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Lavín-Pérez AM, Collado-Mateo D, Hinojo González C, Batista M, Mayo X, Ruisánchez Villar C, Jiménez A. An online home-based exercise program improves autonomic dysfunction in breast cancer survivors. Front Physiol 2023; 14:1256644. [PMID: 37841312 PMCID: PMC10570414 DOI: 10.3389/fphys.2023.1256644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction: Exercise interventions for breast cancer survivors have proved their potential to improve clinical, physical, and psychosocial outcomes. However, limited studies have explored exercise effects on autonomic dysfunction and the measurement of exercise tolerance and progression through daily heart rate variability (HRV). Purpose: To analyze the effects of a 16-wk exercise intervention on the autonomic modulation of breast cancer survivors, as well as to examine the evolution of daily measured HRV and its interaction with exercise sessions in this population. Methods: A total of 29 patients who had undergone chemotherapy and radiotherapy were randomly assigned to the exercise group or to the control group. The exercise intervention was delivered remotely through online meetings and consisted of supervised training resistance and cardiovascular exercise 3 times per week. During the intervention all patients measured their HRV daily obtaining the napierian logarithm of the root mean square of successive differences between normal heartbeats (lnrMSSD) and the napierian logarithm of the standard deviation of the interbeat interval of normal sinus beats (lnSDNN) values at four moments: day 0 (the morning of the training sessions), 24, 48, and 72 h after exercise. Results: The results revealed a significant interaction between group and months during the intervention period for lnrMSSD and lnSDNN (p < 0.001). Additionally, there were significant differences in lnSDNN recovery time between months (p < 0.05), while differences in lnrMSSD become apparent only 24 h after exercise (p = 0.019). The control group experienced a significant decrease in both variables monthly (p < 0.05) while exercise group experienced a significant increment (p < 0.05). Conclusion: HRV is daily affected by exercise training sessions in cancer patients. Although results strongly support the role of exercise as a post-chemotherapy and radiotherapy rehabilitation strategy for breast cancer survivors to improve autonomic imbalance, further research is necessary to validate these initial findings.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain
- GO Fit LAB, GO Fit Life, Science and Technology, S.A., Madrid, Spain
- Program of Epidemiology and Public Health (Interuniversity), Ph.D. International School of Rey Juan Carlos University, Madrid, Spain
| | | | | | - Marco Batista
- Sport, Health, and Exercise Research Unit (SHERU), Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Xián Mayo
- Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain
| | | | - Alfonso Jiménez
- Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain
- GO Fit LAB, GO Fit Life, Science and Technology, S.A., Madrid, Spain
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
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Lavín-Pérez AM, Collado-Mateo D, Hinojo González C, de Juan Ferré A, Ruisánchez Villar C, Mayo X, Jiménez A. Exploring autonomic modulation: day-to-day recovery after exercise sessions in breast cancer survivors. Front Oncol 2023; 13:1231683. [PMID: 37614512 PMCID: PMC10442838 DOI: 10.3389/fonc.2023.1231683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 08/25/2023] Open
Abstract
Purpose The current study aimed to analyze the changes in heart rate variability (HRV) 24h, 48h and 72h after exercise sessions in breast cancer survivors. Methods Sixteen survivors who had undergone chemotherapy and radiotherapy were included. Participants trained resistance and cardiovascular components 3 times per week. The intervention was supervised and delivered online for 4 weeks. In this period, patients measured their HRV daily obtaining the lnrMSSD and lnSDNN values of: day 0 (the morning of the training sessions), 24h, 48h and 72h after exercise. Results Significant changes in lnrMSSD (p=0.015) and lnSDNN (p=0.031) during recovery times and lnSDNN during the weeks were found (p=0.015). The most prominent differences were identified between the baseline measurement taken on day 0 and 24h after exercise (p=0.007 and p=0.048, respectively) and between measurements obtained 24h and 48h after the training session (p=0.019 and p=0.026, respectively). Conclusion Our study suggests that patients may decrease their lnrMSSD and lnSDNN values 24h after exercise and they were close to recover 48h after the sessions. In this regard, HRV may be an useful tool to monitor their recovery and exercise tolerance.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain
- GO Fit LAB, GO Fit Life, Science and Technology, S.A., Madrid, Spain
- Program of Epidemiology and Public Health (Interuniversity), Ph.D. International School Rey Juan Carlos University, Madrid, Spain
| | | | - Carmen Hinojo González
- Oncology Department, Hospital Universitario Marques de Valdecilla, Santander, Spain
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Ana de Juan Ferré
- Oncology Department, Hospital Universitario Marques de Valdecilla, Santander, Spain
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Cristina Ruisánchez Villar
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
- Cardiology Department, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Xián Mayo
- Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain
| | - Alfonso Jiménez
- Sport Sciences Research Centre, Rey Juan Carlos University, Madrid, Spain
- GO Fit LAB, GO Fit Life, Science and Technology, S.A., Madrid, Spain
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
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Lavín-Pérez AM, Collado-Mateo D, Hinojo González C, de Juan Ferré A, Ruisánchez Villar C, Mayo X, Jiménez A. High-intensity exercise prescription guided by heart rate variability in breast cancer patients: a study protocol for a randomized controlled trial. BMC Sports Sci Med Rehabil 2023; 15:28. [PMID: 36890601 PMCID: PMC9993392 DOI: 10.1186/s13102-023-00634-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 02/16/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Breast cancer is a chronic disease with a large growth in its treatments, prognosis, improvements, side effects and rehabilitation therapies research. These advances have also highlighted the need to use physical exercise as a countermeasure to reduce the cardiotoxicity of pharmacological treatments, increase patients' strength and quality of life and improve body composition, physical condition and mental health. However, new investigations show the need for a closed exercise individualisation to produce higher physiological, physical and psychological benefits in remote exercise programs. To this end, the present study will use, in a novel way in this population, heart rate variability (HRV) as a measure for prescribing high-intensity training. Thus, the primary objective of this randomised clinical trial is to analyse the effects of a high-intensity exercise program daily guided by HRV, a preplanned moderate to high-intensity exercise intervention and a usual care group, in breast cancer patients after chemotherapy and radiotherapy treatments. METHODS For this purpose, a 16-week intervention will be carried out with 90 breast cancer patients distributed in 3 groups (a control group, a moderate to high-intensity preplanned exercise group and a high-intensity exercise group guided by HRV). Both physical exercise interventions will be developed remotely and supervised including strength and cardiovascular exercises. Physiological variables, such as cardiotoxicity, biomarkers, lipid profile, glucose, heart rate and blood pressure; physical measures like cardiorespiratory capacity, strength, flexibility, agility, balance and body composition; and psychosocial variables, as health-related quality of life, fatigue, functionality, self-esteem, movement fear, physical exercise level, anxiety and depression will be measure before, after the intervention and 3 and 6 months follow up. DISCUSSION Personalized high-intensity exercise could be a promising exercise intervention in contrast to moderate-intensity or usual care in breast cancer patients to reach higher clinical, physical and mental effects. In addition, the novelty of controlling HRV measures daily may reflect exercise effects and patients' adaptation in the preplanned exercise group and a new opportunity to adjust intensity. Moreover, findings may support the effectiveness and security of physical exercise remotely supervised, although with high-intensity exercise, to reach cardiotoxicity improvements and increase physical and psychosocial variables after breast cancer treatments. Trial registration ClinicalTrials.gov nº NCT05040867 ( https://clinicaltrials.gov/ct2/show/record/NCT05040867 ).
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, Spain.,GO fitLAB, Ingesport, Madrid, Spain.,Program of Epidemiology and Public Health (Interuniversity), PhD International School of the Rey Juan Carlos University, Madrid, Spain
| | | | - Carmen Hinojo González
- Onchology Department, Hospital Universitario Marqués de Valdecilla and Instituto de Investigación Marqués de Valdecilla (IDIVAL)., Santander, Spain
| | - Ana de Juan Ferré
- Onchology Department, Hospital Universitario Marqués de Valdecilla and Instituto de Investigación Marqués de Valdecilla (IDIVAL)., Santander, Spain
| | - Cristina Ruisánchez Villar
- Cardiology Department, Hospital Universitario Marqués de Valdecilla and Instituto de Investigación Marqués de Valdecilla (IDIVAL)., Santander, Spain
| | - Xián Mayo
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, Spain
| | - Alfonso Jiménez
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, Spain.,GO fitLAB, Ingesport, Madrid, Spain.,Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
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Santaballa A, Pinto Á, Balanyà RP, Ramírez Merino N, Martín IR, Grau SS, Fombella JPB, Cano JM, González CH, Bayo J. SEOM clinical guideline for secondary prevention (2019). Clin Transl Oncol 2020; 22:187-192. [PMID: 32006339 DOI: 10.1007/s12094-020-02302-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 12/19/2022]
Abstract
Cancer is one of the major public health problems in our society. It is estimated that more than 18 million new cases are diagnosed worldwide every year; 280,000 in Spain. Incidence in following a growing trend. This epidemic could be controlled with research into new treatments and, above all, with adequate prevention. Primary prevention could prevent avoid up to half of all cases. For many others, secondary prevention is essential, as it make diagnosis possible in the stages of the disease when it is easily curable. These guidelines present the scientific evidence regarding secondary prevention in tumors in which its use is well-accepted: breast, cervical, colorectal, prostate, lung, ovarian, melanoma, and gastric cancer.
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Affiliation(s)
- A Santaballa
- Medical Oncology Department, Hospital Universitari I Politècnic la Fe, Valencia, Avda. de Fernando Abril Martorell, 106, 46026, Valencia, Spain.
| | - Á Pinto
- Medical Oncology Department, Hospital Universitario la Paz, Madrid, Spain
| | - R P Balanyà
- Medical Oncology Department, Hospital Universitari Dr. Josep Trueta, ICO Girona, Girona, Spain
| | - N Ramírez Merino
- Medical Oncology Department, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | - I R Martín
- Medical Oncology Department, Hospital Rio Carrión, Palencia, Spain
| | - S S Grau
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - J P B Fombella
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J M Cano
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - C H González
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - J Bayo
- Medical Oncology Department, Hospital Juan Ramón Jiménez, Huelva, Spain
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Brunner E, Gargoloff P, Caro O, González C, Landa E, González CH, Barahona A, Soria D, Tamayo J, Rovner J, Adrianzen C, Silva H, Hodge A, O'Halloran R, Assunção SSM. [The intercontinental schizophrenia outpatient health outcomes study (IC-SOHO): initial 6 month findings of the sample in Latin America]. Actas Esp Psiquiatr 2006; 34:16-27. [PMID: 16525901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The IC-SOHO study was designed to supply information on antipsychotic treatments in the real clinical practice by assessment of a large and diverse sample population with schizophrenia. This document describes the findings of the first 6 months of IC-SOHO in Latin America. To date, this is the largest observational study of its type in this region. In this observational and prospective study, those out-patients with schizophrenia, who require a change or initiation of antipsychotic medication are hospitalized. Effectiveness was evaluated using the Clinical Global Impression-Seriousness (CGI-S) grading scale. Tolerability was assessed by questionnaires on adverse events and weight measurements. Herein, the comparisons between olanzapine (monotherapy), risperidone (monotherapy) and conventional antipsychotics (monotherapy and combined therapy) are presented. As a whole, 7,658 patients participated in the ICSOHO; n=2,671 from 11 countries of Latin America that were included in this report. At 6 months, the proportion of patients who responded to olanzapine was significantly greater than those who responded to risperidone or conventional antipsychotics (p<0.001). Patients from the olanzapine group had greater improvements in all the symptom domains, including general, positive, negative, depressive and cognitive symptoms in comparison with risperidone (p<0.05) or conventional antipsychotics (p < 0.001). Extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) decreased from baseline in the groups treated with olanzapine and risperidone, but increased in the conventional group. The adverse events related with the sexual function were more prominent in the conventional group. Weight gain was observed in each treatment group, although the patients from the olanzapine group had greater weight grain followed by those of risperidone and then by those of conventional antipsychotics. Our findings in this population of the Latin American sample emulate the results of other studies in different samples, where it was found that olanzapine was more effective and better tolerated than risperidone or conventional antipsychotics.
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Abstract
We present a sibship of three brothers affected with the GAPO syndrome. This is a rare and very characteristic autosomal-recessive trait whose main manifestations are growth retardation, alopecia, pseudo anodontia, and optic atrophy. So far nine affected individuals are known (4 males and 5 females). Two of them, the patient of Andersen and Pindborg cited in Tipton and Gorlin [1983] and one of the cases of Wajntal et al [1982], died at 39 and 37 years respectively.
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