. Spinal cord injuries and hemiplegias are the most common impairments. Forty-two percent of the PMR units take the patients in all the stages of cancer treatment. Working relationships between PMR and oncology units are formalized only eight times out of 52. In case of health degradation, relationships with a palliative care unit are frequent but not generalized. Eighty-five percent of the centers think that PMR is not enough developed in oncology. CONCLUSIONS In spite of its limited character, this investigation shows that the PMR units take these patients. Situations where PMR has an important role in the follow-up of cancer patients are multiple and publications have showed its interest, especially on the limitations of activities. It is important to make better known the interest of PMR in oncology units but also to develop specific care within PMR units.
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Affiliation(s)
- A Palacio
- CRMPR Les Herbiers, CHU de Rouen, 111, rue Herbeuse, 76230 Bois-Guillaume, France.
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Hayes SC, Spence RR, Galvão DA, Newton RU. Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. J Sci Med Sport 2009; 12:428-34. [PMID: 19428291 DOI: 10.1016/j.jsams.2009.03.002] [Citation(s) in RCA: 187] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 03/20/2009] [Accepted: 03/20/2009] [Indexed: 02/06/2023]
Abstract
Cancer represents a major public health concern in Australia. Causes of cancer are multifactorial with lack of physical activity being considered one of the known risk factors, particularly for breast and colorectal cancers. Participating in exercise has also been associated with benefits during and following treatment for cancer, including improvements in psychosocial and physical outcomes, as well as better compliance with treatment regimens, reduced impact of disease symptoms and treatment-related side-effects, and survival benefits for particular cancers. The general exercise prescription for people undertaking or having completed cancer treatment is of low to moderate intensity, regular frequency (3-5 times/week) for at least 20 min per session, involving aerobic, resistance or mixed exercise types. Future work needs to push the boundaries of this exercise prescription, so that we can better understand what constitutes optimal, desirable and necessary frequency, duration, intensity and type, and how specific characteristics of the individual (e.g., age, cancer type, treatment, presence of specific symptoms) influence this prescription. What follows is a summary of the cancer and exercise literature, in particular the purpose of exercise following diagnosis of cancer, the potential benefits derived by cancer patients and survivors from participating in exercise programs, and exercise prescription guidelines and contraindications or considerations for exercise prescription with this special population. This report represents the position stand of the Australian Association of Exercise and Sport Science on exercise and cancer recovery and has the purpose of guiding exercise practitioners in their work with cancer patients.
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Affiliation(s)
- Sandra C Hayes
- Institute of Health and Biomedical Innovation, School of Public Health, Queensland University of Technology, Australia.
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May AM, Korstjens I, van Weert E, van den Borne B, Hoekstra-Weebers JEHM, van der Schans CP, Mesters I, Passchier J, Grobbee DE, Ros WJG. Long-term effects on cancer survivors’ quality of life of physical training versus physical training combined with cognitive-behavioral therapy: results from a randomized trial. Support Care Cancer 2008; 17:653-63. [DOI: 10.1007/s00520-008-0519-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/01/2008] [Indexed: 01/22/2023]
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