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 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 Updated systematic review of exercise studies in breast cancer survivors: attention to the principles of exercise training

2017 ◽  
Vol 53 (8) ◽  
pp. 504-512 ◽  
Author(s):  
Sarah E Neil-Sztramko ◽  
Kerri M Winters-Stone ◽  
Kelcey A Bland ◽  
Kristin L Campbell
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Exercise Training ◽  
Cancer Survivors ◽  
Randomised Controlled Trials ◽  
Breast Cancer Survivors ◽  
Exercise Prescription ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomised Controlled

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.

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 ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
Cardiac Rehabilitation ◽  
Cancer Survivors ◽  
Solid Tumor ◽  
Exercise Prescription ◽  
Exercise Session ◽  
Exercise Interventions ◽  
Time Points ◽  
Supervised Exercise

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]

scholarly journals Effects of Different Types of Exercise Training on Pulmonary Arterial Hypertension: A Systematic Review

2020 ◽  
Vol 9 (6) ◽  
pp. 1689 ◽  
Author(s):  
Lena Waller ◽  
Karsten Krüger ◽  
Kerstin Conrad ◽  
Astrid Weiss ◽  
Katharina Alack
Keyword(s):  
Physical Activity ◽  
Pulmonary Arterial Hypertension ◽  
Exercise Training ◽  
Arterial Hypertension ◽  
Treatment Options ◽  
Human Studies ◽  
Respiratory Muscle Training ◽  
Exercise Interventions ◽  
Different Types ◽  
Pulmonary Arterial

Pulmonary arterial hypertension (PAH) represents a chronic progressive disease characterized by high blood pressure in the pulmonary arteries leading to right heart failure. The disease has been a focus of medical research for many years due to its worse prognosis and limited treatment options. The aim of this study was to systematically assess the effects of different types of exercise interventions on PAH. Electronic databases were searched until July 2019. MEDLINE database was used as the predominant source for this paper. Studies with regards to chronic physical activity in adult PAH patients are compared on retrieving evidence on cellular, physiological, and psychological alterations in the PAH setting. Twenty human studies and 12 rat trials were identified. Amongst all studies, a total of 628 human subjects and 614 rats were examined. Regular physical activity affects the production of nitric oxygen and attenuates right ventricular hypertrophy. A combination of aerobic, anaerobic, and respiratory muscle training induces the strongest improvement in functional capacity indicated by an increase of 6 MWD and VO2 peak. In human studies, an increase of quality of life was found. Exercise training has an overall positive effect on the physiological and psychological components of PAH. Consequently, PAH patients should be encouraged to take part in regular exercise training programs.

scholarly journals How to promote physical activity maintenance after an exercise-training program in cancer patients?

2016 ◽  
Vol 59 ◽  
pp. e55 ◽  
Author(s):  
Katia Reichhart ◽  
Mélissa Evesque ◽  
Marion M.C. Cavana ◽  
Pauline Muszynski ◽  
Marie-Madeleine Leclercq ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Training Program ◽  
Cancer Patients ◽  
Exercise Training Program ◽  
Physical Activity Maintenance

scholarly journals Physical Activity for Oncological Patients in COVID-19 Era: No Time to Relax

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Alice Avancini ◽  
Ilaria Trestini ◽  
Daniela Tregnago ◽  
Joachim Wiskemann ◽  
Massimo Lanza ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Cancer Patients ◽  
Mortality Risk ◽  
Physical Inactivity ◽  
Great Effort ◽  
Scientific Societies ◽  
Oncological Patients ◽  
Containment Measures ◽  
Exercise Guidelines

Abstract Whereas the coronavirus disease 2019 (COVID-19) storm is relentlessly progressing worldwide, a great effort from scientific societies has been made to give recommendations for safely continuing oncological care, prioritizing the interventions according to patients' condition and type and stage of tumor. Nevertheless, to date no specific suggestions regarding physical activity and exercise in cancer patients during the COVID-19 era have been released, neglecting the potential deleterious effects of quarantine and sedentary behaviour (imposed as containment measures against COVID-19), particularly in these subjects. Moreover, literature is constantly consolidating the crucial impact of regular physical activity in cancer in reducing recurrence and mortality risk. In this commentary, we discuss possible adaptations of the recently published exercise guidelines to the current pandemic emergency, proposing various modalities to prevent or mitigate the physical inactivity risk in cancer patients.

Effect of the volume and intensity of exercise training on insulin sensitivity

2004 ◽  
Vol 96 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Joseph A. Houmard ◽  
Charles J. Tanner ◽  
Cris A. Slentz ◽  
Brian D. Duscha ◽  
Jennifer S. McCartney ◽  
...  
Keyword(s):  
Physical Activity ◽  
Insulin Sensitivity ◽  
Exercise Training ◽  
High Intensity ◽  
Insulin Action ◽  
Exercise Prescription ◽  
High Volume ◽  
Moderate Intensity ◽  
Group 12 ◽  
Low Volume

Physical activity enhances insulin action in obese/overweight individuals. However, the exercise prescription required for the optimal enhancement is not known. The purpose of this study was to test the hypothesis that exercise training consisting of vigorous-intensity activity would enhance insulin sensitivity more substantially than moderate-intensity activity. Sedentary, overweight/obese subjects ( n = 154) were randomly assigned to either control or an exercise group for 6 mo: 1) low-volume/moderate-intensity group [∼12 miles walking/wk at 40–55% peak O2 consumption (V̇o2 peak)], 2) low-volume/high-intensity group (∼12 miles jogging/wk at 65–80% V̇o2 peak), and 3) high-volume/high-intensity group (∼20 miles jogging/wk at 65–80% V̇o2 peak). Training volume (miles/wk) was achieved by exercising ∼115 min/wk (low-volume/high-intensity group) or ∼170 min/wk (low-volume/moderate-intensity and high-volume/high-intensity groups). Insulin action was measured with an insulin sensitivity index (SI) from an intravenous glucose tolerance test. In the control group, there was a decrement ( P < 0.05) in SI. In contrast, all the exercise groups significantly ( P < 0.05) increased SI; the relative increment in the low-volume/moderate-intensity and high-volume/high-intensity groups (∼85%) were greater than in the low-volume/high-intensity group (∼40%). In conclusion, physical activity encompassing a wide range of intensity and volume minimizes the insulin resistance that develops with a sedentary lifestyle. However, an exercise prescription that incorporated ∼170 min of exercise/wk improved insulin sensitivity more substantially than a program utilizing ∼115 min of exercise/wk, regardless of exercise intensity and volume. Total exercise duration should thus be considered when designing training programs with the intent of improving insulin action.

scholarly journals The impact of physical activity for recovering cancer patients

2017 ◽  
Vol 5 (2) ◽  
pp. 225
Author(s):  
Martyn Queen ◽  
Diane Crone ◽  
Andrew Parker ◽  
Saul Bloxham
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Patients ◽  
Physical Activity Intervention ◽  
Phase 1 ◽  
Exercise Programme ◽  
Exercise Interventions ◽  
Care Plans ◽  
The Impact

Rationale: There is a growing body of evidence that supports the use of physical activity during and after cancer treatment, although activity levels for patients remain low. As more cancer patients are treated successfully and treatment costs continue to escalate, physical activity may be a promising adjunct to a person-centered healthcare approach to recovery.Aim: The aim was to further understand how physical activity may enhance the recovery process for a group of mixed-site cancer patients.Objectives: The research investigated longitudinal changes in physical activity and perceived quality of life between 2 and 6 month’s post-exercise interventions. It also investigated support systems that enabled patients to sustain these perceived changes.Method: The respondent cohort comprised 14 mixed-site cancer patients aged 43-70 (11 women, 3 men), who participated in a 2-phase physical activity intervention that took place at a university in the South West of England, UK. Phase 1 consisted of an 8 week structured physical activity programme; Phase 2 consisted of 4 months of non-supervised physical activity. Semi-structured interviews took place 3 times over 6 months with each participant. Grounded theory informed the data collection and analysis which, in turn, facilitated theoretical development.Findings: Our findings propose 3 theories on the impact of physical activity for recovering cancer patients: (1) Knowledge gained through a structured exercise programme can enable recovering cancer patients to independently sustain physical activity to 4 month follow-up. (2) Sustaining physical activity for 6 months promotes positive changes in the quality of life indicators of chronic fatigue, self-efficacy, ability to self-manage and energy levels & (3) Peer support from patients facilitates adherence to a structured exercise programme and support from a spouse or life partner facilitates independently sustained physical activity to 4 month follow-up.Conclusions: This study demonstrates that qualitative research can provide an evidence base that could be used to support future care plans for cancer patients. Our findings also demonstrate that a physical activity intervention can be effective at helping cancer patients recover from the side effects of their treatment and we recommend that physical activity should become an adjunct therapy alongside traditional cancer treatments.

scholarly journals Importance of performance status and physical activity in cancer patients

2021 ◽  
Author(s):  
David Kiesl
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Performance Status ◽  
Current Data ◽  
Standardized Assessments ◽  
Control Groups ◽  
Exercise Interventions ◽  
Positive Effects ◽  
Patient Studies

Summary Background This review summarizes current data on the effects of exercise interventions and physical activity in cancer prevention, treatment and related side effect management, as well as on the rehabilitation of cancer patients. Patients and methods The overall quality of patient studies is still poor due to methodological limitations. Major limitations of the interventional exercise studies conducted include their designs, with regard to missing randomization or the absence of control groups, and the use of heterogeneous assessment methods to quantify and objectify physical activity. As a result, there are no specific exercise recommendations in cancer patients as yet that would essentially differ from exercise recommendations for healthy subjects. Nevertheless, due to major findings and empirical data, the field of research into exercise- and physical activity-related effects on disease and therapy-associated aspects is young and rapidly emerging. Conclusion Exercise potentially contributes to the prevention and rehabilitation of cancer and represents a powerful tool in the prevention of various side effects under chemotherapy. Current data from interventional studies show preliminary positive effects for diverse movement programs and especially through specific combinations of endurance and resistance training. Additional randomized controlled trials with standardized assessments and controlling for potential confounders are needed to confirm and expand these findings.

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