Exercise and cancer: return to work as a firefighter with ostomy after rectal carcinoma - a case report

Return to Physical Activity in Individuals with Surgical Stomas: A Scoping Review

In surgically treated individuals with surgical stomas, the return to physical activity is an indicator of quality of life that reflects their well-being. With the aim of synthesizing the available evidence regarding the return to physical activity in individuals with surgical stomas, a scoping review was developed following the methodological approach of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews criteria. Searches were conducted in Medline (PubMed), Scopus, Web of Science, Cinahl, and Lilacs, as well as the meta-search engines TripDatabase and Epistemonikos, using MeSH terms. Included studies were written in Spanish, English, Portuguese, and German, without any limitation on the year of publication. A total of n = 15 studies was included (n = 2 qualitative; n = 2 case reports; n = 1 case series; n = 1 cohort; n = 8 cross-sectional; and n = 1 randomized clinical trial), which showed variability in the quality of the designs. The qualitative studies explored themes such as motivation, beliefs about physical activity, and other lifestyle factors. The case reports described physiological, psychological, and functional implications of returning to physical activity for specific individuals after ostomy surgery. Quantitative studies evaluated the effects of different types of physical activity on quality of life and tolerance to physical activity in these individuals, employing various measurement instruments. In conclusion, the evidence on returning to sports and physical activity after stoma surgery is limited and varied. While studies highlight the importance of social support and self-confidence, they generally lack rigor and primarily focus on adults and oncology patients. There is a need for more research to establish clear guidelines on physical activity type, frequency, and intensity to ensure safe and beneficial outcomes for individuals with stomas.

Parastomal hernia: an overview

Parastomal hernia (PH) is one of the most frequent ostomy complications, and the reported incidence in the literature is highly variable. As highlighted by the Association of Stoma Care Nurses UK, this complication develops mainly in children and older men over 70, but many predisposing factors are related to the individual patient and surgery. There is no standardised system for assessing PH. The main assessment techniques include objective examination, ultrasound scan and computed tomography. Prevention is based on various interventions by surgeons and stoma care nurses (SCNs). The SCN's primary interventions include accurate patient evaluation, pre-operative ostomy siting, education about body weight management and advice on appropriate exercises. The treatment of PH can be conservative or surgical, and the choice is based on the patient's clinical condition. Ostomy can significantly impact on a patient's quality of life (QoL), and the presence of PH can further aggravate the situation. This overview of PH considers the incidence, aetiology, prevention, treatment and impact on QoL.

Full duodenal rupture after direct abdominal trauma in soccer: a case report of an elite soccer player with follow up and return to play protocol

Severe traumatic abdominal injuries and duodenal ruptures are relatively rare in soccer and can be easily missed and turn into a life-threatening condition. All team physicians need to be familiar with the warning sign in these situations. This report aims to report a case, discuss the diagnostic and treatment process and the return to play protocol.During a professional female soccer team training session, the injury occurred while the player's epigastrium was hit hardly by the opponent's knee. In the first evaluation, there was only mild epigastrium pain without any other sign. Eventually, pain exacerbated, nausea and vomiting were added. All the initial evaluation (Physical examination, abdominal X-ray, ultrasonography, blood tests) were normal. Eventually, she developed abdominal guarding and underwent abdominopelvic computed tomography with intravenous contrast where Duodenal rupture becomes evident. She underwent laparotomy and full duodenal repair and discharged from the hospital in good health.For the return to play determination in such injuries, the abdomen should not be imposed on any trauma for about 6 months, so while the player can start a self-training session firstly without a ball and then with a ball, she is not allowed to play or train with others for 6 months.

A qualitative study exploring what it takes to be physically active with a stoma after surgery for rectal cancer

PURPOSE

Many adults must cope with the adverse effects of cancer and adjuvant therapies, which may limit their engagement in health-enhancing behaviors such as physical activity (PA). Furthermore, the placement of a stoma during surgery for rectal cancer may cause additional challenges to being physically active. The aim of this study was to explore the experiences of rectal cancer survivors who were living with a stoma and the impact on their engagement in PA.

METHODS

Interpretive phenomenological analysis was used as the approach for this qualitative study. Fifteen rectal cancer survivors took part in a semi-structured interview post-chemotherapy, and thematic analysis was used to identify themes within their accounts.

RESULTS

Three themes captured participants' personal lived experience: (1) reasons for engaging in PA, (2) deterrents to engaging in PA, and (3) practical implications.

CONCLUSIONS

Participants' accounts offered insight into both their cancer and stoma-related experiences, highlighting both reasons for and deterrents to engaging in PA. Further, findings helped to identify tangible strategies that those learning to be physically active with a stoma may find useful.

High-intensity interval training and hyperoxia during chemotherapy: A case report about the feasibility, safety and physical functioning in a colorectal cancer patient

INTRODUCTION

We conducted a case study to examine the feasibility and safety of high-intensity interval training (HIIT) with increased inspired oxygen content in a colon cancer patient undergoing chemotherapy. A secondary purpose was to investigate the effects of such training regimen on physical functioning.

CASE PRESENTATION

A female patient (51 years; 49.1 kg; 1.65 m; tumor stage: pT3, pN2a (5/29), pM1a (HEP), L0, V0, R0) performed 8 sessions of HIIT (5 × 3 minutes at 90% of Wmax, separated by 2 minutes at 45% Wmax) with an increased inspired oxygen fraction of 30%. Patient safety, training adherence, cardiorespiratory fitness (peak oxygen uptake and maximal power output during an incremental cycle ergometer test), autonomous nervous function (i.e., heart rate variability during an orthostatic test) as well as questionnaire-assessed quality of life (EORTC QLQ-C30) were evaluated before and after the intervention.No adverse events were reported throughout the training intervention and a 3 months follow-up. While the patient attended all sessions, adherence to total training time was only 51% (102 of 200 minutes; mean training time per session 12:44 min:sec). VO2peak and Wmax increased by 13% (from 23.0 to 26.1 mL min kg) and 21% (from 83 to 100 W), respectively. Heart rate variability represented by the root mean squares of successive differences both in supine and upright positions were increased after the training by 143 and 100%, respectively. The EORTC QLQ-C30 score for physical functioning (7.5%) as well as the global health score (10.7%) improved, while social function decreased (17%).

CONCLUSIONS

Our results show that a already short period of HIIT with concomitant hyperoxia was safe and feasible for a patient undergoing chemotherapy for colon cancer. Furthermore, the low overall training adherence of only 51% and an overall low training time per session (∼13 minutes) was sufficient to induce clinically meaningful improvements in physical functioning. However, this case also underlines that intensity and/or length of the HIIT-bouts might need further adjustments to increase training compliance.