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Mur-Gimeno E, Coll M, Yuguero-Ortiz A, Navarro M, Vernet-Tomás M, Noguera-Llauradó A, Sebio-García R. Comparison of water- vs. land-based exercise for improving functional capacity and quality of life in patients living with and beyond breast cancer (the AQUA-FiT study): a randomized controlled trial. Breast Cancer 2024:10.1007/s12282-024-01596-0. [PMID: 38811516 DOI: 10.1007/s12282-024-01596-0] [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: 11/21/2023] [Accepted: 05/16/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Patients living with and beyond breast cancer frequently exhibit several side effects that can impact quality of life and physical functioning way beyond diagnosis and cancer therapies. Traditional on-land exercise has shown to be effective in reducing several symptoms of BC but little is known about the role of water-based exercise in improving physical and psychological well-being. OBJECTIVES To compare land- vs. water-based exercise training for BC survivors to improve Health-Related Quality of Life (HRQoL), cancer-related fatigue (CRF), physical functioning, body composition and physical activity in patients with BC. METHODS A randomised, parallel group (1:1) controlled trial was conducted between 2020 and 2022. Patients were randomly allocated to complete a similar exercise training twice weekly during 12 weeks either on land (LG) using traditional gym equipment or in a swimming pool (WG) using body-weight exercises and water-suitable accessories. Both groups were supervised and monitored by an experienced physiotherapist. Main outcome was HRQoL (EORTC QLQ C30 and B23 module) and CRF measured with the Piper Scale. Secondary variables included functional capacity with the 6 Minutes Walking Test (6MWT), upper and lower body strength (handgrip strength and 30″ Sit-to-Stand (STS) test), body composition and objectively measured physical activity. RESULTS 28 patients were assessed and randomised during the study period. One patient did not receive the allocated intervention due to skin issues and one patient was dropped out during the intervention. A significant effect of time was found for both symptom severity (F(2,52) = 6.46, p = 0.003) and overall functioning (F1.67,43.45 = 5.215, p =0 .013) but no interaction was found between group and time. No effects were reported for CRF. Similar findings were reported for functional capacity (time effect F1.231,32.019 = 16.818, p < 0.001) and lower body strength (time effect F2,52 = 15.120, p < 0.001) as well as fat mass (time effect F2,52 = 4.38, p = 0.017). Notably, a significant time per group interaction was reported for physical activity (F2,52 = 6.349, p =0.003) with patients in the WG significantly improving PA levels over time while patients in the LG exhibited a marked decreased. CONCLUSIONS Exercise training either in water or on land can decrease symptom severity and improve functionality and body composition. Water-based training seems more effecting than land-based exercise to improve physical activity patterns over time.
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Affiliation(s)
- E Mur-Gimeno
- School of Health Sciences, TecnoCampus, University Pompeu Fabra, Av. Ernest Lluch 32, 08302, Mataró, Barcelona, Spain
- Research Group in Attention to Chronic Care and Health Innovation, TecnoCampus, University Pompeu Fabra, Mataró, Spain
- CEM Marítim, Fundació Claror, Barcelona, Spain
| | - M Coll
- CEM Marítim, Fundació Claror, Barcelona, Spain
| | - A Yuguero-Ortiz
- CEM Marítim, Fundació Claror, Barcelona, Spain
- Physical Medicine and Rehabilitation Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - M Navarro
- CEM Marítim, Fundació Claror, Barcelona, Spain
| | - M Vernet-Tomás
- Breast Cancer Unit, Department of Gynecology and Obstetrics, Hospital del Mar-Parc Salut Mar, Barcelona, Spain
| | - A Noguera-Llauradó
- Breast Cancer Unit, Department of Gynecology and Obstetrics, Hospital del Mar-Parc Salut Mar, Barcelona, Spain
| | - R Sebio-García
- School of Health Sciences, TecnoCampus, University Pompeu Fabra, Av. Ernest Lluch 32, 08302, Mataró, Barcelona, Spain.
- Research Group in Attention to Chronic Care and Health Innovation, TecnoCampus, University Pompeu Fabra, Mataró, Spain.
- Physical Medicine and Rehabilitation Department, Hospital Clinic de Barcelona, Barcelona, Spain.
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Ramadan AM, ElDeeb AM, Ramadan AA, Aleshmawy DM. Effect of combined Kinesiotaping and resistive exercise on muscle strength and quality of life in breast cancer survivors: a randomized clinical trial. J Egypt Natl Canc Inst 2024; 36:1. [PMID: 38221574 DOI: 10.1186/s43046-023-00205-z] [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: 05/30/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Breast cancer (BC) and its treatment affect women's tissue architecture and physiology, which leads to impaired muscle strength and joint dysfunction, affecting quality of life (QOL). Most evidence has focused on exercises; however, due to the complexity and heterogeneity of patients' rehabilitation needs, further research is required to investigate more adjunctive methods to help optimal rehabilitation according to patients' needs, preferences, and effective interventions. METHODS This study aimed to determine the effect of Kinesiotaping (KT) combined with resistive exercise on muscle strength and QOL in breast cancer survivors (BCS). Forty premenopausal BCS treated with chemotherapy postmastectomy participated in this study. Their age ranged from 40 to 55 years, and their body mass index (BMI) was 25-29.9 kg/m2. They were randomly distributed into two equal groups. The control group received resistive exercise two times/week for 12 weeks, while the study group received resistive exercise and KT applied to the lower limbs. Hip, knee, and ankle muscle strength were measured using a hand-held dynamometer, and QOL was evaluated using 36-Item Short Form (SF-36) before and after treatment. RESULTS Both groups showed a significant increase (p = 0.0001) in the strength of hip flexors, knee extensors, flexors, ankle plantar flexors, and dorsiflexors, as well as SF-36 score after treatment. However, the study group showed a more significant increase in strength of hip flexors (p = 0.005), knee extensors (p = 0.01) and flexors (p = 0.02), ankle plantar flexors (p = 0.01), and dorsiflexors (p = 0.01), as well as SF-36 score (p = 0.006) than the control group. CONCLUSIONS KT plus resistive exercise is more effective than exercise alone for improving muscle strength and QOL in BCS. So, the KT can be recommended as a non-invasive, adjunctive method added to the protocol therapy for BCS to help better outcomes during the rehabilitation period.
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Affiliation(s)
- Alaa M Ramadan
- Department of Physical Therapy for Obstetrics and Gynecology, Faculty of Physical Therapy, October 6 University, Giza, Egypt
| | - Abeer M ElDeeb
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Ahmed A Ramadan
- Department of Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Dina M Aleshmawy
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Skouras AZ, Antonakis-Karamintzas D, Tsolakis C, Koulouvaris P. Unraveling the "golden ratio": a pilot study investigating acute-to-chronic workload ratio in breast cancer patients undergoing active treatment. Front Physiol 2024; 14:1273624. [PMID: 38260104 PMCID: PMC10801086 DOI: 10.3389/fphys.2023.1273624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Training load monitoring is a common practice in sports medicine for supporting athletes' health and performance. Despite progress in exercise oncology research for breast cancer patients, training load monitoring is underutilized. This study retrospectively investigated the relationship between maintained training load within a defined range and physical and health outcomes of ten breast cancer patients during active anticancer treatment who underwent a 12-week exercise program. Intervention consisted of endurance and resistance training, three times a week, with each session lasting 30-45 min. Assessments were conducted at baseline, 6 and 12 weeks after enrollment, evaluating physical function (6-min walk test-6MWT, and sit-to-stand), muscle strength, body composition, sleep quality (Pittsburgh Sleep Quality Index-Pittsburgh Sleep Quality Index), quality of life (EORTC-QLQ-C30), heart rate variability and physical activity levels (International Physical Activity Questionnaire-International Physical Activity Questionnaire). The Physiological Cost Index/Energy Expenditure Index (PCI/EEI) was estimated using the 6MWT and Heart rate. Training load monitoring was performed by session rating of perceived exertion (sRPE, relative intensity multiplying with session duration). Acute-to-Chronic Workload Ratio (ACWR) (7:28, rolling average) was calculated accordingly. Analyses were performed within-subjects across time points and between-subjects, comparing those who maintained from weeks 6-12 an ACWR of 0.8-1.3 with those who did not. Adherence rates were similar between groups. Physical function improved in the total sample with large effect sizes (Δ6MWT = 56.5 m [95%CI: 6-100 m], effect size [w] = 0.52, p = 0.006; ΔSit-to-Stand = 1.5 [95%CI: 1-5], effect size [w] = 0.681, p < 0.001), demonstrating greater changes in patients with higher ACWR. Sleep quality improvements were higher in the appropriate ACWR group (p = 0.016). A positive correlation was demonstrated between global health status and 6MWT change from baseline to 12 weeks (ρ = 0.689, p = 0.04). Despite a small sample size, patients maintaining sufficient relative training load presented greater physical fitness and sleep quality improvements. Thus, training load monitoring may enhance exercise program benefits in breast cancer patients under active treatment.
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Affiliation(s)
- Apostolos Z. Skouras
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Antonakis-Karamintzas
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Charilaos Tsolakis
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Koulouvaris
- Sports Excellence, 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Sousa BLSC, Dos Santos Rosa T, Silvino VO, Barros EML, de Luca Corrêa H, do Prado DML, Veras-Silva AS, de Souza MD, de Lima CEB, de Oliveira LFL, Dos Santos MAP. Physical and autonomic functionality in women with breast cancer pre and post chemotherapy: a case control study. BMC Sports Sci Med Rehabil 2024; 16:5. [PMID: 38167062 PMCID: PMC10763182 DOI: 10.1186/s13102-023-00797-y] [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: 07/24/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Breast cancer (BC) is one of the most incident types of cancer among women in the world. Although chemotherapy is an effective way to treat several types of cancer, it may also cause serious complications, including cardiotoxicity. This study aimed to identify the impact of chemotherapy on functional capacity, muscle strength and autonomic function. METHODS Ten breast cancer patients in therapeutic follow-up (TG) and ten women without comorbidities (CG) participated in the study (46±8.87 years old). Both groups were evaluated at two time points, before and 20 weeks after the start of chemotherapy. Functional capacity and muscle strength were assessed by 6-minute walk test (6MWT) and handgrip test, respectively. Autonomic function was assessed by heart rate variability analysis. RESULTS TG presented greater reductions in the handgrip test for the non-dominant hand (TG ↓15.2%; CG: ↑1.1%, p<0.05) compared to GC. However, no significant differences were found regarding VO2max (p>0.05) and 6MWT total distance (p>0.05). Regarding the heart rate variability variables before and after follow-up period, rMSSD (CG= 39.15±37.66; TG= 14.89±8.28, p= 0.01) and SDNN (CG= 55.77±40.03; TG= 26.30±10.37, p= 0.02) showed effect in the group and time interaction, whereas the LF/HF ratio presented significant difference only in the time analysis (CG= 2.24±2.30; TG= 2.84±1.82, p= 0.04). CONCLUSION Chemotherapy used in the treatment of breast cancer patients resulted in decreased muscle strength and autonomic imbalance. The data suggests that chemotherapy may carry the risk of developing cardiovascular disease. TRIAL REGISTRATION Registration not required.
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Affiliation(s)
- Bruna Lorena Soares Cavalcante Sousa
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil.
- Rehabilitation Sciences Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
- University Federal of Minas Gerais (UFMG), 641 Ministro Pedro Borges Street, Tabuleta, Teresina, PI, 64019650, Brazil.
| | | | - Valmir Oliveira Silvino
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
- Rede Nordeste de Biotecnologia (RENORBIO), Federal University of Piaui, Teresina, PI, Brazil
| | - Esmeralda Maria Lustosa Barros
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
- Rede Nordeste de Biotecnologia (RENORBIO), Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Federal University of Piaui, Teresina, PI, Brazil
| | - Hugo de Luca Corrêa
- Department of Physical Education, Catholic University of Brasilia, Brasilia, DF, Brazil
| | | | | | - Mariana Duarte de Souza
- Rehabilitation Sciences Program, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carlos Eduardo Batista de Lima
- Clinical Research Center of the University Hospital, Federal University of Piaui, Empresa Brasileira de Serviços Hospitalares (EBSERH), Teresina, PI, Brazil
| | | | - Marcos Antonio Pereira Dos Santos
- Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
- Rede Nordeste de Biotecnologia (RENORBIO), Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Federal University of Piaui, Teresina, PI, Brazil
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Beebe-Dimmer JL, Finlay DG, Ruterbusch JJ, Baird T, Simon MS, Abrams J, Harper FW, Podgorski I, Heath EI. The impact of high intensity interval training in a diverse group of cancer survivors: CAPABLE, a pilot study. Prev Med Rep 2023; 35:102288. [PMID: 37449003 PMCID: PMC10336780 DOI: 10.1016/j.pmedr.2023.102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/15/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose Given the well-documented benefits of regular exercise to cancer survivors, current American Cancer Society guidelines recommend that patients engage in a minimum of 150 min per week of moderate-to-vigorous physical activity with a minimum of two days of strength training. However, few survivors meet this goal, particularly among minorities. Methods The CAPABLE study is a single-arm, pilot exercise intervention that introduced 48 cancer survivors to a high intensity interval and strength training program three days a week for 12 weeks. We evaluated the impact of this unique training method on bodyweight, % body fat, serum markers correlated with an adverse cardiometabolic profile and health-related quality of life (HRQoL). Measures were summarized at baseline and program exit. Paired t-tests were used to assess change in each of these measures over time. Results We observed losses in weight, body mass index, and % body fat, and glycosylated hemoglobin (HbA1c) levels over 12-weeks. There were also clinically meaningful improvements in reported overall HRQoL (FACTG total change +9.5 (95% CI, 4.6, 14.4)) and in each one of the individual domains (physical, social, emotional, and functional well-being). Conclusions We observed meaningful improvements in body composition, HbA1c and quality of life over 12 weeks among cancer survivors participating in a high-intensity interval training program. Future work will include a control arm for comparison and address barriers to participation and adherence which will be important in using this intervention and others like it to improve outcomes and reduce cancer health disparities.
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Affiliation(s)
- Jennifer L. Beebe-Dimmer
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - David G. Finlay
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Julie J. Ruterbusch
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Tara Baird
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Michael S. Simon
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Judith Abrams
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Felicity W.K. Harper
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Izabela Podgorski
- Wayne State University, School of Medicine Departments of Pathology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Elisabeth I. Heath
- Wayne State University, School of Medicine Departments of Oncology, Detroit, MI 48201, United States
- Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, United States
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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.
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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
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Petrigna L, Zanghì M, Maugeri G, D'Agata V, Musumeci G. Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review. Heliyon 2023; 9:e17470. [PMID: 37455988 PMCID: PMC10338308 DOI: 10.1016/j.heliyon.2023.e17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality. Results The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings. Conclusion It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Velia D'Agata
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Department of Biology, College of Science and Technology, Sbarro Health Research Organization, Temple University, Philadelphia, PA, 19122, USA
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Zhou J, Luo L, Xie L, Hu S, Tan L, Lei X, Luo X, Yang M. Sarcopenic obesity by the ESPEN/EASO criteria for predicting mortality in advanced non-small cell lung cancer. Clin Nutr 2023; 42:817-824. [PMID: 37084468 DOI: 10.1016/j.clnu.2023.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/04/2023] [Accepted: 04/09/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recently released the first international consensus on the diagnostic criteria for sarcopenic obesity (SO), which recommended skeletal muscle mass adjusted for body weight (SMM/W) to determine low muscle mass. SMM adjusted for body mass index (SMM/BMI) appeared to be better associated with physical performance than SMM/W. Thus, we modified the ESPEN/EASO criteria by using SMM/BMI. We aimed (1) to evaluate the agreement of the ESPEN/EASO-defined SO (SOESPEN) and the modified ESPEN/EASO-defined SO (SOESPEN-M) with other commonly used SO definitions, and (2) to compare different SO definitions for predicting mortality in a prospective cohort with advanced non-small cell lung cancer (NSCLC). METHODS This prospective study included patients with advanced NSCLC. We defined SO according to five different diagnostic criteria: SOESPEN, SOESPEN-M, Asian Working Group for Sarcopenia (AWGS)-determined sarcopenia with BMI-determined obesity (SOAWGS), computed tomography-derived sarcopenia with BMI-determined obesity (SOCT), and fat mass to fat-free mass ratio >0.8 (SOFM). The outcome was all-cause mortality. RESULTS Of the 639 participants (mean age 58.6 years, 229 women) we studied, 488 (76.4%) died during the median follow-up period of 25 months. SMM/BMI was significantly lower in the death group than in the survivor group (men: p = 0.001, women: p < 0.001), but SMM/W was not. Only 3 (0.47%) participants met all five SO diagnostic criteria. SOESPEN showed an excellent agreement with SOESPEN-M (Cohen's kappa = 0.896), a moderate agreement with SOAWGS (Cohen's kappa = 0.415), but poor agreements with SOCT and SOFM (Cohen's kappa = 0.078 and 0.092, respectively). After full adjustment for potential confounders, SOESPEN (HR 1.54, 95% CI 1.26-1.89), SOESPEN-M (HR 1.56, 95% CI 1.26-1.92), and SOAWGS (HR 1.43, 95% CI 1.14-1.78) were significantly associated with mortality. However, SOCT (HR 1.17, 95% CI 0.87-1.58) and SOFM (HR 1.15, 95% CI 0.90-1.46) showed no significant association with mortality. CONCLUSIONS SOESPEN showed an excellent agreement with SOESPEN-M, a moderate agreement with SOAWGS, but poor agreements with SOCT and SOFM. SOESPEN, SOESPEN-M, and SOAWGS were independent prognostic factors for mortality in our study population, but SOCT and SOFM were not. Although SMM/BMI was better associated with survival than SMM/W, SOESPEN-M did not show an advantage in predicting survival over SOESPEN.
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Affiliation(s)
- Jinqiu Zhou
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China
| | - Li Luo
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China
| | - Lingling Xie
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China; Department of Oncology, Shangjin Nanfu Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Song Hu
- Department of Radiology, Shangjin Nanfu Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lingling Tan
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China
| | - Xiaozhen Lei
- Department of Oncology, Shangjin Nanfu Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaozhen Luo
- Department of Oncology, Shangjin Nanfu Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Yang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China; Precision Medicine Research Center, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China; National Clinical Research Center for Geriatric Diseases at West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China.
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9
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"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.
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Caperchione CM, Sharp P, Phillips JL, Agar M, Liauw W, Harris CA, Marin E, McCullough S, Lilian R. Bridging the gap between attitudes and action: A qualitative exploration of clinician and exercise professional's perceptions to increase opportunities for exercise counselling and referral in cancer care. PATIENT EDUCATION AND COUNSELING 2022; 105:2489-2496. [PMID: 34823926 DOI: 10.1016/j.pec.2021.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 11/02/2021] [Accepted: 11/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to 1) understand factors impacting the implementation of exercise communication and referral, and 2) explore integrated clinical approaches to exercise communication and referral in cancer care. METHODS Seven focus groups (N = 53) were conducted with clinicians and exercise professionals throughout Sydney, Australia. A sub-sample of participants (n = 9) attended a half-day workshop to identifying best practice approaches for moving forward. Data were analysed using thematic content analysis. RESULTS Two themes emerged: 1) Factors impacting the knowledge-to-action gap, inclusive of limited exercise specific knowledge and training opportunities, funding structure, and current referral process, and 2) Recommendations for a consistent and efficient way forward, detailing the need for oncologist-initiated communication, distribution of cancer-exercise resources, and access to exercise professionals with cancer expertise. CONCLUSIONS This study identified factors (e.g., cancer-exercise specific training, integration of exercise physiologists) influencing exercise counselling and referral. A potential implementation-referral approach accounting for these factors and how to incorporate exercise into a standard model of cancer care, is described. Future testing is required to determine feasibility and practicality of these approaches. PRACTICAL IMPLICATIONS A pragmatic model is provided to guide implementation-referral, inclusive of oncologist-initiated communication exchange, relevant resources, and access to exercise professionals with cancer expertise.
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Affiliation(s)
- Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia.
| | - Paul Sharp
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
| | - Jane L Phillips
- IMPACCT, University of Technology Sydney, Sydney, NSW, Australia; Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Meera Agar
- IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Winston Liauw
- Cancer Care Centre, St George Hospital, Sydney, NSW, Australia; St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Translational Cancer Research Network Sydney, Australia
| | - Carole A Harris
- Cancer Care Centre, St George Hospital, Sydney, NSW, Australia; St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Translational Cancer Research Network Sydney, Australia
| | - Elizabeth Marin
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Ruth Lilian
- Translational Cancer Research Network Sydney, Australia
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Recreational physical activity reduces breast cancer recurrence in female survivors of breast cancer: A meta-analysis. Eur J Oncol Nurs 2022; 59:102162. [PMID: 35716452 DOI: 10.1016/j.ejon.2022.102162] [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: 02/17/2022] [Revised: 04/30/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this review was to systematically collect the published evidence to assess the effect of recreational physical activity (PA) in reducing breast cancer (BC) recurrence in female survivors. METHODS A bibliographic search was carried out in PubMed Medline, CINAHL Complete, Scopus and Lilacs until June 2021. We selected observational studies or clinical trials comprising women diagnosed with BC, in which the risk of recurrence of BC was measured before or after performing recreational PA. As a secondary outcome, we analyzed disease free survival for recurrence/disease-specific mortality. The methodological quality of observational studies was assessed with the Newcastle-Ottawa Scale and clinical trials with the PEDro scale. A random effects model was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) to infer the results for any female survivor of BC. We performed separate meta-analyses for prediagnosis and postdiagnosis recreational PA. RESULTS Eleven studies were included, providing data from 29,677 surviving women with BC with an age range of 18-79 years old. Postdiagnosis recreational PA reduced the risk of BC recurrence by 16% (RR, 0.84; 95% CI: 0.78 to 0.91) and the risk of recurrence/disease-specific mortality by 23% (RR, 0.77; 95% CI: 0.66 to 0.93). Prediagnosis PA reduced the risk of BC by 18% (RR, 0.82; 95% CI: 0.74 to 0.91). CONCLUSION This systematic review with meta-analysis shows that recreational PA can be an interesting therapeutic tool to protect against recurrence of BC in female survivors.
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Hiraoui M, Gmada N, Al-Hadabi B, Mezlini A, Al Busafi M, Doutrellot PL, Bouhlel E, Ahmaidi S. Effects of multimodal training program on muscle deoxygenation in women with breast cancer: A randomized controlled trial. Physiol Int 2022; 109:246-260. [DOI: 10.1556/2060.2022.00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/19/2022] [Accepted: 03/04/2022] [Indexed: 11/19/2022]
Abstract
Abstract
Purpose
Chemotherapy and/or radiation are the most often delivered treatments to cancer patients. Usually during the adjuvant treatment, patients complain about fatigue. In addition, physical exercise during adjuvant treatment of cancer seems to have beneficial effects. The aim of this investigation was to assess the effects of multimodal aerobic and strength exercises programs on muscle deoxygenation of patients with breast cancer undergoing adjuvant chemotherapy treatment.
Methods
Thirty-two women with breast cancer (20 patients as the training group and 12 patients as the control group) undergoing adjuvant chemotherapy participated in the study. The training group took part in 6 weeks of supervised intermittent aerobic cycling, home-based walking, isometric and electrical muscle stimulation (EMS) exercise training programs. The Outcome measures were muscle deoxygenation (ΔHHb), Maximal Voluntary isometric Contraction (MViC) and Endurance Time (ET) before and after the training period.
Results
Compared to the control group, a significant increase in ΔHHb (P < 0.01) accompanied with an increase in ET (P < 0.01) and MViC (P < 0.01) of the quadriceps was obtained in the training group. However, no significant differences of MViC, ET and ΔHHb were observed in the control group.
Conclusion
Multimodal aerobic and strength exercise programs enhance muscle oxygen utilization, which may partly explain the improvement in muscular strength and endurance, and the reduction of muscle fatigue in patients with breast cancer during an adjuvant chemotherapy period.
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Affiliation(s)
- Mouadh Hiraoui
- EA-3300: APERE, Exercise Physiology and Rehabilitation Laboratory, Sport Sciences Department, Picardie Jules Verne University, Amiens Cedex, France
- Medical Oncology Department, Salah Azaiez Oncologic Hospital, Tunis, Tunisia
- Bizerte Sciences Faculty, Carthage University, Bizerte, Tunisia
| | - Nabil Gmada
- Physical Education and Sport Sciences Department, College of Education, Sultan Qaboos University, Muscat, Sultanate of Oman
- Research Unit, “Sportive Performance and Physical Rehabilitation,” High Institute of Sports and Physical Education, Kef, University of Jendouba, Jendouba, Tunisia
| | - Badria Al-Hadabi
- Physical Education and Sport Sciences Department, College of Education, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Amel Mezlini
- Medical Oncology Department, Salah Azaiez Oncologic Hospital, Tunis, Tunisia
| | - Majid Al Busafi
- Physical Education and Sport Sciences Department, College of Education, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Pierre Louis Doutrellot
- EA-3300: APERE, Exercise Physiology and Rehabilitation Laboratory, Sport Sciences Department, Picardie Jules Verne University, Amiens Cedex, France
| | - Ezdine Bouhlel
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Said Ahmaidi
- EA-3300: APERE, Exercise Physiology and Rehabilitation Laboratory, Sport Sciences Department, Picardie Jules Verne University, Amiens Cedex, France
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