scholarly journals Impact of an exercise programme on sustaining physical activity for recovering cancer patients: A qualitative study.

2016 ◽  
Vol 4 (1) ◽  
pp. 230
Author(s):  
Martyn Queen ◽  
Saul Bloxham ◽  
Phil Brown ◽  
Melissa Coyle ◽  
Ben Jane
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Exercise Programme ◽  
Theory Approach ◽  
Physically Active ◽  
Physical Activity Programme ◽  
Number Of Patients ◽  
The Impact

Background Pedometers have been shown to improve adherence to exercise programmes. Evidence suggests that PA can improve physical function, wellbeing and reduce the negative impact of some cancer related side-effects. Yet, there are limited PA guidelines for cancer patients in the UK. The aim was to examine the impact of an 8-week exercise programme on sustaining physical activity (PA) at 3-month follow-up. Method A qualitative study with 12 mixed site cancer patients aged 43-70 (10 women, 2 men), involved in an 8-week exercise programme. The Programme took place at a University in the South West of England, UK. Semi-structured interviews with patients took place 3 times over 6 months. A grounded theory approach was used to analyse the data. Results We found that the number of patients perceived to be physically active prior to take-up of the physical activity programme were low (20%). At completion, most patients reported being physically active (84%), sustained but to a lesser extent (67%) at 3-month follow-up. Explanations for sustained PA at follow-up included application of knowledge gained from the Programme in relation to walking technique and use of pedometers and perceived health and fitness gains. Explanations for those not physically active included new diagnosis, reduced mobility following surgery and lack of clear exit route or progression to another structured opportunity. Conclusion Our study has provided valuable insight into how a supervised multi-modal physical activity programme can enable recovering cancer patients to develop a physically active lifestyle.

scholarly journals Support systems for mixed-site recovering cancer patients to sustain physical activity: a qualitative study

2017 ◽  
Vol 5 (1) ◽  
pp. 102
Author(s):  
Martyn Queen ◽  
Saul Bloxham ◽  
Phil Brown
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Support Systems ◽  
Exercise Programme ◽  
External Support ◽  
Valuable Insight ◽  
Theory Approach ◽  
Structured Interviews ◽  
Internal Support

Rationale, aims and objectives: Uptake and adherence to physical activity (PA) programmes for recovering cancer patients remain low with only 20% of patients meeting the UK guidelines of 150 minutes a week. The aim of our study was to examine the support systems that enabled a group of cancer patients to sustain PA for 6 months.Method: Fourteen mixed site cancer patients aged 43-70 (11 women, 3 men) participated in a 2-phase PA intervention that took place at a University in the South West of England, UK. The intervention consisted of an 8-week structured exercise programme and a 4-month period of independent PA. Semi-structured interviews were employed to collect the data and a grounded theory approach was used for the analysis.Results: We found that different types of support were required for each stage of the intervention. Internal support was necessary while undertaking a structured PA programme. External support was necessary to sustain PA to 4-month follow-up. The two aspects of internal support were identified that enabled the patients to adhere to the programme; support from exercise professionals and peer support from patients on the programme. External support that enabled the patients to sustain independent PA to 4-month follow-up was support from close partners or from a spouse.Conclusions: Our study has provided valuable insight into internal support systems that enable recovering mixed-site cancer patients to adhere to a structured PA programme and external support from close relationships to sustain independent PA for an additional 4 months.

scholarly journals Impact of Regular Physical Activity on Aortic Diameter Progression in Paediatric Patients with Bicuspid Aortic Valve

2021 ◽  
Author(s):  
Emanuele Monda ◽  
◽  
Adelaide Fusco ◽  
Alessandro Della Corte ◽  
Martina Caiazza ◽  
...  
Keyword(s):  
Physical Activity ◽  
Ascending Aorta ◽  
Regular Physical Activity ◽  
Aortic Diameter ◽  
Sinus Of Valsalva ◽  
Physically Active ◽  
The Impact ◽  
Aorta Diameter ◽  
Sedentary Subjects

AbstractPatients with bicuspid aortic valve (BAV) have an increased risk of aortic dilation and aortic dissection or rupture. The impact of physical training on the natural course of aortopathy in BAV patients remains unclear. The aim of this study was to evaluate the impact of regular physical activity on aortic diameters in a consecutive cohort of paediatric patients with BAV. Consecutive paediatric BAV patients were evaluated and categorized into two groups: physically active and sedentary subjects. Only the subjects with a complete 2-year follow-up were included in the study. To evaluate the potential impact of physical activity on aortic size, aortic diameters were measured at the sinus of Valsalva and mid-ascending aorta using echocardiography. We defined aortic diameter progression the increase of aortic diameter ≥ 10% from baseline. Among 90 BAV patients (11.5 ± 3.4 years of age, 77% males), 53 (59%) were physically active subjects. Compared to sedentary, physically active subjects were not significantly more likely to have > 10% increase in sinus of Valsalva (13% vs. 8%, p-value = 0.45) or mid-ascending aorta diameter (9% vs. 13%, p-value = 0.55) at 2 years follow-up, both in subjects with sinus of Valsalva diameter progression (3.7 ± 1.0 mm vs. 3.5 ± 0.8 mm, p-value = 0.67) and in those with ascending aorta diameter progression (3.0 ± 0.8 mm vs. 3.2 ± 1.3 mm, p-value = 0.83). In our paediatric cohort of BAV patients, the prevalence and the degree of aortic diameter progression was not significantly different between physically active and sedentary subjects, suggesting that aortic dilation is unrelated to regular physical activity over a 2-year period.

Physical Activity and Exercise Interventions in Cancer Survivors

2021 ◽  
pp. 528-534
Author(s):  
Chloe Grimmett ◽  
Rebecca J. Beeken ◽  
Abigail Fisher
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Survival Data ◽  
Physically Active ◽  
Face To Face ◽  
Number Of Patients ◽  
Care Package ◽  
After Cancer ◽  
Behavioral Trials ◽  
Colorectal Cancer Patients

The field of exercise oncology has developed such that it is clear that people affected by cancer should be encouraged to be physically active from the point of diagnosis; indeed, this is now a key component of the survivorship care package in many countries. However, there are still gaps in the evidence. The majority of evidence for the benefits of exercise after cancer comes from breast, prostate, and colorectal cancer patients, usually without metastatic disease. Trials have usually been rated as low to moderate in quality, and although double-blinding will always be an issue in behavioral trials, there is a need to approach exercise studies with the rigor applied to drug trials if it is to be considered an adjuvant cancer therapy. Additionally, there are still gaps around the most appropriate types of exercise for specific cancer sites and how best to implement exercise as part of cancer care, balancing interventions that are likely to reach a large number of patients (e.g., remote, digital) versus those that may have greater benefit (e.g., supervised, face to face). Finally, while observational data are strongly supportive of higher self-reported postdiagnosis physical activity being associated with lower all-cause and cancer-specific mortality, and possibly recurrence, definitive trial data does not yet exist (although a number of trials are underway). Until survival data are generated, caution should be used in how the benefits of exercise are presented to cancer patients, with a focus on the large number of outcomes that have been robustly demonstrated to improve in response to intervention.

scholarly journals Perceived changes to quality of life indicators following a physical activity intervention for recovering cancer patients: A qualitative study.

2016 ◽  
Vol 4 (2) ◽  
pp. 305
Author(s):  
Martyn Queen ◽  
Saul Bloxham ◽  
Phil Brown ◽  
Melissa Coyle ◽  
Ben Jane
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Psychological Health ◽  
Physical Activity Intervention ◽  
Chronic Fatigue ◽  
Theory Approach ◽  
Structured Interviews

The aim of this study was to examine the perceived changes to the quality of life (QoL) for a group of recovering cancer patients, following 6 months of physical activity.Background Evidence suggests that physical activity can improve the QoL of recovering cancer patients, reducing many of the side-effects of cancer and its related treatments, including depression, anxiety, chronic fatigue and improve physical and psychological health. Method A qualitative study with 14 mixed site cancer patients aged 43-70 (12 women, 2 men). The intervention was in 2 parts the first part was an 8-week physical activity programme, the second part related to a period of non-supervised, physical activity for 4 months (6 months in total). The Programme took place at a university in the South West of England. Semi-structured interviews with patients took place 3 times over 6 months. A grounded theory approach was used to analyse the data.Results We found that prior to the 6-month physical activity intervention many of the patients were anxious about being able to complete the initial 8 week programme. Anxieties related to low self-esteem and the chronic fatigue resulting from their cancer treatment. Consequently several patients expressed concerns about their ability to help themselves self-manage their recovery through physical activity. On completion of the intervention the majority of patients reported improvements in their perceived QoL relating to their ability to self-manage, their self-efficacy, energy levels, along with decreases in chronic fatigue.Conclusion Our study has provided valuable insights into how the perceived QoL of a group of recovering cancer patients can be improved through a combined 6-month period of supervised and independent physical activity. These findings serve as further evidence of the effectiveness of a person centred healthcare approach for recovering cancer patients.

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.

Cognitive Impairment and Physical Activity in Old Age: The Impact on All-Cause Mortality in a 15-Year Follow-Up of the Bambuí Cohort Study of Aging

2020 ◽  
Author(s):  
Erico Castro-Costa ◽  
Jerson Laks ◽  
Cecilia Godoi Campos ◽  
Josélia OA Firmo ◽  
Maria Fernanda Lima-Costa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Old Age ◽  
All Cause Mortality ◽  
The Impact

scholarly journals Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Leon-Justel ◽  
Jose I. Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez-Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Secondary Outcome ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Ed Visits ◽  
The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

scholarly journals POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 900.1-900
Author(s):  
L. Diebold ◽  
T. Wirth ◽  
V. Pradel ◽  
N. Balandraud ◽  
E. Fockens ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Disease Activity ◽  
Univariate Analysis ◽  
Route Of Administration ◽  
Anxiety And Depression ◽  
Administration Route ◽  
Factors Associated ◽  
The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

scholarly journals Impact of Work and Recreational Physical Activity on Prediabetes Condition among U.S. Adults: NHANES 2015–2016

2021 ◽  
Vol 18 (4) ◽  
pp. 1378
Author(s):  
Lenin Pazmino ◽  
Wilmer Esparza ◽  
Arian Ramón Aladro-Gonzalvo ◽  
Edgar León
Keyword(s):  
Physical Activity ◽  
Protective Factor ◽  
Hemoglobin A1c ◽  
Physical Activities ◽  
Recreational Physical Activity ◽  
Physically Active ◽  
Hba1c Test ◽  
Health And Nutrition ◽  
The Impact

More minutes of physical activity (PA) accumulated during a day are associated with a lower risk of diabetes mellitus type 2. However, it is less known if distinct dimensions of PA can produce a different protective effect in the prevention of prediabetes. The aim of this study was to analyze the impact of work and recreational PA on prediabetes among U.S. adults during the period 2015–2016 using the National Health and Nutrition Examination Survey (NHANES) database. Individuals (n = 4481) with hemoglobin A1c (HbA1c) test values of 5.7% to 6.4% were included. A logistic regression multivariate-adjusted analysis was conducted to estimate the association between the odds ratios (ORs) and 95% confidence intervals (CIs) of prediabetes, with work and recreational PA. The prevalence of prediabetes among U.S. adults was lower in physically active individuals both at work (~24%) and recreational (~21%) physical activities compared to individuals who were not physically active (27 to 30%). Individuals lacking practice of recreational PA had a high risk of prediabetes (OR = 1.26, 95% CI: 1.080 to 1.466). PA may be a protective factor for prediabetes conditions depending on gender, age, ethnic group, waist circumference, and thyroid disease.

scholarly journals 288. Follow-Up Blood Cultures in Gram-Negative Bacteremia: How Do They Impact Outcomes

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
Azza Elamin ◽  
Faisal Khan ◽  
Ali Abunayla ◽  
Rajasekhar Jagarlamudi ◽  
aditee Dash
Keyword(s):  
Clinical Outcomes ◽  
Antibiotic Treatment ◽  
Readmission Rate ◽  
Blood Cultures ◽  
Categorical Variables ◽  
Gram Negative ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Background As opposed to Staphylococcus. aureus bacteremia, there are no guidelines to recommend repeating blood cultures in Gram-negative bacilli bacteremia (GNB). Several studies have questioned the utility of follow-up blood cultures (FUBCs) in GNB, but the impact of this practice on clinical outcomes is not fully understood. Our aim was to study the practice of obtaining FUBCs in GNB at our institution and to assess it’s impact on clinical outcomes. Methods We conducted a retrospective, single-center study of adult patients, ≥ 18 years of age admitted with GNB between January 2017 and December 2018. We aimed to compare clinical outcomes in those with and without FUBCs. Data collected included demographics, comorbidities, presumed source of bacteremia and need for intensive care unit (ICU) admission. Presence of fever, hypotension /shock and white blood cell (WBC) count on the day of FUBC was recorded. The primary objective was to compare 30-day mortality between the two groups. Secondary objectives were to compare differences in 30-day readmission rate, hospital length of stay (LOS) and duration of antibiotic treatment. Mean and standard deviation were used for continuous variables, frequency and proportion were used for categorical variables. P-value < 0.05 was defined as statistically significant. Results 482 patients were included, and of these, 321 (67%) had FUBCs. 96% of FUBCs were negative and 2.8% had persistent bacteremia. There was no significant difference in 30-day mortality between those with and without FUBCs (2.9% and 2.7% respectively), or in 30-day readmission rate (21.4% and 23.4% respectively). In patients with FUBCs compared to those without FUBCs, hospital LOS was longer (7 days vs 5 days, P < 0.001), and mean duration of antibiotic treatment was longer (14 days vs 11 days, P < 0.001). A higher number of patients with FUBCs needed ICU care compared to those without FUBCs (41.4% and 25.5% respectively, P < 0.001) Microbiology of index blood culture in those with and without FUBCs Outcomes in those with and without FUBCs FUBCs characteristics Conclusion Obtaining FUBCs in GNB had no impact on 30-day mortality or 30-day readmission rate. It was associated with longer LOS and antibiotic duration. Our findings suggest that FUBCs in GNB are low yield and may not be recommended in all patients. Prospective studies are needed to further examine the utility of this practice in GNB. Disclosures All Authors: No reported disclosures

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