Physical Activity and Palliative Cancer Care

Abstract Purpose: This study aimed to document the successes and challenges of teleprehabilitation programs for cancer patients undergoing surgery.Method: This pilot-cohort study included adults scheduled for elective cancer surgery, referred to the prehabilitation clinic to engage in physical activity and received a teleprehabilitation program between August 1st 2020 and February 28th 2021. Using a technology platform that included a tablet and was wearable, data were acquired through virtual physical activity monitoring in addition to patient charts.Results: Ten patients (8 males and 2 females; mean age: 68.3 years, SD: 11.96) diagnosed with various thoraco-abdominal malignancies were included in the current descriptive study. The successes identified were related to recruitment and assessment, improvement in functional capacity, clinic scheduling and interventions, and optimal medical follow-up. The challenges identified were related to the adoption of the technologies by patients and the multidisciplinary team, the accurate acquisition of patient physical activity data, and the initial costs to acquire the new technologies. Patients were satisfied with the teleprehabilitation program (i.e., services delivered; average appreciation: 96%), and they perceived the technologies provided to be 90% user-friendly.Conclusion: The findings of the current study are paramount in view of the current international health paradigm changes prioritizing remote interventions facilitated through digital communication technologies. It provides important insight into the clinical application of telehealth in elderly populations, notably in the context of acute preoperative cancer care. This article may provide guidance for other cancer care facilities aiming to implement teleprehabilitation programs.

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Cancer specialist nurses’ perspectives of physical activity promotion and the potential role of physical activity apps in cancer care

Journal of Cancer Survivorship ◽

10.1007/s11764-019-00801-w ◽

2019 ◽

Vol 13 (5) ◽

pp. 815-828

Author(s):

Anna L. Roberts ◽

Henry W. W. Potts ◽

Claire Stevens ◽

Phillippa Lally ◽

Lee Smith ◽

...

Keyword(s):

Physical Activity ◽

Cancer Care ◽

Potential Role ◽

Physical Activity Promotion ◽

Activity Promotion ◽

Specialist Nurses ◽

Cancer Specialist

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Mindfulness-Based Movement: A Polyvagal Perspective

Integrative Cancer Therapies ◽

10.1177/1534735416682087 ◽

2016 ◽

Vol 17 (1) ◽

pp. 5-15 ◽

Cited By ~ 4

Author(s):

Alexander R. Lucas ◽

Heidi D. Klepin ◽

Stephen W. Porges ◽

W. Jack Rejeski

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Cancer Care ◽

Vigorous Physical Activity ◽

Compelling Evidence ◽

Polyvagal Theory ◽

Cancer Treatments ◽

Considerable Evidence ◽

And Control ◽

Active Cancer

Compelling evidence suggests that physical activity is an effective intervention for cancer survivors, including for those undergoing active cancer treatments. However, to date most evidence has emerged from interventions that have promoted moderate to vigorous physical activity. In this conceptual review, we argue that attention should be given to the entire continuum of physical activity from reducing sedentary behavior to increasing higher levels of physical activity when possible. In addition, considerable evidence in the cancer literature supports the value of mindfulness-based interventions as a means of helping patients and survivors cope with the variety of threats that accompany this disease. Based on the success of these two areas of research, we argue for conceptualizing and promoting physical activity as Mindfulness-Based Movement, using Polyvagal Theory as a theoretical framework to understand the role and value of Mindfulness-Based Movement as a potential intervention for cancer care and control.

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A three-year national follow-up study on the development of community-level cancer rehabilitation in Denmark

Scandinavian Journal of Public Health ◽

10.1177/1403494817746535 ◽

2017 ◽

Vol 47 (5) ◽

pp. 511-518 ◽

Cited By ~ 7

Author(s):

Maria Kristiansen ◽

Lis Adamsen ◽

Karin Piil ◽

Ida Halvorsen ◽

Nanna Nyholm ◽

...

Keyword(s):

Physical Activity ◽

Cancer Care ◽

Cancer Rehabilitation ◽

Community Level ◽

Assessment Tools ◽

Dietary Advice ◽

Follow Up Study ◽

Number Of Patients ◽

And Gender

Aims: Scandinavian cancer care policies emphasise community-level rehabilitation services, but little is known about changes in service provision over time. This follow-up study explores development in these services in Danish municipalities, focusing on availability, utilisation and organisation of services, including existing opportunities and challenges. Methods: A national survey among all 98 Danish municipalities was conducted in 2013 (baseline) and repeated in 2016 (follow-up). The electronic questionnaire comprised closed- and open-ended questions. Data were analysed using descriptive statistics and content analysis. Results: A total of 93 municipalities responded (95% response rate) and the services offered primarily comprised group physical activity, dietary advice, smoking cessation and individual counselling on physical activity. The number of patients enrolled was below the estimated number needing rehabilitation in Denmark. Inequality in utilisation by ethnicity, age and gender was reported. Key challenges for the delivery of services were: inadequate referral and recruitment procedures; lack of needs assessment tools; obstacles to ensuring collaboration and referral of patients between hospitals and municipalities; and inadequate evidence on the rehabilitation’s effect. Key recommendations include ensuring collaboration between municipalities; provision of diagnosis-specific group-based activities; services focusing on physical activity; and gender-specific activities directed particularly at men. Conclusions: This study, which highlights improvements in the provision of community-level cancer rehabilitation, recommends that more effort be made to ensure equality in utilisation across patient groups, improved integration of municipal-level services into cancer care trajectories, more uniform documentation of service delivery and the enforcement of patient outcomes to gradually build a more robust evidence base for community-level cancer rehabilitation.

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Implementing exercise in standard cancer care: Bizi Orain hybrid, clinical and implementation randomized trial study protocol to evaluate the effectiveness of a community-based exercise programme for people living with cancer (Preprint)

10.2196/preprints.24835 ◽

2020 ◽

Author(s):

Maria Soledad Arietaleanizbeaskoa ◽

Erreka Gil Rey ◽

Nere Mendizabal Gallastegui ◽

Arturo García Álvarez ◽

Ibon De La Fuente ◽

...

Keyword(s):

Physical Activity ◽

Overall Survival ◽

Side Effects ◽

Physical Function ◽

Cancer Patients ◽

Cancer Care ◽

Exercise Programme ◽

Programme Evaluation ◽

Activity Level ◽

Community Based

BACKGROUND Despite the established benefits of regular exercise for cancer patients to counteract the deleterious effects of the disease itself, and treatment-related side-effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programmes that are accessible and generalizable to a large proportion of cancer patients into routine cancer care. This paper describes the implementation of Bizi Orain, a community-based exercise programme for people with cancer, and the protocol for the programme evaluation. OBJECTIVE To describe the implementation of a community-based exercise programme for cancer patients (“Bizi Orain”) and the protocol for programme evaluation. METHODS This will be a hybrid study, with a first experimental phase in which patients diagnosed with any type of cancer will be randomized to two parallel groups, one that immediately performs Bizi Orain, a 3-month supervised exercise programme (3 times a week) in addition to behavioural counselling in a primary healthcare setting, and the other, a reference group that starts the exercise programme 3 months later (delayed treatment). In a second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the programme. Evaluation of the programme involves uptake, safety, adherence and effectiveness assessed on the completion of the programme and at 3, 6, 12, 24, 36, 48 and 60 months of follow-ups. The primary outcomes of the experimental study, to be compared between groups, are physical function and patient-reported outcomes, whereas overall survival is the main endpoint of the prospective study. To analyse the association between changes in physical activity level and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures. RESULTS It is a protocol, so there are no results CONCLUSIONS Bizi Orain is the first population-based exercise programme in Spain that will offer more insight into the implementation of feasible, generalizable and sustainable supportive care services involving structured exercise to extend cancer patients’ survival, improve their physical function and quality of life, and reverse the side-effects of their disease and related treatments, thereby reducing the clinical burden. CLINICALTRIAL Clinical Trials.gov Identifier: NCT03819595. Date of registration: 18/01/2019

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Integrating Physical Activity Into Clinical Cancer Care

American Journal of Lifestyle Medicine ◽

10.1177/1559827618759478 ◽

2018 ◽

Vol 12 (3) ◽

pp. 220-223

Author(s):

Nathan H. Parker ◽

Katherine R. Arlinghaus ◽

Craig A. Johnston

Keyword(s):

Physical Activity ◽

Cancer Survivors ◽

Goal Setting ◽

Cancer Care ◽

Exercise Prescription ◽

Well Being ◽

Physical Activity Guidelines ◽

Important Target ◽

Health And Well Being

Physical activity is an important target for improving health and well-being among cancer survivors. Cancer clinicians are uniquely positioned to promote physical activity among survivors through follow-up visits for treatment planning and surveillance. Providers should prioritize assessment of guideline-concordant physical activity and facilitate achievement of physical activity guidelines through exercise prescription, goal setting, addressing barriers, and capitalizing on support systems.

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Self-Management of Cancer

Promoting Self-Management of Chronic Health Conditions ◽

10.1093/med-psych/9780190606145.003.0010 ◽

2017 ◽

pp. 225-261

Author(s):

Amy Deckert ◽

Gerald M. Devins

Keyword(s):

Physical Activity ◽

Smoking Cessation ◽

Health Behavior ◽

Cancer Care ◽

Essential Elements ◽

The Self ◽

Self Management ◽

Future Research ◽

Management Skills ◽

Treatment Benefits

Cancer self-management aims to minimize the physical and psychosocial suffering that people can experience due to cancer and its treatment. The self-management of cancer is important in light of changes to the cancer-care system that rely on the affected person to administer and follow treatments (e.g., chemotherapy) and to initiate changes to lifestyle (e.g., physical activity) or health behavior (e.g., smoking cessation) to maximize treatment benefits and prevent complications or recurrence. This chapter highlights distinctions between chronic medical conditions and cancer. It describes the essential elements of self-management programs and the application of self-management skills to the problems introduced by cancer. It reviews and critiques the cancer self-management literature in relation to four categories of self-management targets and offers suggestions for future research.

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