Physical function and quality of life in patients with chronic GvHD: a summary of preclinical and clinical studies and a call for exercise intervention trials in patients

Background Hyperkyphosis negatively affects health status, physical mobility, and quality of life, but there is no standard protocol for treating people with hyperkyphosis. Treatment options include targeted exercise. Objectives This single-site randomized controlled trial (RCT) will determine the efficacy of a targeted multimodal spine-strengthening exercise program, compared with no exercise intervention, among community-dwelling men and women aged ≥60 years. Design The RCT is a parallel-group design, with 1:1 randomization to exercise and attentional control groups. Setting The study will be conducted at one primary site (one academic medical center partnered with one local community medical center). Participants One hundred men and women, aged ≥60 years, with thoracic kyphosis ≥40 degrees will be randomized. Intervention The targeted multimodal spine-strengthening exercise intervention includes exercise and postural training delivered by a physical therapist in a group of 10 participants, 3 times a week for 6 months. Controls receive monthly health education meetings in a group of 10 participants and monthly calls from the study coordinator to monitor physical activity and any adverse events. Measurements The primary outcome is change in Cobb angle of kyphosis measured from lateral spine radiographs at baseline and 6 months. Secondary outcomes include change in physical function (assessed with the modified Physical Performance Test, Timed “Up & Go” Test, timed loaded standing, 4-m walk, and Six-Minute Walk Test) and health-related quality of life (assessed with the modified Scoliosis Research Society instrument [SRS-30] self-image domain and Patient Reported Outcomes Measurement Information System [PROMIS] global health and physical function indexes). Additional secondary outcomes include pain, physical activity level, spinal flexion and extension muscle strength, paraspinal extensor muscle density, and adverse events. Limitations Blinding of the participants and instructors providing the intervention is not possible. Conclusions The efficacy of a high-quality, adequately powered exercise intervention in men and women with kyphosis ≥40 degrees will be evaluated to determine whether targeted multimodal spine-strengthening exercise reduces hyperkyphosis in older adults and improves important secondary outcomes of physical function and health-related quality of life.

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Are patient-reported outcomes of physical function a valid substitute for objective measurements?

Current Oncology ◽

10.3747/co.25.4080 ◽

2018 ◽

Vol 25 (5) ◽

Cited By ~ 1

Author(s):

J. A.J. Douma ◽

H. M.W. Verheul ◽

L. M. Buffart

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Stem Cell ◽

Physical Function ◽

Patient Reported Outcomes ◽

Exercise Intervention ◽

Objective Measures ◽

Patients With Cancer ◽

Patient Reported

BackgroundPhysical function is important for defining treatment strategies in patients with cancer and can be estimated using patient-reported outcomes (pros). Although pros are subjective, physical activity and fitness can be tested objectively with adequate, but more labour-intensive methods that are rarely used in daily clinical practice. To determine whether pros for physical function (pro-pf) accurately predict physical function, we studied their interrelationships with objective measures of physical activity and fitness in patients with cancer who had completed cancer treatment, including adjuvant or neoadjuvant chemotherapy or autologous stem-cell transplantation.MethodsBaseline data from the react (Resistance and Endurance Exercise After Chemotherapy) and exist(Exercise Intervention After Stem-Cell Transplantation) studies were evaluated. In those studies, the effects of an exercise intervention on physical fitness, fatigue, and health-related quality of life in patients with cancer shortly after completion of chemotherapy or stem-cell transplantation were studied. Interrelationships between pro-pf (physical function subscale of the European Organisation for Research and Treatment of Cancer 30-question core Quality of Life Questionnaire), physical activity (accelerometer), and cardiorespiratory fitness (peak oxygen uptake) were assessed using univariable and multivariable multilevel linear mixed-model analyses.ResultsAfter adjustment for age, sex, and body mass index, the pro-pf was significantly associated with physical activity (β = 1.75; 95% confidence interval: 1.08 to 2.42) and cardiorespiratory fitness (β = 0.10; 95% confidence interval: 0.06 to 0.13). Standardized coefficients were 0.28 and 0.26 respectively, indicating a weak association.ConclusionsThe pro-pf is only weakly associated with objective physical activity and fitness evaluation in patients after curative treatment for cancer. The pro-pf cannot, therefore, be used in clinical practice as a substitute for objective measures of physical function.

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Effects of a personal trainer-led exercise intervention on physical activity, physical function, and quality of life of breast cancer survivors

Breast Cancer ◽

10.1007/s12282-020-01211-y ◽

2021 ◽

Author(s):

Linda F. Wang ◽

Yvonne L. Eaglehouse ◽

Janette T. Poppenberg ◽

Jill W. Brufsky ◽

Emily M. Geramita ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Physical Activity ◽

Cancer Survivors ◽

Physical Function ◽

Breast Cancer Survivors ◽

Exercise Intervention ◽

Personal Trainer

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A Novel Exercise Initiative for Seniors to Improve Balance and Physical Function

Journal of Aging and Health ◽

10.1177/0898264316662359 ◽

2016 ◽

Vol 29 (8) ◽

pp. 1424-1443 ◽

Cited By ~ 11

Author(s):

Myrla Sales ◽

Remco Polman ◽

Keith D. Hill ◽

Pazit Levinger

Keyword(s):

Quality Of Life ◽

Physical Function ◽

Exercise Intervention ◽

Fear Of Falling ◽

Controlled Trial ◽

Intervention Group ◽

Participation Rate ◽

Post Intervention ◽

And Function

Objective: To investigate the feasibility, effectiveness, and short-term effects of an exercise intervention using a novel exercise park in improving seniors’ balance, physical function, and quality of life. Method: Randomized controlled trial with pre- and post-intervention design (baseline and 18-week intervention) was used. Outcome measures included measures of balance, strength, and function, as well as quality of life and fear of falling. MANCOVA was used to assess differences between groups (control and exercise intervention) over time. Results: Intervention group showed significant improvement on single leg stance ( p = .02, 95% confidence interval [CI] = [−8.35, −0.549]), knee strength ( p < .01, 95% CI = [−29.14, −5.86]), 2-min walk ( p = 0.02, 95% CI = [−19.13, −0.859]), and timed sit to stand ( p = .03, 95% CI = [−2.26, −0.143]) tests. Discussion: The exercise park program improved physical function and had high adherence and participation rate. Such intervention has been shown to be safe and therefore might enhance participation in exercise programs for older adults.

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