A pilot study of individualized exercise prescription to improve physical activity in cancer survivors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24030-e24030
Author(s):  
Priyanka Avinash Pophali ◽  
Urshila Durani ◽  
John Shin ◽  
Melissa C. Larson ◽  
Adam Shultz ◽  
...  

e24030 Background: Physical activity (PA) in cancer survivors improves quality of life (QOL), functioning, fatigue, and reduces the risk of treatment complications, cancer recurrence and death. However, the optimal intervention for increasing PA is not established. Most prospective studies have shown a 6-12-week program to be an effective intervention but this is often not feasible. Therefore, we piloted a one-time individualized exercise prescription in our cardiac rehabilitation center to improve PA in cancer survivors. Methods: We prospectively enrolled cancer survivors who had completed curative intent treatment, with no evidence of active disease in this pilot study. Survivors who consented underwent a consultation with an exercise physiologist for needs assessment followed by a supervised exercise session with a tailored exercise prescription. Survivors also filled out surveys assessing their PA and QOL at baseline (bl), 3, 6 and 12 months after intervention. Clinical information was collected via chart review. We estimated longitudinal PA score and change in PA using mixed models incorporating scores from all available time points using SAS (v 9.4). Results: Between May 2018 and January 2020, 50 participants (26 lymphoma and 24 solid tumor survivors) completed the intervention. 20% participants were on maintenance therapy during the study. Clinical characteristics of 42 evaluable participants are summarized in Table. The survey response rate was 82%, 58%, 58%, 46% at bl, 3, 6 and 12 months respectively. The level of PA improved with time [mean (SE) PA score: 58.5 (4.3) bl, 63.9 (4.8) at 3, 57.6 (4.8) at 6, 62.6 (5.3) at 12 months]. The change in PA from baseline to follow-up time-points [bl vs 3m p=0.41; bl vs 6m p=0.88; bl vs 12m p=0.55] or between the lymphoma and solid tumor survivors was not statistically significant and limited by sample size. No significant trend in QOL was seen. Conclusions: Individualized exercise prescription using the cardiac rehabilitation program may be a feasible, widely applicable tool to implement a PA intervention among cancer survivors. The trend towards improvement in PA in this novel one-time intervention provides intriguing evidence and deserves future study in larger sample sizes to understand if it can improve and create sustainable PA change comparable to longer term exercise interventions.[Table: see text]

2017 ◽  
Vol 53 (8) ◽  
pp. 504-512 ◽  
Author(s):  
Sarah E Neil-Sztramko ◽  
Kerri M Winters-Stone ◽  
Kelcey A Bland ◽  
Kristin L Campbell

ObjectivesTo update our previous evaluation of the exercise interventions used in randomised controlled trials of breast cancer survivors in relation to (1) the application of the principles of exercise training in the exercise prescription; (2) the reporting of the components of the exercise prescription; and (3) the reporting of adherence of participants to the prescribed interventions.DesignSystematic review.Data sourcesThe OVID Medline, Embase, CINAHL and SPORTDiscus electronic databases were searched from January 2010 to January 2017.Eligibility criteriaRandomised controlled trials of at least 4 weeks of aerobic and/or resistance exercise in women diagnosed with breast cancer, reporting on physical fitness or body composition outcomes.ResultsSpecificity was appropriately applied by 84%, progression by 29%, overload by 38% and initial values by 67% of newly identified studies. Reversibility was reported by 3% anddiminishing returns by 22% of newly identified studies. No studies reported all components of the exercise prescription in the methods, or adherence to the prescribed intervention in the results. Reporting of reversibility has increased from 2010, but no other improvements in reporting were noted from the previous review.Summary/ConclusionNo studies of exercise in women with breast cancer attended to all principles of exercise training, or reported all components of the exercise prescription in the methods, or adherence to the prescription in the results. Full reporting of the exercise prescribed and completed is essential for study replication in research and translating research findings into the community, and should be prioritised in future trials.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Brito ◽  
I Aguiar-Ricardo ◽  
P Alves Da Silva ◽  
B Valente Da Silva ◽  
N Cunha ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Despite the established benefits of cardiac rehabilitation (CR), it remains significantly underutilized. Home-based CR (CR-HB) programs should offer the same core CR components as Centre-based programs (CR-CB) but several aspects need to be adapted, communication and supervision must be improved. Although CR-HB has been successfully deployed and is a valuable alternative to CR-CB, there is less structured experience with these non-uniform programs and further studies are needed to understand which patients (pts) are indicated to this type of program. Purpose To investigate pt-perceived facilitators and barriers to home-based rehabilitation exercise. Methods Prospective cohort study which included pts who were participating in a CR-CB program and accepted to participate in a CR-HB program after CR-CB closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital CR program, including pt risk evaluation and regular assessment, exercise, educational and psychological sessions. The online exercise training sessions consisted of recorded videos and real time online supervised exercise training group sessions. It was recommended to do each session 3 times per week, during 60 min. A pictorial exercise training guidebook was available to all participants including instructions regarding safety, clothing and warm-up, and a detailed illustrated description of each  exercise sessions. Also, for questions or difficulties regarding the exercises, an e-mail and telephone was provided. Once a month, real time CR exercise sessions was provided with a duration of 60min. Results 116 cardiovascular disease pts (62.6 ± 8.9years, 95 males) who were attending a face-to-face CR program were included in a CR-HB program. The majority of the pts had coronary artery disease (89%) and 5% valvular disease. Regarding risk factors, obesity was the most common (75%) followed by hypertension (60%), family history (42%), dyslipidaemia (38%), diabetes (18%), and smoking (13%). Almost half (47%) of the participants did at least one online exercise training session per week: 58% did 2-3 times per week, 27% once per week and 15% more than 4 times per week. Participants who did less than one exercise session per week reported as cause: lack of motivation (38%), preference of a different mode of exercise training such as exercise in the exterior space (26%), technology barrier such as impossibility to stream online videos (11%), fear of performing exercise without supervision (4%), and limited space at home (4%). Conclusions Our study based on real-life results of a CR-HB program shows a sub-optimal rate of participation in exercise sessions due to different causes, but mainly for the lack of motivation to exercise alone or preference for walking in exterior space. The knowledge of the CR-HB program barriers will facilitate to find out strategies to increase the participation rate and to select the best candidates for this type of programs.


10.2196/18491 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e18491
Author(s):  
Tracy E Crane ◽  
Meghan B Skiba ◽  
Austin Miller ◽  
David O Garcia ◽  
Cynthia A Thomson

Background The collection of self-reported physical activity using validated questionnaires has known bias and measurement error. Objective Accelerometry, an objective measure of daily activity, increases the rigor and accuracy of physical activity measurements. Here, we describe the methodology and related protocols for accelerometry data collection and quality assurance using the Actigraph GT9X accelerometer data collection in a convenience sample of ovarian cancer survivors enrolled in GOG/NRG 0225, a 24-month randomized controlled trial of diet and physical activity intervention versus attention control. Methods From July 2015 to December 2019, accelerometers were mailed on 1337 separate occasions to 580 study participants to wear at 4 time points (baseline, 6, 12, and 24 months) for 7 consecutive days. Study staff contacted participants via telephone to confirm their availability to wear the accelerometers and reviewed instructions and procedures regarding the return of the accelerometers and assisted with any technology concerns. Results We evaluated factors associated with wear compliance, including activity tracking, use of a mobile app, and demographic characteristics with chi-square tests and logistic regression. Compliant data, defined as ≥4 consecutive days with ≥10 hours daily wear time, exceeded 90% at all study time points. Activity tracking, but no other characteristics, was significantly associated with compliant data at all time points (P<.001). This implementation of data collection through accelerometry provided highly compliant and usable activity data in women who recently completed treatment for ovarian cancer. Conclusions The high compliance and data quality associated with this protocol suggest that it could be disseminated to support researchers who seek to collect robust objective activity data in cancer survivors residing in a wide geographic area.


Author(s):  
Ciaran M Fairman ◽  
Jesper F Christensen

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.


2020 ◽  
Vol 14 ◽  
pp. 117822182091888
Author(s):  
Danielle E Jake-Schoffman ◽  
Meredith S Berry ◽  
Marissa L Donahue ◽  
Demetra D Christou ◽  
Jesse Dallery ◽  
...  

Background: Opioid maintenance treatment (OMT) is the standard for treatment of opioid use disorder, but some individuals on OMT experience disrupted sleep, heightened sensitivity to pain, and continued relapse to non-medical opioid use. An adjunctive treatment that has potential to address these shortcomings of OMT is aerobic exercise. Objective: The aim of the present review was to identify and evaluate components of aerobic exercise interventions targeting OMT patients. Methods: For this PROSPERO-registered review (ID CRD42020139626), studies were identified via electronic bibliographic databases, funded research ( NIH RePORTER) and clinical trials databases ( ClinicalTrials.gov), and reference sections of relevant manuscripts. Studies that evaluated the effects of an aerobic exercise intervention using a comparison condition or pretest-posttest design in adult OMT patients were included. Results: Of 2971 unique records, three primary studies and one supplemental manuscript comprised the final sample. All studies were randomized trials involving supervised exercise interventions enrolling small samples of middle-aged OMT patients. Exercise interventions included a variety of aerobic and non-aerobic activities (e.g. flexibility exercises), and none controlled the dose of aerobic exercise. Few studies used objective measures of physical activity or cardiorespiratory fitness and there were no significant effects of adjunctive exercise on substance use outcomes, but tests of the latter were likely underpowered. Conclusions: Though early in the accumulation of evidence, interventions targeting aerobic exercise for OMT patients appear feasible, acceptable to patients, and beneficial. Longer-term studies that employ larger samples, include assessments of behavioral and biological mechanisms of change, more rigorous measurement of physical activity, and controlled doses of aerobic activity are warranted.


2019 ◽  
Vol 47 ◽  
pp. 102197 ◽  
Author(s):  
Lenora W.M. Loo ◽  
Kryslin Nishibun ◽  
Leslie Welsh ◽  
TeMoana Makolo ◽  
Clayton D. Chong ◽  
...  

Retos ◽  
2021 ◽  
Vol 44 ◽  
pp. 370-385
Author(s):  
Igor Cigarroa ◽  
Estefanía Díaz ◽  
Constanza Ortiz ◽  
Raquel Otero ◽  
Irene Cantarero ◽  
...  

There is a discrepancy about the characteristics and effects of exercise-based programs in older cancer survivors (OCS). Therefore, this scoping review aimed to identify the characteristics and effects of physical activity programs in OCS health. This scoping review followed the PRISMA guidelines and included randomized clinical trials and clinical trials from MEDLINE by PubMed, Scopus, Scielo, and PEDro, published between 2010 and 2020. Results suggest that physical programs were carried out in health centers (54.2%) and were based on physical exercise (74.4%). The length of the exercise interventions was between 3–6 months (87.5%) was performed 2–3 times per week (73.1%) with a duration between 20–60 minutes (78.2%) and was run by health professionals (94.4%). The health outcomes with the most positive effects were physical activity, depression, and quality of life. In conclusion, physical programs for OCS based on aerobic exercises are safe and could be a therapeutic strategy to improve different health markers in OCS.  Resumen. En la literatura existe discrepancia sobre las características y los efectos de los programas basados en el ejercicio físico en sobrevivientes de cáncer (SC) de edad avanzada. Por lo tanto, esta revisión de alcance tuvo como objetivo identificar las características y los efectos de los programas de actividad física en la salud de personas SC de edad avanzada. Esta revisión de ensayos clínicos aleatorizados y ensayos clínicos, se realizó considerando las siguientes bases de datos: MEDLINE (de Pubmed), Scopus, Scielo y PEDro, entre los años 2010 y 2020. Los resultados indican que los programas de ejercicio se realizaron en centros de salud (54.2%), y se basaron en ejercicio físico principalmente (74.4%). La extensión de las intervenciones físicas fue entre 3–6 meses (87.5%), se realizaron 2–3 veces por semana (73.1%) con una duración entre 20–60 minutos, y fueron dirigidas por profesionales de salud (94.4%). El impacto sobre la salud con mayores efectos positivos fueron la actividad física, la depresión y la calidad de vida. En conclusión, los programas de ejercitación física para personas SC en edad avanzada, basados en ejercicios aeróbicos son seguros y podrían ser una estrategia terapéutica para mejorar diferentes variables de salud en este grupo de personas.


2011 ◽  
Vol 21 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Marieke Van Puymbroeck ◽  
Arlene Schmid ◽  
Kimberly Shinew ◽  
Pei-Chun Hsieh

Breast cancer survivors often experience changes in their perception of their bodies following surgical treatment. These changes in body image may increase self-consciousness and perceptions of physical activity constraints and reduce participation in physical activity. While the number of studies examining different types of yoga targeting women with breast cancer has increased, studies thus far have not studied the influence that Hatha yoga has on body image and physical activity constraints. The objective of this study was to explore the changes that occur in breast cancer survivors in terms of body image, perceived constraints, and physical fitness following an 8-week Hatha yoga intervention. This study used a nonrandomized two-group pilot study, comparing an 8-week Hatha yoga intervention with a light exercise group, both designed for women who were at least nine months post-treatment for breast cancer. Both quantitative and qualitative data were collected in the areas of body image, physical activity constraints,and physical fitness. Findings indicated that quantitatively, yoga participants experienced reductions in physical activity constraints and improvements in lower- and upper-body strength and flexibility, while control participants experienced improvements in abdominal strength and lower-body strength. Qualitative findings support changes in body image, physical activity constraints, and physical fitness for the participants in the yoga group. In conclusion,Hatha yoga may reduce constraints to physical activity and improve fitness in breast cancer survivors. More research is needed to explore the relationship between Hatha yoga and improvements in body image.


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