1
|
Worthen-Chaudhari L, Schnell PM, Hackney ME, Lustberg MB. Partnered dance evokes greater intrinsic motivation than home exercise as therapeutic activity for chemotherapy-induced deficits: secondary results of a randomized, controlled clinical trial. Front Psychol 2024; 15:1383143. [PMID: 38962217 PMCID: PMC11220256 DOI: 10.3389/fpsyg.2024.1383143] [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: 02/07/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Dance has been proposed to support superior intrinsic motivation over non-dance forms of therapeutic physical activity. However, this hypothesis has yet to be evaluated empirically, particularly among populations living with neuropathology such as survivors of cancer with neurologic complications from chemotherapy treatment. Questions about motivation are relevant to clinical outcomes because motivation mediates neuroplasticity. We conducted this secondary analysis of a randomized-controlled study to begin to investigate the relationships between personal motivation and neurophysiologic effects of dance-based intervention for healthy aging among populations with neurologic complications of cancer. Methods We measured motivation using the Intrinsic Motivation Inventory, a validated patient-reported outcome from the psychological approach of Self Determination Theory. We assessed intrinsic motivation, extrinsic motivation, and satisfaction with intervention within a randomized controlled trial of dance versus exercise designed to alleviate symptoms of chemotherapy-induced impairment. Fifty-two survivors of breast cancer with chemotherapy-induced neuropathy diagnosis and associated sensorimotor functional deficits were randomized (1:1) to 8 weeks of partnered dance or home exercise, performed biweekly (NCT05114005; R21-AG068831). Results While satisfaction did not differ between interventions, intrinsic motivation was higher among participants randomized to dance than those randomized to exercise (p < 0.0001 at all timepoints: 2 weeks, 4 weeks, 6 weeks, and 8 weeks of intervention), as was extrinsic motivation at 2 weeks (p = 0.04) and 8 weeks (p = 0.01). Discussion These data provide evidence that social dance is more motivating than the type of home exercise generally recommended as therapeutic physical activity. The results inform directions for future study of the effect of dance-based therapeutics on embodied agency, neuroplastic changes, and clinically-relevant neuropathic improvement.
Collapse
Affiliation(s)
- Lise Worthen-Chaudhari
- NeuroArtsRx Laboratory, Department of Physical Medicine and Rehabilitation, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Patrick M. Schnell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Madeleine E. Hackney
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University, Atlanta, GA, United States
- Center for Visual and Neurocognitive Rehabilitation, United States Department of Veterans Affairs, Atlanta, GA, United States
| | - Maryam B. Lustberg
- Center for Breast Cancer, Yale Cancer Center, Yale University, New Haven, CT, United States
| |
Collapse
|
2
|
Fram J, Boss K, Villaflor V, Jayabalan P. Barriers to and enablers of physical activity participation in lung cancer survivors. PM R 2024. [PMID: 38874321 DOI: 10.1002/pmrj.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/21/2024] [Accepted: 04/03/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Although physical activity physical activity has been shown to have significant benefits for individuals living with cancer, engaging lung cancer survivors (LCS) in increasing routine physical activity participation has been particularly challenging. PURPOSE To describe enablers of, barriers to, and patterns of physical activity among LCS and to characterize interest in a physical activity program as a first step to improving physical activity engagement. METHODS The study consisted of a cross-sectional survey (n = 100) of adult LCS recruited from a thoracic oncology clinic assessing multiple domains of physical activity (engagement, perceived barriers, benefits, physical function, psychosocial factors, self-efficacy, and programmatic preferences). RESULTS Only 12% of LCS in our cohort (average age 67 years, 54% male, 81% with stage III or IV disease) met American College of Sports Medicine (ACSM) physical activity guidelines. Participants engaged in moderate-to-vigorous physical activity, with an average (SD) of 48.4 (91.8) minutes per week. The most commonly reported barriers to physical activity were fatigue (49%), dyspnea (39%), and difficulty with daily activities (34%). Regression analysis demonstrated a positive association between moderate-to-vigorous physical activity and higher income (r = 0.241, p = .016), physical function (r = 0.281, p = .005), and physical activity self-efficacy (r = 0.270, p = .007). Qualitative results demonstrated a strong interest in physical activity programming that is lung-cancer specific with a high level of support and guidance. CONCLUSION This study identified that LCS had low levels of physical activity with fatigue, dyspnea, socioeconomic, and functional limitations contributing. The majority of LCS are interested in an exercise program and believe that exercise engagement will produce functional benefits. The present study presents a framework to guide development of community-based interventions to increase LCS physical activity participation among LCS.
Collapse
Affiliation(s)
- Julia Fram
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Victoria Villaflor
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA
| | - Prakash Jayabalan
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
3
|
O'Rourke RH, Vani MF, O'Loughlin EK, Thibodeau DE, Sabiston CM. Exploring the reasons for wanting a peer partner to be physically active among women living with and beyond a cancer diagnosis: a content analysis. Support Care Cancer 2024; 32:411. [PMID: 38839643 DOI: 10.1007/s00520-024-08602-3] [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: 03/05/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Initiating and maintaining exercise is challenging for women during and post-cancer treatment. Adopting a peer partner model to provide social support to be active may contribute to lasting behaviour change of both partners. Despite this, finding a "like peer" can be challenging. PURPOSE To explore women's reasons for seeking an online exercise partner following a diagnosis with cancer (through www.activematch.ca ). We also examined women's potential sociodemographic and cancer-related differences by reported reasons for wanting an exercise partner. METHODS Individuals creating an ActiveMatch profile completed demographic and physical activity questions (N = 199, Mage(SD) = 51.9(10.8) years), including an open-ended question regarding their "reason for wanting an exercise partner". An inductive content analysis was completed focusing on the participants' peer exercise partner preferences. Additional chi-square tests were run to assess whether participants differed based on sociodemographic and cancer-related characteristics and their motivations to be active by category of "reason for wanting an exercise partner" endorsed in the open-ended question. RESULTS The participants' reasons for wanting an exercise partner were coded into seven categories, with most participants highlighting the reasons of motivation (52.3%), social support (48.7%), and accountability and adherence (26.6%). Women < 50 years of age were more likely to report accountability and adherence-related preferences for a partner. Those reporting endorsing weight loss as their primary reason for becoming active were more likely to be categorized as wanting a peer partner for motivation. CONCLUSIONS While finding a peer partner can be challenging, matching women living with and beyond a cancer diagnosis based on their reason for wanting an exercise partner, as well as their reasons for wanting to be active, may be important to build successful peer exercise partnerships.
Collapse
Affiliation(s)
- Roxy H O'Rourke
- Faculty of Kinesiology and Physical Education, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada
| | - Madison F Vani
- Faculty of Kinesiology and Physical Education, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada
| | - Erin K O'Loughlin
- Faculty of Kinesiology and Physical Education, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada
- Centre de Recherche du Centre Hospitalier, Université de Montréal, Montréal, Québec, Canada
| | - Delaney E Thibodeau
- Faculty of Kinesiology and Physical Education, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada.
| |
Collapse
|
4
|
Mihic-Góngora L, Jimenez-Fonseca P, Coca-Membribes S, Cruz-Castellanos P, Galán-Moral R, Asensio-Martínez E, Palacín-Lois M, Carmona-Bayonas A, Caramés-Sánchez C, Calderon C. Physical Activity in Patients with Advanced Cancer: Sociodemographic, Clinical, and Psychological Correlates. Brain Sci 2024; 14:573. [PMID: 38928572 PMCID: PMC11201712 DOI: 10.3390/brainsci14060573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/20/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
As cancer progresses, patients may experience physical decline, which can impair their ability to carry out essential daily tasks. The aim of this study was to analyze the levels of physical activity in patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. A prospective, cross-sectional, multicenter study was carried out in 15 oncology departments in Spain. Patients with locally advanced, unresectable, or metastatic cancer who were candidates for systemic treatment were included. Participants completed demographic information and psychological scales. In total, 508 patients were included in the study, the majority of whom were male, over the age of 65, and diagnosed with bronchopulmonary tumors (36%) and metastatic disease. Based on their physical activity levels, participants were categorized as sedentary (20%, n = 190), engaging in light physical activity (43%, n = 412), or demonstrating moderate physical activity (37%, n = 351). Patients who were over 65 years old; had a worse baseline status (ECOG ≥ 1); lacked a partner; had a lower educational level; or were retired or unemployed were found to have lower levels of physical activity. Those with sedentary physical activity reported higher levels of psychological distress, anxiety, depression, somatization, and physical symptoms, as well as worse functional status, global health status, and well-being. Understanding the complex interplay between physical activity and sociodemographic, clinical, and psychological factors can help neuroscientists develop tailored exercise interventions that address the unique needs of advanced cancer patients.
Collapse
Affiliation(s)
- Luka Mihic-Góngora
- Department of Medical Oncology, Hospital Universitario Central de Asturias, 33007 Oviedo, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, 33007 Oviedo, Spain
| | - Sara Coca-Membribes
- Department of Medical Oncology, Hospital Universitario de Canarias, La Laguna, 38320 Santa Cruz de Tenerife, Spain
| | - Patricia Cruz-Castellanos
- Department of Medical Oncology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain
| | - Rocío Galán-Moral
- Department of Medical Oncology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain
| | - Elena Asensio-Martínez
- Department of Medical Oncology, Hospital General Universitario de Elche, 03203 Alicante, Spain
| | - María Palacín-Lois
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08007 Barcelona, Spain
| | - Alberto Carmona-Bayonas
- Department of Medical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, IMIB, 30008 Murcia, Spain
| | - Cristina Caramés-Sánchez
- Department of Medical Oncology, Hospital Universitario Fundación Jiménez-Diaz, 28040 Madrid, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08007 Barcelona, Spain
| |
Collapse
|
5
|
Shallwani SM, Thomas R, Poitras S, Toupin-April K, Sheill G, King J. Canadian oncology physiotherapists' perspectives of physical activity in people with advanced cancer: a mixed-methods study. Physiother Theory Pract 2024; 40:1281-1299. [PMID: 36305676 DOI: 10.1080/09593985.2022.2138663] [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: 04/22/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Individuals with advanced cancer can benefit from physical activity (PA), but face barriers to PA participation. Physiotherapists can be well-positioned to support this patient population. OBJECTIVE Our objective was to describe the perspectives, practices, knowledge, and skills of oncology physiotherapists related to PA in people with advanced cancer. METHODS In this mixed-methods study, we recruited Canadian physiotherapists with current or recent clinical experience with advanced cancer. Phase I consisted of an online survey about views toward PA in advanced cancer and activity-related recommendations and concerns for two case scenarios. Phase II involved individual, semi-structured interviews about perspectives related to working with advanced cancer. RESULTS Sixty-two physiotherapists participated in the survey, of which 13 participated in interviews. Most respondents (> 85%) agreed or strongly agreed PA is important and safe for individuals with advanced cancer. Case responses highlighted cancer-related considerations (e.g. bone metastases) tailored activity recommendations, and patient-centered, interprofessional care. Interview themes included: 1) situating PA within individually meaningful goals; 2) tailored strategies to promote PA; 3) overarching roles in functional optimization and symptom management; and 4) generalized lack of awareness regarding physiotherapy. CONCLUSION Our findings indicate Canadian oncology physiotherapists describe knowledge of the safety and importance of PA, as well as key considerations in advanced cancer. Moreover, they highlight the importance of a patient-centered approach to support this population, particularly in facilitating safe and meaningful PA, as well as optimizing function and alleviating symptom burden. Further efforts are needed to investigate the development and integration of physiotherapy within cancer care.
Collapse
Affiliation(s)
- Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
- McGill Lymphedema Research Program, McGill University Health Centre, Montreal, QC, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Stéphane Poitras
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Institut du savoir Montfort, Ottawa, ON, Canada
| | - Grainne Sheill
- Department of Physiotherapy, Trinity College Dublin, University of Dublin, College Green, Ireland
- Department of Physiotherapy, Dublin Trinity Centre for Health Sciences, Dublin, Ireland
| | - Judy King
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
6
|
Moraitis AM, Iacob E, Wong B, Beck SL, Echeverria C, Donaldson G, Mooney K. Pairing automated exercise coaching with patient-reported symptom monitoring: A way to nudge exercise uptake during cancer treatment? Support Care Cancer 2024; 32:258. [PMID: 38558321 DOI: 10.1007/s00520-024-08450-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Symptoms during cancer treatment cause burden, diminished physical functioning, and poor quality of life. Exercise is recommended during treatment to mitigate symptoms; however, interventions are difficult to translate into clinical care due to the lack of patient uptake and clinical implementation barriers. We evaluated the uptake, acceptability, and impact of an automated ePRO exercise module triggered by three patient-reported symptoms: nausea/vomiting, fatigue, and anxiety, during chemotherapy. METHODS We conducted a secondary analysis of an exercise module intervention imbedded in the cancer symptom monitoring and management platform, Symptom Care at Home (SCH). Utilizing behavioral economics principles, the exercise module was triggered when any of the three symptoms were reported. Once triggered, participants were coached on exercise benefits for symptom reduction and then offered the opportunity to set weekly exercise goals plus tracking of the goal outcomes and receive further encouragement. We examined uptake, exercise goal setting and attainment, and symptom impact. RESULTS Of 180 SCH participants receiving the SCH intervention, 170 (94.4%) triggered the exercise module and 102 of the 170 (60%) accepted the module, setting goals on average for 6.3 weeks. Of 102 participants, 82 (80.4%) achieved one or more exercise goals, exercising on average 79.8 min/week. Participants who achieved a higher proportion of goals had statistically significant lower overall symptom severity and lower severity of the triggered symptom. CONCLUSION An automated mHealth exercise coaching intervention, aimed to nudge those receiving chemotherapy to initiate an exercise routine had significant uptake, is acceptable and may reduce symptom severity. TRIAL REGISTRATION NCT01973946.
Collapse
Affiliation(s)
- Ann Marie Moraitis
- Dana Farber Cancer Institute, Department of Pediatric Oncology, Boston, MA, USA.
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Susan L Beck
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | | | - Gary Donaldson
- Pain Research Center, Department of Anesthesiology, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Kathi Mooney
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
7
|
Shallwani SM, Thomas R, King J, Toupin-April K, Poitras S. Perspectives and experiences of leisure-time physical activity in adults with stage 4 cancer: a qualitative interpretive-description study. Disabil Rehabil 2024; 46:1515-1526. [PMID: 37067063 DOI: 10.1080/09638288.2023.2200037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Leisure-time physical activity (LTPA) can be beneficial for individuals with advanced cancer, but little is known on how to tailor rehabilitation strategies targeting LTPA in cancer care. Our objective was to explore perspectives and experiences of LTPA in people with stage 4 cancer. MATERIALS AND METHODS Guided by interpretive-description methodology, our qualitative study consisted of individual, semi-structured interviews with 20 Canadian adults diagnosed with stage 4 cancer. Interviews were transcribed verbatim and analyzed inductively. RESULTS The participants' median age was 51.5 (range, 35-73) years. Cancer types included breast (n = 12), lung (n = 4), and other (n = 4). Participants highlighted their experiences of LTPA as diverse and complex, impacted by individual and cancer-related factors. They emphasized being intentional with LTPA through activity planning and modification. LTPA participation was linked to physical well-being, social connections, and meanings of accomplishment and loss. Many participants desired personalized support related to LTPA, that is integrated, interprofessional, and accessible in cancer care. CONCLUSION The experiences of LTPA for people with stage 4 cancer are personal and connected to health and psychosocial meanings. Further efforts in rehabilitation are needed to address the challenges faced by people with advanced cancer and optimize safe, meaningful participation in LTPA.IMPLICATIONS FOR REHABILITATIONExperiences of leisure-time physical activity in individuals with stage 4 cancer are personal and linked to health benefits and psychosocial meanings.Activity participation frequently involves consideration of cancer-related symptoms, management of risks, and intentional planning and modification of activities.Trained rehabilitation professionals integrated in cancer care may be well suited to support people with stage 4 cancer through personalized activity recommendations.This research can help inform future clinical, research, and educational efforts in rehabilitation aimed at targeting physical activity in individuals with advanced cancer.
Collapse
Affiliation(s)
- Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Lymphedema Research Program, McGill University Health Centre, Montreal, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Judy King
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Institut du savoir Montfort, Ottawa, Canada
| | - Stéphane Poitras
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| |
Collapse
|
8
|
Tock WL. Motivation for Health Promotion in Cancer Survivors: An Evolutionary Concept Analysis. ANS Adv Nurs Sci 2024; 47:202-217. [PMID: 34693911 DOI: 10.1097/ans.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Motivation for health promotion is an essential concept in health care research, as it pertains to an individual's ability to adapt to the adversity of chronic illnesses, including cancer. Adopting Rodgers' evolutionary method of concept analysis, the objective of this article is to clarify the concept based on its existing operationalization noted in cancer survivorship literature. Through a close examination of the construction of the concept, this article facilitates the understanding of concept as it relates to the field of cancer survivorship care, which in turn helps provide guidance for developing health promotion intervention targeted at cancer survivors.
Collapse
Affiliation(s)
- Wing Lam Tock
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
| |
Collapse
|
9
|
Adamovich T, Watson R, Murdoch S, Giovino L, Kulkarni S, Luchak M, Smith-Turchyn J. Barriers and facilitators to physical activity participation for child, adolescent, and young adult cancer survivors: a systematic review. J Cancer Surviv 2024; 18:245-262. [PMID: 35665472 DOI: 10.1007/s11764-022-01217-9] [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] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this systematic review is to explore and describe the barriers and facilitators to physical activity (PA) participation for child, adolescent, and young adult cancer survivors. METHODS MEDLINE, Embase, AMED, CINAHL, Cochrane, and Web of Science were searched for manuscripts published between January 2000 and February 2021. To be included in this review, studies had to report qualitative or quantitative data on barriers and facilitators to PA participation in child (4 to < 10 years), adolescent (10 to 19 years), and young adult (> 19 to < 40 years) cancer survivors. Six independent reviewers assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT-version 18) in duplicate. RESULTS Fifteen studies were included in this systematic review. Fatigue and psychological factors were the most prevalent barriers shared between children, adolescents, and young adults. Support from others was a shared facilitator between age groups. CONCLUSION Psychological barriers and social support are important to address in younger cancer survivors. Clinicians can use these findings to create exercise interventions to facilitate and overcome barriers to PA participation. IMPLICATIONS FOR CANCER SURVIVORS While PA is beneficial for cancer survivors of all ages, different barriers and facilitators to PA participation exist depending on a survivors age and life stage. Survivors should discuss PA with their healthcare team at all timepoints in the cancer treatment trajectory in order to gain the associated benefits during and after treatment.
Collapse
Affiliation(s)
- Tatsiana Adamovich
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Watson
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sydney Murdoch
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Liana Giovino
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sunket Kulkarni
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Michael Luchak
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
10
|
Agnew M, Cadmus-Bertram L, Kwekkeboom K, Gorzelitz J, Ruzicka M, Gangnon R, Andersen SW. "There is no expiration date": a qualitative analysis using the Social Cognitive Theory to identify factors influencing physical activity among adults living with advanced cancer. Support Care Cancer 2024; 32:242. [PMID: 38514490 DOI: 10.1007/s00520-024-08440-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify cognitive, behavioral, environmental, and other factors that influence physical activity in adults with advanced cancer using qualitative, semi-structured interviews. METHODS Eighteen semi-structured interviews were conducted with adults living with stage IV breast, prostate, or colorectal cancer; or multiple myeloma recruited from the University of Wisconsin Carbone Cancer Center. We used the Social Cognitive Theory to design the interview guide and a reflexive thematic approach for analysis. RESULTS Participants were 62 years old on average and currently receiving treatment. Despite reporting numerous barriers to physical activity, most participants discussed engaging in some physical activity. Participants reported difficulties coping with changes in physical functioning especially due to fatigue, weakness, neuropathy, and pain. While cold weather was seen as a deterrent for activity, access to sidewalks was a commonly reported feature of neighborhood conduciveness for physical activity. Regardless of current activity levels, adults with advanced cancer were interested in engaging in activities to meet their goals of gaining strength and maintaining independence. Having a conversation with a provider from their cancer care team about physical activity was seen as encouraging for pursuing some activity. CONCLUSIONS Adults living with advanced cancer are interested in pursuing activity to gain strength and maintain independence despite reported barriers to physical activity. To ensure patients are encouraged to be active, accessible resources, targeted referrals, and interventions designed to address their goals are critical next steps. RELEVANCE Integrating conversations about physical activity into oncology care for adults living with advanced cancer is an important next step to encourage patients to remain active and help them improve strength and maintain quality of life and independence.
Collapse
Affiliation(s)
- Megan Agnew
- Department of Population Health Sciences, University of Wisconsin Madison, 610 Walnut St #707, Madison, WI, 53726, USA.
| | - Lisa Cadmus-Bertram
- Department of Kinesiology, University of Wisconsin Madison, 1300 University Ave, Madison, WI, 53706, USA
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
| | - Kristine Kwekkeboom
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
- School of Nursing, University of Wisconsin Madison, 701 Highland Ave, Madison, WI, 53705, USA
| | - Jessica Gorzelitz
- Department of Health and Human Physiology, University of Iowa, 225 E Market St, Iowa City, IA, 52242, USA
- Holden Comprehensive Cancer Center, University of Iowa, 200 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Marla Ruzicka
- Department of Kinesiology, University of Wisconsin Madison, 1300 University Ave, Madison, WI, 53706, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin Madison, 610 Walnut St #707, Madison, WI, 53726, USA
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin Madison, 600 Highland Ave, Madison, WI, 53792, USA
| | - Shaneda Warren Andersen
- Department of Population Health Sciences, University of Wisconsin Madison, 610 Walnut St #707, Madison, WI, 53726, USA
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
| |
Collapse
|
11
|
Rodrigues B, Encantado J, Franco S, Silva MN, Carraça EV. Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2024:10.1007/s11764-024-01559-6. [PMID: 38448768 DOI: 10.1007/s11764-024-01559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. METHODS Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. RESULTS Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. CONCLUSIONS This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. IMPLICATIONS FOR CANCER SURVIVORS Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.
Collapse
Affiliation(s)
- Bruno Rodrigues
- Faculty of Sport, University of Porto (Research Centre in Physical Activity, Health and Leisure), R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Jorge Encantado
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Sofia Franco
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Marlene N Silva
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Eliana V Carraça
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| |
Collapse
|
12
|
Lally P, Kennedy F, Smith S, Beeken RJ, Buck C, Thomas C, Counsell N, Wyld L, Martin C, Williams S, Roberts A, Greenfield DM, Gath J, Potts HWW, Latimer N, Smith L, Fisher A. The feasibility and acceptability of an app-based intervention with brief behavioural support (APPROACH) to promote brisk walking in people diagnosed with breast, prostate and colorectal cancer in the UK. Cancer Med 2024; 13:e7124. [PMID: 38529687 DOI: 10.1002/cam4.7124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Increased moderate to vigorous physical activity (MVPA) can improve clinical and psychosocial outcomes for people living with and beyond cancer (LWBC). This study aimed to assess the feasibility and acceptability of trial procedures in a pilot randomised controlled trial (RCT) of a theory-driven app-based intervention with behavioural support focused on promoting brisk walking (a form of MVPA) in people LWBC (APPROACH). METHODS Participants diagnosed with breast, prostate or colorectal cancer were recruited from a single UK hospital site. Assessments at baseline and 3 months included online questionnaires, device-measured brisk walking (activPAL accelerometer) and self-reported weight and height. Participants were randomised to intervention or control (care as usual). The intervention comprised a non-cancer-specific app to promote brisk walking (National Health Service 'Active 10') augmented with print information about habit formation, a walking planner and two behavioural support telephone calls. Feasibility and acceptability of trial procedures were explored. Initial estimates for physical activity informed a power calculation for a phase III RCT. A preliminary health economics analysis was conducted. RESULTS Of those medically eligible, 369/577 (64%) were willing to answer further eligibility questions and 90/148 (61%) of those eligible were enrolled. Feasibility outcomes, including retention (97%), assessment completion rates (>86%) and app download rates in the intervention group (96%), suggest that the trial procedures are acceptable and that the intervention is feasible. The phase III RCT will require 472 participants to be randomised. As expected, the preliminary health economic analyses indicate a high level of uncertainty around the cost-effectiveness of the intervention. CONCLUSIONS This pilot study demonstrates that a large trial of the brisk walking intervention with behavioural support is both feasible and acceptable to people LWBC. The results support progression onto a confirmatory phase III trial to determine the efficacy and cost-effectiveness of the intervention.
Collapse
Affiliation(s)
- Phillippa Lally
- Department of Psychological Sciences, University of Surrey, Guildford, Surrey, UK
| | - Fiona Kennedy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Susan Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, London, UK
| | - Chloe Thomas
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Nicholas Counsell
- Cancer Research UK & Cancer Trials Centre, Cancer Institute, University College London, London, UK
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Charlene Martin
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Sarah Williams
- Department of Behavioural Science and Health, University College London, London, UK
| | - Anna Roberts
- Department of Behavioural Science and Health, University College London, London, UK
| | - Diana M Greenfield
- Sheffield Teaching Hospitals NHS FT, Weston Park Hospital, Sheffield, UK
| | - Jacqui Gath
- Independent Cancer Patients' Voice (ICPV), London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Nicholas Latimer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lee Smith
- The Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
| |
Collapse
|
13
|
Kearney N, Connolly D, Begic S, Mockler D, Guinan E. Feasibility metrics of exercise interventions during chemotherapy: A systematic review. Crit Rev Oncol Hematol 2024; 195:104272. [PMID: 38272152 DOI: 10.1016/j.critrevonc.2024.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Exercise has been shown to play an important role in managing chemotherapy-related side effects, preserving skeletal muscle mass, and attenuating decline in cardiorespiratory fitness associated with chemotherapy treatment, however, the feasibility of how these exercise programs are being delivered has yet to be synthesized. The objective of this review was to measure the rates of recruitment, adherence, and retention to exercise programs delivered for cancer patients during chemotherapy. METHODS Relevant studies were identified through a search of MEDLINE, Cochrane, EMBASE and CINAHL databases from January 2002 to July 2022 using keywords relating to exercise interventions during chemotherapy. Title and abstract screening, full text review, data extraction, and quality assessment were all performed independently by two reviewers. RESULTS A total of 36 studies were included in the review. The mean recruitment rate for the included studies was 62.39% (SD = 19.40; range 25.7-95%). Travel was the most common reason for declining recruitment in these trials. Adherence rates ranged from 17-109%, however the definition of adherence varied greatly between studies. Mean retention rates for the exercise groups was 84.1% (SD = 12.7; range 50-100%), with chemotherapy side effects being the most common reason why participants dropped out of these trials. CONCLUSION Multiple challenges exist for cancer patients during chemotherapy and careful consideration needs to be given when designing an exercise program for this population. Future research should include public and patient involvement to ensure exercise programs are pragmatic and patient centred.
Collapse
Affiliation(s)
- Neil Kearney
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland.
| | - Deirdre Connolly
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sanela Begic
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Library, Trinity Centre for Health Sciences, Dublin, Ireland
| | - Emer Guinan
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
14
|
Smith-Turchyn J, Mukherjee SD, Tomasone JR, Fong AJ, Nayiga BK, Ball E, Stouth DW, Sabiston CM. Evaluating Wall-Mounted Prompts to Facilitate Physical Activity-Related Discussion between Individuals with Cancer and Oncology Health Care Providers: A Pre-post Survey Study. Physiother Can 2024; 76:34-45. [PMID: 38465300 PMCID: PMC10919365 DOI: 10.3138/ptc-2023-0046] [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: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 03/12/2024]
Abstract
Purpose To evaluate the use of wall-mounted prompts in facilitating physical activity (PA)-related discussions between individuals with cancer and oncology care providers. Methods Individuals with cancer were approached to participate in a survey-based pre-post study. Half of participants (n = 100) completed a survey prior to installation of wall-mounted prompts in clinic while the other half (n = 100) completed a survey following installation of the prompts. Survey questions included content of PA-related discussion, satisfaction with PA education across treatment, and current PA level. The post-prompt survey also asked questions related to the prompt. Survey responses were analyzed using descriptive statistics. Chi-squared tests were performed to determine significance between timepoints. Results One hundred participants completed the survey at each timepoint. A significant difference was found pre and post-prompt in the number of PA discussions occurring overall during care (p = 0.03). Some participants (53%) were satisfied with the PA education received during treatment. There was no significant difference in occurrence of PA discussion (p = 0.36) pre and post-prompt and no difference in PA behaviour was observed (p = 0.130). Conclusions Wall-mounted prompts may be effective in increasing the frequency of PA-related discussions between individuals with cancer and their oncology team across treatment. Additional strategies, such as easy referral to rehabilitation professionals, are also needed to facilitate safe and effective PA behaviour during and after cancer treatments.
Collapse
Affiliation(s)
- Jenna Smith-Turchyn
- From the:
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Som D. Mukherjee
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer R. Tomasone
- School of Kinesiology and Health Studies, Queens University, Kingston, Ontario, Canada
| | - Angela J. Fong
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Brenda Kibuka Nayiga
- From the:
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Ball
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Derek W. Stouth
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Catherine M. Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
15
|
Wingood M, Criss MG, Irwin KE, Bamonti PM, Harris R, Phillips EL, Vincenzo JL, Chui KK. Examining physical activity participation barriers among adults 50 years and older: a scoping review. PHYSICAL THERAPY REVIEWS 2023; 28:195-210. [PMID: 38348467 PMCID: PMC10859686 DOI: 10.1080/10833196.2023.2265767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 09/12/2023] [Indexed: 02/15/2024]
Abstract
Background Addressing physical activity (PA) barriers is essential for increasing PA levels in middle-aged and older adults. However, there are no recommendations on selecting PA barrier assessment tools. Objectives Thus, we aimed to identify and provide clinimetric properties on PA barrier assessment tools that healthcare providers, exercise experts, and public health officials can use to examine potential barriers faced by community-dwelling adults 50 years and older. Methods We performed a systematic search of the following databases: PubMed, PsycINFO, CINAHL, and Web of Science. Articles were included if they presented clinimetric data on a PA participation barrier assessment tool for community-dwelling participants with a mean age of 50 years and older. The 561 identified articles underwent multiple rounds of blinded reviews. Included articles underwent data extraction for participant characteristics, scoring, constructs, reference tests, and clinimetric properties. Results The 35 included articles reported on 33 different PA participation barrier assessment tools. Eighteen articles reported on participants with cardiovascular, musculoskeletal, or neurological diagnoses, diabetes, hemodialysis, history of cancer, or mobility limitations. Tools with two or more supporting publications included the Exercise Benefits/Barrier Scale (EBBS), Episode-Specific Interpretations of Exercise Inventory (ESIE), and Inventory of Physical Activity and Barriers (IPAB). Due to differences in methodologies, across-tool comparison was not possible. Conclusion The EBBS, ESIE, and IPAB are promising tools for community-dwelling adults 50 years and older. However, additional research is warranted to identify the best PA barrier assessment tool among adults 50 years and older.
Collapse
Affiliation(s)
- Mariana Wingood
- Department of Implementation Science, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
- Sticht Center for Healthy Aging and Alzheimer’s
Prevention, Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
| | - Michelle G. Criss
- Doctor of Physical Therapy Program, Chatham University,
Pittsburgh, PA, USA
| | - Kent E. Irwin
- Department of Physical Therapy, Midwestern University,
Downers Grove, IL, USA
| | - Patricia M. Bamonti
- Research & Development, Veterans Affairs Boston
Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston,
MA, USA
| | - Rebekah Harris
- New England Geriatric Education and Clinical Center,
Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Physical Medicine and Rehabilitation, Harvard Medical
School, Boston, MA, USA
| | | | - Jennifer L. Vincenzo
- Department of Implementation Science, University of
Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Kevin K. Chui
- Department of Physical Therapy, Radford University,
Roanoke, VA, USA
| |
Collapse
|
16
|
Avancini A, Borsati A, Trestini I, Tregnago D, Belluomini L, Sposito M, Rota M, Insolda J, Schena F, Milella M, Pilotto S. Exploring the feasibility of a combined exercise program for patients with advanced lung or pancreatic cancer. Asia Pac J Oncol Nurs 2023; 10:100298. [PMID: 38197044 PMCID: PMC10772206 DOI: 10.1016/j.apjon.2023.100298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/18/2023] [Indexed: 01/11/2024] Open
Abstract
Objective This study aims to assess the safety, feasibility, and potential benefits of a combined aerobic and resistance exercise intervention for patients diagnosed with advanced pancreatic or lung cancer. Methods A prospective, single-arm study was conducted, enrolling patients with advanced lung or pancreatic cancer. Participants engaged in a 12-week exercise intervention comprising personalized bi-weekly aerobic and resistance training tailored to individual baseline conditions. The primary study outcomes focused on safety (absence of serious adverse events) and feasibility. Secondary outcomes included assessments of functional capacity using the "Six minutes walking test", strength measured through handgrip and leg press tests, anthropometric measures including body mass index and waist-hip ratio, quality of life (QoL), and changes in blood parameters. Results The study involved twelve patients (mean age 57.66 ± 7.40 years), with seven having pancreatic cancer and five having lung cancer. The recruitment rate was 50%, and assessment adherence was 100%, with an 84% adherence to the exercise program and no dropouts. No exercise-related adverse events were recorded, while three non-severe, non-exercise-related adverse events were observed: treatment-related dermatitis (Grade 2), axillary lymphadenopathy (Grade 2), and migraine (Grade 1). Significant enhancements in functional capacity, emotional well-being, and social functioning within the QoL domains were observed. Anthropometric measures, specifically waist-hip ratio and body mass index, remained stable. Conclusions The findings suggest that a tailored 12-week exercise intervention is both feasible and safe for patients with advanced lung or pancreatic cancer. This intervention appears to enhance functional capacity, specific aspects of QoL, and contribute to maintaining body weight.
Collapse
Affiliation(s)
- Alice Avancini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Anita Borsati
- Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Ilaria Trestini
- Dietetics Service, Medical Direction, University Hospital of Verona, Verona, Italy
| | - Daniela Tregnago
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Lorenzo Belluomini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Marco Sposito
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Michele Rota
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Jessica Insolda
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Milella
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| | - Sara Pilotto
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Italy
| |
Collapse
|
17
|
Feil K, Fritsch J, Rhodes RE. The intention-behaviour gap in physical activity: a systematic review and meta-analysis of the action control framework. Br J Sports Med 2023; 57:1265-1271. [PMID: 37460164 DOI: 10.1136/bjsports-2022-106640] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Intention is the proximal antecedent of physical activity in many popular psychological models. Despite the utility of these models, the discrepancy between intention and actual behaviour, known as the intention-behaviour gap, is a central topic of current basic and applied research. The purpose of this meta-analysis was to quantify intention-behaviour profiles and the intention-behaviour gap. DESIGN Systematic review and meta-analysis. DATA SOURCES Literature search was conducted in June 2022 and updated in February 2023 in five databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Eligible studies included a measure of physical activity, an assessment of physical activity intention and the employment of the intention-behaviour relationship into profile quadrants. Only papers published in the English language and in peer-reviewed journals were considered. Screening was assisted by the artificial intelligence tool ASReview. RESULTS Twenty-five independent samples were selected from 22 articles including a total of N=29 600. Random-effects meta-analysis revealed that 26.0% of all participants were non-intenders not exceeding their intentions, 4.2% were non-intenders who exceeded their intentions, 33.0% were unsuccessful intenders and 38.7% were successful intenders. Based on the proportion of unsuccessful intenders to all intenders, the overall intention-behaviour gap was 47.6%. CONCLUSION The findings underscore that intention is a necessary, yet insufficient antecedent of physical activity for many. Successful translation of a positive intention into behaviour is nearly at chance. Incorporating mechanisms to overcome the intention-behaviour gap are recommended for clinical practice.
Collapse
Affiliation(s)
- Katharina Feil
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Julian Fritsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| |
Collapse
|
18
|
Yang HY, Chou YJ, Shun SC. The Effect of Walking Intervention on Cognitive Function Among Patients With Non-Central Nervous System Cancer: A Systematic Review. Cancer Nurs 2023; 46:375-385. [PMID: 37607373 DOI: 10.1097/ncc.0000000000001106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment is one of the most frequently reported symptoms in patients with non-central nervous system (non-CNS) cancer. Walking has positive effects on cognitive function. However, the effects of walking interventions on cognitive function outcomes in patients with non-CNS cancer are not well synthesized. OBJECTIVE The aim of this study was to explore the characteristics of walking intervention and its effects on cognitive function in patients with non-CNS cancer. METHODS Ten databases were searched to identify eligible randomized controlled trials from each database's inception to June 7, 2021. The Physiotherapy Evidence Database Scale was used to assess the quality of the included studies. RESULTS Five randomized controlled trials involving 242 adults with non-CNS cancer were included. Two studies involving immediate treadmill walking interventions with moderate intensity at 40% to 60% maximal heart rate reported significantly improved objective cognitive domains of processing speed and spatial working memory with small to moderate effect sizes for cancer survivors. One study delivering home-based, moderate-intensity walking intervention had borderline significantly positive effects on perceived cognitive functioning for patients with non-CNS cancer during chemotherapy. CONCLUSION Walking intervention with moderate intensity is a beneficial approach to improve objective cognitive domains of processing speed and spatial working memory and perceived cognitive function. IMPLICATIONS FOR PRACTICE Nurses may provide moderate-intensity walking with 40% to 60% maximal heart rate monitoring to alleviate cognitive problems during the continuous process of cancer care. The modality and dosage of intervention should be adjusted depending on this population's tolerance to better maintain training.
Collapse
Affiliation(s)
- Hui-Ying Yang
- Author Affiliations: School of Nursing, College of Medicine, National Taiwan University (Ms Yang), Taipei; School of Nursing, College of Medicine, Chang Gung University (Dr Chou), Taoyuan; and School of Nursing, National Yang Ming Chiao Tung University (Dr Shun), Taipei, Taiwan
| | | | | |
Collapse
|
19
|
Bucciarelli V, Bianco F, Di Blasio A, Morano T, Tuosto D, Mucedola F, Di Santo S, Cimini A, Napolitano G, Bucci I, Di Baldassarre A, Cianchetti E, Gallina S. Cardiometabolic Profile, Physical Activity, and Quality of Life in Breast Cancer Survivors after Different Physical Exercise Protocols: A 34-Month Follow-Up Study. J Clin Med 2023; 12:4795. [PMID: 37510910 PMCID: PMC10381308 DOI: 10.3390/jcm12144795] [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: 06/10/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Breast cancer (BC) and cardiovascular (CV) disease share many risk factors associated with worse outcomes, in terms of cancer relapse, CV events, and quality of life (QoL), that could be counteracted by physical exercise (PE). We aimed to assess the impact of a 12-week differential PE protocol on cardiometabolic profile, QoL, CV- and BC-related long-term outcomes, and physical activity (PA) in a cohort of BC survivors (BCS) not treated with chemotherapy. METHODS 57 BCS participated in a 12-week PE protocol [aerobic exercise training (AET) or resistance exercise training (RET)]. Anthropometric and CV evaluation, health-related (HR)-QoL, daily PA, cortisol, and dehydroepiandrosterone sulfate (DHEA-S) levels were assessed before (T0) and after (T1) PE. We assessed BC and CV outcomes, HR-QoL, CV-QoL, and PA at the follow-up. RESULTS RET improved waist circumference, DHEA-S, cortisol/DHEA-S, systolic and mean blood pressure, and ventricular/arterial coupling; AET ameliorated sagittal abdomen diameter and pulse wave velocity. Regarding HR-QoL, physical function improved only in AET group. At a mean 34 ± 3.6-month follow-up, we documented no significant differences in CV-QoL, HR-QoL, and PA or CV and BC outcomes. CONCLUSIONS AET and RET determine specific, positive adaptations on many parameters strongly related to CV risk, CV and BC outcomes, and QoL, and should be included in any cardio-oncology rehabilitation program.
Collapse
Affiliation(s)
- Valentina Bucciarelli
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Francesco Bianco
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Teresa Morano
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Desiree Tuosto
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Francesco Mucedola
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Serena Di Santo
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Alessandra Cimini
- Eusoma Breast Centre, "G. Bernabeo" Hospital, ASL02 Lanciano-Vasto-Chieti, 66026 Ortona, Italy
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Ines Bucci
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Ettore Cianchetti
- Eusoma Breast Centre, "G. Bernabeo" Hospital, ASL02 Lanciano-Vasto-Chieti, 66026 Ortona, Italy
| | - Sabina Gallina
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| |
Collapse
|
20
|
Schad F, Rieser T, Becker S, Groß J, Matthes H, Oei SL, Thronicke A. Efficacy of Tango Argentino for Cancer-Associated Fatigue and Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial. Cancers (Basel) 2023; 15:cancers15112920. [PMID: 37296883 DOI: 10.3390/cancers15112920] [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: 03/30/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Persistent impairments of quality of life-in particular, cancer-associated fatigue-are a major limitation for breast cancer survivors. As physical activity and mindfulness interventions have been shown to be effective in reducing fatigue symptoms, we investigated the efficacy of a six-week Argentine tango program. METHODS A randomized controlled trial was conducted with 60 breast cancer survivors diagnosed with stage I-III tumors 12-48 months prior to study enrollment and who had increased symptoms of fatigue. The participants were randomly assigned with a 1:1 allocation to either the tango or the waiting group. The treatment consisted of six weeks of supervised weekly one-hour tango group-sessions. Self-reported fatigue and further quality of life parameters were assessed at baseline and six weeks post-baseline. Longitudinal changes, correlations, Cohen's D (d) effect sizes, and association factors were also calculated. RESULTS Superiority of the tango intervention over the waiting list control was found in terms of improvement in fatigue (d = -0.64; 95%CI, -1.2 to -0.08; p = 0.03), especially cognitive fatigue. In addition, a superiority of the tango intervention over the waiting list was found in the improvement of diarrhea (d = -0.69; 95%CI, -1.25 to -0.13; p = 0.02). A pooled pre-post analysis of the 50 participants completing the six-week tango program revealed a close to 10% improvement of fatigue (p = 0.0003), insomnia (p = 0.008) and further quality of life outcomes. Adjusted multivariate linear regression analyses revealed the greatest improvements for participants who were more active in sports. In particular, survivors who received endocrine therapies, were obese, or had no prior dance experience seemed to especially benefit from the tango program. CONCLUSIONS This randomized controlled trial demonstrated that a six-week Argentine tango program improves fatigue in breast cancer survivors. Further trials are warranted to determine whether such improvements lead to better long-term clinical outcomes. TRIAL REGISTRATION trial registration number DRKS00021601. Retrospectively registered on 21 August 2020.
Collapse
Affiliation(s)
- Friedemann Schad
- Research Institute Havelhöhe, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Thomas Rieser
- Research Institute Havelhöhe, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Sarah Becker
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Jessica Groß
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Harald Matthes
- Research Institute Havelhöhe, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- Institute for Gastroenterology, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Shiao Li Oei
- Research Institute Havelhöhe, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| | - Anja Thronicke
- Research Institute Havelhöhe, Hospital Gemeinschaftskrankenhaus Havelhöhe, 14089 Berlin, Germany
| |
Collapse
|
21
|
Georgescu I, Minvielle E, Scotté F. Motivation of patients with chronic cancer during COVID-19: a qualitative analysis. Support Care Cancer 2023; 31:296. [PMID: 37093535 PMCID: PMC10123469 DOI: 10.1007/s00520-023-07735-1] [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: 11/29/2022] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE Motivation to treat cancer and prevent its negative impact has been largely explored in a non-pandemic context. However, little is known about the motivation to comply with the treatment, especially during a pandemic. To fill this gap, we have explored the individual and contextual factors impacting patients' motivation during the COVID-19 period using the integrated model. METHODS We have conducted two qualitative studies before (study 1) and during the COVID-19 (study 2) period in a cancer centre. We respectively interviewed 30 and 22 patients with various chronic cancers in study 1 and also with COVID-19 in study 2. Data analysis was based on content analysis and grounded theory approach identifying the factors affecting patient motivations during both periods, and then comparing them. RESULTS Our results show the mechanisms that allow patients to maintain their motivation despite the threats related to COVID-19. They underline the importance of respecting the rules and laws for patients' motivation. CONCLUSION Compliance with legislation fuels the psychological need of protection in patients, which is a key determinant of motivation in the context of the pandemic. Considering patients' self-regulatory activities to assess motivational factors, going beyond clinical aspects, to include organisational and quality-of-life-related aspects throughout their care pathway is crucial.
Collapse
Affiliation(s)
- Irène Georgescu
- MRM, University of Montpellier, Rue Vendémiaire, 34000, Montpellier, France.
| | - Etienne Minvielle
- I3-Centre de Recherche en Gestion, Ecole polytechnique, CNRS, Institut polytechnique de Paris, Gustave Roussy, Villejuif, France
- Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, 94800, France
| | - Florian Scotté
- Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, 94800, France
| |
Collapse
|
22
|
Depenbusch J, Sweegers MG, Aaronson NK, Wengström Y, Backman M, Arraras JI, Schranz M, Büchler B, Lachowicz M, May AM, Steindorf K, Stuiver MM. PERSPECTIVEs on supervised exercise programs in people with metastatic breast cancer- a qualitative study in four European countries. Support Care Cancer 2023; 31:281. [PMID: 37074497 PMCID: PMC10115708 DOI: 10.1007/s00520-023-07739-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/06/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Supervised exercise is a potentially promising supportive care intervention for people with metastatic breast cancer (MBC), but research on the patients' perspective is limited. The aim of the current focus group study was to gain an in-depth understanding of MBC patients' perceived barriers, facilitators, and preferences for supervised exercise programs. METHODS Eleven online focus groups with, in total, 44 MBC patients were conducted in four European countries (Germany, Poland, Spain, Sweden). Main topics of the semi-structured discussions covered attitudes towards participation in supervised exercise programs, perceived facilitators, experienced barriers, and exercise preferences. Interviews were transcribed verbatim, translated into English, and coded based on a preliminary coding framework, supplemented by themes emerging during the sessions. The codes were subsequently examined for interrelations and re-organized into overarching clusters. RESULTS Participants had positive attitudes towards exercise, but experienced physical limitations and insecurities that inhibited their participation. They expressed a strong desire for exercise tailored to their needs, and supervision by an exercise professional. Participants also highlighted the social nature of group training as an important facilitator. They had no clear preference for exercise type, but rather favored a mixture of different activities. Flexible training modules were considered helpful to increase exercise program adherence. CONCLUSIONS MBC patients were generally interested in supervised exercise programs. They preferred group exercise that facilitates social interaction, but also expressed a need for individualized exercise programs. This suggests the relevance to develop flexible exercise programs that are adjusted to the individual's needs, abilities, and preferences.
Collapse
Affiliation(s)
- Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Maike G Sweegers
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Yvonne Wengström
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Backman
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Juan I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Melanie Schranz
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Britta Büchler
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Milena Lachowicz
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
| |
Collapse
|
23
|
Toohey K, Chapman M, Rushby AM, Urban K, Ingham G, Singh B. The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv 2023; 17:399-415. [PMID: 35040076 DOI: 10.1007/s11764-021-01153-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this systematic review with meta-analysis was to evaluate the safety, feasibility and effectiveness of exercise in the palliative care phase for people with advanced cancer. METHODS Electronic databases were searched for exercise randomised controlled trials involving individuals with incurable cancer that were published prior to April 14, 2021. Meta-analyses were performed to evaluate the effects of exercise on health outcomes. Subgroup effects for exercise mode, supervision, intervention duration and cancer diagnosis were assessed. RESULTS Twenty-two trials involving interventions ranging between 2 weeks and 6 months were included. Interventions comprised of aerobic (n = 3), resistance (n = 4), mixed-mode (n = 14) and other exercise (n = 1) modalities. Cancer types consisted of lung (n = 6), breast (n = 3), prostate (n = 2), multiple myeloma (n = 1) and mixed cancer types (n = 10). Meta-analysis of 20 RCTs involving 1840 participants showed no difference in the risk of a grade 2-4 adverse event between exercise and usual care (n = 110 adverse events (exercise: n = 66 events; usual care: n = 44 events), RD = - 0.01 (91% CI = - 0.01, 0.02); p = 0.24). Overall median recruitment, retention and adherence rates were 56%, 80% and 69%, respectively. Meta-analysis of health outcomes showed effects in favour of exercise for quality of life, fatigue, aerobic fitness and lower-body strength (SMD range = 0.27-0.48, all p < 0.05). CONCLUSIONS Participants who engaged in exercise experienced an increase in quality of life, fitness and strength and a decrease in fatigue. IMPLICATIONS FOR CANCER SURVIVORS Physical activity programs were found to be safe and feasible for people with advanced cancer in the palliative care phase.
Collapse
Affiliation(s)
- Kellie Toohey
- Faculty of HealthCanberra Specialist Medical CentreACT, University of Canberra, Level C Office 3, Bruce, 2617, Australia.
- Exercise and Survivorship (PACES) Research Group, University of Canberra, ActivityBruce ACT, Cancer, Australia.
| | - Michael Chapman
- Palliative Care, Canberra Hospital, ACT Health Services, Canberra ACT, Australia
- ANU Medical School, Australian National University, Canberra, Australia
| | - Anne-Marie Rushby
- Faculty of HealthCanberra Specialist Medical CentreACT, University of Canberra, Level C Office 3, Bruce, 2617, Australia
- University of South Australia, Adelaide, SA, Australia
- Australian Institute of Health and Welfare, Canberra, Australia
| | - Kat Urban
- Palliative Care, Lismore Base Hospital, Lismore, NSW, Australia
| | - Gemma Ingham
- Palliative Care, Prince of Wales Hospital, Randwick, NSW, Australia
| | | |
Collapse
|
24
|
Patient characteristics and preferences for a surgical prehabilitation program design: results from a pilot survey. J Cancer Res Clin Oncol 2023; 149:1361-1367. [PMID: 36283998 DOI: 10.1007/s00432-022-04420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/13/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE Surgical prehabilitation aims to reduce a decline in the functional capacity thereby optimising health and fitness before surgery. One of the major barriers in successfully implementing a prehabilitation program in hospitals has been poor patient adherence. In our pilot survey on surgical patients, we sought to explore patient preferences regarding the program design, the barriers and enablers to patient participation in a multimodal prehabilitation program. METHODS The survey was administered to patients undergoing major abdominal surgery in the preoperative period. The first two parts of the instrument mainly included questions on demographics, social history, activity levels, interest towards prehabilitation program and their involvement in co-design, preferences towards the components of the program, the barriers and enablers. The last part of survey included symptom and physical assessments. RESULTS The survey was completed by 24 patients undergoing major abdominal surgery. The median age of our cohort was 71 (range 35-91) years and 75% were retired. 75% of our participants were extremely interested in improving health and fitness and 63% were very keen to co-design their program when explained. Home-based programs were preferred by most participants and among exercises, walking was preferred by 71% of the participants. One third of the participants were interested in professional dietary counselling. There were only two participants who preferred group psychological therapy while 25% preferred individual psychological counselling sessions. CONCLUSION Our survey highlighted a need to design a personalised program with tailored interventions due to the wide variation in the interest and preferences among surgical patients.
Collapse
|
25
|
Song D, Liu Y, Lai CKY, Li Y. Effects of dyadic-based physical activity intervention on cancer-related fatigue among cancer survivors: A scoping review. Front Psychol 2023; 14:1102019. [PMID: 36777230 PMCID: PMC9909825 DOI: 10.3389/fpsyg.2023.1102019] [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: 11/18/2022] [Accepted: 01/05/2023] [Indexed: 01/27/2023] Open
Abstract
Objective Cancer-related fatigue is one of the most common adverse reactions to cancer survivors, which has a significant impact on the daily life. As a traumatic event, cancer not only brings great physical and mental harm to patients, but also poses a threat to the physical and psychological health of caregivers. Current studies have shown that physical activity improves cancer-related fatigue in cancer survivors. And studies have suggested that dyadic interventions are more effective in improving patient outcomes and may also provide some benefits to caregivers. But the literature on the effects of dyadic-based physical activity on improving cancer-related fatigue has not been synthesized. This scoping review described the scope and impact of studies on cancer-related fatigue with dyadic-based physical activity interventions. Methods Six databases which is PubMed, Cochrane Library, Web of Science, Embase, CINAHL and Medline were searched for all studies of dyadic-based physical activity interventions with outcome measures including cancer-related fatigue published since the inception of the databases through May 2022. The search strategy was developed based on PICO principles. Results This article includes 6 pre and post-test designs and 2 randomized controlled trial design. The majority of participants were survivors with breast and lung cancer. The overall results showed that the effectiveness of dyadic-based physical activity interventions in improving cancer-related fatigue was unsatisfactory. Conclusions This scoping review suggests that current dyadic-based physical activity interventions are not well-researched among cancer survivors. In the future, more high-quality studies with more sophisticated and rigorous interventions are needed.
Collapse
Affiliation(s)
- Dongyu Song
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuzhou Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Claudia K. Y. Lai
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,*Correspondence: Yuli Li ✉
| |
Collapse
|
26
|
"OPERATION PHALCO"-Adapted Physical Activity for Breast Cancer Survivors: Is It Time for a Multidisciplinary Approach? Cancers (Basel) 2022; 15:cancers15010034. [PMID: 36612031 PMCID: PMC9817922 DOI: 10.3390/cancers15010034] [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: 11/08/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
The international literature emphasizes the importance of physical activity (PA) in the first steps after cancer surgery. The regular practice of physical exercise causes positive adaptations on several functional capacities, with positive consequences on patients' quality of life. This project aims to evaluate the effect of a post-operative training protocol, structured by taking into account both cancer-related issues and the presence of comorbidities, on functional capacities and quality of life of breast cancer survivors. Therefore, it was necessary to create a synergy between oncologists (referring physicians), sport medicine physicians (risk stratification and exercise prescription) and kinesiologists (trainers). Thirty-five post-surgery BC patients decided on a voluntary basis to attend an online Adapted PA (APA) protocol for 4 months, twice a week (APA Group) or Usual Care Group (UC Group). Functional capacity of the APA Group significantly increased, by 13.1% (p = 0.000), whereas perceived exertion decreased by 19.7% (p = 0.020). In the same group, the general health evaluated through the questionnaire EORTC-QLQ-C30 increased (p = 0.050). No differences were found in the UC Group. Operation Phalco, creating a network between oncologists, sports medicine physicians and kinesiologists, confirms the importance of structuring a post-operative path where APA should be included as early as possible in the cancer patient care.
Collapse
|
27
|
Felser S, Gube M, Gruen J, Coutre PI, Schulze S, Muegge LO, Junghanss C, Ulbricht S. Association Between Cancer-Related Fatigue and Falls in Patients With Myeloproliferative Neoplasms: Results of a Multicenter Cross-Sectional Survey From the East German Study Group for Hematology and Oncology (OSHO #97). Integr Cancer Ther 2022; 21:15347354221143064. [PMID: 36539979 PMCID: PMC9791269 DOI: 10.1177/15347354221143064] [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] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study retrospectively examined the association between cancer-related fatigue (CrF) and the number of falls during the last 12 months in patients with myeloproliferative neoplasms (MPNs). METHODS A multicenter, 1-time anonymous survey was conducted using analog and digital questionnaires. Sex-stratified multinomial logistic regression analysis was applied to investigate the association between CrF and number of falls. All analyses were adjusted for age, school education, body mass index, MPN subtype, and quality of life. RESULTS The final sample comprised 688 patients (mean age 57.4 ± 13.8, 62.4% women). The fall rate was 16.2% in women and 12.2% in men (P = .153). There were no differences between women and men in terms of CrF between individuals with more than 1 fall, whereas women with 1 fall had a higher CrF compared to those without a fall (RRR = 1.019; 95% CI [1.002-1.039]), respectively. CONCLUSION CrF increases the risk of falls in women with MPN. Physicians should evaluate and manage CrF symptoms and implement fall prevention strategies for those who are at increased risk. Further research is needed to better understand the effects of CrF on gait performance and associated fall risk.
Collapse
Affiliation(s)
- Sabine Felser
- Rostock University Medical Center, Rostock, Germany,Sabine Felser, Department of Internal Medicine, Clinic III—Hematology, Oncology and Palliative Care, Rostock University Medical Center, Ernst-Heydemann-Straße 06, Rostock 18057, Germany.
| | - Martin Gube
- Rostock University Medical Center, Rostock, Germany,University of Rostock, Rostock, Germany
| | - Julia Gruen
- Rostock University Medical Center, Rostock, Germany
| | | | - Susann Schulze
- University Hospital Halle, Halle (Saale), Germany,Carl-von-Basedow-Klinikum, Merseburg, Germany
| | | | | | | |
Collapse
|
28
|
Janjua S, Brown M, Parker R, Prue G, Closier P, Cramp F. Physical activity for the management of cancer-related fatigue in adults. Hippokratia 2022. [DOI: 10.1002/14651858.cd015348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Sadia Janjua
- Pain, Palliative and Supportive Care Review Group; Cochrane; Oxford UK
| | - Malcolm Brown
- School of Nursing and Midwifery; Queen's University Belfast; Belfast UK
| | - Roses Parker
- Cochrane MOSS Network; c/o Cochrane Pain Palliative and Supportive Care Group; Oxford UK
| | - Gillian Prue
- School of Nursing and Midwifery; Queen's University Belfast; Belfast UK
| | - Philippa Closier
- University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Fiona Cramp
- Faculty of Health & Applied Sciences; University of the West of England; Bristol UK
| |
Collapse
|
29
|
Murphy BT, Mackrill JJ, O'Halloran KD. Impact of cancer cachexia on respiratory muscle function and the therapeutic potential of exercise. J Physiol 2022; 600:4979-5004. [PMID: 36251564 PMCID: PMC10091733 DOI: 10.1113/jp283569] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/09/2022] [Indexed: 01/05/2023] Open
Abstract
Cancer cachexia is defined as a multi-factorial syndrome characterised by an ongoing loss of skeletal muscle mass and progressive functional impairment, estimated to affect 50-80% of patients and responsible for 20% of cancer deaths. Elevations in the morbidity and mortality rates of cachectic cancer patients has been linked to respiratory failure due to atrophy and dysfunction of the ventilatory muscles. Despite this, there is a distinct scarcity of research investigating the structural and functional condition of the respiratory musculature in cancer, with the majority of studies exclusively focusing on limb muscle. Treatment strategies are largely ineffective in mitigating the cachectic state. It is now widely accepted that an efficacious intervention will likely combine elements of pharmacology, nutrition and exercise. However, of these approaches, exercise has received comparatively little attention. Therefore, it is unlikely to be implemented optimally, whether in isolation or combination. In consideration of these limitations, the current review describes the mechanistic basis of cancer cachexia and subsequently explores the available respiratory- and exercise-focused literature within this context. The molecular basis of cachexia is thoroughly reviewed. The pivotal role of inflammatory mediators is described. Unravelling the mechanisms of exercise-induced support of muscle via antioxidant and anti-inflammatory effects in addition to promoting efficient energy metabolism via increased mitochondrial biogenesis, mitochondrial function and muscle glucose uptake provide avenues for interventional studies. Currently available pre-clinical mouse models including novel transgenic animals provide a platform for the development of multi-modal therapeutic strategies to protect respiratory muscles in people with cancer.
Collapse
Affiliation(s)
- Ben T Murphy
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - John J Mackrill
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Ken D O'Halloran
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
30
|
Mind–body practices for cancer-related symptoms management: an overview of systematic reviews including one hundred twenty-nine meta-analyses. Support Care Cancer 2022; 30:10335-10357. [DOI: 10.1007/s00520-022-07426-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/20/2022] [Indexed: 12/04/2022]
|
31
|
Colton A, Smith MA, Broadbent S, Rune KT, Wright HH. Perceptions of Older Adults with Hematological Cancer on Diet and Exercise Behavior and Its Role in Navigating Daily Tasks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15044. [PMID: 36429764 PMCID: PMC9690783 DOI: 10.3390/ijerph192215044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Diet and exercise are associated with the maintenance of physical function, independence and better health-related quality of life in cancer survivors. Adherence to healthy diet and exercise guidelines, however, remains low. The aim of this study was to explore the perceptions of hematological cancer survivors (HCS, ≥50 years) on the role of diet and exercise in navigating daily tasks using a qualitative descriptive research method. Eligible HCS completed an online survey gathering demographic information including physical functioning, exercise frequency, malnutrition and frailty risk. Following a semi-structured telephone interview, thematic analysis was used. Nine HCS (67 ± 2 years) were included in the final analysis, with 55.5% sufficiently active, three at risk of malnutrition and five of frailty. Three primary themes reflected the survivors' perceptions: (1) beliefs about the impact of diet and exercise on physical and mental wellbeing, (2) the ability to overcome barriers to adhere to healthy diet and exercise behavior, and (3) diet and exercise empowered and gave hope. Participants had a more nuanced understanding of the role of exercise in physical function but lacked insight into the role of a healthy diet. Knowledge, support and instruction were key enablers of diet and exercise behavior, with community connection a unique enabler identified in this group.
Collapse
Affiliation(s)
- Alana Colton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
| | - Monica A. Smith
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
| | - Suzanne Broadbent
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
| | - Karina T. Rune
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
| | - Hattie H. Wright
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
- Sunshine Coast Health Institute, Birtinya, QLD 4575, Australia
| |
Collapse
|
32
|
Jensen W, Schmidt T. Bewegungstherapie bei nicht-heilbaren, fortgeschrittenen
Krebserkrankungen. B&G BEWEGUNGSTHERAPIE UND GESUNDHEITSSPORT 2022. [DOI: 10.1055/a-1901-4262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ZusammenfassungDank der Entwicklung neuer Chemotherapie-Protokolle und verbesserter
zielgerichteter Therapiestrategien hat sich das Überleben von Patienten
mit nicht-heilbaren, fortgeschrittenen Krebserkrankungen deutlich
verlängert. Durch die krankheitsbedingten Symptome und die
zusätzlichen therapiebedingten Nebenwirkungen wird die
Lebensqualität dieser Patienten aber deutlich eingeschränkt.
Übersichtsarbeiten zeigen, dass auch Patienten mit nicht-heilbaren,
fortgeschrittenen Krebserkrankungen von angepasster Bewegungstherapie
profitieren können. Es wurde eine Literaturrecherche mithilfe
elektronischer Datenbanken (PubMed, MEDLINE, EMBASE, Cochrane Library)
durchgeführt und eine Übersicht der randomisierten
kontrollierten Studien (RCTs) zur Bewegungstherapie bei nicht-heilbaren,
fortgeschrittenen Krebserkrankungen gegeben. Die dargestellten Studien zeigen,
dass eine gezielte Bewegungstherapie bei Patienten mit nicht-heilbaren,
fortgeschrittenen Krebserkrankungen sicher und durchführbar ist und
positive Effekte auf die Lebensqualität, auf krankheits- und
therapiebedingte Symptome wie Fatigue, Dyspnoe und auf den körperlichen
Funktionsstatus erzielen kann. Der Artikel beinhaltet außerdem einen
Diskurs mit einem Praxisbezug zum Thema Knochenmetastasen.
Collapse
Affiliation(s)
- Wiebke Jensen
- Universitätsklinikum Hamburg-Eppendorf, Hubertus Wald
Tumorzentrum, Universitäres Cancer Center Hamburg (UCCH)
| | - Thorsten Schmidt
- UCCSH, Universitäres Cancer Center Schleswig-Holstein, Campus
Kiel
| |
Collapse
|
33
|
De Lazzari N, Wichum F, Götte M, David C, Seid K, Tewes M. Entwicklung einer KI-gestützten Bewegungstherapie bei
onkologischen Palliativpatienten. B&G BEWEGUNGSTHERAPIE UND GESUNDHEITSSPORT 2022. [DOI: 10.1055/a-1909-5766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Zusammenfassung
HintergrundDie wechselnde Symptomlast ist eine große Hürde
in der Sporttherapie von onkologischen Palliativpatienten. Die täglich
variierende Symptomstärke erschwert die Einstellung einer optimalen
Trainingsbelastung und stellt neben der Motivation eine große Barriere
für die Teilnahme an bewegungstherapeutischen Interventionen dar. Ein
durch Künstliche Intelligenz (KI) gesteuertes Training könnte
helfen, die Trainingseinheiten individuell anzupassen und die Autonomie von
Palliativpatienten zu erhalten.
Methoden Fünf Patienten mit fortgeschrittener unheilbarer
Krebsdiagnose haben im Rahmen der Routineversorgung eine supervidierte
Bewegungstherapie absolviert. Dabei wurde ein Elektrokardiogramm über
einen Polar H10 Brustgurt aufgezeichnet und daraus kardiale und respiratorische
Vitalparameter extrahiert. Eine Klassifikation in drei Intensitätsstufen
über KI erfolgte anhand von neuronalen Netzen.
Ergebnisse Das KI-gesteuerte Training hat eine sehr hohe
Klassifikationsgüte (F1-Score: 0,95±0,05) durch die Vereinigung
von respiratorischen und kardialen Vitalparametern. Diese Kombination erzielt
genauere Klassifikationsergebnisse als die einzelnen Datensätze
für kardiale Parameter (0,93±0,06) und respiratorische Parameter
(0,72±0,06). Die Berücksichtigung einer Baselinemessung hat eine
positive Wirkung auf die Klassifikationsgenauigkeit.
Diskussion Diese Studie stellt die erste Untersuchung zum Einsatz von KI
zur Klassifizierung von trainingswissenschaftlichen Inhalten bei onkologischen
Palliativpatienten dar. Diese vulnerable Patientengruppe kann von einer
objektiven Erfassung des Belastungsniveaus anhand von Parametern des
kardiovaskulären Systems profitieren. Mit nur fünf Patienten
wird die Aussagekraft dieser explorativen Studie über Kreuzvalidierung
hergestellt. Zukünftig sollen weitere Parameter wie ein subjektives
Empfinden, Alter, Größe und Geschlecht die Klassifikation weiter
verbessern. In einem integrierten System ist eine individuelle
Trainingssteuerung in Echtzeit möglich.
Collapse
Affiliation(s)
- Nico De Lazzari
- Westdeutsches Tumorzentrum – Comprehensive Cancer Center,
Innere Klinik (Tumorforschung), Universitätsklinikum Essen, 45122 Essen,
Deutschland
| | - Felix Wichum
- Fraunhofer IMS, Universität Duisburg-Essen, 47057 Duisburg,
Deutschland
| | - Miriam Götte
- Westdeutsches Tumorzentrum – Comprehensive Cancer Center,
Klinik für Kinderheilkunde 3, Universitätsklinikum Essen, 45122
Essen, Deutschland
| | - Corinna David
- Fachhochschule Münster, Fachbereich
Physikingenieurwesen
| | - Karsten Seid
- Fraunhofer-Institut für Mikroelektronische Schaltungen und
Systeme (IMS), 47057 Duisburg und Fachgebiet Elektronische Bauelemente und
Schaltungen (EBS), Universität Duisburg-Essen
| | - Mitra Tewes
- Palliativmedizin der Universitätsmedizin Essen,
Universitätsklinikum Essen, 45122 Essen, Deutschland
| |
Collapse
|
34
|
Takemura N, Cheung DST, Fong DYT, Lin CC. Promoting moderate-to-vigorous physical activities in patients with advanced lung cancer: preferences and social cognitive factors, and the mediating roles. Support Care Cancer 2022; 30:7419-7429. [PMID: 35622150 PMCID: PMC9136819 DOI: 10.1007/s00520-022-07149-5] [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: 02/27/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to assess the prevalence and preferences of moderate-to-vigorous physical activities (MVPA) in patients with advanced lung cancer, explore the social cognitive factors that were associated with MVPA and interest in PA counseling and program, and examine the mediating role of social cognitive factors. METHODS This was a cross-sectional study. Questionnaires on PA levels, PA counseling and programming preferences, and social cognitive variables (social support and self-efficacy) were administered to 105 patients with advanced lung cancer. Linear regression model was used to explore the social cognitive factors associated with MVPA, and logistic regression model was used to explore the factors associated with interest in PA counseling and program. Mediation analysis was used to examine the mediating role of self-efficacy on social support and MVPA. RESULTS Merely 30.5% of patients met the recommended level of MVPA; however, the majority of patients (89.5%) were interested in PA program. Social support (β = 0.60; p = 0.007) and self-efficacy (β = 1.06; p = 0.027) were positively associated with MVPA. Specifically, self-efficacy mediated the relationship between social support and MVPA (β = 0.63, p = 0.004). CONCLUSION The majority of the patients with advanced lung cancer did not meet the recommended level of MVPA; however, they are interested in receiving PA counseling and joining PA programs. Social support was key to promoting higher levels of MVPA, and the association was mediated by self-efficacy. The established mediating model provides insights into designing PA programs and targeting the mediating variable, self-efficacy, to enhance the level of MVPA.
Collapse
Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, Hong Kong.
| |
Collapse
|
35
|
Workplace Physical Activity Barriers and Facilitators: A Qualitative Study Based on Employees Physical Activity Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159442. [PMID: 35954798 PMCID: PMC9367711 DOI: 10.3390/ijerph19159442] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022]
Abstract
Introduction: Lack of time, management support, insufficient facilitates, workload balance, and culture are often reported as common barriers to physical activity (PA) participation in the workplace. In comparison, identifying facilitators of PA in the workplace are scarce. A ‘one-size-fits-all’ approach to overcoming the barriers may also be unsuccessful within university settings where multidisciplinary workforce exists due to the heterogeneity nature of job roles. Thus, the aim of this study was to understand the perceived barriers and facilitators of PA of university employees who were classified as active or inactive based on their job roles. Methods: Forty-one employees (female = 17; male = 24) participated in focus groups to discuss their perceived barriers and facilitators to PA in the workplace. Participants were categorised based on their PA levels as active and inactive prior analysing the semi-structured focus groups data via using thematic analysis. Results and Discussion: The results showed that a lack of time was reported by 80% of the participants as a barrier to PA, including 63% inactive and 17% of the active participants. This included 27% administrators’ staff, 23% academics, 19% senior management, and 11% professional service staff. Over 75% participants reported a lack of management support as one of the perceived barriers to their PA engagement in the workplace. Approximately 58% also reported workplace culture as a barrier to PA participation. Open access to a gym on campus was perceived to be the main facilitator to engaging in PA in the future. Similarly, increased management support for engaging in PA and having flexibility during working days were perceived as facilitators for PA engagement and a way to reduced sedentary behaviour in the workplace. Conclusions: These findings contribute to the limited literature in terms of evaluating obstacles and facilitators of university employees to encourage engagement with PA in the workplace. These findings can be applied to form PA, health, and wellbeing-related interventions specifically targeting these identified barriers that are experienced in the workplace and thereby potentially reducing absenteeism and increasing productivity.
Collapse
|
36
|
Himbert C, Hathaway CA, Daniels B, Salas K, Ashworth A, Gigic B, Lin T, Viskochil R, Kirchhoff AC, Grossman D, Ose J, Tward J, Scaife C, Figueiredo JC, Toriola AT, Beck A, Shibata D, Gonzalez BD, Matsen C, Christenson C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Schneider M, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM, Peoples AR. Factors associated with changes in exercise behaviors during the COVID-19 pandemic. Cancer Causes Control 2022; 33:939-950. [PMID: 35554777 PMCID: PMC9096745 DOI: 10.1007/s10552-022-01580-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/28/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE There is limited information on how the COVID-19 pandemic has changed health behaviors among cancer patients. We examined changes in exercise behaviors since the pandemic and identified characteristics associated with these changes among cancer patients. METHODS Cancer patients (n = 1,210) completed a survey from August to September 2020 to assess COVID-19 pandemic-related changes in health behaviors and psychosocial factors. Patients were categorized into three groups: exercising less, exercising did not change, and exercising more. Patient characteristics were compared by exercise groups. RESULTS One-third of the patients reported a decreased amount of regular exercise, while 10% reported exercising more during the pandemic. Patients who exercised less were more likely to be unemployed/retired and have poor health status and psychosocial stressors such as disruptions in daily life while less likely to be former smokers (all p < 0.05). In contrast, patients who exercised more were younger, had stage IV diagnosis, and also reported disruptions in daily life (all p < 0.05). Patients who were living in rural areas were also more likely not to experience changes in exercise habits (all p < 0.05), although rural-urban status was not identified as a strong predictor. CONCLUSION A significant proportion of cancer patients experienced changes in exercise habits, especially exercising less, during the first 6 months of the COVID-19 pandemic. Age, employment status, tumor stage, health status, smoking status, and psychosocial factors were associated with changes in exercise behaviors. Our results highlight the importance of promoting physical activity guidelines for cancer survivorship during the COVID-19 pandemic and may help improve the identification of cancer patients susceptible to exercising less.
Collapse
Affiliation(s)
- Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Cassandra A Hathaway
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Karen Salas
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Biljana Gigic
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Anne C Kirchhoff
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Pediatrics, Division of Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jonathan Tward
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - Courtney Scaife
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Jane C Figueiredo
- Department of Medicine, Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Adetunji T Toriola
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - David Shibata
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cindy Matsen
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | | | - Debra S Ma
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Howard Colman
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA
| | - Jason P Hunt
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Kevin B Jones
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Orthopedics, University of Utah, Salt Lake City, UT, USA
| | - Catherine J Lee
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Tracy Onega
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Wallace L Akerley
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Martin Schneider
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, USA
| | - Erin M Siegel
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Anita R Peoples
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| |
Collapse
|
37
|
Martin JL, Saredakis D, Hutchinson AD, Crawford GB, Loetscher T. Virtual Reality in Palliative Care: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071222. [PMID: 35885749 PMCID: PMC9319274 DOI: 10.3390/healthcare10071222] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Virtual reality (VR) using head-mounted displays (HMDs) has demonstrated to be an effective tool for treating various somatic and psychological symptoms. Technological advances and increased affordability of VR technology provide an interesting option for delivering psychological interventions to patients in palliative care. The primary aim of this systematic review was to synthesise the available research on the use of VR for enhancing psychological and somatic outcomes for palliative care patients. Secondary aims included assessing general satisfaction and overall usability. Method: A pre-registered systematic literature search was conducted according to PRISMA guidelines using OVID Emcare, Cochrane Library, Embase, Medline, PsycINFO, and PubMed Care Search: Palliative Care Knowledge Network. Peer-reviewed experimental, quasi-experimental, observational, case, and feasibility studies consisting of single or multiple VR sessions using HMDs that reported psychological and/or somatic outcomes were included. Results: Eight studies published between 2019 and 2021 were included, representing 138 patients. While the reported quantitative psychological and somatic outcomes were ambiguous, the qualitative outcomes were largely positive. Participants were generally satisfied with VR, and most studies reported the VR interventions as usable, feasible, and acceptable. Conclusions: VR shows promise in palliative care and generally addresses a range of symptoms with few adverse effects. Future research should consist of adequately powered RCTs evaluating dosage and focusing on providing meaningful activities to enhance outcomes further.
Collapse
Affiliation(s)
- Jessica L. Martin
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
| | - Dimitrios Saredakis
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
- Correspondence:
| | - Amanda D. Hutchinson
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
| | - Gregory B. Crawford
- Northern Adelaide Local Health Network, Adelaide 5092, Australia;
- Discipline of Medicine, University of Adelaide, Adelaide 5005, Australia
| | - Tobias Loetscher
- UniSA Justice & Society, University of South Australia, Adelaide 5001, Australia; (J.L.M.); (A.D.H.); (T.L.)
| |
Collapse
|
38
|
Bland KA, Krishnasamy M, Parr EB, Mulder S, Martin P, van Loon LJC, Cormie P, Michael N, Zopf EM. “I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study. BMC Palliat Care 2022; 21:75. [PMID: 35578224 PMCID: PMC9110215 DOI: 10.1186/s12904-022-00948-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/15/2022] [Indexed: 11/10/2022] Open
Abstract
Cachexia is a prevalent muscle wasting syndrome among people with advanced cancer that profoundly impacts patient quality of life (QoL) and physical function. Exercise can improve QoL, physical function, and overall health in people with cancer and may be an important addition to treatment approaches for cancer cachexia. Greater understanding of patients’ perception of exercise can help elucidate the feasibility of implementing exercise interventions for cancer cachexia and facilitate the design of patient-centered interventions. We aimed to describe the perception of exercise in patients with advanced cancer and cachexia, and capture exercise motivators, barriers, and preferences, to inform the feasibility of exercise interventions. Individual interviews (n = 20) with patients with locally advanced or metastatic cancer with cachexia were conducted and analyzed using reflexive thematic analysis. Main themes from interviews were: 1) Life is disrupted by cancer and cachexia; 2) Exercise offers hope; 3) Exercise barriers are multifaceted; and 4) Exercise access and support are important. Participants reported that their cancer and cachexia had intensely altered their lives, including ability to exercise. Exercise was perceived as important and participants described a hope for exercise to improve their health and wellbeing. Yet, several complex exercise barriers, such as burdensome cancer symptoms and the overwhelming impact of the COVID-19 pandemic, hindered exercise participation and prevented participants from fully realizing the perceived benefits of exercise. Factors believed to improve exercise engagement and overcome exercise barriers included increased exercise support (e.g., professional supervision) and accessibility (e.g., convenient locations). Patient-reported exercise barriers and preferences can inform the design of exercise interventions, particularly within future research studies aiming to establish exercise feasibility and efficacy in people with advanced cancer and cachexia.
Collapse
|
39
|
Peng X, Chen R, Rao Z, Yang Y, Yan Y, Xia Y, Wang T, Wang J, Lu F, Pan H, Liu Y, Cheng J, He Q. High recurrence of lymphedema and influencing factors in discharged breast cancer patients during the COVID-19 pandemic: A multicenter, cross-sectional survey. Cancer Med 2022; 11:3572-3580. [PMID: 35543195 PMCID: PMC9348332 DOI: 10.1002/cam4.4737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 03/11/2022] [Accepted: 03/25/2022] [Indexed: 12/11/2022] Open
Abstract
Background There has been a delay in the detection and treatment of lymphedema in breast cancer patients during the lockdown owing to quarantine and limited social activity. Moreover, this scenario has caused psychosocial issues in these patients. Given that there is scarce information on the prevalence and influence of lymphedema during the coronavirus disease (COVID‐19) pandemic, we aimed to estimate the prevalence of lymphedema recurrence and its influencing factors among discharged breast cancer patients during the COVID‐19 pandemic. Methods This was a multicenter, cross‐sectional, hospital‐based survey of discharged breast cancer patients was conducted during the COVID‐19 pandemic in eight first‐class hospitals in Wuhan, China. The Norman Questionnaire was used to assess lymphedema. Univariable and multivariable binary logistic regression analyses were performed to identify factors influencing moderate or severe lymphedema. Differences in living characteristics, anxiety, and depression were compared between the no/mild lymphedema group and the moderate/severe lymphedema groups. Preferences for lymphedema management during the pandemic were determined. Results Overall, 202 patients were included in this study, and 191 of them reported recurrent lymphedema (prevalence: 94.6%, 95% confidence interval [CI] 90.5% to 97.3%). Among them, 134 and 57 had mild and moderate/severe lymphedema, respectively. In 191 patients, the main symptoms were swelling (140; 69.3%) and pain (56, 27.7%). Multivariable regression showed that older age (odds ratio [OR], 1.06; 95% CI: 1.02–1.10), radical surgery (OR = 4.35, 95% CI: 1.54–12.50), and fully complete radiotherapy (OR = 2.62, 95% CI: 1.17–5.87, p = 0.019) were associated with an elevated risk of moderate/severe lymphedema. The moderate/severe lymphedema group experienced a higher rate of anxiety and depression than the no/mild lymphedema group did. Patients equally preferred treatment in the hospital and self‐care at home. Conclusion During the COVID‐19 pandemic, high prevalence of lymphedema was observed in patients Age, radical surgery and fully completed radiotherapy were associated with increased risk of severer lymphedema. Meanwhile, the patients with severe lymphedema experienced psychological distress. While the Covid‐19 pandemic was still raging, continuous efforts should be made to identify patient at risk of lymphedema and distribute feasible guidance and education for self‐management in lymphedema.
Collapse
Affiliation(s)
- Xin Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Renwang Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenli Rao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunli Yan
- Breast Center, Hubei Cancer Hospital, Wuhan, China
| | - Ying Xia
- Thyroid Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Wang
- Department of Nursing, Wuhan First Hospital, Wuhan, China
| | - Jianying Wang
- Thyroid Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fang Lu
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Pan
- Thyroid Breast Surgery, Wuhan Central Hospital, Wuhan, China
| | - Yan Liu
- Department of Nursing, Wuhan Third Hospital, Wuhan, China
| | - Jing Cheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qin He
- Public Health Section, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
40
|
Roldán-Jiménez C, Pajares B, Ruiz-Medina S, Trinidad-Fernández M, González-Sánchez M, Ribelles N, García-Almeida JM, Ríos-López MJ, Alba E, Cuesta-Vargas AI. Design and implementation of a standard care programme of therapeutic exercise and education for breast cancer survivors. Support Care Cancer 2022; 30:1243-1251. [PMID: 34463835 PMCID: PMC8405716 DOI: 10.1007/s00520-021-06470-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/24/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Breast cancer survivors (BCS) face several symptoms and are at higher risk of weight gain following diagnosis. Current literature shows that both exercise and diet play a key role in recovery of BCS. However, there is a gap between current guidelines and the real-world context. The aim of this article is to describe the process behind a free, not-for-profit community-based therapeutic exercise and education programme (TEEP) for BCS in the clinical setting. METHODS The "Onco-Health Club" (OHC) consists of therapeutic exercise (TE) intervention aimed at ameliorating cancer-related fatigue (CRF) and improving QoL and physical function. TE is supplemented with nutritional education, providing information about the Mediterranean diet. To this end, patients are recruited from an oncologist and are referred to a physiotherapist and a nutritionist for baseline assessment. TEEP consists of a 3-month intervention, delivered twice a week in a group format with 1 h of TE and 30 min of nutritional education. BCS then have a final assessment and are advised to continue with a healthy lifestyle. Data about referral, compliance and assessment were collected. RESULTS From May 2017 to February of 2020, a total of 158 patients were recruited from 8 cohorts and 142 initially started the OHC. From 119 that joined the program, 96 patients were considered to have finished it with good adherence (assistance > 80%). BCS significantly improved their QoL, as well as upper and lower limb's function, and increased their level of physical activity. CRF tended to decrease (p = 0.005). CONCLUSIONS This study obtained data on recruitment, compliance, and possible limitations of these kinds of programmes in a real-world context. Further research is needed in order to optimize patient engagement and compliance, as well as to determine the transferability of these programmes in the clinical setting. TRIAL REGISTRATION NCT03879096, Registered 18th March 2019. Retrospectively registered.
Collapse
Affiliation(s)
- Cristina Roldán-Jiménez
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucia Tech, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Bella Pajares
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | - Manuel Trinidad-Fernández
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucia Tech, Málaga, Spain
| | - Manuel González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucia Tech, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Nuria Ribelles
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | | | - Emilio Alba
- Hospital Universitario Virgen de La Victoria, Málaga, Spain
| | - Antonio Ignacio Cuesta-Vargas
- Departamento de Fisioterapia, Facultad de Ciencias de La Salud, Universidad de Málaga, Andalucia Tech, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Australia
| |
Collapse
|
41
|
Watson G, Coyne Z, Houlihan E, Leonard G. Exercise oncology: an emerging discipline in the cancer care continuum. Postgrad Med 2021; 134:26-36. [PMID: 34854802 DOI: 10.1080/00325481.2021.2009683] [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: 10/19/2022]
Abstract
Exercise is an essential component of healthy living and well-being. While there is a global acceptance of the benefits of exercise for the general population, there exists hesitancy and confusion among health-care professionals, particularly oncologists, as to whether these benefits translate to cancer patients. Patient referrals to accessible, structured exercise programs in this setting are often overlooked by physicians when formulating a cancer management plan. There is however increasing awareness and acceptance of cancer survivorship as a part of the cancer care continuum, identifying multiple factors that contribute to well-being beyond just cancer outcomes. Efforts to optimize cancer survivorship have stimulated further academic interest in the benefits of healthy living and particularly exercise oncology. There is now compelling evidence that exercise, which includes daily activities such as walking, as well as structured programs, improves multiple-cancer outcomes such as fatigue, quality of life and likely survival, and warrants consideration in the multidisciplinary care of cancer patients. International guidelines have been established that recommend counseling cancer patients with regard to healthy lifestyle changes including exercise. However, there still remains a reluctance from oncology physicians to prescribe exercise for these patients, largely due to uncertainty with regard to their patients' ability to tolerate such an intervention, coupled with insufficient understanding of the potential benefits of these programs. There also exist patient barriers and attitudes that must be overcome. Exercise strategies and bespoke programs that are tailored to the unique abilities and goals of the patients will enhance participation. To move the field forward and integrate exercise oncology into standard practice, it is imperative to raise awareness of the benefits of exercise to cancer patients and their health-care providers. This will facilitate the prescription of exercise as part of the multimodal treatment plan with the ultimate aim of promoting an active lifestyle to optimize patient care and well-being.
Collapse
Affiliation(s)
- Ga Watson
- Department of Medical Oncology, University Hospital Galway, Galway, Ireland
| | - Zl Coyne
- Department of Medical Oncology, University Hospital Galway, Galway, Ireland
| | - E Houlihan
- Department of Physiotherapy, Cancer Care West, Galway, Ireland
| | - Gd Leonard
- Department of Medical Oncology, University Hospital Galway, Galway, Ireland
| |
Collapse
|
42
|
Oei SL, Rieser T, Becker S, Groß J, Matthes H, Schad F, Thronicke A. TANGO: effect of tango Argentino on cancer-associated fatigue in breast cancer patients-study protocol for a randomized controlled trial. Trials 2021; 22:866. [PMID: 34857031 PMCID: PMC8637025 DOI: 10.1186/s13063-021-05869-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The majority of breast cancer patients suffer from persistent impairments after completion of their primary oncological therapy. Cancer-related fatigue (CRF) in particular is a multidimensional syndrome having a profound negative impact on the quality of life. To counter CRF symptoms, physical activities are suggested as first-line interventions, mind-body therapies have been shown to be effective, and music therapy can also reduce anxiety and stress in breast cancer patients. Tango therapy that combines various elements can have an impact on physical, psychological, and cognitive abilities and could therefore have a beneficial effect on breast cancer patients. The purpose of this study is to investigate whether a 6-week tango module is suited as a therapeutic approach for people after primary breast cancer therapy to favorably influence their quality of life, especially CRF levels. METHODS Sixty patients with a diagnosis for stage I-III breast cancer 12-48 months before enrollment and with CRF (age > 18) will be recruited and randomized 1:1 to a tango or a waiting-list group. Movement concepts using elements of Argentine tango (self-awareness, musical and spatial perception, self-perception, playfulness, shared experience) will be examined with the participants during six consecutive weekly 1-h tango sessions. The primary outcome will be the improvement of CRF (German version of the Cancer Fatigue Scale), and the secondary outcomes will be the improvement in sleep quality (Pittsburgh Sleep Quality Index) and quality of life (EORTC-QLQ-C30). Patient-reported outcomes will be measured at baseline and 6 weeks later; follow-up will be performed 6, 12, and 24 months after baseline. An evaluation will be performed by means of descriptive data analyses. DISCUSSION Argentine tango, as a music-based movement therapy, can influence different skills and may improve several outcomes. The therapeutic use of Argentine tango in the care of breast cancer patients has not yet been reported. It is anticipated that participants receiving the tango module will have improved CRF, sleep, and quality of life scores compared to a waitlist control. TRIAL REGISTRATION German Clinical Trials Registry (DRKS) DRKS00021601 . Retrospectively registered on 21 August 2020.
Collapse
Affiliation(s)
- Shiao Li Oei
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Thomas Rieser
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Sarah Becker
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Jessica Groß
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Harald Matthes
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Medical Clinic for Gastroenterology, Infectiology and Rheumatology CBF Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Friedemann Schad
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
- Institute for Gastroenterology, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Anja Thronicke
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany.
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany.
| |
Collapse
|
43
|
Zyzniewska-Banaszak E, Kucharska-Mazur J, Mazur A. Physiotherapy and Physical Activity as Factors Improving the Psychological State of Patients With Cancer. Front Psychiatry 2021; 12:772694. [PMID: 34880794 PMCID: PMC8645643 DOI: 10.3389/fpsyt.2021.772694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022] Open
Abstract
Physiotherapy in oncology is a process closely related to cancer treatment methods. Rehabilitation is based on physical activity in various forms involving the musculoskeletal system but also affects the emotional state. Physical activity influences physical and psychological well-being of people undergoing oncological treatment, in the course of which the most common psychiatric disorders are depression, substance use disorder, sleep disorders, fatigue syndrome, resulting in worsening of the quality of life. Difficulties in implementing physical exercise in cancer patients pose a challenge to treatment teams.
Collapse
Affiliation(s)
| | | | - Aleksandra Mazur
- Department of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| |
Collapse
|
44
|
Himbert C, Hathaway CA, Daniels B, Salas K, Ashworth A, Gigic B, Lin T, Viskochil R, Kirchhoff AC, Grossman D, Ose J, Tward J, Scaife C, Figueiredo JC, Toriola AT, Beck A, Shibata D, Gonzalez BD, Matsen C, Christenson C, Ma DS, Colman H, Hunt JP, Jones KB, Lee CJ, Larson M, Onega T, Akerley WL, Li CI, Schneider M, Penedo FJ, Siegel EM, Tworoger SS, Ulrich CM, Peoples AR. Impact of the COVID-19 pandemic on exercise habits among cancer patients. RESEARCH SQUARE 2021:rs.3.rs-704646. [PMID: 34580667 PMCID: PMC8475966 DOI: 10.21203/rs.3.rs-704646/v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Purpose There is limited information on how the COVID-19 pandemic has changed health behaviors among cancer patients. We examined the impact of the pandemic on changes in exercise behaviors and identified characteristics associated with these changes among cancer patients. Methods Cancer patients (n = 1,361) completed a survey from August-September 2020 to assess COVID-19 pandemic-related changes in health behaviors and psychosocial factors. Patients were categorized into 3 groups: exercising less, exercising did not change, and exercising more. Patient characteristics were compared by exercise groups. Results One-third of the patients reported a decreased amount of regular exercise, while 11% reported exercising more during the pandemic. Patients who exercised less were more likely to be unemployed/retired, undergoing active treatment, and had increased pandemic-related alcohol consumption and psychosocial stressors such as loneliness and financial stress (all p < 0.05). In contrast, patients who exercised more were younger, female, full-time employed, did not consume alcohol, and had good health status and more social interactions (all p < 0.05). Patients who were living in rural areas and did not experience changes in daily life, were also more likely not to experience changes in exercise habits (all p < 0.05). Conclusion Our results indicate that a significant proportion of cancer patients experienced changes in exercise habits during the first 6 months of the COVID-19 pandemic. Age, sex, employment status, health status, alcohol consumption, and psychosocial factors were associated with changes in exercise behaviors. Providers should monitor for changes in health behaviors, such as exercise, because of their importance in improving cancer survivorship.
Collapse
Affiliation(s)
- Caroline Himbert
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | | | - Bailee Daniels
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Karen Salas
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Anjelica Ashworth
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Biljana Gigic
- Heidelberg University: Ruprecht Karls Universitat Heidelberg
| | - Tengda Lin
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Richard Viskochil
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Anne C Kirchhoff
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Douglas Grossman
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jennifer Ose
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jonathan Tward
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Courtney Scaife
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jane C Figueiredo
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | | | - Anna Beck
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - David Shibata
- University of Tennessee Health Science Center Bookstore: The University of Tennessee Health Science Center VolShop Memphis
| | | | - Cindy Matsen
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Cristina Christenson
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Debra S Ma
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Howard Colman
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Jason P Hunt
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Kevin B Jones
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Catherine J Lee
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Mikaela Larson
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Tracy Onega
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | - Wallace L Akerley
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| | | | | | | | | | | | | | - Anita R Peoples
- Huntsman Cancer Institute Cancer Hospital: University of Utah Health Huntsman Cancer Institute
| |
Collapse
|
45
|
De Lazzari N, Niels T, Tewes M, Götte M. A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer. Cancers (Basel) 2021; 13:cancers13174478. [PMID: 34503288 PMCID: PMC8430671 DOI: 10.3390/cancers13174478] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Most advanced cancer patients suffer from severe symptoms due to cancer and medical treatment. Common symptoms are physical weakness, mental problems, and tiredness. Research has shown that exercise positively influences cancer-related side effects during and after treatment and longevity in cancer survivorship. However, exercise as a supportive therapy in advanced cancer patients is still not recommended in oncological guidelines. Therefore, the aim of this systematic review was to assess the safety, feasibility, and benefits of exercise for patients with advanced cancer. Based on the results of 14 included exercise intervention studies, we conclude that exercise is safe and feasible, seems to improve physical performance, and may lower symptoms like chronic tiredness. Early integration of exercise for advanced cancer patients should be considered as usual care as a supportive strategy. Abstract Exercise therapy is a common supportive strategy in curative cancer treatment with strong evidence regarding its positive effects on, for example, cancer-related fatigue, health- related quality of life, and physical function. In the field of advanced cancer patients, knowledge about exercise as a useful supportive strategy is missing. The aim of this systematic review was to evaluate the feasibility and safety of exercise interventions as well as its effects on lowering the symptom burden. We included randomized controlled trials and nonrandomized controlled trials with advanced cancer patients receiving any type of exercise intervention. After an extensive literature search (in accordance to PRIMSA guidelines) in PubMed, Cochrane Library, and SPORTDiscus, 14 studies including 940 participants with different cancer entities were eligible. The results indicated the safety of exercise. In total, 493 participants received exercise interventions, with nine adverse events and no severe adverse events. The median recruitment rate was 68.33%, and adherence to exercise intervention was 86%. Further research with a high-quality and larger sample size is needed to clarify the potential of exercise with advanced cancer patients. Different advanced cancer entities have distinguished symptoms, and future research should construct entities-specific trial populations to figure out the best supportive exercise interventions.
Collapse
Affiliation(s)
- Nico De Lazzari
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
- Correspondence:
| | - Timo Niels
- Department I of Internal Medicine, Center of Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, 50937 Cologne, Germany;
| | - Mitra Tewes
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
| | - Miriam Götte
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics 3, Center for Child and Adolescent Medicine, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
| |
Collapse
|
46
|
Galindo Vázquez O, Aguilar González CN, Meneses García A, Calderillo Ruiz G, Bargalló Rocha E, Herrera Gómez Á. Validación del cuestionario básico de síntomas M. D. Anderson (MDASI) para pacientes con cáncer en población mexicana. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.77757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: Los diferentes síntomas en el paciente con cáncer pueden afectar las actividades en la vida cotidiana, las decisiones terapéuticas, así como la calidad de vida. Por lo que identificar la sintomatología en este grupo de pacientes es de suma importancia. Objetivo: Validar el cuestionario básico de síntomas M. D. Anderson (MDASI) para pacientes con cáncer en población mexicana. Método: Se incluyeron 309 pacientes del Instituto Nacional de Cancerología con edad entre 18 a 85 años, el tipo de estudio fue transversal, no experimental. Instrumentos: Cuestionario básico de síntomas MDASI, Cuestionario de Calidad de Vida de la Organización Europea para el tratamiento e Investigación del cáncer (EORTC-QLQ-C30) y Termómetro de Distrés. Resultados: Un análisis factorial ajustado a dos factores presentó un instrumento con 12 reactivos, similar a la versión original. La consistencia interna de la escala global mostró un índice satisfactorio (0,86). Las alfas de Cronbach de cada subescala tuvieron un valor de 0,79 y 0,80 que explicaron el 48,04% de la varianza global. La validez, por medio de correlación con las medidas concurrentes, mostró resultados significativos (r de Pearson de 0,954 a -0,267, p<0,01). Conclusiones: El instrumento MDASI mostro propiedades psicométricas adecuadas, similar a la versión original. Es útil para la práctica clínica e investigación. Se recomienda realizar estudios complementarios para determinar su sensibilidad en efectos de intervenciones médicas y psicológicas.
Collapse
|
47
|
Holler P, Jaunig J, Moser O, Tuttner S, Simi H, Wallner D, Amort FM, van Poppel M. Primary Care and Physical Literacy: A Non-Randomized Controlled Pilot Study to Combat the High Prevalence of Physically Inactive Adults in Austria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168593. [PMID: 34444341 PMCID: PMC8394934 DOI: 10.3390/ijerph18168593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022]
Abstract
The multidimensional concept of physical literacy is fundamental for lifelong physical activity engagement. However, physical literacy-based interventions are in their infancy, especially among adults. Therefore, the purpose of this pilot study was to assess the association of a physical literacy-based intervention with changes in self-reported physical literacy among inactive adults. A non-randomized controlled study (2 × 2 design) was conducted, comparing pre- vs. postintervention. Twenty-eight inactive healthy participants in the intervention group (89% female, 53 ± 10 years) entered a physical literacy-based intervention once weekly for 14 weeks. The non-treated control group consisted of 22 inactive adults (96% female, 50 ± 11 years). Physical literacy was evaluated with a questionnaire encompassing five domains: physical activity behavior, attitude/understanding, motivation, knowledge, and self-efficacy/confidence. ANOVA models were applied to evaluate changes by time and condition. Following the intervention, significant improvements were seen for overall physical literacy and in four out of five physical literacy domains, including physical activity behavior, attitude/understanding, knowledge, and self-efficacy/confidence (all p < 0.01, Cohen's d = 0.38-0.83). No changes by time x condition were found for motivation. The physical literacy-based intervention applied in this study may be a promising approach to help inactive adults to adopt an active lifestyle.
Collapse
Affiliation(s)
- Peter Holler
- Institute of Health Management in Tourism, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria; (S.T.); (H.S.); (D.W.); (F.M.A.)
- Sport Science Laboratory, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria; (J.J.); (M.v.P.)
- Correspondence:
| | - Johannes Jaunig
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria; (J.J.); (M.v.P.)
| | - Othmar Moser
- Division Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95447 Bayreuth, Germany;
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria
| | - Silvia Tuttner
- Institute of Health Management in Tourism, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria; (S.T.); (H.S.); (D.W.); (F.M.A.)
| | - Helmut Simi
- Institute of Health Management in Tourism, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria; (S.T.); (H.S.); (D.W.); (F.M.A.)
- Sport Science Laboratory, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria
| | - Dietmar Wallner
- Institute of Health Management in Tourism, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria; (S.T.); (H.S.); (D.W.); (F.M.A.)
- Sport Science Laboratory, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria
| | - Frank Michael Amort
- Institute of Health Management in Tourism, FH JOANNEUM—University of Applied Sciences, 8344 Bad Gleichenberg, Austria; (S.T.); (H.S.); (D.W.); (F.M.A.)
| | - Mireille van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria; (J.J.); (M.v.P.)
| |
Collapse
|
48
|
Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy. Support Care Cancer 2021; 29:7725-7735. [PMID: 34155534 PMCID: PMC8550207 DOI: 10.1007/s00520-021-06345-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/06/2021] [Indexed: 11/30/2022]
Abstract
Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methodology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B = − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.
Collapse
|
49
|
Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act 2021; 18:50. [PMID: 33823832 PMCID: PMC8025326 DOI: 10.1186/s12966-021-01116-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients' PA participation. METHODS A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions. RESULTS Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients' PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs. CONCLUSIONS There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
Collapse
Affiliation(s)
- Sarah Elshahat
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Charlene Treanor
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| |
Collapse
|
50
|
Frikkel J, Beckmann M, De Lazzari N, Götte M, Kasper S, Hense J, Schuler M, Teufel M, Tewes M. Changes in fatigue, barriers, and predictors towards physical activity in advanced cancer patients over a period of 12 months-a comparative study. Support Care Cancer 2021; 29:5127-5137. [PMID: 33608761 PMCID: PMC8295138 DOI: 10.1007/s00520-021-06020-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/21/2021] [Indexed: 01/28/2023]
Abstract
Purpose Physical activity (PA) is recommended to improve advanced cancer patients’ (ACP) physical functioning, fatigue, and quality of life. Yet, little is known about ACPs’ attitude towards PA and its influence on fatigue and depressiveness over a longer period. This prospective, non-interventional cohort study examined ACPs’ fatigue, depression, motivation, and barriers towards PA before and after 12 months of treatment among ACP Methods Outpatients with incurable cancer receiving treatment at a German Comprehensive Cancer Center reporting moderate/severe weakness/tiredness during self-assessment via MIDOS II were enrolled. Fatigue (FACT-F), depression (PHQ-8), cancer-related parameters, self-assessed PA behavior, motivation for and barriers against PA were evaluated (T0). Follow-up data was acquired after 12 months (T1) using the same questionnaire. Results At follow-up, fatigue (p=0.017) and depressiveness (p=0.015) had increased in clinical relevant extent. Physically active ACP did not show significant progress of FACT-F (p=0.836) or PHQ-8 (p=0.799). Patient-reported barriers towards PA remained stable. Logistic regression analyses identified motivation as a positive predictor for PA at both time points (T0, β=2.152, p=0.017; T1, β =2.264, p=0.009). Clinically relevant depression was a negative predictor for PA at T0 and T1 (T0, β=−3.187, p=0.044; T1, β=−3.521, p=0.041). Conclusion Our findings emphasize the importance of psychological conditions in physical activity behavior of ACP. Since psychological conditions seem to worsen over time, early integration of treatment is necessary. By combining therapy approaches of cognitive behavioral therapy and exercise in interdisciplinary care programs, the two treatment options might reinforce each other and sustainably improve ACPs’ fatigue, physical functioning, and QoL. Trial registration German Register of Clinical Trials, DRKS00012514, registration date: 30.05.2017
Collapse
Affiliation(s)
- J Frikkel
- West German Cancer Center Essen, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
| | - M Beckmann
- Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-Klinikum Essen, 45147, Essen, Germany
| | - N De Lazzari
- West German Cancer Center Essen, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
| | - M Götte
- Department of Pediatric Hematology/Oncology, Center for Child and Adolescent Medicine, University Hospital Essen, Essen, Germany
| | - S Kasper
- West German Cancer Center Essen, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
| | - J Hense
- West German Cancer Center Essen, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany
| | - M Schuler
- West German Cancer Center Essen, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45147, Essen, Germany
| | - M Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-Klinikum Essen, 45147, Essen, Germany
| | - M Tewes
- West German Cancer Center Essen, Department of Medical Oncology, University Hospital Essen, 45147, Essen, Germany.
| |
Collapse
|