scholarly journals Advanced Exercise Prescription for Cancer Patients and its Application in Germany

2020 ◽  
Vol 2 (3) ◽  
pp. 201-214
Author(s):  
Moritz Schumann ◽  
Nils Freitag ◽  
Wilhelm Bloch
Keyword(s):  
Exercise Training ◽  
Cancer Patients ◽  
Sports Medicine ◽  
Exercise Prescription ◽  
Cancer Disease ◽  
Beneficial Effects ◽  
Sports Science ◽  
Exercise Medicine ◽  
Individualized Approach ◽  
Exercise Induced

Abstract The scientific interest of exercise medicine for the treatment of cancer is ever expanding. Recently published and updated guidelines for exercise training in cancer patients by the American College of Sports Medicine (ACSM), the Clinical Oncology Society of Australia (COSA) or the Exercise and Sports Science Australia (ESSA) are leading the way towards an individualized approach for exercise prescription. These guidelines provide physicians and therapists with a comprehensive and detailed overview about the beneficial effects of exercise training and, more so, summarize the evidence on potential dose–response mechanisms, including pathways of exercise-induced stimuli to counteract tumour microenvironmental pathologies. However, the most optimal types and doses of exercise training across the cancer disease and treatment continuum are yet to be determined. Therefore, the purpose of this narrative review was to illustrate the current implications but also limitations of exercise training during the different stages of cancer therapy, as well as to discuss necessary future directions. As a second purpose, special attention will be given to the current role of exercise in the treatment of cancer in Germany.

scholarly journals Targeted Exercise Training for Cancer Patients: Moving beyond Generic Exercise Guidelines in Clinical Oncology

2021 ◽  
pp. 43-52
Author(s):  
Ciaran M Fairman ◽  
Jesper F Christensen
Keyword(s):  
Physical Activity ◽  
South Carolina ◽  
Exercise Training ◽  
Cancer Patients ◽  
Clinical Oncology ◽  
Exercise Prescription ◽  
Exercise Interventions ◽  
Sports Science ◽  
Exercise Guidelines ◽  
Exercise Oncology

Targeted Exercise Training for Cancer Patients: Moving beyond Generic Exercise Guidelines in Clinical Oncology Ciaran M Fairman1 and Jesper F Christensen()2,3  1Department of Exercise Science, University of South Carolina, USA 2Center for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark 3Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Denmark © The Authors   Abstract The field of exercise oncology has rapidly evolved over the past 30 years. Initial investigations of safety and feasibility have progressed towards efficacy and effectiveness trials with a variety of health-related outcomes in mind. More recently, it has been recognized that interventions aimed at modifying physical activity behavior (i.e. behavioral interventions to increase participation in un/structured physical activity) are distinctly different from those aiming to target a clinically relevant outcome (using a specific exercise prescription). There is a strong rationale for the latter, where cancer/treatment toxicities can result in musculoskeletal, cardiopulmonary, and/or hematological declines with important prognostic implications. Treatment intolerance, unfavorable tumor response and heightened risk of mortality are all consequences of leaving these impairments unaddressed. Importantly, the control/reversal of the decline in these systems is more likely to occur through a targeted exercise prescription, specifically designed to target the impairment, rather than interventions trying to change behavior. This requires careful consideration in the study design in exercise oncology in relation to the selection of clinically relevant outcomes, decisions on methods of assessments and ensuring the exercise is targeted to the outcome.     The objective of this review is to 1) conceptualize and provide a clinical rationale for targeted exercise interventions in exercise oncology, and 2) provide a framework for consideration in the design and execution in targeted exercise interventions in oncology. We hope that this framework can encourage research into targeted exercise interventions in oncology and that our framework can be used to inform the design of future trials.

scholarly journals The benefits of exercise in cancer patients and the criteria for exercise prescription in cardio-oncology

2019 ◽  
pp. 204748731987490 ◽  
Author(s):  
Flavio D’Ascenzi ◽  
Francesca Anselmi ◽  
Caterina Fiorentini ◽  
Roberta Mannucci ◽  
Marco Bonifazi ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Cancer Patients ◽  
Exercise Prescription ◽  
Cardiovascular Complications ◽  
Individual Characteristics ◽  
Negative Effects ◽  
Cardiac Damage ◽  
Beneficial Effects ◽  
Tailored Approach ◽  
Response To Exercise

Cancer and cardiovascular diseases are the leading causes of death in high-income countries. Cardiovascular complications can be found in cancer patients, being the result of so-called ‘cardio-toxicity’. Therefore, it becomes essential to thoroughly investigate the origin of cardiac damage and the strategy to prevent it or to reverse the negative remodelling associated with cardiotoxicity. In this review the beneficial effects of physical exercise in cancer patients were analysed, particularly to prevent cardio-toxicity before its clinical manifestation. According to the relevance of exercise, we suggest strategies for exercise prescription with a tailored approach in these patients. In conclusion, physical exercise seems to be a promising and effective treatment for cancer patients during and after therapy and seems to counteract the negative effects induced by drugs on the cardiovascular system. Exercise prescription should be tailored according to patient’s individual characteristics, to the drugs administered, to the personal history, and to his/her response to exercise, taking into account that different types of training can be prescribed according also to the patient’s choice. A cardiological evaluation including exercise testing is essential for an appropriate prescription of exercise in these patients.

Detrimental effect of combined exercise training and eNOS overexpression on cardiac function after myocardial infarction

2009 ◽  
Vol 296 (5) ◽  
pp. H1513-H1523 ◽  
Author(s):  
Monique C. de Waard ◽  
Jolanda van der Velden ◽  
Nicky M. Boontje ◽  
Dick H. W. Dekkers ◽  
Rien van Haperen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Exercise Training ◽  
Left Ventricular ◽  
Lv Function ◽  
Enos Expression ◽  
Beneficial Effects ◽  
Protein Levels ◽  
Enos Uncoupling ◽  
Lv Remodeling ◽  
Exercise Induced

It has been reported that exercise after myocardial infarction (MI) attenuates left ventricular (LV) pump dysfunction by normalization of myofilament function. This benefit could be due to an exercise-induced upregulation of endothelial nitric oxide synthase (eNOS) expression and activity. Consequently, we first tested the hypothesis that the effects of exercise after MI can be mimicked by elevated eNOS expression using transgenic mice with overexpression of human eNOS (eNOSTg). Both exercise and eNOSTg attenuated LV remodeling and dysfunction after MI in mice and improved cardiomyocyte maximal force development (Fmax). However, only exercise training restored myofilament Ca2+-sensitivity and sarco(endo)plasmic reticulum Ca2+-ATPase (SERCA)2a protein levels and improved the first derivative of LV pressure at 30 mmHg. Conversely, only eNOSTg improved survival. In view of these partly complementary actions, we subsequently tested the hypothesis that combining exercise and eNOSTg would provide additional protection against LV remodeling and dysfunction after MI. Unexpectedly, the combination of exercise and eNOSTg abolished the beneficial effects on LV remodeling and dysfunction of either treatment alone. The latter was likely due to perturbations in Ca2+ homeostasis, as myofilament Fmax actually increased despite marked reductions in the phosphorylation status of several myofilament proteins, whereas the exercise-induced increases in SERCA2a protein levels were lost in eNOSTg mice. Antioxidant treatment with N-acetylcysteine or supplementation of tetrahydrobiopterin and l-arginine prevented these detrimental effects on LV function while partly restoring the phosphorylation status of myofilament proteins and further enhancing myofilament Fmax. In conclusion, the combination of exercise and elevated eNOS expression abolished the cardioprotective effects of either treatment alone after MI, which appeared to be, at least in part, the result of increased oxidative stress secondary to eNOS “uncoupling.”

Abstract 13469: Novel Role of Extracellular SOD-derived H 2 O 2 Signaling in Exercise-induced Vascular Adaptation in Type 2 Diabetes

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sudhahar Varadarajan ◽  
Kareem Abdelsaid ◽  
Malgorzata McMenamin ◽  
Xuexiu Fang ◽  
Yali Hou ◽  
...  
Keyword(s):  
Exercise Training ◽  
Endothelial Function ◽  
Skeletal Muscles ◽  
Dependent Manner ◽  
Vascular Adaptation ◽  
Beneficial Effects ◽  
Initial Event ◽  
Enos Uncoupling ◽  
Exercise Induced

Background: Exercise training promotes vascular adaptation (restoration of endothelial function and angiogenesis) in type2 diabetes (T2D). Since eNOS uncoupling/O 2 - are increased in T2D, exercise may promote vascular adaptation via mechanism other than eNOS-NO axis. Extracellular superoxide dismutase (ecSOD) is a secreted copper (Cu) containing SOD that catalyzes the dismutation of O 2 - to H 2 O 2 and its full activity requires Cu transporter ATP7A. We reported that ATP7A-ecSOD pathway is reduced in T2D and that ecSOD-derived H 2 O 2 promotes VEGFR2 signaling and angiogenesis in endothelial cells. However, role of ATP7A-ecSOD axis and H 2 O 2 signaling in vascular adaptation to exercise in T2D have not been reported. Oxidation of Cysteine residues of targets proteins to generate cysteine sulfenic acid (Cys-OH) is a key initial event in H 2 O 2 -mediated signaling. Results: Here we show that ATP7A protein (49%), ecSOD activity (51%) and extracellular H 2 O 2 levels in blood vessels and skeletal muscles were significantly decreased in high fat diet-induced T2D mice compared to control C57Bl6 mice, which were rescued by volunteer wheel exercise (2 weeks) or in T2D/ATP7A overexpressing mice. In parallel, exercise training restored impaired endothelium-dependent relaxation (EDR) of resistant arteries and angiogenesis (CD31+ capillary, 2.4-fold) in skeletal muscle of T2D mice, which were inhibited by exogenous catalase or in T2D/ecSOD KO mice, but not by L-NAME, suggesting that ecSOD-derived H 2 O 2 , but not eNOS/NO, mediates exercise-induced beneficial effects. Mechanistically, exercise significantly increased Cys-OH formation of PKG1α (2.3-fold), which was shown to induce EDR in H 2 O 2 -, but not NO/cGMP-, dependent manner, in T2D vascular tissues as well as Cys-OH formation of AMPK (3.6-fold) and AMPK downstream angiogenic PGC1α and VEGF protein expression in T2D skeletal muscles. Of note, these exercise-induced Cys oxidation of PKG1α and AMPK were not observed in control or T2D/ecSOD KO mice. Conclusion: Exercise-induced ATP7A-ecSOD axis-mediated out-side in H 2 O 2 signaling plays an important role in promoting vascular adaptation in T2D via Cys oxidation of redox-sensitive kinases required for endothelial function and angiogenesis in skeletal muscles.

scholarly journals Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: a narrative review

2020 ◽  
Vol 8 ◽  
pp. 205031212092265 ◽  
Author(s):  
Elise Piraux ◽  
Gilles Caty ◽  
Frank Aboubakar Nana ◽  
Gregory Reychler
Keyword(s):  
Side Effects ◽  
Exercise Training ◽  
Cancer Patients ◽  
Exercise Intervention ◽  
Medical Condition ◽  
Exercise Programme ◽  
Narrative Review ◽  
Cancer Treatments ◽  
Beneficial Effects ◽  
Narrative Design

Despite its beneficial effects, radiotherapy still results in a range of side effects that negatively impact quality of life of patients. Exercise has been shown to counteract the side effects induced by cancer treatment. This narrative review aims to provide an up-to-date review of the effects of an exercise intervention in cancer patients during radiotherapy. A literature search was performed on PubMed to identify original articles that evaluated the effects of an exercise programme to alleviate treatment-related side effects in cancer patients undergoing radiotherapy with or without other cancer treatments. Benefits related to exercise training have been shown in breast, prostate, rectal, lung, head and neck cancer patients undergoing radiotherapy. Therefore, exercise should be considered as a concurrent treatment alongside radiotherapy to alleviate treatment-related side effects and facilitate effective recovery. Due to the onset and progress of treatment-related side effects throughout radiotherapy, a regular clinical evaluation seems strongly advisable in order to continuously adapt the exercise programme depending on symptoms and side effects. An exercise professional is needed to personalize exercise training based on the medical condition and tailor it throughout the intervention according to progress and the patient’s medical status. Future studies are needed to confirm the potential benefits of exercises observed on treatment-related side effects. Furthermore, because of the narrative design of this study, a systematic review is required to evaluate the strength of the evidence reported.

Cardiopulmonary Responses and Exercise Prescription in Cancer Patients During Exercise Training Program in Addition to Chemotherapy

2010 ◽  
Vol 42 ◽  
pp. 163-164
Author(s):  
Luiz A. Riani Costa ◽  
Suelen D. Polanczyk ◽  
Patricia L. C. Ferraz ◽  
Rodrigo B. A. S. Ferraz ◽  
Luciana O. P. Lancha ◽  
...  
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Cancer Patients ◽  
Exercise Prescription ◽  
Exercise Training Program

scholarly journals Exercise load monitoring: integrated approaches to advance the individualisation of exercise oncology

2021 ◽  
Vol 7 (3) ◽  
pp. e001134
Author(s):  
Stephen J Carter ◽  
Marissa N Baranauskas ◽  
Tarah J Ballinger ◽  
Laura Q Rogers ◽  
Kathy D Miller ◽  
...  
Keyword(s):  
Exercise Training ◽  
External Load ◽  
Sports Medicine ◽  
Exercise Prescription ◽  
Exercise Adherence ◽  
Exercise Load ◽  
Recovery Capacity ◽  
Load Monitoring ◽  
Integrated Approaches ◽  
Exercise Oncology

Whether slowing disease progression or combatting the ills of advancing age, the extensive utility of exercise training has contributed to the outright declaration by the American College of Sports Medicine that ‘exercise is medicine’. Consistent with general framework of adaptation, the advantages of exercise training are indiscriminate—benefitting even the most susceptible clinical populations. Still, the benefit of exercise training presupposes healthy adaptation wherein progressive overload matches sufficient recovery. Indeed, a difference exists between healthy adaptation and non-functional over-reaching (ie, when internal/external load exceeds recovery capacity)—a difference that may be blurred by cancer treatment and/or comorbidity. Recent advances in smartwatches make them ideally suited to non-invasively monitor the physiological stresses to exercise training. Resolving whether individuals are successfully adapting to exercise training via load monitoring bears clinical and practical relevance. While behaviour-change research aims to identify positive constructs of exercise adherence, further attention is needed to uncover how to optimise exercise prescription among cancer populations. Herein, we briefly discuss the constituents of exercise load monitoring, present examples of internal and external load and consider how such practices can be applied to cancer populations.

Effects of Antioxidant Supplementation and Exercise Training on Erythrocyte Antioxidant Enzymes

2006 ◽  
Vol 76 (5) ◽  
pp. 324-331 ◽  
Author(s):  
Marsh ◽  
Laursen ◽  
Coombes
Keyword(s):  
Antioxidant Enzymes ◽  
Exercise Training ◽  
Endurance Training ◽  
Young Male ◽  
Antioxidant Defenses ◽  
Antioxidant Enzyme Activities ◽  
Antioxidant Supplementation ◽  
Male Wistar Rats ◽  
Exercise Induced ◽  
Antioxidant Supplements

Erythrocytes transport oxygen to tissues and exercise-induced oxidative stress increases erythrocyte damage and turnover. Increased use of antioxidant supplements may alter protective erythrocyte antioxidant mechanisms during training. Aim of study: To examine the effects of antioxidant supplementation (α-lipoic acid and α-tocopherol) and/or endurance training on the antioxidant defenses of erythrocytes. Methods: Young male Wistar rats were assigned to (1) sedentary; (2) sedentary and antioxidant-supplemented; (3) endurance-trained; or (4) endurance-trained and antioxidant-supplemented groups for 14 weeks. Erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT) activities, and plasma malondialdehyde (MDA) were then measured. Results: Antioxidant supplementation had no significant effect (p > 0.05) on activities of antioxidant enzymes in sedentary animals. Similarly, endurance training alone also had no effect (p > 0.05). GPX (125.9 ± 2.8 vs. 121.5 ± 3.0 U.gHb–1, p < 0.05) and CAT (6.1 ± 0.2 vs. 5.6 ± 0.2 U.mgHb–1, p < 0.05) activities were increased in supplemented trained animals compared to non-supplemented sedentary animals whereas SOD (61.8 ± 4.3 vs. 52.0 ± 5.2 U.mgHb–1, p < 0.05) activity was decreased. Plasma MDA was not different among groups (p > 0.05). Conclusions: In a rat model, the combination of exercise training and antioxidant supplementation increased antioxidant enzyme activities (GPX, CAT) compared with each individual intervention.

Barriers to Supervised Exercise Training in a Randomized Controlled Trial of Breast Cancer Patients Receiving Chemotherapy

2008 ◽  
Vol 35 (1) ◽  
pp. 116-122 ◽  
Author(s):  
Kerry S. Courneya ◽  
Donald C. McKenzie ◽  
Robert D. Reid ◽  
John R. Mackey ◽  
Karen Gelmon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Exercise Training ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Breast Cancer Patients ◽  
Randomized Controlled ◽  
Supervised Exercise

scholarly journals The effectiveness of supplemental oxygen during exercise training in patients with chronic obstructive pulmonary disease who show severe exercise-induced desaturation: a protocol for a meta-regression analysis and systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Shohei Kawachi ◽  
Shuhei Yamamoto ◽  
Kenichi Nishie ◽  
Takayoshi Yamaga ◽  
Manaka Shibuya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Exercise Training ◽  
Exercise Tolerance ◽  
Supplemental Oxygen ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Exercise ◽  
Meta Regression ◽  
Exercise Induced

Abstract Background Supplemental oxygen during exercise training is used to increase the training effect of an exercise program in patients with chronic obstructive pulmonary disease (COPD) who show exercise-induced desaturation. Exercise-induced desaturation is not clearly defined in the guidelines; however, it is generally defined in clinical studies as a decrease in SpO2 of more than 4% from rest or a decrease to less than 88% during exercise. Although some meta-analyses examined the effectiveness of supplemental oxygen during exercise training, these studies concluded that it does not further improve exercise tolerance compared to exercise training alone. However, supplemental oxygen during exercise training may be effective in improving exercise tolerance in COPD patients with severe exercise-induced desaturation. Therefore, this study will be performed to elucidate the effectiveness of supplemental oxygen during exercise training and the relationship between its effectiveness and severity of exercise-induced desaturation at baseline. Methods We will first assess the effectiveness of supplemental oxygen during exercise training in COPD. The main outcome is the change in exercise tolerance before and after the intervention, indicated by the 6-min walking distance, the walking distance, or the walking time in incremental shuttle walking test, and analyzed as the standardized mean difference (SMD). The quality and risk of bias in individual studies will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and risk-of-bias tool (RoB ver.2). If statistical heterogeneity in terms of the effectiveness of exercise tolerance is shown, we will conduct meta-regression analyses to examine the association between the effectiveness of exercise training with supplemental oxygen and severity of exercise-induced desaturation at baseline. Discussion One strength of this study is that it is a systematic review with meta-regression analysis to elucidate the effectiveness of supplemental oxygen during exercise training in patients with COPD who show severe exercise-induced desaturation. Furthermore, we will assess the severity of exercise-induced desaturation for which exercise training with supplemental oxygen is effective, the influence of acute effects at baseline, and the effect of supplemental oxygen on adverse events. Systematic review registration Registration number, UMIN000039960.

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