1
|
Zhou R, Chen Z, Zhang S, Wang Y, Zhang C, Lv Y, Yu L. Effects of Exercise on Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Life (Basel) 2024; 14:1011. [PMID: 39202753 PMCID: PMC11355832 DOI: 10.3390/life14081011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/15/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024] Open
Abstract
The primary objective of this study was to assess the influence of exercise interventions on cancer-related fatigue (CRF), specifically in breast cancer patients, with the ultimate goal of establishing an optimal exercise prescription for breast cancer patients. A comprehensive search was undertaken across multiple databases, including Embase, PubMed, Cochrane Library, Web of Science, and Scopus, covering data published up to 1 September 2023. A meta-analysis was conducted to calculate the standardized mean difference (SMD) along with its corresponding 95% confidence interval (CI), thereby quantifying the effectiveness of exercise in alleviating CRF in the breast cancer patient population. Twenty-six studies met the inclusion criteria. Aerobic exercise (SMD, -0.17, p = 0.02), resistance exercise (SMD, -0.37, p = 0.0009), and combined exercise (SMD, -0.53, p < 0.0001) significantly improved CRF in breast cancer patients. In addition, exercise intervention conducted ≥3 times per week (SMD, -0.47, p = 0.0001) for >60 min per session (SMD, -0.63, p < 0.0001) and ≥180 min per week (SMD, -0.79, p < 0.0001) had greater effects on improving CRF in breast cancer patients, especially middle-aged patients (SMD, -0.42, p < 0.0001). Exercise is an effective approach to improving CRF in breast cancer patients. When devising an exercise program, the primary consideration should be the incorporation of combined exercise as the principal intervention. This entails ensuring that participants engage in the program at least three times weekly, with each session lasting for more than 60 min. The ultimate aim is to achieve a total weekly exercise duration of 180 min by progressively increasing the frequency of exercise sessions.
Collapse
Affiliation(s)
- Runyu Zhou
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing 100084, China;
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (S.Z.)
| | - Zhuying Chen
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (S.Z.)
| | - Shiyan Zhang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (S.Z.)
| | - Yushu Wang
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China; (Y.W.); (C.Z.)
| | - Chiyang Zhang
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China; (Y.W.); (C.Z.)
| | - Yuanyuan Lv
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing 100084, China;
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China; (Y.W.); (C.Z.)
| | - Laikang Yu
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing 100084, China;
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (S.Z.)
| |
Collapse
|
2
|
Martin-Quesada AI, Hennessy MA, Gutiérrez AC. Charting cancer's course: revealing the role of diet, exercise, and the microbiome in cancer evolution and immunotherapy response. Clin Transl Oncol 2024:10.1007/s12094-024-03595-1. [PMID: 39095683 DOI: 10.1007/s12094-024-03595-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/03/2024] [Indexed: 08/04/2024]
Abstract
A variety of pathophysiological mechanisms exist by which physical exercise, nutrition, and the microbiome can impact the development of cancer and the response of tumor cells to systemic anti-cancer therapy. Physical exercise positively impacts the different stages of oncological disease and may improve overall survival and quality of life, reduce treatment-associated toxicity, and improve response to immunotherapy. Nutrition impacts quality of life, and novel nutritional regimens and their role in cancer treatment and outcomes are under active investigation. Finally, the microbiome may act as a predictor of response and resistance to immunotherapy. This comprehensive review delves into the interplay between these elements and their impact on oncological outcomes, emphasizing their role in modulating the immune system and enhancing the response to immunotherapy.The data that support the findings of this study are openly available and referenced in the bibliography section.
Collapse
Affiliation(s)
- Ana Isabel Martin-Quesada
- Cell Therapy and Early Drug Development Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | | | | |
Collapse
|
3
|
Zhang Q, Gao Y, Wang W, Zhao X, Yu J, Huang H. Effect of resistance exercise on physical fitness, quality of life, and fatigue in patients with cancer: a systematic review. Front Oncol 2024; 14:1393902. [PMID: 39099690 PMCID: PMC11294253 DOI: 10.3389/fonc.2024.1393902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/20/2024] [Indexed: 08/06/2024] Open
Abstract
Objective The purpose of this study is to conduct a systematic review to assess the effects of different forms of resistance exercises (resistance exercise, resistance exercise combined with aerobic exercise, and resistance exercise combined with other exercises) on physical fitness, quality of life (QOL), and fatigue of patients with cancer. Methods We conducted a systematic review using the Cochrane Handbook for Systematic Reviews of Interventions guidelines. We searched PubMed, Web of Science, and Scopus databases for the studies from the establishment of the database to September 2023, including randomized controlled trials and clinical trials that evaluated the effects of different resistance exercise on physical fitness, QOL, and fatigue in all patients with cancer. Two reviewers independently assessed the quality of all the included studies using the Cochrane Handbook for Systematic Reviews of Interventions and MINORS scale. We divided the intervention into three types: resistance exercise, resistance exercise combined with aerobic exercise, and resistance exercise combined with other exercises. Results In total, 48 studies (3,843 participants) met the inclusion criteria. The three exercise intervention forms have significant effects on physical fitness and QOL, but the improvement effect on fatigue is not clear. A total of 34 studies reported significant and beneficial effects of resistance exercise on physical fitness across all types of cancer. There were 28 studies that reported significant or borderline improvement effects of resistance on QOL, and only 10 studies reported significant effects of resistance exercise interventions on fatigue improvement in patients with cancer. Conclusions Resistance exercise, resistance exercise combined with aerobic exercise, and resistance exercise combined with other exercises all have a positive effect on improving fitness and QOL in patients with cancer. Resistance exercise has an advantage in improving muscle strength, while combined resistance exercise has an advantage in improving QOL; however, there are no consistent findings in improving fatigue, although low-intensity resistance exercise is effective. Systematic review registration www.inplasy.com, identifier INPLASY2023110034.
Collapse
Affiliation(s)
- Qiuhua Zhang
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| | - Yanan Gao
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, Fujian, China
| | - Wenjun Wang
- Ningbo New Fitness Health Technology Co., Ltd, Ningbo, Zhejiang, China
| | - Xiaoguang Zhao
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| | - Jiabin Yu
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| | - Huiming Huang
- Faculty of Sports Science, Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China
| |
Collapse
|
4
|
Brown NI, Sauls R, Almendares M, Gray HL, Stern M. Factors impacting physical activity among post-treatment pediatric cancer survivors with overweight and obesity. Eur J Pediatr 2024; 183:3129-3136. [PMID: 38668797 DOI: 10.1007/s00431-024-05584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Pediatric cancer survivors (PCS) with overweight and obesity are at risk for various secondary chronic diseases. Although previous research has found physical activity (PA) as beneficial after treatment, the PA levels are low among PCS, highlighting the need for lifestyle interventions targeting PA. METHODS A secondary analysis of preliminary baseline data from a multi-site trial, NOURISH-T + , a healthy lifestyle intervention for PCS with overweight and obesity, and their caregivers, was conducted to assess factors related to PCS PA (i.e., moderate to vigorous intensity PA, MVPA). Kendall's Tau-b was used to assess correlations between PCS MVPA, health and treatment-related factors, and caregivers' sedentary behavior and MVPA. Wilcoxon Signed Ranks Test was used to assess the differences between PCS and caregiver sedentary behavior and MVPA. A multiple linear regression analysis was performed to determine predictors of PCS MVPA. RESULTS Seventy-three PCS-caregiver dyads were included in this analysis (N = 146). Many of the PCS were female, diagnosed with Acute Lymphoblastic Leukemia, stage 1, with a mean body mass index (BMI) percentile of 94.4 ± 4.7. Caregivers were female and parents to the PCS. Significant correlations were found between PCS MVPA, time since treatment, PCS weight change since COVID, caregiver sedentary behavior and MVPA. Significant differences were observed between PCS and caregiver sedentary behavior and MVPA. Household income, radiation treatment, and caregiver MVPA were significant predictors of PCS MVPA. Conclusions: Demographics, cancer treatment type, and caregiver role modeling are important factors to consider when developing future lifestyle interventions for PCS. (NCT04656496, registered 12-07-2020). WHAT IS KNOWN • Parents/caregivers are presumed to be a potential influence on their children's physical activity What is new: • Parents/caregivers' moderate-to-vigorous physical activity is the strongest predictor of their children's (pediatric cancer survivors') physical activity.
Collapse
Affiliation(s)
- Nashira I Brown
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rachel Sauls
- Department of Non-Therapeutic Research Office, Moffitt Cancer Center, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Maria Almendares
- Department of Non-Therapeutic Research Office, Moffitt Cancer Center, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA.
| |
Collapse
|
5
|
van Coevorden-van Loon EMP, Horemans HHLD, Heijenbrok-Kal MH, van den Berg-Emons RJG, Rozenberg R, Vincent AJPE, Ribbers GM, van den Bent MJ. Physical fitness and its association with fatigue in patients with low-grade glioma. Disabil Rehabil 2023; 45:3323-3329. [PMID: 36148487 DOI: 10.1080/09638288.2022.2125084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate physical fitness and its association with fatigue in patients with low grade glioma (LGG). METHODS Cross-sectional study. Muscle strength was measured with a digital dynamometer, cardiorespiratory fitness (peak oxygen uptake (VO2peak), maximal workload (MWL)) by cardiopulmonary-exercise-testing, and fatigue by using the Multidimensional Fatigue Inventory. RESULTS Thirty patients were included, mean age of 44.1 (SD11.2) years, and 67% were men, 31.2 (SD18) months post-diagnosis. Muscle strength (p < 0.01), and cardiorespiratory fitness (VO2peak, MWL) (p < 0.01) were significantly decreased compared to predicted values based on age and gender. Thirty percent of the patients experienced severe physical fatigue, and severe mental fatigue was reported in 57% of the patients. Cardiorespiratory fitness showed weak to moderate (r - 0.46 to r - 0.52) but significant (p < 0.01) correlations with physical fatigue, not with mental and general fatigue. Muscle strength was not associated with fatigue. A lower VO2peak was independently associated with a higher level of physical fatigue, adjusted for Karnofsky Performance Status (R2 0.40). CONCLUSIONS Physical fitness (muscle strength, cardiorespiratory fitness) is reduced in patients with LLG, and a lower level of cardiorespiratory fitness (VO2peak) is independently associated with a higher level of experienced physical fatigue. Trials to explore the benefit of exercise programs to improve cardiorespiratory fitness and, consequently, fatigue are warranted.Implications for rehabilitationPhysical fitness (muscle strength and cardiorespiratory fitness) is reduced in patients with low-grade glioma.Patients with low-grade glioma should be screened for fatigue with the multidimensional fatigue inventory, to differentiate between mental and physical fatigue.Patients with low-grade glioma with severe physical fatigue should be screened for reduced physical fitness, especially cardiorespiratory fitness by objective cardiopulmonary-exercise-testing.Rehabilitation exercise programs to improve cardiorespiratory fitness and, consequently, (physical) fatigue could be warranted in patients with low-grade glioma.
Collapse
Affiliation(s)
- Ellen M P van Coevorden-van Loon
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Rehabilitation, Revant Rehabilitation, Goes, The Netherlands
| | - Herwin H L D Horemans
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Majanka H Heijenbrok-Kal
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert Rozenberg
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arnaud J P E Vincent
- The Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Gerard M Ribbers
- Rijndam Rehabilitation, Rotterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | |
Collapse
|
6
|
Marmol-Perez A, Ubago-Guisado E, Rodriguez-Solana A, Gil-Cosano JJ, Martinez-Vizcaino V, Cavero-Redondo I, Ruiz JR, Gracia-Marco L. Effect of exercise on bone health in children and adolescents with cancer during and after oncological treatment: A systematic review and meta-analysis. Front Physiol 2023; 14:1088740. [PMID: 37035662 PMCID: PMC10081564 DOI: 10.3389/fphys.2023.1088740] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/07/2023] [Indexed: 03/16/2023] Open
Abstract
Background: Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled effect of exercise interventions following frequency, intensity, time and type prescriptions.Objective: This systematic review and meta-analysis aimed to synthesise evidence regarding the effectiveness of exercise interventions on bone health in children and adolescents with cancer during and after oncological treatment.Methods: A systematic search was conducted in the MEDLINE (via PubMed), Web of Science and Scopus databases from November 2021 to January 2022. Randomised controlled trials (RCTs) and non-RCTs reporting pre-post changes of the effectiveness of exercise interventions on DXA-measured bone parameters in young population (1–19 years) during or after oncological treatment were included. Pooled (ESs) and 95% confidence intervals (95%CIs) were calculated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.Results: A total of eight trials with 341 participants were included. The meta-analyses did not reveal a statistically significant increase in whole body areal bone mineral density (ES = 0.10; 95%CI: −0.14, 0.34), lumbar spine (ES = 0.03; 95%CI: −0.21, 0.26) or femoral neck (ES = 0.10; 95%CI: −0.37, 0.56). Similarly, during the oncological treatment phase the ES was 0.04 (95%CI: −0.17, 0.25) and after the ES was 0.07 (95%CI: −0.20, 0.33).Conclusion: To date, exercise interventions have been inappropriate and therefore, ineffective to illustrate any beneficial effect on bone health in children and adolescents with cancer during and after oncological treatment.Systematic Review Registration: PROSPERO registration number: CRD42022310876
Collapse
Affiliation(s)
- Andres Marmol-Perez
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Esther Ubago-Guisado
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
- *Correspondence: Esther Ubago-Guisado,
| | - Andrea Rodriguez-Solana
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Jose J. Gil-Cosano
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Department of Communication and Education, Universidad Loyola Andalucía, Sevilla, Spain
| | - Vicente Martinez-Vizcaino
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Ivan Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Jonatan R. Ruiz
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Gracia-Marco
- Department of Physical Education and Sports, Faculty of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
7
|
Gutiérrez-Santamaría B, Castañeda-Babarro A, Arietaleanizbeaskoa MS, Mendizabal-Gallastegui N, Grandes G, Coca A. Physiological and mental health changes in cancer patients during the COVID-19 state of emergency. SPORT SCIENCES FOR HEALTH 2023; 19:123-130. [PMID: 36211532 PMCID: PMC9525225 DOI: 10.1007/s11332-022-01008-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/15/2022] [Indexed: 11/24/2022]
Abstract
Backgrounds Due to the COVID-19 pandemic that we are currently facing, many governments across the world have declared a state of emergency and even confinements. This stressful situation, in addition to prolonged stays at home, may imply a radical change in lifestyle behavior and physical activity (PA). The aim of this study is to evaluate the physiological and psychological effects in cancer patients who changed their PA habits during the COVID-19 state of emergency in Spain. Methods Thirty-three participants were evaluated pre- and post-state of emergency. A series of questionnaires was used to assess cancer-specific quality of life. Results The most relevant results revealed significantly lower walking time (p < 0.001) and sitting time (p = 0.014). Upper and lower body strength also decreased significantly (p = 0.009 and 0.012, respectively) and oxygen consumption (VO2 peak) (p = 0.023). None of the parameters analysed showed significant differences for psychological aspects (QLQ-C-30 and SF-36) and body composition. Conclusion Lower physical activity leads to negative physiological adaptation, particularly affecting cardiovascular and strength levels. While it is important to maintain the general population's amount and intensity of exercise, this particularly vulnerable group's physical capacity is vital to their health and well-being.
Collapse
Affiliation(s)
- Borja Gutiérrez-Santamaría
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bizkaia, Spain
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bizkaia, Spain
| | - Maria Soledad Arietaleanizbeaskoa
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay Spain
| | - Nere Mendizabal-Gallastegui
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay Spain
| | - Aitor Coca
- Department of Physical Activity and Sports Sciences, Faculty of Health Sciences, Euneiz University, La Biosfera Ibilbidea, 6, 01013 Vitoria-Gasteiz, Spain
| |
Collapse
|
8
|
Wang J, Chen X, Wang L, Zhang C, Ma J, Zhao Q. Does aquatic physical therapy affect the rehabilitation of breast cancer in women? A systematic review and meta-analysis of randomized controlled trials. PLoS One 2022; 17:e0272337. [PMID: 35921372 PMCID: PMC9348687 DOI: 10.1371/journal.pone.0272337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
To determine and evaluate the benefits of aquatic physical therapy as a rehabilitation strategy for women with breast cancer on health outcomes. Electronic databases including PubMed, Web of Science, Embase, Cochrane Library and China National Knowledge Infrastructure (CNKI), Weipu (VIP) and Wanfang database were systematically searched until June 2021. Randomized controlled trials were included if they evaluated the effects of aquatic physical therapy in breast cancer patients. The quality of the trials included was assessed by the two independent researchers according to the Cochrane Collaboration Handbook recommendations. Outcome measures were fatigue, waist circumference and quality of life (QoL). The study was registered under PROSPERO (CRD42021157323). Totally, five studies comprising 356 participants were included in the study. Meta-analyses showed that aquatic physical therapy interventions significantly reduced the fatigue score (MD = -2.14, 95%CI: -2.82, -1.45, p<0.01) compared with usual care; In addition, we also observed that, compared with land-based exercise, aquatic physical therapy greatly improved the QoL (MD = 2.85, 95%CI: 0.62, 5.09, p = 0.01). However, aquatic physical therapy cannot improve physical index (waist circumference) compared to usual care (MD = -3.49, 95%CI: -11.56,4.58, p = 0.4). Consequently, aquatic physical therapy had a positive effect on the fatigue and QoL. The results of this meta-analysis can provide a reliable evidence for evaluating the interventional effectiveness of aquatic physical therapy.
Collapse
Affiliation(s)
- Juzi Wang
- Department of Nursing, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
| | - Xiaoyu Chen
- School of Nursing, Shanxi University of Traditional Chinese Medicine, Jinzhong, Shanxi, China
| | - Lili Wang
- Department of Nursing, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
| | - Caiyun Zhang
- Department of Nursing, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
| | - Ji Ma
- The Orthopaedic Spinal Ward, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
- * E-mail: (JM); (QZ)
| | - Qian Zhao
- Department of Nursing, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, China
- * E-mail: (JM); (QZ)
| |
Collapse
|
9
|
Medeiros Torres D, Jorge Koifman R, da Silva Santos S. Impact on fatigue of different types of physical exercise during adjuvant chemotherapy and radiotherapy in breast cancer: systematic review and meta-analysis. Support Care Cancer 2022; 30:4651-4662. [PMID: 35064331 DOI: 10.1007/s00520-022-06809-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Physical exercise in women with breast cancer has shown benefits in reducing fatigue levels during adjuvant radiotherapy and chemotherapy. However, it is not well understood which type of exercise is more effective. OBJECTIVE Assess the impact of different types of physical exercises on fatigue and which is the most effective in reducing this adverse effect during adjuvant treatment in breast cancer. METHODS The inclusion criteria were randomized clinical trials of physical exercise in women diagnosed with breast cancer in stages I to IV, above 18 years, evaluating fatigue using validated questionnaires. The meta-analysis pooled results by standardized mean difference (SMD). RESULTS A total of 20 randomized clinical trials involving 1793 participants revealed that the practice of physical exercise was statistically effective in reducing fatigue (SMD = - 0.46; 95% CI: - 0.66, - 0.27). Our analysis of subgroups suggests that the supervised combination of resistance training (RT) with aerobic training (AT) is the most effective physical exercise to reduce fatigue (SMD = - 1.13; 95% CI: - 2.09, - 0.17). The supervised RT was more effective (SMD = - 0.30; 95% CI: - 0.46, - 0.15) than supervised AT or mind-body techniques. It was observed that only during chemotherapy, women with breast cancer in the intervention groups showed a significant reduction in fatigue (SMD = - 0.38; 95% CI: - 0.55 to - 0.20). CONCLUSION Physical exercise during adjuvant chemotherapy and/or radiotherapy in women with breast cancer can be considered beneficial in reducing fatigue, especially for women undergoing chemotherapy and for supervised training of resistance or combined RT and AT.
Collapse
Affiliation(s)
| | - Rosalina Jorge Koifman
- National Public Health School (ENSP, Escola Nacional de Saúde Pública), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Sabrina da Silva Santos
- National Public Health School (ENSP, Escola Nacional de Saúde Pública), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| |
Collapse
|
10
|
Schmidt-Andersen P, Fridh MK, Müller KG, Anna Pouplier, Hjalgrim LL, Faigenbaum AD, Schmiegelow K, Hasle H, Lykkedegn S, Zhang H, Christensen J, Larsen HB. Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): Study Protocol for a Multicenter, Two-Arm Parallel-Group Randomized Controlled Superiority Trial. Front Pediatr 2022; 10:833850. [PMID: 35359909 PMCID: PMC8964065 DOI: 10.3389/fped.2022.833850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/14/2022] [Indexed: 12/19/2022] Open
Abstract
Background Improved survival rates for children and adolescents diagnosed with cancer call for novel strategies for reducing short- and long-term treatment-related side effects. These include the physical and metabolic sequelae that are exacerbated by sedentary behavior and treatment-induced toxicities. We aim to investigate the effect of an integrative neuromuscular training intervention during the first 6 months of anti-cancer treatment primarily on muscle strength, and secondarily on exercise capacity, physical function, markers of metabolic syndrome, dysmetabolism, and health-related quality of life during and after ended treatment. Methods One hundred and twenty-seven children and adolescents, newly diagnosed with malignant and benign neoplasia, aged 6-17 years, and treated with chemotherapy or radiation will be randomized to either the intervention or the control arm of the study. The intervention group will, in addition to usual care, be offered a combination of 6 months of supervised physical exercise (integrative neuromuscular training) and home-based exercise. The active control group will, in addition to usual care, receive information along an unsupervised written home-based training program. All participants, including parents, will receive information about the importance of physical exercise during the course of cancer treatment, at the start of treatment, and in 5 monthly sessions. The primary outcome is measured in terms of isometric quadriceps muscle strength. Secondary outcomes include muscle strength and endurance, markers of metabolic syndrome and dysmetabolism, exercise capacity, physical function and activity, days of hospitalization, and health-related quality of life. Assessment will be conducted at treatment initiation (baseline), at 3 and 6 months after inclusion, and 1 month and 1 year after ended treatment. The primary endpoint for lower-body muscle strength is at 6 months after treatment initiation. The effects of the intervention will be evaluated through a constrained linear mixed model. Discussion This national randomized controlled study has the potential to provide new knowledge concerning the short- and long-term effects of a novel, inclusive approach for youth exercise programming (integrative neuromuscular exercise) in children and adolescents during anti-cancer treatment. Using a pragmatic, low-cost, and time-efficient training design, this intervention can be easily adapted to both hospital and home settings. Clinical Trial Registration ClinicalTrials.gov (NCT04706676), first released January 5, 2021.
Collapse
Affiliation(s)
- Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Klaus Gottlob Müller
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Avery D. Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, United States
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sine Lykkedegn
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - He Zhang
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
11
|
Morales-Rodriguez E, Pérez-Bilbao T, San Juan AF, Calvo JL. Effects of Exercise Programs on Physical Factors and Safety in Adult Patients with Cancer and Haematopoietic Stem Cell Transplantation: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1288. [PMID: 35162312 PMCID: PMC8834842 DOI: 10.3390/ijerph19031288] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/17/2022]
Abstract
This study looks at the effects of exercise programs on physical factors and safety in adult patients with cancer and hematopoietic stem cell transplantation (HSCT) or bone marrow transplantation (BMT). A systematic search was performed in the PubMed and Web of Science databases (from inception to 26 August 2021). A review was carried out following the Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) checklist. The methodological quality of the included studies was assessed with the Physiotherapy Evidence Database (PEDro) scale, based, in turn, on the Delphi list. A total of 25 randomized controlled trials studies were included, comprising 1434 patients. The most significant result of this systematic review is that exercise program interventions are safe and produce positive changes in cardiorespiratory fitness, muscle strength, and the functional mobility-state in adult patients with cancer and HSCT or BMT. Only 3 patients from the 711 participants in the exercise interventions (i.e., 0.42%) reported adverse events related to exercise interventions. Moreover, exercise training programs may have a cardiological and muscular protective effect, as well as a healthy effect on the prevention and control of transplant complications, improving health outcomes.
Collapse
Affiliation(s)
- Erica Morales-Rodriguez
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (E.M.-R.); (J.L.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Txomin Pérez-Bilbao
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
- Department of Education, Investigation Methods and Evaluation, Faculty of Human and Social Sciences, Universidad Pontificia de Comillas, 28049 Madrid, Spain
| | - Alejandro F. San Juan
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Jorge Lorenzo Calvo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (E.M.-R.); (J.L.C.)
| |
Collapse
|
12
|
André N, Gastinger S, Rébillard A. Chronic Fatigue in Cancer, Brain Connectivity and Reluctance to Engage in Physical Activity: A Mini-Review. Front Oncol 2022; 11:774347. [PMID: 34988017 PMCID: PMC8721035 DOI: 10.3389/fonc.2021.774347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
A large amount of evidence shows that after a cancer diagnosis, patients significantly reduce their level of physical activity. Usually, this reduction is attributed to cancer-related fatigue. However, to our knowledge, no study has clearly demonstrated that fatigue alters effort-based decision-making in cancer. This mini-review aimed to provide evidence that chronic fatigue in cancer patients causes changes in brain connectivity that impact effort-based decision-making. Indeed, three patterns of activation to compensate for dysfunctional networks have been reported: greater variability in the executive network and hyperactivation in the executive network, which account for less efficient and costly processes in the frontal cortex, and reduced deactivation in the default mode network. Nevertheless, these activation patterns are also observed with other factors, such as anticipatory stressors (worry, rumination or sleep loss), that might also cause reluctance to engage in physical activity. Effort-based decision-making involving weighing costs against benefits and physical activity interventions should increase immediate benefits to facilitate engagement in effortful activities.
Collapse
Affiliation(s)
- Nathalie André
- Research Centre on Cognition and Learning (UMR CNRS 7295), University of Poitiers, Sport Sciences Faculty, Poitiers, France.,Maison des Sciences de l'Homme et de la Société (USR CNRS 3565), Université de Poitiers, Poitiers, France
| | - Steven Gastinger
- M2S-EA7470, University of Rennes, Rennes, France.,APCoSS - Institut de Formation en Education Physique et en Sport (IFEPSA), UCO Angers, Angers, France
| | - Amélie Rébillard
- M2S-EA7470, University of Rennes, Rennes, France.,Institut Universitaire de France (IUF), Paris, France
| |
Collapse
|
13
|
Morales JS, Valenzuela PL, Velázquez-Díaz D, Castillo-García A, Jiménez-Pavón D, Lucia A, Fiuza-Luces C. Exercise and Childhood Cancer-A Historical Review. Cancers (Basel) 2021; 14:cancers14010082. [PMID: 35008246 PMCID: PMC8750946 DOI: 10.3390/cancers14010082] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/18/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Childhood cancer survivors are at risk of developing important adverse effects, but there is growing evidence that physical exercise could help in this regard. The present review summarizes the history of pediatric exercise oncology and the main milestones achieved along the way. Overall, physical exercise appears to be safe and beneficial even during the most aggressive phases of pediatric cancer treatment and can represent an effective coadjuvant therapy for attenuating cancer-related adverse effects. Abstract Childhood cancer survivors are at risk of developing important adverse effects, many of which persist for years after the end of treatment. The implementation of interventions aiming at attenuating tumor/treatment-associated adverse effects is therefore a major issue in pediatric oncology, and there is growing evidence that physical exercise could help in this regard. The present review aims to summarize the main milestones achieved in pediatric exercise oncology. For this purpose, we conducted a systematic review of relevant studies written in English in the electronic database PubMed (from inception to 14 August 2021). This review traces the field of pediatric exercise oncology throughout recent history based on three fundamental pillars: (i) exercise during childhood cancer treatment; (ii) exercise during/after hematopoietic stem cell transplantation; and (iii) exercise after childhood cancer treatment. Accumulating evidence––although still preliminary in many cases––supports the safety and potential benefits of regular exercise (with no major contraindications in general) in the childhood cancer continuum, even during the most aggressive phases of treatment. Exercise can indeed represent an effective coadjuvant therapy for attenuating cancer-related adverse effects.
Collapse
Affiliation(s)
- Javier S. Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, Universidad de Cádiz, 11519 Cadiz, Spain; (J.S.M.); (D.V.-D.); (D.J.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cadiz, Spain
| | - Pedro L. Valenzuela
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (P.L.V.); (A.L.)
- Physical Activity and Health Research Group (‘PaHerg’), Research Institute of the Hospital 12 de Octubre (‘imas12’), 28041 Madrid, Spain
| | - Daniel Velázquez-Díaz
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, Universidad de Cádiz, 11519 Cadiz, Spain; (J.S.M.); (D.V.-D.); (D.J.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cadiz, Spain
| | | | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, Universidad de Cádiz, 11519 Cadiz, Spain; (J.S.M.); (D.V.-D.); (D.J.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11009 Cadiz, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (P.L.V.); (A.L.)
- Physical Activity and Health Research Group (‘PaHerg’), Research Institute of the Hospital 12 de Octubre (‘imas12’), 28041 Madrid, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain
| | - Carmen Fiuza-Luces
- Physical Activity and Health Research Group (‘PaHerg’), Research Institute of the Hospital 12 de Octubre (‘imas12’), 28041 Madrid, Spain
- Correspondence: ; Tel.: +34-91-779-2713
| |
Collapse
|
14
|
Zemlin C, Stuhlert C, Schleicher JT, Wörmann C, Altmayer L, Lang M, Scherer LS, Thul IC, Müller C, Kaiser E, Stutz R, Goedicke-Fritz S, Ketter L, Zemlin M, Wagenpfeil G, Steffgen G, Solomayer EF. Longitudinal Assessment of Physical Activity, Fitness, Body Composition, Immunological Biomarkers, and Psychological Parameters During the First Year After Diagnosis in Women With Non-Metastatic Breast Cancer: The BEGYN Study Protocol. Front Oncol 2021; 11:762709. [PMID: 34737966 PMCID: PMC8560964 DOI: 10.3389/fonc.2021.762709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background Moderate physical activity is associated with an improved prognosis and psychosocial outcome in breast cancer patients. Although exercise and physical activity are associated with multiple physiological and psychological effects, many of the underlying mechanisms remain obscure. The BEGYN study (Influence of physical activity in breast cancer patients on physiological and psychological parameters and on biomarkers) aims at identifying potential associations between the extent of physical activity, fitness, body composition, immunological biomarkers, psycho-emotional parameters, and the course of treatment during the first year after diagnosis of breast cancer. Methods The prospective observational BEGYN study will include 110 non-metastatic breast cancer patients. The patients will be assessed during a base line visit prior to the initiation of the antineoplastic therapy and after 3, 6, 9 and 12 months. The physical activity will be measured using a fitness tracker and a self-assessment diary during the entire study. Each visit will include the assessment of (i) cardiorespiratory fitness measured by spiroergometry, (ii) body composition, (iii) psycho-emotional parameters (quality of life, mental health, fatigue, depression, distress, anxiety, well-being), and (iv) extensive blood tests including routine laboratory, vitamin D, selenium and immunologically relevant biomarkers (e.g., leukocyte subpopulations and cytokine profiles). Discussion Whereas most studies investigating the influence of physical activity in breast cancer patients focus on specific activities for three months or less, the BEGYN study will quantify the daily physical activity and cardiorespiratory fitness of breast cancer patients based on objective measurements in the context of the oncological therapy for 12 months after diagnosis. The study will reveal potential associations between exercise, immune status and physical as well as psycho-emotional outcome and the clinical course of the disease. Moreover, complementary therapies such as Vit D and Selenium supplementation and parameters investigating the motivation of the patients are part of the study. Due to this holistic approach, the BEGYN study will guide towards confirmatory studies on the role of physical activity in breast cancer patients to develop individualized counselling regarding the recommended type and extent of exercise. Trial Registration This study has been registered at the German Clinical Trials Register DRKS00024829.
Collapse
Affiliation(s)
- Cosima Zemlin
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Caroline Stuhlert
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Julia Theresa Schleicher
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Carolin Wörmann
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Laura Altmayer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Marina Lang
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Laura-Sophie Scherer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Ida Clara Thul
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Carolin Müller
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Elisabeth Kaiser
- Department for General Pediatrics, Saarland University Medical Center, Homburg, Germany
| | - Regine Stutz
- Department for General Pediatrics, Saarland University Medical Center, Homburg, Germany
| | | | - Laura Ketter
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Michael Zemlin
- Department for General Pediatrics, Saarland University Medical Center, Homburg, Germany
| | - Gudrun Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics (IMBEI), Saarland University, Homburg, Germany
| | - Georges Steffgen
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Erich-Franz Solomayer
- Department for Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| |
Collapse
|
15
|
Munsie C, Ebert J, Collins J, Plaster M, Joske D, Ackland T. A supervised exercise intervention during cancer treatment for adolescents and young adults-FiGHTING F!T: study protocol of a randomised controlled trial. Trials 2021; 22:676. [PMID: 34602065 PMCID: PMC8489079 DOI: 10.1186/s13063-021-05616-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 09/13/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND High-quality evidence supports the integration of exercise to mitigate treatment-related side effects in a wide range of paediatric and adult cancer cohorts. However, the implementation of exercise in adolescent and young adult (AYA) cancer patients is yet to be explored in depth. FiGHTINGF!T is a randomised controlled cross over trial designed to determine if a supervised, structured, and progressive exercise programme can reduce the decline in physical fitness (V02peak) associated with cancer treatment in AYAs from diagnosis. METHODS/DESIGN A total of 40 AYAs recently diagnosed and due to commence systemic treatment (± 2 weeks) for a primary haematological malignancy or solid tumour will be recruited and randomised to either an immediate exercise intervention or usual care (delayed exercise) for 10 weeks. This randomised controlled crossover trial will see both groups engage in a supervised exercise intervention from either diagnosis (baseline assessment) for 10 weeks (0-10 weeks) or following an interim assessment to 20 weeks (10-20 weeks). The bi-weekly tailored exercise programme will combine aerobic and resistance exercises and be supervised by an Accredited Exercise Physiologist. Participants will complete a range of assessments at 0, 10, and 20 weeks including cardiopulmonary exercise tests, 1 repetition maximum strength measures, physical functioning, and self-reported quality of life measurements. Patient-reported treatment-related toxicities will be recorded on a weekly basis. DISCUSSION The FiGHTINGF!T trial will provide insight into the potential benefits of a supervised exercise programme in AYAs undergoing cancer treatment. This trial will contribute to the evidence supporting the necessary integration of exercise during cancer treatment, specifically in the under-reported AYA cohort. TRIAL REGISTRATION This trial was registered retrospectively with the Australia New Zealand Clinical Trial registry ( ACTRN12620000663954 ). Registered on 10 June 2020.
Collapse
Affiliation(s)
- Claire Munsie
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia Australia
- Western Australian Youth Cancer Service, Perth, Western Australia Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia Australia
| | - Jay Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia Australia
| | - Joanne Collins
- Western Australian Youth Cancer Service, Perth, Western Australia Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia Australia
| | - Megan Plaster
- Western Australian Youth Cancer Service, Perth, Western Australia Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia Australia
| | - David Joske
- Sir Charles Gairdner Hospital, Perth, Western Australia Australia
- School of Medicine, University of Western Australia, Western Australia Perth, Australia
| | - Timothy Ackland
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia Australia
| |
Collapse
|
16
|
Martins AD, Brito JP, Oliveira R, Costa T, Ramalho F, Santos-Rocha R, Pimenta N. Relationship between Heart Rate Variability and Functional Fitness in Breast Cancer Survivors: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9091205. [PMID: 34574979 PMCID: PMC8469708 DOI: 10.3390/healthcare9091205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Breast cancer is the most common malignancy among women worldwide. The treatments may also cause neuromuscular and skeletal disorders; therefore, the aim of this study was to verify the existence of a relationship between heart rate variability and different functional fitness parameters in women survivors of breast cancer. Methods: This cross-sectional study included 25 women survivors of breast cancer, with a mean ± SD age, height, and body mass of 50.8 ± 8.8 years, 1.6 ± 0.7 m, and 67.1 ± 12.3 kg, respectively. Patients underwent measurements of heart rate variability with time and frequency domain analyses, as well as a “30 s chair-stand test”, “6 min walking test”, “timed up and go test”, and “ball throwing test”. Results: A multiple linear regression analysis showed that from the heart rate variability frequency domain, high frequency explained 21% (R2 = 0.21) of the “30 s chair-stand test” performance. Conclusion: The findings of this study highlight high frequency as a predictor of “30 s chair-stand test” performance, regardless of age and time after diagnosis, suggesting its usefulness as a clinical indicator of functionality in breast cancer survivors. This study presents a straightforward and non-invasive methodology predicting functional fitness in women breast cancer survivors potentially applicable to clinical practice.
Collapse
Affiliation(s)
- Alexandre D. Martins
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
- CIEQV—Life Quality Research Centre, Av. Dr. Mário Soares No. 110, 2040-413 Rio Maior, Portugal
- Correspondence: ; Tel.: +351-243-999-280
| | - João Paulo Brito
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
- CIEQV—Life Quality Research Centre, Av. Dr. Mário Soares No. 110, 2040-413 Rio Maior, Portugal
- CIDESD—Research Centre in Sport Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal
| | - Rafael Oliveira
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
- CIEQV—Life Quality Research Centre, Av. Dr. Mário Soares No. 110, 2040-413 Rio Maior, Portugal
- CIDESD—Research Centre in Sport Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal
| | - Tiago Costa
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
| | - Fátima Ramalho
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
- CIPER—Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, Estr. da Costa, Cruz Quebrada, Oeiras, 1495-751 Lisboa, Portugal
| | - Rita Santos-Rocha
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
- CIPER—Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, Estr. da Costa, Cruz Quebrada, Oeiras, 1495-751 Lisboa, Portugal
| | - Nuno Pimenta
- Institute of Santarém, Sports Science School of Rio Maior–Polytechnic, 2140-413 Rio Maior, Portugal; (J.P.B.); (R.O.); (T.C.); (F.R.); (R.S.-R.); (N.P.)
- CIPER—Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, Estr. da Costa, Cruz Quebrada, Oeiras, 1495-751 Lisboa, Portugal
| |
Collapse
|
17
|
Ezzatvar Y, Ramírez-Vélez R, Sáez de Asteasu ML, Martínez-Velilla N, Zambom-Ferraresi F, Lobelo F, Izquierdo M, García-Hermoso A. Cardiorespiratory fitness and all-cause mortality in adults diagnosed with cancer systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1745-1752. [PMID: 33909308 DOI: 10.1111/sms.13980] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The inverse association between cardiorespiratory fitness and all-cause mortality in apparently healthy populations has been previously reported; however, the existence of this association among adults diagnosed with cancer is unclear. AIM To determine the association between cardiorespiratory fitness and all-cause mortality in adults diagnosed with cancer. METHODS Medline, Embase, and SPORTDiscus databases were searched. Eligible prospective cohort studies that examined the association of cardiorespiratory fitness with all-cause mortality in adults diagnosed with cancer were included. Hazard ratios (HRs) with associated 95% confidence intervals (CIs) were extracted from studies for all-cause mortality and pooled HRs were calculated using the random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman adjustment. RESULTS Data from 13 studies with 6,486 adults were included. Compared with lower levels of cardiorespiratory fitness, high levels were associated with a reduced risk of all-cause mortality among adults diagnosed with any cancer (HR = 0.52; 95% CI, 0.35-0.77), lung cancer (HR = 0.62; 95% CI, 0.46-0.83), and among those with cardiorespiratory fitness measurement via indirect calorimetry (HR = 0.47; 95% CI, 0.27-0.80). Pooled HRs for the reduction in all-cause mortality risk per 1-MET increase were also statistically significant (HR = 0.82; 95% CI, 0.69-0.99). Neither age at baseline nor the length of follow-up had a significant influence on the HR estimates for all-cause mortality risk. CONCLUSION Cardiorespiratory fitness may confer an independent protective benefit against all-cause mortality in adults diagnosed with cancer. The use of cardiorespiratory fitness as a prognostic parameter might help determine risk for future adverse clinical events and optimize therapeutic management strategies to reduce long-term treatment-related effects in adults diagnosed with cancer.
Collapse
Affiliation(s)
- Yasmin Ezzatvar
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, Universitat de València, Valencia, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Mikel L Sáez de Asteasu
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Nicolás Martínez-Velilla
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.,Geriatric Department, Complejo Hospitalario de Navarra (CHN), Pamplona, Spain
| | - Fabricio Zambom-Ferraresi
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.,Geriatric Department, Complejo Hospitalario de Navarra (CHN), Pamplona, Spain
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Exercise is Medicine Global Research and Collaboration Center, Atlanta, GA, USA
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.,Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
| |
Collapse
|
18
|
Bøhn SKH, Lie HC, Reinertsen KV, Fosså SD, Haugnes HS, Kiserud CE, Loge JH, Wisløff T, Thorsen L. Lifestyle among long-term survivors of cancers in young adulthood. Support Care Cancer 2021; 29:289-300. [PMID: 32358776 PMCID: PMC7686209 DOI: 10.1007/s00520-020-05445-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/27/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To investigate lifestyle in a population-based sample of long-term (≥ 5 years since diagnosis) young adult cancer survivors (YACSs), and explore factors associated with not meeting the lifestyle guidelines for physical activity (PA), body mass index (BMI), and smoking. METHODS YACSs (n = 3558) diagnosed with breast cancer (BC), colorectal cancer (CRC), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), or localized malignant melanoma (MM) between the ages of 19 and 39 years and treated between 1985 and 2009 were invited to complete a mailed questionnaire. Survivors of localized MM treated with limited skin surgery served as a reference group for treatment burden. RESULTS In total, 1488 YACSs responded (42%), and 1056 YACSs were evaluable and included in the present study (74% females, average age at survey 49 years, average 15 years since diagnosis). Forty-four percent did not meet PA guidelines, 50% reported BMI ≥ 25 and 20% smoked, with no statistically significant differences across diagnostic groups. Male gender, education ≤ 13 years, comorbidity, lymphedema, pain, chronic fatigue, and depressive symptoms were associated with not meeting single and/or an increasing number of lifestyle guidelines. CONCLUSION A large proportion of long-term YACSs do not meet the lifestyle guidelines for PA, BMI, and/or smoking. Non-adherence to guidelines is associated with several late effects and/or comorbidities that should be considered when designing lifestyle interventions for YACSs.
Collapse
Affiliation(s)
- Synne-Kristin H Bøhn
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway.
| | - Hanne C Lie
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristin V Reinertsen
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Sophie D Fosså
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hege S Haugnes
- Department of Clinical Medicine, Arctic University of Tromsø, Tromsø, Norway
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - Cecilie E Kiserud
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
| | - Jon Håvard Loge
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Regional Advisory Unit in Palliative Care, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Wisløff
- Department of Community Medicine, Arctic University of Tromsø, Tromsø, Norway
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Lene Thorsen
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
19
|
Feasibility and preliminary efficacy of a hypopressive exercise program on postmenopausal cancer survivors: A pilot study. J Bodyw Mov Ther 2020; 24:484-489. [PMID: 33218551 DOI: 10.1016/j.jbmt.2020.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 02/01/2020] [Accepted: 02/17/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common symptom during and after cancer treatment that negatively affects the patient's quality of life. Exercise is one of the most effective non-pharmacological treatments for CRF. Multimodal exercise therapy programs that include hypopressive exercises, relaxation and myofascial release may be beneficial for CRF. The aim of this pilot study was to evaluate the feasibility and efficacy of a multimodal program on CRF and lower limb functional strength in postmenopausal women diagnosed with cancer. METHODS 7 postmenopausal women (age = 55.28 years; BMI = 26.05 kg/m2) who had a cancer diagnosis participated in a supervised and progressive 55-min class once per week for 12-weeks. CRF was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer Related Fatigue 12 and lower limb strength was assessed with the sit and stand test. RESULTS No adverse events were reported during the training period and all participants completed the exercise protocol. There was a significant increase (p = 0.01) in lower limb functional strength (pre: 19.60 (SD = 2.19) vs post: 24.60(SD = 2.19)) with an effect size of d = 2.28 and a decrease in CRF (p = 0.245) (pre: 29.36 ± 24.42; post: 17.85 ± 14.23) with a trivial effect size (d < 0.5). CONCLUSIONS These preliminary findings indicate that a supervised once per week multimodal program that includes hypopressive exercises for postmenopausal cancer survivors increased lower limb functional strength without exacerbating their CRF. These findings support further randomized trials of hypopressive training programs on patients with cancer.
Collapse
|
20
|
Mallard J, Hucteau E, Schott R, Petit T, Demarchi M, Belletier C, Ben Abdelghani M, Carinato H, Chiappa P, Fischbach C, Kalish-Weindling M, Bousinière A, Dufour S, Favret F, Pivot X, Hureau TJ, Pagano AF. Evolution of Physical Status From Diagnosis to the End of First-Line Treatment in Breast, Lung, and Colorectal Cancer Patients: The PROTECT-01 Cohort Study Protocol. Front Oncol 2020; 10:1304. [PMID: 32903594 PMCID: PMC7438727 DOI: 10.3389/fonc.2020.01304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/23/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Cancer cachexia and exacerbated fatigue represent two hallmarks in cancer patients, negatively impacting their exercise tolerance and ultimately their quality of life. However, the characterization of patients' physical status and exercise tolerance and, most importantly, their evolution throughout cancer treatment may represent the first step in efficiently counteracting their development with prescribed and tailored exercise training. In this context, the aim of the PROTECT-01 study will be to investigate the evolution of physical status, from diagnosis to the end of first-line treatment, of patients with one of the three most common cancers (i.e., lung, breast, and colorectal). Methods: The PROTECT-01 cohort study will include 300 patients equally divided between lung, breast and colorectal cancer. Patients will perform a series of assessments at three visits throughout the treatment: (1) between the date of diagnosis and the start of treatment, (2) 8 weeks after the start of treatment, and (3) after the completion of first-line treatment or at the 6-months mark, whichever occurs first. For each of the three visits, subjective and objective fatigue, maximal voluntary force, body composition, cachexia, physical activity level, quality of life, respiratory function, overall physical performance, and exercise tolerance will be assessed. Discussion: The present study is aimed at identifying the nature and severity of maladaptation related to exercise intolerance in the three most common cancers. Therefore, our results should contribute to the delineation of the needs of each group of patients and to the determination of the most valuable exercise interventions in order to counteract these maladaptations. This descriptive and comprehensive approach is a prerequisite in order to elaborate, through future interventional research projects, tailored exercise strategies to counteract specific symptoms that are potentially cancer type-dependent and, in fine, to improve the health and quality of life of cancer patients. Moreover, our concomitant focus on fatigue and cachexia will provide insightful information about two factors that may have substantial interaction but require further investigation. Trial registration: This prospective study has been registered at ClinicalTrials.gov (NCT03956641), May, 2019.
Collapse
Affiliation(s)
- Joris Mallard
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France.,EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Elyse Hucteau
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France.,EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Roland Schott
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Thierry Petit
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Martin Demarchi
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | | | | | - Hélène Carinato
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Pascale Chiappa
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Cathie Fischbach
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | | | - Audren Bousinière
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Stéphane Dufour
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Fabrice Favret
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Xavier Pivot
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Thomas J Hureau
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Allan F Pagano
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| |
Collapse
|
21
|
Obstructions and the Recognition of Cancer Inpatient Physical Activity Based on Exercise Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155482. [PMID: 32751331 PMCID: PMC7432869 DOI: 10.3390/ijerph17155482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to analyze and understand the mechanisms of physical activity obstructions in hospitalized cancer patients by investigating their physical activity levels, previous exercise experience levels, and exercise recognition. A survey was conducted for 194 hospitalized cancer patients using a questionnaire. In addition, we performed exploratory factor analysis, frequency analysis, reliability analysis, and hierarchical multiple regression analysis, using SPSS Statistics for Windows, Ver. 23.0. The results were as follows: (1) The physical activity level of the previous exercise participation experience (EPE) group had a greater effect on physical activity obstructions compared with the non-experience (NE) group. (2) The results for the effects of exercise recognition on the physical activity level and physical activity obstructions indicated that exercise recognition in the two groups increased the relative effects on physical activity obstructions in all variables except for the physical obstructions of the EPE group. Consequently, the physical activity level, exercise experience level, and exercise recognition in those patients were confirmed to be the major factors affecting their physical activity obstruction. Therefore, in this study, we provided quantitative data required for establishing healing environments based on motion.
Collapse
|
22
|
Mizrahi D, Wakefield CE, Simar D, Ha L, McBride J, Field P, Cohn RJ, Fardell JE. Barriers and enablers to physical activity and aerobic fitness deficits among childhood cancer survivors. Pediatr Blood Cancer 2020; 67:e28339. [PMID: 32386117 DOI: 10.1002/pbc.28339] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Physical activity and aerobic fitness are modifiable risk factors for cardiovascular disease (CVD) after childhood cancer. How survivors engage in physical activity remains unclear, potentially increasing CVD risk. We assessed survivors' physical activity levels, barriers and enablers, fitness, and identified predictors of fitness and physical activity stage of change. METHODS Childhood cancer survivors (CCS; 8-18 years old) ≥1 year post-treatment were assessed for aerobic fitness (6-min walk test), used to extrapolate VO2max , and body composition (InBody 570). Survivors self-reported physical activity to determine stage of change (Patient-Centered Assessment and Counselling for Exercise). Physical activity and fitness were compared with guidelines and CVD-risk cut-points (VO2max < 42 mL/kg/min: males; VO2max < 35 mL/kg/min: females). Multiple regression and mediator-moderator analysis were used to identify fitness predictors and stage of change. RESULTS One hundred two survivors (12.8 ± 3.3 years) participated (46% acute lymphoblastic leukaemia). Forty percent of males (VO2max = 43.3 ± 6.3 mL/kg/min) and 28% of females (VO2max = 36.5 ± 5.9 mL/kg/min) were in the CVD-risk category, while 25% met physical activity guidelines. Most prevalent physical activity barriers were fatigue (52%), preferring television instead of exercise (38%), and lacking time (34%). Predictive factors for reduced fitness included being older, female, higher waist-to-height ratio, higher screen time, and moderated by lower physical activity (r2 = 0.91, P < .001). Survivors with higher physical activity stage of change were male, lower body fat percentage, lower screen time, and lived with both parents (r = 0.42, P = .003). CONCLUSION Aerobic fitness and physical activity of CCS is low compared with population norms, potentially increasing CVD risk. Addressing physical activity barriers and enablers, including reducing screen time, could promote regular physical activity, reducing CVD risk.
Collapse
Affiliation(s)
- David Mizrahi
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - David Simar
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia
| | - Lauren Ha
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - James McBride
- Respiratory Medicine, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Penelope Field
- Respiratory Medicine, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Richard J Cohn
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Joanna E Fardell
- UNSW Medicine, UNSW, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
23
|
[Effect of activities profile variations on health-related quality of life among breast cancer patients: Secondary exploratory analysis from PASAPAS study data]. Bull Cancer 2020; 107:763-772. [PMID: 32416926 DOI: 10.1016/j.bulcan.2020.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/29/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Lifestyle changes in breast cancer patients, by physical activity increasing, are becoming a main objective in supportive care. The objective of this study was to explore the impact of the daily activity profile evolution on the quality of life among this public. METHODS Sixty patients (18 to 75 years) with non-metastatic breast cancer were randomized to a 2:1 ratio (physical activity intervention; control) in the PASAPAS randomized clinical trial. Multiple linear regression analyzes were computed to explain quality of life scores 6 months after the start of adjuvant therapy. Variables retained were the baseline quality of life scores, the anxiety trait, the randomization arm, the variations of time spent in different physical activity classes ([3-4 [MET, [4-6 [MET, ≥6 MET) and in sedentary behaviors. RESULTS Only the decrease in time spent in sedentary behaviors really appeared as a predictor of the quality of physical life. Participation in the intervention group appeared as a predictor of quality of mental life. DISCUSSION Results plead in favor of sedentary life style decrease as part of the objectives of care program for women with breast cancer. It also highlights the need of collective supervised sessions implemented by competent staff. This research also suggests that the dynamics of daily activity profile variations should be studied further in association to quality of life.
Collapse
|
24
|
Dumoulin C, Reynes E, Berthouze SE. Éléments structurant les programmes d’activité physique dans la lutte contre le surpoids et l’obésité : état des lieux et suggestions. Appl Physiol Nutr Metab 2020; 45:1-8. [PMID: 32283035 DOI: 10.1139/apnm-2019-0890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To date, physical activity (PA) programs for overweight and obese people are built around recommendations established for the general population. However, these people have special characteristics that require adapted coaching. In order to begin this work of recommendations, the objective of this article was to list the criteria usually used to describe and study PA programs for overweight and obese people and its associated postprogram follow-up. A systematic review of both meta-analyses and systematic reviews related to PA programs in the management of overweight and obesity has highlighted that few descriptive elements of programs are systematically reported, and that PA programs are rarely sufficiently detailed to be able to calculate a PA dose or to compare the different programs. These convergences, disparities or gaps in the description of PA programs, led us to initiate a reflection on the interest of these criteria as well as on the interest of their systematization in weight management program design, including PA. We hope that will be a first step towards facilitating the development of recommendations for PA management of overweight and obesity. Novelty Objective: to identify criteria used to describe PA programs in the management of overweight and obesity. Criteria to systematize: data to calculate PA dose; description of program individualization strategy. Criteria to develop: drop-out rate as an indicator of program adaptation; description of fatigue management strategy.
Collapse
Affiliation(s)
- Coralie Dumoulin
- Université de Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la motricité (LIBM, EA 7424), UFR STAPS, 27-29 Bd du 11 nov. 1918, 69622 Villeurbanne Cedex, France
- Association « FORT EN SPORT », 2 place de Francfort, Immeuble Terra Mundi, 69003 Lyon, France
| | - Eric Reynes
- Université de Lyon, Université Claude Bernard Lyon 1, Laboratoire sur les Vulnérabilités et l'Innovation dans le Sport (L-ViS, EA 7428), UFR STAPS, 27-29 Bd du 11 nov. 1918, 69622 Villeurbanne Cedex, France
| | - Sophie E Berthouze
- Université de Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la motricité (LIBM, EA 7424), UFR STAPS, 27-29 Bd du 11 nov. 1918, 69622 Villeurbanne Cedex, France
| |
Collapse
|
25
|
Sica A, Sagnelli C, Papa A, Ciccozzi M, Sagnelli E, Calogero A, Martinelli E, Casale B. An Anecdotal Case Report of Chronic Lymphatic Leukemia with del(11q) Treated with Ibrutinib: Artificial Nourishment and Physical Activity Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1929. [PMID: 32188040 PMCID: PMC7142487 DOI: 10.3390/ijerph17061929] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Abstract
Chronic lymphatic leukemia (CLL) is the most frequent type of leukemia in western countries and when association with del(11q) is correlated with a worse prognosis. We reported the clinical case of an 80-year-old patient with CLL related to del(11q) and a BMI of 16.4 kg/m2, who presented a voluminous mass in abdominal cavity (23 × 14 × 4 cm) which occupied the whole of the mesentery and the retroperitoneal space, treated with ibrutinib, adequate nutrition, and a program of physical activity. He showed a great improvement under ibrutinib therapy and took to artificial nourishment and adequate muscle rehabilitation until he recovered his autonomy. In August 2018, a 5-days-a-week training program was started: Physical activity for at least 20 min consisting of a fast walk in the open air three times a week and a moderate physical activity in the remaining two days of at least 20 consecutive minutes (cycling at a regular pace, carrying light weights). The exercise program included also aerobic, upper and lower limb resistance training, chore stability and stretches. The physical condition further improved and remained excellent throughout the follow-up period. In December 2018, his clinical condition was quite normal; a CT showed a great decrease of all lymphoadenomegaly, and FISH test did not show del(11q). He continued to cultivate his land, while still being treated with ibrutinib. The combination of the right therapy, adequate nutrition, and muscle rehabilitation is the best solution to improve the clinical condition of old cachectic CLL del(11q) patient.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Alfonso Papa
- Pain Department, AORN Dei Colli V. Monaldi, 80131 Naples, Italy;
| | - Massimo Ciccozzi
- Medical Statistics and Molecular Epidemiology, Campus Bio-Medico University, 00100 Rome, Italy;
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Erika Martinelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AORN Dei Colli - V. Monaldi, 80131 Naples, Italy;
| |
Collapse
|
26
|
Pegon C, Rochette E, Rouel N, Pereira B, Doré E, Isfan F, Grèze V, Merlin E, Kanold J, Duché P. Childhood Leukemia Survivors and Metabolic Response to Exercise: A Pilot Controlled Study. J Clin Med 2020; 9:jcm9020562. [PMID: 32092881 PMCID: PMC7073622 DOI: 10.3390/jcm9020562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/07/2020] [Accepted: 02/16/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Leukemia is the most common cancer in pediatrics, with many late effects such as higher risk of dyslipidemia, insulin resistance, obesity, and metabolic syndrome. The objective of this work was to investigate substrate oxidation during submaximal exercise in survivors of childhood acute leukemia. Methods: A total of 20 leukemia survivors and 20 healthy children were matched by sex, age, and Tanner stage. They all took a submaximal incremental exercise test to determine fat and carbohydrate oxidation rates. Results: Cardiorespiratory fitness was significantly lower in leukemia survivors, with lower relative VO2 peaks (p < 0.001), lower heart rate values (p = 0.02), and lower exercise power (p = 0.012), whereas rest metabolism and body mass index did not differ between the two groups. During exercise, upward of heart rate relative to VO2 peak was significantly higher (p < 0.001) in childhood leukemia survivors. We found lower carbohydrate and fat oxidation rates (p = 0.07) in leukemia survivors compared with healthy children, and also a significantly lower relative maximal fat oxidation rate (p = 0.014). Conclusion: Despite impaired physical fitness and metabolic response to exercise, childhood leukemia survivors remained sensitive to physical activity interventions, and could readily adapt to submaximal exercise intensity.
Collapse
Affiliation(s)
- Charline Pegon
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
| | - Emmanuelle Rochette
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
- Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, F-63000 Clermont-Ferrand, France
- Université de Toulon, Laboratoire IAPS, F-83041 Toulon, France;
- Correspondence: ; Tel.: +33-4-73-75-22-97; Fax: + 33-4-73-75-22-86
| | - Nadège Rouel
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
- Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, F-63000 Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation de la Recherche Clinique et Innovations, F-63000 Clermont-Ferrand, France;
| | - Eric Doré
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
| | - Florentina Isfan
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
| | - Victoria Grèze
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
- Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, F-63000 Clermont-Ferrand, France
| | - Etienne Merlin
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
- Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, F-63000 Clermont-Ferrand, France
- Université Clermont Auvergne, INRA, UMR 1019 UNH, ECREIN, F-63000 Clermont-Ferrand, France
| | - Justyna Kanold
- CHU Clermont-Ferrand, Pédiatrie, F-63000 Clermont-Ferrand, France; (C.P.); (N.R.); (E.D.); (F.I.); (V.G.); (E.M.); (J.K.)
- Université Clermont Auvergne, INSERM, CIC 1405, Unité CRECHE, F-63000 Clermont-Ferrand, France
| | - Pascale Duché
- Université de Toulon, Laboratoire IAPS, F-83041 Toulon, France;
- Université Clermont Auvergne, Laboratoire des Adaptations Métaboliques en conditions Physiologiques et Physiopathologiques (AME2P), EA 3533, F-63000 Clermont-Ferrand, France
| | | |
Collapse
|
27
|
Sica A, Vitiello P, Ronchi A, Casale B, Calogero A, Sagnelli E, Costa Nachtigal G, Troiani T, Franco R, Argenziano G, Moscarella E, Sagnelli C. Primary Cutaneous Anaplastic Large Cell Lymphoma (pcALCL) in the Elderly and the Importance of Sport Activity Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030839. [PMID: 32013101 PMCID: PMC7037068 DOI: 10.3390/ijerph17030839] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/16/2020] [Accepted: 01/22/2020] [Indexed: 12/22/2022]
Abstract
Primary cutaneous anaplastic large cell lymphoma (pcALCL) is part of a spectrum of cutaneous CD30+ lymphoproliferative disease that also includes lymphomatoid papulosis. It often occurs in elderly patients, presenting at a median age of 60 years, although it may occur at any age. It is a CD30+ T-cell neoplasm composed of large cells with anaplastic, pleomorphic, or immunoblastic morphology, with exclusively cutaneous onset and localization. The clinical course of pcALCL is predominantly indolent. Most elderly patients with lymphoma tend to have a sedentary lifestyle, which has a negative effect on their quality of life (QoL) and survival. Several studies indicate that exercise has a positive impact on QoL because it reduces peak oxygen consumption, improves physical capacity, increases self-esteem, reduces accumulated stress, and promotes relaxation. Therefore, particularly in indolent lymphomas, it is necessary to indicate a program of physical activity to be practiced systematically. Complete surgical excision and local radiotherapy are the first line gold standard in pcALCL with a solitary lesion.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
- Correspondence: ; Tel.: +39-333-225-3315; +39-0811-957-3375
| | - Paola Vitiello
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (P.V.); (G.A.); (E.M.)
| | - Andrea Ronchi
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AO Dei Colli—V. Monaldi, 80130 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Evangelista Sagnelli
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| | - Gilca Costa Nachtigal
- Department of Clinical Medicine, Faculty of Medicine at UFPel—Federal University of Pelotas, 1160 Centro, Pelotas, Brazil;
| | - Teresa Troiani
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Renato Franco
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| | - Giuseppe Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (P.V.); (G.A.); (E.M.)
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (P.V.); (G.A.); (E.M.)
| | - Caterina Sagnelli
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| |
Collapse
|
28
|
Fischetti F, Greco G, Cataldi S, Minoia C, Loseto G, Guarini A. Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:medicina55070379. [PMID: 31315290 PMCID: PMC6681308 DOI: 10.3390/medicina55070379] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 02/05/2023]
Abstract
Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk-1). Each session included a combined progressive training of cardiorespiratory, resistance, flexibility and postural education exercises. Self-efficacy and fatigue were measured with the Regulatory Emotional Self-Efficacy scale and 0-10 rating scale, respectively. Physical fitness was assessed with the body mass index, lower back flexibility, static balance, muscle strength and functional mobility. Results: Adherence to exercise was high (91.2% ± 4.8%) and no major health problems were noted in the patients over the intervention period. At baseline, significant differences were found between Hodgkin's lymphoma and non-Hodgkin's lymphoma patients by age and all dependent measures (p < 0.05). Fatigue significantly decreased and the perceived capability to regulate negative affect and to express positive emotions improved after exercise (p < 0.001). Significant improvements were found for body mass index, trunk lateral flexibility, monopodalic balance, isometric handgrip force and functional mobility (p < 0.001). Fatigue was significantly correlated with handgrip force (r = -0.56, p < 0.001) and functional mobility (r = -0.69, p < 0.001). Conclusions: The supervised exercise program improved psychological and physical fitness without causing adverse effects and health problems. Therefore, exercise to improve fitness levels and reduce perceived fatigue should be considered in the management of lymphoma patients.
Collapse
Affiliation(s)
- Francesco Fischetti
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, School of Medicine, University of Study of Bari, 70124 Bari, Italy.
| | - Gianpiero Greco
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, School of Medicine, University of Study of Bari, 70124 Bari, Italy
| | - Stefania Cataldi
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, School of Medicine, University of Study of Bari, 70124 Bari, Italy
| | - Carla Minoia
- Haematology Unit, IRCCS Cancer Institute "Giovanni Paolo II", 70124 Bari, Italy
| | - Giacomo Loseto
- Haematology Unit, IRCCS Cancer Institute "Giovanni Paolo II", 70124 Bari, Italy
| | - Attilio Guarini
- Haematology Unit, IRCCS Cancer Institute "Giovanni Paolo II", 70124 Bari, Italy
| |
Collapse
|
29
|
The effect of a 12-week home-based walking program on reducing fatigue in women with breast cancer undergoing chemotherapy: A randomized controlled study. Int J Nurs Stud 2019; 99:103376. [PMID: 31442785 DOI: 10.1016/j.ijnurstu.2019.06.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/19/2019] [Accepted: 06/16/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fatigue is the most common symptom experienced by cancer patients during treatment and can last long after completing treatment. Fatigue in cancer patients who have completed treatment is well known to be reduced by exercise, but the effect of exercise on reducing fatigue in patients under treatment has been inconsistent. OBJECTIVES The purposes of this study were to examine short-term and long-term effects of an individually tailored, home-based brisk walking program on reducing fatigue in breast cancer patients under chemotherapy. DESIGN, SETTING, PARTICIPANTS For this randomized controlled trial, women were recruited from a medical center in northern Taiwan if they were diagnosed with stages I-III breast cancer and experienced insomnia, fatigue, pain, or depressive symptoms after their first cycle of chemotherapy. Consenting participants (N = 159) were randomly assigned to either an exercise (12-week home-based walking program) group (n = 81) or an attention-control group (n = 78). METHODS The 12-week, home-based brisk walking program started on the first day of the third chemotherapy cycle. Fatigue was measured by the Brief Fatigue Inventory. Covariates, i.e., functional performance, sleep disturbance, anxiety, depression, and exercise-related variables, were also measured. Data were collected at baseline, two times during the exercise intervention, and five times after the exercise intervention (eight times in total). The effects of time-varying and time-invariant predictors on fatigue were analyzed by multilevel modeling. RESULTS Fatigue levels increased over time for both groups, even after completing treatment. At the end of the 12-week exercise program, the exercise group had less fatigue than the attention-control group, and this group difference was maintained for the whole study period. At the end of exercise program, women who had spent more time exercising before diagnosis had less fatigue than those who had exercised less often. In addition, patients' fatigue levels at various time points fluctuated along with their functional performance, sleep disturbance, and depression. CONCLUSIONS Our tailored, home-based brisk walking program effectively reduced fatigue in breast cancer patients under chemotherapy, and this effect lasted after completing treatment.
Collapse
|
30
|
Hiraoui M, Al-Haddabi B, Gmada N, Doutrellot PL, Mezlini A, Ahmaidi S. Effects of combined supervised intermittent aerobic, muscle strength and home-based walking training programs on cardiorespiratory responses in women with breast cancer. Bull Cancer 2019; 106:527-537. [PMID: 31122656 DOI: 10.1016/j.bulcan.2019.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/06/2019] [Accepted: 03/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of this investigation was to study the effects of supervised combined intermittent aerobic, muscle strength and home-based walking training programs on cardiorespiratory fitness in women with breast cancer during adjuvant chemotherapy treatment. METHODS Thirty-two women with breast cancer undertaking adjuvant chemotherapy participated in the study (trained group n=20 and control group n=12). The trained group carried out 6weeks of supervised intermittent cycling aerobic, muscle strength and home-based walking training programs. The self-selected walking speed (WS), walking distance covered (WD), heart rate (rHR), blood lactate ([La]b) concentration and rating of perceived exertion (RPE) were assessed in the two groups during the 6-min walking test before and after the training period. RESULTS Compared to controls, a significant increase in the WS (P<0.01) and the WD (P<0.01) accompanied by a significant decrease in resting rHR (P<0.01), exercising HR6' (P<0.01), [La]b (P<0.05), HR6'/WS (P<0.01) and [La]b/WS ratios (P<0.01) was reported in the trained group. However, a significant decrease both in WD (P<0.01) and WS (P<0.01) has been observed in the controls. No significant difference was observed in resting HR, exercising HR6', [La]b, HR6'/WS, and [La]b/WS ratios were observed in the control group. A significant improvement was observed for RPE in training group (P<0.05). However, no difference was shown in controls. CONCLUSION Combined training based on intermittent aerobic exercise, muscle strength and walking improve cardiorespiratory responses and reduce the perception of fatigue in women with breast cancer.
Collapse
Affiliation(s)
- Mouadh Hiraoui
- Picardie Jules-Verne University, Sport Sciences department, EA-3300: APERE, Exercise Physiology and Rehabilitation laboratory, Amiens cedex, France; Salah Azaiez Oncologic Hospital, Medical Oncology Department, Tunis, Tunisia; Carthage University, Bizerte Sciences Faculty, Bizerte, Tunisia
| | - Badria Al-Haddabi
- Sultan Qaboos University, College of Education, Physical Education Department, Oman
| | - Nabil Gmada
- Sultan Qaboos University, College of Education, Physical Education Department, Oman; University of Jendouba, High Institute of Sports and Physical Education, "Sportive Performance and Physical Rehabilitation", Research Unit, Kef, Jendouba, Tunisia.
| | - Pierre Louis Doutrellot
- Picardie Jules-Verne University, Sport Sciences department, EA-3300: APERE, Exercise Physiology and Rehabilitation laboratory, Amiens cedex, France
| | - Amel Mezlini
- Salah Azaiez Oncologic Hospital, Medical Oncology Department, Tunis, Tunisia
| | - Said Ahmaidi
- Picardie Jules-Verne University, Sport Sciences department, EA-3300: APERE, Exercise Physiology and Rehabilitation laboratory, Amiens cedex, France
| |
Collapse
|
31
|
Kampshoff CS, Verdonck-de Leeuw IM, van Oijen MG, Sprangers MA, Buffart LM. Ecological momentary assessments among patients with cancer: A scoping review. Eur J Cancer Care (Engl) 2019; 28:e13095. [PMID: 31090160 PMCID: PMC9285429 DOI: 10.1111/ecc.13095] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/01/2019] [Accepted: 04/12/2019] [Indexed: 12/21/2022]
Abstract
Introduction Ecological momentary assessment (EMA) is an emerging method to assess an individual's current thoughts, affect, behaviour, physical states and contextual factors as they occur in real‐time and in their natural environment. Whereas EMA is frequently used in mental health, little is known about the added value of EMA in oncology research. This review aimed to synthesise methodological information and results of studies that applied EMA among patients with cancer to inform future researchers about the opportunities and challenges. Methods We included full‐text articles on studies that: (a) were conducted among adult cancer patients; and (b) examined cancer and treatment‐related experiences by EMA. Information from selected studies was synthesised: study designs, EMA data collection methods, response‐related results and main findings. Results Twelve studies were included, which all applied an observational design. The EMA data collection methods varied considerably and the reporting of response‐related results were poor. Nevertheless, EMA was found feasible as no systematic patterns of problems were reported and reported response‐related results were acceptable. Furthermore, EMA was found useful as it facilitated examination of real‐time experiences and behaviour. Conclusion Ecological momentary assessment is useful and feasible in oncology research. Future studies would benefit from guidelines for designing and reporting EMA studies.
Collapse
Affiliation(s)
- Caroline S Kampshoff
- Department of Medical Oncology, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical, Neuro- and Developmental Psychology, Section Clinical Psychology, Amsterdam Public Health (APH) Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn G van Oijen
- Department of Medical Oncology, Cancer Center Amsterdam (CCA), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam A Sprangers
- Department of Medical Psychology, Amsterdam Public Health (APH) Research Institute, Cancer Center Amsterdam (CCA), Amsterdam UMC (location Academic Medical Center), University of Amsterdam, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Medical Oncology, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health (APH) Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
32
|
Ho KY, Li WH, Lam KWK, Wei X, Chiu S, Chan CFG, Chung OKJ. Relationships among fatigue, physical activity, depressive symptoms, and quality of life in Chinese children and adolescents surviving cancer. Eur J Oncol Nurs 2019; 38:21-27. [DOI: 10.1016/j.ejon.2018.11.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/22/2018] [Accepted: 11/21/2018] [Indexed: 11/25/2022]
|
33
|
Mizrahi D, Wakefield C, Ha L, Cohn R, Simar D, Fardell J. Satisfaction with an exercise physiology consultation after treatment for childhood cancer: An opportunity for healthy lifestyle education. HEART AND MIND 2019. [DOI: 10.4103/hm.hm_47_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
34
|
Lam KKW, Li WHC, Chung OK, Ho KY, Chiu SY, Lam HS, Chan GCF. An integrated experiential training programme with coaching to promote physical activity, and reduce fatigue among children with cancer: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2018; 101:1947-1956. [PMID: 30007765 DOI: 10.1016/j.pec.2018.07.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/14/2018] [Accepted: 07/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study examined the effectiveness of an integrated programme in promoting physical activity, reducing fatigue, enhancing physical activity self-efficacy, muscle strength and quality of life among Chinese children with cancer. METHODS A randomised controlled trial was conducted in a Hong Kong public hospital. Seventy eligible children were randomly assigned to an experimental group (n = 37) or a control group (n = 33). The experimental group received an integrated programme with 28 home visits from coaches over a 6-month period. The control group received a placebo intervention. The primary outcome was fatigue at 9 months (3 months after intervention completion). Secondary outcomes were physical activity levels, physical activity self-efficacy, muscle strength and quality of life at 9 months, assessed at baseline, and 6 and 9 months after starting the intervention. RESULTS The experimental group reported significantly lower levels of cancer-related fatigue, higher levels of physical activity and physical activity self-efficacy, greater right- and left-hand grip strength and better quality of life than the control group at 9 months. CONCLUSION The programme is effective and feasible to implement among children with cancer and offers an alternative means of ameliorating the healthcare burden. PRACTICE IMPLICATIONS Healthcare professionals should build multidisciplinary partnerships to sustain such programmes.
Collapse
Affiliation(s)
- Katherine K W Lam
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - William H C Li
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - O K Chung
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - K Y Ho
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - S Y Chiu
- Department of Adolescent Medicine, Queen Mary Hospital, Hong Kong, China.
| | - H S Lam
- Hong Kong Council for Accreditation of Academic and Vocational Qualifications, Hong Kong, China.
| | - Godfrey C F Chan
- Department of Adolescent Medicine, Queen Mary Hospital, Hong Kong, China.
| |
Collapse
|
35
|
Yildiz Kabak V, Calders P, Duger T, Mohammed J, van Breda E. Short and long-term impairments of cardiopulmonary fitness level in previous childhood cancer cases: a systematic review. Support Care Cancer 2018; 27:69-86. [DOI: 10.1007/s00520-018-4483-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 09/19/2018] [Indexed: 01/29/2023]
|
36
|
Ranjbar M, Siamian H, Fallahpour MJ. Study on the Quality of Life Among the Cancer Patients at the Sari Comprehensive Cancer Center in 2017. Mater Sociomed 2018; 30:127-130. [PMID: 30061803 PMCID: PMC6029910 DOI: 10.5455/msm.2018.30.127-130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Cancer is a disease caused by abnormal cells shape change and loss of cell variation. Cancer patients suffer from mental and physical problems, which affect their social quality of life (QOL). A cancer diagnosis and its treatment can be expensive. Methods: In this descriptive-analytical and cross-sectional study, 183 patients referring to the Sari Comprehensive Cancer Center were enrolled. The data on QOL of patients and the cost of diagnosis and treatment were collected in QLQ questionnaire-C30. The obtained Data were analyzed using the Kruskal-Wallis test of the correlation coefficient, the Mann–Whitney U-test, ANOVA and T-test. Results: The average cost of treating patients in a comprehensive cancer center was $20161801 and the average QOL was 2.43 (5 points). Therefore, the patients achieved, 2.41% of the QOL per one million rails. Conclusions: Considering the average QOL for cancer patients at Sari Comprehensive Cancer Center and the hospital cost, the evaluation of the patients from the view point of the hospital equipment was positive.
Collapse
Affiliation(s)
- Mansour Ranjbar
- Department of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hasan Siamian
- Department of Medical Records and Health Information Technology, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Health Sciences Research Center, Sari, Iran
| | - Mohammad Javad Fallahpour
- Master of Financial Management, Graduated from Islamic Azad University, Qaemshahr Branch, Qaemshahr, Mazandaran, Iran
| |
Collapse
|
37
|
Twomey R, Martin T, Temesi J, Culos-Reed SN, Millet GY. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer 2018; 18:757. [PMID: 30041626 PMCID: PMC6057053 DOI: 10.1186/s12885-018-4668-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/11/2018] [Indexed: 12/29/2022] Open
Abstract
Background Cancer-related fatigue (CRF) is a common and distressing symptom of cancer and/or cancer treatment that persists for years after treatment completion in approximately one third of cancer survivors. Exercise is beneficial for the management of CRF, and general exercise guidelines for cancer survivors are available. There are multiple potential pathways by which exercise improves CRF, and cancer survivors with CRF are diverse with respect to cancer type, treatments and experienced side effects. While the general exercise guidelines are likely sufficient for most cancer survivors, tailoring of exercise interventions may be more effective in those with persistent fatigue. The primary aim of this research is to investigate the effect of a traditional vs. tailored exercise intervention on CRF severity in cancer survivors with persistent CRF. Methods/design Cancer survivors (≥ 3 months and ≤ 5 years since primary treatment) who score ≤ 34 on the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F) will be randomly allocated to one of two parallel treatment arms: traditional (active control) and tailored exercise. Participants in the traditional exercise group will engage in aerobic and resistance exercise that is consistent with exercise guidelines for cancer survivors. The tailored exercise group will be prescribed an intervention designed to address individual deficits identified at baseline, such as loss of muscular strength, cardiorespiratory deconditioning or sleep disturbance. Participants will be assessed before and after the intervention for CRF severity and other patient-reported outcomes, neuromuscular function and fatigue in response to whole-body exercise, sleep quantity and quality, physical activity levels, cardiorespiratory fitness and blood biomarkers. Discussion To our knowledge, this will be the first study to compare the effects of a traditional vs. tailored exercise intervention on CRF severity in cancer survivors with persistent CRF. Using physiological, behavioural and patient-reported outcomes, this study will add to the current knowledge about both the factors contributing to CRF, and the potential reduction in CRF severity with an exercise intervention. Trial registration The study is registered at ClinicalTrials.gov (NCT03049384), February, 2017. Electronic supplementary material The online version of this article (10.1186/s12885-018-4668-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rosie Twomey
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Tristan Martin
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - John Temesi
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Guillaume Y Millet
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.
| |
Collapse
|
38
|
Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors: A randomized controlled trial. Int J Nurs Stud 2018; 83:65-74. [PMID: 29689482 DOI: 10.1016/j.ijnurstu.2018.04.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/10/2018] [Accepted: 04/10/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cancer-related fatigue is one of the most distressing symptoms reported by childhood cancer survivors. Despite the body of evidence that regular physical activity helps alleviate cancer-related fatigue, insufficient participation in physical activity is frequently observed among childhood cancer survivors. OBJECTIVES This study examined the effectiveness of an adventure-based training programme in promoting physical activity, reducing fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors. DESIGN A prospective randomised controlled trial. SETTINGS A paediatric oncology outpatient clinic, a non-governmental organisation, and a non-profit voluntary organisation. PARTICIPANTS Hong Kong Chinese childhood cancer survivors aged 9-16 years who reported symptoms of fatigue and had not engaged in regular physical exercise in the past 6 months. METHODS The experimental group underwent a 4-day adventure-based training programme. The control group received a placebo intervention. The primary outcome was fatigue at 12 months. Secondary outcomes were physical activity levels, self-efficacy and quality of life at 12 months. Data collection was conducted at baseline, and 6 and 12 months after the intervention began. We performed intention-to-treat analyses. RESULTS From 6 January, 2014 to 8 June, 2015, we randomly assigned 222 eligible childhood cancer survivors to either an experimental (n = 117) or a control group (n = 105). The experimental group showed statistically significantly lower levels of cancer-related fatigue (P < 0.001), higher levels of self-efficacy (P < 0.001) and physical activity (P < 0.001), and better quality of life (P < 0.01) than the control group at 12 months. CONCLUSIONS This study provides evidence that adventure-based training is effective in promoting physical activity, reducing cancer-related fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors. These results may help inform parents and healthcare professionals that regular physical activity is crucial for the physical and psychological wellbeing and quality of life of childhood cancer survivors.
Collapse
|
39
|
Simioni C, Zauli G, Martelli AM, Vitale M, Ultimo S, Milani D, Neri LM. Physical training interventions for children and teenagers affected by acute lymphoblastic leukemia and related treatment impairments. Oncotarget 2018; 9:17199-17209. [PMID: 29682216 PMCID: PMC5908317 DOI: 10.18632/oncotarget.24762] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 02/25/2018] [Indexed: 12/28/2022] Open
Abstract
A decreased physical fitness has been reported in patients and survivors of acute lymphoblastic leukemia (ALL). This is influenced by the negative effects of the disease and by the treatments of childhood cancer. In the past, children were advised to recover in bed, and to take as much relax as possible. Nowadays, it is considered that too much immobility may result in a further decrease of physical fitness and functioning. Exercise training for ALL children has frequently been reported to improve physical fitness and the well-being of the children, since it prevents the negative effects of a sedentary life-style, such as obesity and a poor skeletal health. In recent years, different studies and protocols on this subject has become available for children and young adults with cancer, both during and after treatment. The efficacy of recent physical exercise training interventions, that act on several ALL impairments in children such as skeletal, musculoskeletal, neuromuscular, cardiopulmonary and cardiovascular systems, fatigue, body balance disorders and metabolism alterations have been examined. These side effects might be prevented or significantly reduced by introducing a physical exercise program during or shortly after cancer treatment. Several interventions are discussed and presented for each impairment, reducing their level caused by the disease and thus suggesting the importance of physical training activity in ameliorating the children quality of life.
Collapse
Affiliation(s)
- Carolina Simioni
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Alberto M Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Vitale
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,CoreLab, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Simona Ultimo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Daniela Milani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luca M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| |
Collapse
|
40
|
Diet and exercise interventions for pediatric cancer patients during therapy: tipping the scales for better outcomes. Pediatr Res 2018; 83:50-56. [PMID: 29068433 PMCID: PMC5865395 DOI: 10.1038/pr.2017.225] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 08/31/2017] [Indexed: 12/20/2022]
Abstract
Obesity at diagnosis is a negative prognostic indicator for several pediatric cancers including acute leukemia and bone tumors. Incidence of obesity in children has increased three-fold over the past 2 decades, and causes for this include poor diet, excessive caloric intake, and lack of physical activity, which are collectively referred to as energy balance-related behaviors. Few energy balance interventions have been implemented in pediatric cancer patients during treatment, and here we will probe the rationale for pursuing such studies. The need to modify composition of calories consumed and to identify specific beneficial exercise regimens will be discussed, relative to weight reduction or management.
Collapse
|
41
|
Kalter J, Kampshoff CS, Chinapaw MJM, VAN Mechelen W, Galindo-Garre F, Schep G, Verdonck-DE Leeuw IM, Brug J, Buffart LM. Mediators of Exercise Effects on HRQoL in Cancer Survivors after Chemotherapy. Med Sci Sports Exerc 2017; 48:1859-65. [PMID: 27128668 DOI: 10.1249/mss.0000000000000976] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE We investigated the hypothesis that combined resistance and endurance exercise improves cardiorespiratory fitness and muscle strength, thereby reducing fatigue and improving global quality of life (QoL) and physical function among cancer survivors who completed curative treatment including chemotherapy. METHODS Cancer survivors were assigned to a 12-wk exercise intervention (n = 186) or a wait list control group (n = 91). Data were collected at baseline and after 12 wk. Path analyses using follow-up values adjusted for baseline values, age, and gender were conducted to test if the exercise effects on global QoL and physical function (European Organization Research and Treatment of Cancer Quality of Life questionnaire-Core 30) were mediated by changes in cardiorespiratory fitness (peak V˙O2), hand-grip strength, lower body muscle function (30-s chair stand test), and fatigue (Multidimensional Fatigue Inventory). RESULTS Compared with the wait list control, exercise increased cardiorespiratory fitness (β = 1.8; 95% confidence interval (CI), 1.0-2.6 mL·kg·min) and reduced general (β = -1.0; 95% CI, -1.8 to -0.2) and physical fatigue (β = -1.5; 95% CI, -2.3 to -0.6). The exercise effect on physical fatigue was mediated by change in cardiorespiratory fitness (β = -0.2; 95% CI, -0.4 to -0.1). Higher hand-grip strength was significantly associated with lower physical fatigue and better lower body muscle function with lower physical and general fatigue. Lower general fatigue and physical fatigue were significantly associated with higher global QoL (β = -1.6; 95% CI, -2.2 to -1.1; and β = -1.7; 95% CI, -2.3 to -1.1, respectively) and physical function (β = -1.0; 95% CI, -1.3 to -0.7; and β = -1.2; 95% CI, -1.6 to -0.9, respectively). The models explained 44%-61% of the variance in global QoL and physical function. CONCLUSION Beneficial effects of exercise on global QoL and physical function in cancer survivors were mediated by increased cardiorespiratory fitness and subsequent reductions in fatigue.
Collapse
Affiliation(s)
- Joeri Kalter
- 1Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, THE NETHERLANDS; 2Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, THE NETHERLANDS; 3Department of Sports Medicine, Máxima Medical Center, Veldhoven, THE NETHERLANDS; 4Department of Clinical Psychology, VU University, Amsterdam, THE NETHERLANDS; and 5Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, THE NETHERLANDS
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Shin WK, Song S, Jung SY, Lee E, Kim Z, Moon HG, Noh DY, Lee JE. The association between physical activity and health-related quality of life among breast cancer survivors. Health Qual Life Outcomes 2017; 15:132. [PMID: 28666465 PMCID: PMC5493872 DOI: 10.1186/s12955-017-0706-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/20/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy. The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life (HRQOL) in breast cancer survivors. METHODS We conducted a cross-sectional study of breast cancer survivors. A total of 231 women aged 21-78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study. We asked participants about their HRQOL and engagement in physical activity using structured questionnaires. We examined the association between HRQOL levels and physical activity using a generalized linear model. RESULTS Breast cancer survivors in the high physical activity group (3rd tertile) were more likely to have lower scores for fatigue (p for trend = 0.001) and pain (p for trend = 0.02) and higher scores for sexual function (p for trend = 0.007) than those in the low physical activity group (1st tertile). When we stratified participants by stage, we found increasing scores for physical functioning (p for trend =0.01) and decreasing scores for fatigue (p for trend = 0.02) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer. In survivors with stages II and III, we found statistically significant associations with fatigue (p for trend = 0.02) and sexual functioning (p for trend = 0.001). CONCLUSIONS In conclusion, engagement in physical activity was related to better health-related quality of life among breast cancer survivors. Our findings may warrant further prospective and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors.
Collapse
Affiliation(s)
- Woo-Kyoung Shin
- Research Institute of Human Ecology, Seoul National University, Seoul, 08826, South Korea
| | - Sihan Song
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, 04310, South Korea
| | - So-Youn Jung
- Breast Cancer Center, National Cancer Center, Goyang, 10408, South Korea
| | - Eunsook Lee
- Breast Cancer Center, National Cancer Center, Goyang, 10408, South Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, South Korea
| | - Hyeong-Gon Moon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Dong-Young Noh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Jung Eun Lee
- Research Institute of Human Ecology, Seoul National University, Seoul, 08826, South Korea. .,Department of Food and Nutrition, Seoul National University, Seoul, 08826, South Korea.
| |
Collapse
|
43
|
Lipsett A, Barrett S, Haruna F, Mustian K, O'Donovan A. The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: A systematic review and meta-analysis. Breast 2017; 32:144-155. [DOI: 10.1016/j.breast.2017.02.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 01/25/2017] [Accepted: 02/01/2017] [Indexed: 11/26/2022] Open
|
44
|
Minnella EM, Bousquet-Dion G, Awasthi R, Scheede-Bergdahl C, Carli F. Multimodal prehabilitation improves functional capacity before and after colorectal surgery for cancer: a five-year research experience. Acta Oncol 2017; 56:295-300. [PMID: 28079430 DOI: 10.1080/0284186x.2016.1268268] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Multimodal prehabilitation is a preoperative conditioning intervention in form of exercise, nutritional assessment, whey protein supplementation, and anxiety-coping technique. Despite recent evidence suggesting that prehabilitation could improve functional capacity in patients undergoing colorectal surgery for cancer, all studies were characterized by a relatively small sample size. The aim of this study was to confirm what was previously found in three small population trials. MATERIAL AND METHODS Data of 185 participants enrolled in a pilot single group study and two randomized control trials conducted at the McGill University Health Center from 2010 to 2015 were reanalyzed. Subjects performing trimodal prehabilitation (exercise, nutrition, and coping strategies for anxiety) were compared to the patients who underwent the trimodal program only after surgery (rehabilitation/control group). Functional capacity was assessed with the six-minute walk test (6MWT), a measure of the distance walked over six minutes (6MWD). A significant functional improvement was defined as an increase in 6MWD from baseline by at least 19 m. Changes in 6MWD before surgery, at four and eight weeks were compared between groups. RESULTS Of the total study population, 113 subjects (61%) underwent prehabilitation. Changes in 6MWD in the prehabilitation group were higher compared to the rehabilitation/control group during the preoperative period {30.0 [standard deviation (SD) 46.7] m vs. -5.8 (SD 40.1) m, p < 0.001}, at four weeks [-11.2 (SD 72) m vs. -72.5 (SD 129) m, p < 0.01], and at eight weeks [17.0 (SD 84.0) m vs. -8.8 (SD 74.0) m, p = 0.047]. The proportion of subjects experiencing a significant preoperative improvement in physical fitness was higher in those patients who underwent prehabilitation [68 (60%) vs. 15 (21%), p < 0.001]. CONCLUSION In large secondary analysis, multimodal prehabilitation resulted in greater improvement in walking capacity throughout the whole perioperative period when compared to rehabilitation started after surgery.
Collapse
Affiliation(s)
| | | | - Rashami Awasthi
- Department of Anesthesia, McGill University Health Center, Montreal, Quebec, Canada
| | | | - Francesco Carli
- Department of Anesthesia, McGill University Health Center, Montreal, Quebec, Canada
| |
Collapse
|
45
|
Lam KKW, Ho Cheung William L, Ho KYE, Chung OKJ, Chan CFG. Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer: an exploratory study. J Clin Nurs 2016; 26:190-201. [DOI: 10.1111/jocn.13495] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Ka Yan Eva Ho
- School of Nursing; The University of Hong Kong; Hong Kong China
| | | | - Chi Fung Godfrey Chan
- Department of Paediatrics and Adolescent Medicine; LKS Faculty of Medicine; Queen Mary Hospital; The University of Hong Kong; Hong Kong China
| |
Collapse
|
46
|
Dennett AM, Peiris CL, Shields N, Morgan D, Taylor NF. Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study. Asia Pac J Clin Oncol 2016; 13:e515-e527. [PMID: 28004526 DOI: 10.1111/ajco.12642] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 09/20/2016] [Accepted: 10/03/2016] [Indexed: 02/05/2023]
Abstract
AIM Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation. METHODS A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription. RESULTS Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals. CONCLUSION Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care.
Collapse
Affiliation(s)
- Amy M Dennett
- School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health, VIC, Australia
| | - Casey L Peiris
- School of Allied Health, La Trobe University and Northern Health, VIC, Australia
| | - Nora Shields
- School of Allied Health, La Trobe University and Northern Health, VIC, Australia
| | - Delwyn Morgan
- Ambulatory and Community Services Program, Eastern Health, VIC, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health, VIC, Australia
| |
Collapse
|
47
|
Westerink NL, Nuver J, Lefrandt JD, Vrieling AH, Gietema JA, Walenkamp AME. Cancer treatment induced metabolic syndrome: Improving outcome with lifestyle. Crit Rev Oncol Hematol 2016; 108:128-136. [PMID: 27931830 DOI: 10.1016/j.critrevonc.2016.10.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 08/26/2016] [Accepted: 10/26/2016] [Indexed: 12/19/2022] Open
Abstract
Increasing numbers of long-term cancer survivors face important treatment related adverse effects. Cancer treatment induced metabolic syndrome (CTIMetS) is an especially prevalent and harmful condition. The aetiology of CTIMetS likely differs from metabolic syndrome in the general population, but effective treatment and prevention methods are probably similar. In this review, we summarize the potential mechanisms leading to the development of CTIMetS after various types of cancer treatment. Furthermore, we propose a safe and accessible method to treat or prevent CTIMetS through lifestyle change. In particular, we suggest that a lifestyle intervention and optimization of energy balance can prevent or mitigate the development of CTIMetS, which may contribute to optimal survivorship care.
Collapse
Affiliation(s)
- N L Westerink
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - J Nuver
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - J D Lefrandt
- Department of Vascular Medicine, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - A H Vrieling
- Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - J A Gietema
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - A M E Walenkamp
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| |
Collapse
|
48
|
Comprendre la non-adhésion à l’activité physique après un diagnostic de cancer pour mieux accompagner les patients—Partie I : Comprendre la non-adhésion à une pratique régulière d’activité physique. PSYCHO-ONCOLOGIE 2016. [DOI: 10.1007/s11839-016-0582-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
49
|
Giganti MG, Tresoldi I, Sorge R, Melchiorri G, Triossi T, Masuelli L, Lido P, Albonici L, Foti C, Modesti A, Bei R. Physical exercise modulates the level of serum MMP-2 and MMP-9 in patients with breast cancer. Oncol Lett 2016; 12:2119-2126. [PMID: 27602150 DOI: 10.3892/ol.2016.4887] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 05/19/2016] [Indexed: 12/16/2022] Open
Abstract
Matrix metalloproteinases (MMPs) exhibit an important function in extracellular matrix degradation. MMPs modulate the activation of growth factors, cytokines and metastasis. At present, the effect of exercise on serum levels of MMP-2 and -9 remains unclear. The aim of the present study was to investigate the effect of various physical activities on the circulating levels of MMP-2 and -9 in breast cancer (BC) survivors and healthy subjects. A total of 66 female subjects were enrolled in the present study. The cohort included 46 BC survivors and 20 healthy subjects divided into 5 groups: Group A (17 BC survivors, participating in recreational dragon boat paddling), group B (14 BC survivors, participating in recreational physical activity), group C (15 sedentary BC survivors), group D (10 healthy subjects, participating in recreational physical activity) and group E (10 sedentary healthy subjects). ELISA assays revealed a significant increase in the level of circulating MMP-2 in group B compared with all other groups. Recreational physical activity increased the levels of MMP-9 in healthy subjects (group D vs. E), however, the differences were not statistically significant, while in the BC survivor groups the results were opposite, with exercise reducing MMP-9 levels (group B vs. C). Furthermore, a significant increase in MMP-2 was observed in group B lymph node metastasis-positive (N+) subjects compared with group A and C N+ subjects. Thus, the results of the present study indicate that various physical activities modulate the levels of circulating MMP-2 and -9 in BC survivors, and the same exercise program induces a different effect when undertaken by healthy subjects and BC survivors. These results may have important implications with regard to the selection of appropriate physical activities for BC survivors, leading to improvements to their survival and prevention of recurrence, as well as amelioration of physical function, quality of life and fatigue.
Collapse
Affiliation(s)
- Maria Gabriella Giganti
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Ilaria Tresoldi
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Roberto Sorge
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Giovanni Melchiorri
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Tamara Triossi
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Laura Masuelli
- Department of Experimental Medicine, University of Rome 'Sapienza', Rome 00185, Italy
| | - Paolo Lido
- Internal Medicine Residency Program, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Loredana Albonici
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Calogero Foti
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Andrea Modesti
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| | - Roberto Bei
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Rome 00133, Italy
| |
Collapse
|
50
|
Heinrich M, Fisher A, Paton B, McCourt O, Beeken RJ, Hackshaw A, Wardle J, Yong K. Lifestyle in Multiple Myeloma - a longitudinal cohort study protocol. BMC Cancer 2016; 16:387. [PMID: 27377407 PMCID: PMC4932746 DOI: 10.1186/s12885-016-2407-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 06/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Deterioration in bone health is one of the presenting symptoms of Multiple Myeloma (MM), a cancer of plasma cells. As a consequence of this condition, patients suffer bone pain and bone damage and report cancer-related fatigue, resulting in deterioration in their quality of life. Evidence in patients with solid tumours shows promise for the positive effects of physical activity on quality of life. However, in the case of patients with MM a better understanding of the association between physical fitness and quality of life factors is still required. Therefore, this cohort study aims to objectively and longitudinally assess activity and fitness levels in patients with MM in order to explore their role in bone health, fatigue and quality of life for this patient population. METHODS/DESIGN The study is a prospective cohort study of MM patients in remission to assess physical activity, fatigue and bone health. Clinical markers of health, self-reported measures of psychological and physical well-being, and lifestyle behaviours are assessed at baseline, 3, 6 and 12 months. At each time point, patients complete cardiopulmonary exercise testing (CPET) along with a series of objective tests to assess physical fitness (eg accelerometry) and a number of self-report measures. A complementary qualitative study will be carried out in order to explore patients' desire for lifestyle advice and when in their cancer journey they deem such advice to be useful. DISCUSSION This study will be the first to prospectively and longitudinally explore associations between physical fitness and well-being, bone health, and fatigue (along with a number of other physical and clinical outcomes) in a cohort of patients with MM with the use of objective measures. The findings will also help to identify time points within the MM pathway at which physical activity interventions may be introduced for maximum benefit.
Collapse
Affiliation(s)
- M Heinrich
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - A Fisher
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
| | - B Paton
- Institute of Sport, Exercise and Health, London, UK
| | - O McCourt
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - R J Beeken
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - A Hackshaw
- Cancer Institute, University College London, London, UK
| | - J Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - K Yong
- Cancer Institute, University College London, London, UK
| |
Collapse
|