Physical Activity Across the Cancer Journey: Experiences and Recommendations From People Living With and Beyond Cancer

2019 ◽  
Vol 100 (3) ◽  
pp. 575-585
Author(s):  
Mairéad Cantwell ◽  
Deirdre Walsh ◽  
Bróna Furlong ◽  
Lisa Loughney ◽  
Noel McCaffrey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sense Of Self ◽  
Exercise Program ◽  
Well Being ◽  
Home Exercise ◽  
Program Success ◽  
Rehabilitation Programs ◽  
Cancer Support ◽  
And Control

Abstract Background The majority of individuals living with and beyond cancer are not sufficiently active to achieve health benefits. Objective The aim of this study was to explore individuals’ experiences of physical activity (PA) behavior across the cancer journey and to ask individuals living with and beyond cancer to identify strategies to support habitual PA. Design An exploratory, descriptive, qualitative design was used. Methods Purposive sampling methods were used to recruit individuals living with and beyond cancer who had been referred to, and/or participated in, a community-based exercise program or were attending a cancer support center. The focus group discussions were audio recorded, transcribed verbatim, and analyzed using a thematic analysis approach. Results Seven focus groups were conducted with 41 participants. Many individuals reported that regular PA provided a vehicle for recovery that created a sense of “self-power,” defined as taking ownership and control of one’s health to increase well-being. Barriers to PA participation included environmental-, patient-, and treatment-related challenges. Recommendations to support long-term adherence to PA included completion of fitness assessments at regular intervals and provision of a home exercise program. Limitations The benefits and barriers to PA participation for individuals diagnosed with cancers that were not represented may not have been identified. The strategies recommended to support habitual PA may be salient only to individuals whose cancer diagnoses were represented. Conclusions Exercise is seen as a vehicle for recovery from cancer but long-term adherence for individuals is complex. The findings from this study can inform the development of exercise oncology rehabilitation programs and could support a greater likelihood of program success, thereby optimizing the health, well-being, and quality of life of survivors of cancer.

scholarly journals Impact of an at home exercise program in the pediatric, adolescent, and young adult cancer population newly diagnosed with acute lymphoblastic leukemia

2020 ◽  
Vol 3 ◽  
Author(s):  
Punit Vyas ◽  
Danielle Halsey ◽  
Nicholas Kelly ◽  
Melissa Sherman ◽  
Brooklyn Herbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Intervention ◽  
Lymphoblastic Leukemia ◽  
Exercise Program ◽  
Adult Survivors ◽  
Home Exercise ◽  
Control Group ◽  
Newly Diagnosed ◽  
At Home

Background: Over 30,000 cases of leukemia are diagnosed each year in the United States. For individuals ages 0-39, the one-year relative survival rate is 84.5%, and the 5-year survival is 94%. Improved survival rates come with long-term health challenges due to treatment, including cardiovascular disease, obesity, diabetes, fatigue,  low quality of life (QOL), and reduced physical activity (PA). Current literature shows structured exercise in adult survivors can be beneficial for improving the long-term health effects resulting from treatment. Exercise induces the release of many growth factors into the bloodstream that aid in repair of the body following insult. Three factors specific to nerve damage is brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and Platelet-derived growth factor (PDGF). The benefits of exercise seen in adult survivors may translate to young survivors. We hypothesized that an 8-week at home exercise program in newly diagnosed acute lymphoblastic leukemia (ALL) patients (ages 5-25) would improve outcomes compared to baseline or a control group. The preliminary findings presented are based on the initial ten subjects and include physical, biomarker and self-reported outcomes.  Experimental Methods: Newly diagnosed ALL patients were assigned to an 8-week at home exercise intervention during the consolidation phase of treatment. Fitbit activity tracker data and questionnaires were used for assessing adherence and feasibility. Blood samples were taken at baseline and at week eight.  Results:  Subjects were not able to complete over 75% of the exercise intervention; however, they did increase their overall physical activity and their neuropathy scores decreased compared to baseline. BDNF significantly increased in the control group, but not in the exercise group.  Conclusion: The results indicate that an exercise program in this population during the consolidation phase may not be feasible. It also supports the association between neuropathy, physical activity, and BDNF levels after long term exercise. 

Moral Disability, Moral Injury, and the Flight from Vulnerability

2018 ◽  
Author(s):  
Virginia L. Warren
Keyword(s):  
Sense Of Self ◽  
Well Being ◽  
Moral Injury ◽  
Controversial Issues ◽  
Moral Reflection ◽  
Moral Value ◽  
Self Identity ◽  
Moral Conviction ◽  
Moral Importance

This chapter explores the concept of moral disability, identifying two types. The first type involves disabling conditions that distort one’s process of moral reflection. Examples include the incapacity to consider the long-term future, to feel empathy for others, and to be honest with oneself. A noteworthy example of self-deception is systematically denying one’s own—and humanity’s—vulnerability to the power of others, to accidents, and to having one’s well-being linked to that of others and the eco-system. Acknowledging vulnerability often requires a new sense of self. The second type includes incapacities directly resulting from ‘moral injury’—debilitating, self-inflicted harms when one violates a deeply held moral conviction, even if trying to remain true to another moral value. Examining moral disabilities highlights the moral importance of self-identity. More progress may be made on controversial issues if we discuss who we are, how we connect, and how we can heal.

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

scholarly journals Delivering an In-Home Exercise Program via Telerehabilitation: A Pilot Study of Lung Transplant Go (LTGO)

2016 ◽  
Vol 8 (2) ◽  
pp. 15-26 ◽  
Author(s):  
JiYeon Choi ◽  
Andrea L. Hergenroeder ◽  
Lora Burke ◽  
Annette DeVito Dabbs ◽  
Matthew Morrell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Function ◽  
Lung Transplant ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Integrated System ◽  
Home Exercise ◽  
Transplant Recipients ◽  
Walk Distance ◽  
Lung Transplant Recipients

We evaluated the feasibility, safety, system usability, and intervention acceptability of Lung Transplant Go (LTGO), an 8-week in-home exercise intervention for lung transplant recipients using a telerehabilitation platform, and described changes in physical function and physical activity from baseline to post-intervention. The intervention was delivered to lung transplant recipients in their home via the Versatile and Integrated System for TeleRehabilitation (VISYTER). The intervention focused on aerobic and strengthening exercises tailored to baseline physical function. Participants improved walk distance (6-minute walk distance), balance (Berg Balance Scale), lower body strength (30-second chair stand test) and steps walked (SenseWear Armband®). No adverse events were reported. Participants rated the program highly positively in regard to the technology and intervention. The telerehabilitation exercise program was feasible, safe, and acceptable. Our findings provide preliminary support for the LTGO intervention to improve physical function and promote physical activity in lung transplant recipients. 

Serum Myostatin Levels Are Higher in Fitter, More Active, and Non-Frail Long-Term Nursing Home Residents and Increase after a Physical Exercise Intervention

Gerontology ◽  
2018 ◽  
Vol 65 (3) ◽  
pp. 229-239 ◽  
Author(s):  
Haritz Arrieta ◽  
Gotzone Hervás ◽  
Chloe Rezola-Pardo ◽  
Fátima Ruiz-Litago ◽  
Miren Iturburu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Nursing Home ◽  
Physical Fitness ◽  
Physical Activity Level ◽  
Exercise Intervention ◽  
Nursing Home Residents ◽  
Exercise Program ◽  
Activity Level

Background: Myostatin has been proposed as a candidate biomarker for frailty and sarcopenia. However, the relationship of myostatin with these conditions remains inconclusive. Objective: To determine the association of serum myostatin concentration with body composition, physical fitness, physical activity level, and frailty in long-term nursing home residents. We also aimed to ascertain the effect of an exercise program on myostatin levels. Methods: We obtained study data on 112 participants from long-term nursing homes. Participants were randomly assigned to a control or an intervention group and performed a 6-month multicomponent exercise program. Serum myostatin levels were analyzed by ELISA. Assessments also included body composition (anthropometry and bioelectrical impedance), physical fitness (Senior Fitness Test), physical activity level (accelerometry), and frailty (Fried frailty criteria, Clinical Frailty Scale, and Tilburg frailty indicator). Results: The concentration of myostatin at baseline was positively correlated with: a leaner body composition (p < 0.05), and a higher number of steps per day and light and moderate-vigorous physical activity in women (p < 0.005); greater upper and lower limb strength, endurance, and poorer flexibility (p < 0.05) in men; and better performance (less time) in the 8-ft timed up-and-go test in both women (p < 0.01) and men (p < 0.005). We observed higher concentrations of serum myostatin in non-frail than in frail participants (p < 0.05). Additionally, we found that the implemented physical exercise intervention, which was effective to improve physical fitness, increased myostatin concentration in men (p < 0.05) but not in women. The improvements in physical condition were related with increases in serum myostatin only in men (p < 0.05–0.01). Conclusions: Higher serum levels of myostatin were found to be associated with better physical fitness. The improvements in physical fitness after the intervention were positively related to increases in myostatin concentrations in men. These results seem to rule out the idea that high serum myostatin levels are indicative of frailty in long-term nursing home residents. However, although the direction of association was opposite to that expected for the function of myostatin, the use of this protein as a biomarker for physical fitness, rather than frailty, merits further study.

scholarly journals The ‘new normal’ includes online prenatal exercise: Exploring pregnant women’s experiences during the pandemic and the role of virtual group fitness on maternal mental health

2021 ◽  
Author(s):  
Cristina Silva-Jose ◽  
Taniya S Nagpal ◽  
Javier Coterón ◽  
Ruben Barakat ◽  
Michelle F Mottola
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Pregnant Women ◽  
Maternal Mental Health ◽  
Exercise Program ◽  
Well Being ◽  
Group Exercise ◽  
Exercise Classes ◽  
Prenatal Exercise ◽  
Online Group

Abstract Background: Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic. Furthermore, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs.Methods: Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women’s experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory (STAI) and these data supplemented qualitative findings. Results: Twenty-four women were interviewed, and the average STAI score was 32.23 ± 9.31, ranging from low to moderate anxiety. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional.Conclusion: Pregnant women are receptive to online group exercise classes and expressed that these are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health.

Training zu Hause verbessert die Schlafqualität und die Tagesschläfrigkeit älterer Menschen

2019 ◽  
Vol 7 (6) ◽  
pp. 327-328
Author(s):  
Helmut Frohnhofen
Keyword(s):  
Physical Activity ◽  
Sleep Quality ◽  
Cognitive Decline ◽  
Daytime Sleepiness ◽  
Exercise Program ◽  
Sleep Hygiene ◽  
Northeastern Brazil ◽  
Home Exercise ◽  
Quality Of Sleep

Background: Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. Methods: This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n = 65) and a control group - CG (sleep hygiene only, n = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. Results: The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI (p < 0.01) and in all its 7 components of evaluation (p < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01). Conclusion: Our results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders. Trial registration: Ensaiosclinicos.gov.br process number: RBR-3cqzfy.

Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Stroke: One-Year Follow-up

2020 ◽  
Vol 34 (7) ◽  
pp. 609-615
Author(s):  
Jesse Dawson ◽  
Navzer D. Engineer ◽  
Cecília N. Prudente ◽  
David Pierce ◽  
Gerard Francisco ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Vagus Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Exercise Program ◽  
Home Exercise ◽  
Home Exercise Program

Background. Vagus nerve stimulation (VNS) paired with rehabilitation may improve upper-limb impairment and function after ischemic stroke. Objective. To report 1-year safety, feasibility, adherence, and outcome data from a home exercise program paired with VNS using long-term follow-up data from a randomized double-blind study of rehabilitation therapy paired with Active VNS (n = 8) or Control VNS (n = 9). Methods. All people were implanted with a VNS device and underwent 6 weeks in clinic therapy with Control or Active VNS followed by home exercises through day 90. Thereafter, participants and investigators were unblinded. The Control VNS group then received 6 weeks in-clinic Active VNS (Cross-VNS group). All participants then performed an individualized home exercise program with self-administered Active VNS. Data from this phase are reported here. Outcome measures were Fugl-Meyer Assessment—Upper Extremity (FMA-UE), Wolf Motor Function Test (Functional and Time), Box and Block Test, Nine-Hole Peg Test, Stroke Impact Scale, and Motor Activity Log. Results. There were no VNS treatment–related serious adverse events during the long-term therapy. Two participants discontinued prior to receiving the full crossover VNS. On average, participants performed 200 ± 63 home therapy sessions, representing device use on 57.4% of home exercise days available for each participant. Pooled analysis revealed that 1 year after randomization, the FMA-UE score increased by 9.2 points (95% CI = 4.7 to 13.7; P = .001; n = 15). Other functional measures were also improved at 1 year. Conclusions. VNS combined with rehabilitation is feasible, with good long-term adherence, and may improve arm function after ischemic stroke.

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