Motivations and Experiences in a Physical Activity Program for Cancer Survivors: Findings from Key Informant Interviews

Purpose LIVESTRONG at the YMCA is an evidence-based 12-week physical activity (PA) program for cancer survivors. The purpose of our study was to understand the factors that motivated cancer survivors to begin the program, how the program impacted their habits, and how their experience influenced their motivation to continue with the program. Approach or Design Key informant interviews Setting Phone interviews conducted between April 15 and June 1, 2020. Participants 27 cancer survivors in Texas who previously participated in the LS program. Method Participants completed a 30- to 60-minute interview with one of four interviewers. All interviews were recorded, transcribed, and analyzed for themes. Results Most interviewees were motivated to begin the program because of a desire to feel better after treatment. The most cited motivator to continue in the program was the community of cancer survivors. During the program, interviewees enjoyed learning different exercises, the community of cancer survivors, and the supportive teachers. Nearly all interviewees adopted or changed a healthy habit as a result of the program. Conclusion These results could be used by healthcare professionals to better understand what motivates cancer survivors to participate in a PA program. Results could also be used to plan or modify other PA programs for cancer survivors.

Improving Health of People With Multiple Sclerosis From a Multicenter Randomized Controlled Study in Parallel Groups: Preliminary Results on the Efficacy of a Mindfulness Intervention and Intention Implementation Associated With a Physical Activity Program

Objectives: The objective of this study is to investigate the efficacy of psychological Interventions – Mindfulness or Implementation Intention – associated with a Physical Activity program, delivered via internet, in reducing Multiple Sclerosis symptoms.Method: Thirty-five adults were randomly assigned to one of the three groups: a Mindfulness-Based Intervention group (N = 12), Implementation Intention group (N = 11), and a Control Group (N = 12). All the groups received the same Physical Activity program. The Mindfulness condition group received daily training in the form of pre-recorded sessions while the Implementation group elaborated their specific plans once a week. Mobility, fatigue, and the impact of the disease on the patient’s life were measured. Two measurement times are carried out in pre-post intervention, at baseline and after eight weeks.Results: Overall, after 8 weeks intervention, results show that there was a significant increase in Walking distance in the three groups. In addition, the within-group analysis showed a statistically significant improvement between pre and post intervention on the physical component of the Disease Impact scale in the Implementation Intention group (p = 0.023) with large effect size, in the Mindfulness-Based Intervention group (p = 0.008) with a medium effect size and in the control group (p = 0.028) with small effect size. In the Implementation Intention group, all physical, psychosocial and cognitive Fatigue Impact subscales scores decreased significantly (p = 0.022, p = 0.023, and p = 0.012, respectively) and the physical component was statistically and negatively correlated (r = −0.745; p = 0.008) when Implementation Intention group practice a mild to moderate physical activity. In the Mindfulness-Based Intervention group, the physical component (MFIS) showed a statistically significant improvement (p = 0.028) but no correlation with moderate-to-vigorous physical activity (MVPA); the control group outcomes did not reveal any significant change.Conclusion: The results of this study are very encouraging and show the feasibility of Mindfulness interventions associated with physical activity to improve the health of people with MS. Further study should assess Mindfulness interventions tailored to MS condition and using both hedonic and eudemonic measures of happiness.

Physical activity program using active video games with sedentary adolescents

Objective: the aim of our study was to assess the effect of a physical activity that uses active video games in body composition, physical fitness, cardiovascular and biochemical parameters with sedentary adolescents. Methods: a non-controlled clinical trial design with a convenience sample of adolescents, separately, from ages ten to 17, of both genders. The intervention protocol consisted of physical activity with active video games (AVG), lasting two months, in 24 sessions, evolving into three levels (basic, intermediate and advanced) according to the maximum heart rate of the individuals. The adolescents’ body composition, physical fitness, cardiovascular and biochemical parameters were assessed. Data analysis was performed with a 95% confidence interval. Results: among the 14 adolescents that completed the physical training, we observed a improvement of muscle resistance (Δ= 8.26; p= 0.02) and decrease in post-exercise heart rate and systolic blood pressure (p< 0.01). However, were found a non-significant decrease in body fat percentage (Δ= -3.83; p= 0.24) and strength (Δ= 4.26; p= 0.57). A high level of satisfaction with the proposed activity was identified. Conclusion: a physical activity program based on AVG can reduce cardiovascular risk factors and improve muscle resistance in sedentary adolescents.

Cardiovascular Autonomic Function Changes and Predictors During a 2-Year Physical Activity Program in Rheumatoid Arthritis: A PARA 2010 Substudy

Background: Chronic inflammation leads to autonomic dysfunction, which may contribute to the increased risk of cardiovascular diseases (CVD) in patients with rheumatoid arthritis (RA). Exercise is known to restore autonomic nervous system (ANS) activity and particularly its parasympathetic component. A practical clinical tool to assess autonomic function, and in particular parasympathetic tone, is heart rate recovery (HRR). The aim of this substudy from the prospective PARA 2010 study was to determine changes in HRR post-maximal exercise electrocardiogram (ECG) after a 2-year physical activity program and to determine the main predictive factors associated with effects on HRR in RA.Methods: Twenty-five participants performed physiotherapist-guided aerobic and muscle-strengthening exercises for 1 year and were instructed to continue the unsupervised physical activity program autonomously in the next year. All participants were examined at baseline and at years 1 and 2 with a maximal exercise ECG on a cycle ergometer. HRR was measured at 1, 2, 3, 4, and 5 min following peak heart rate during exercise. Machine-learning algorithms with the elastic net linear regression models were performed to predict changes in HRR1 and HRR2 at 1 year and 2 years of the PARA program.Results: Mean age was 60 years, range of 41–73 years (88% women). Both HRR1 and HRR2 increased significantly from baseline to year 1 with guided physical activity and decreased significantly from year 1 to year 2 with unsupervised physical activity. Blood pressure response to exercise, low BMI, and muscular strength were the best predictors of HRR1/HRR2 increase during the first year and HRR1/HRR2 decrease during the second year of the PARA program.Conclusion: ANS activity in RA assessed by HRR was improved by guided physical activity, and machine learning allowed to identify predictors of the HRR response at the different time points. HRR could be a relevant marker of the effectiveness of physical activity recommended in patients with RA at high risk of CVD. Very inactive and/or high CVD risk RA patients may get substantial benefits from a physical activity program.

Adapted Physical Activity for Breast Cancer Patients Treated with Neoadjuvant Chemotherapy and Trastuzumab Against HER2 (APACAN2): A Protocol for a Feasibility Study

BackgroundThe standard care for HER2-positive breast cancer is chemotherapy plus a HER2-directed therapy. This can lead to treatment-induced cardiotoxicity. On the other hand, the practice of physical activity is known to improve cardiac function; thus HER2-positive breast cancer patients could draw particular benefit from physical activity during treatment. However, at the time of diagnosis for breast cancer, the majority of patients are insufficiently active according to physical activity recommendations of World Health Organisation, and it is difficult to remain or become active during the treatment. There is a lack of data in the literature on the optimal program to propose to patients to encourage them to be active during treatment. The aim of our study is to assess the feasibility of a home-based physical activity program during neoadjuvant chemotherapy and trastuzumab for HER2-positive breast cancer.MethodsThe APACAN2 study is a single-centre, non-randomized interventional trial. Patients with HER2-positive breast cancer treated with anthracycline-based neoadjuvant chemotherapy and trastuzumab are eligible for enrolment. The supervised home-based physical activity program takes place during neoadjuvant chemotherapy (NACT). It combines aerobic and strengthening exercises. The primary endpoint is the proportion of patients reaching the international physical activity recommendations, i.e. 150 minutes of moderate-intensity activity per week at the end of NACT. The study started in April 2018 and seventy patients are expected to be recruited.DiscussionIn the literature, the majority of studies on practice of physical activity in breast cancer focus on adjuvant chemotherapy or on the period after the end of treatment. To the best of our knowledge, the APACAN2 study is the first to evaluate a home-based physical activity program during neoadjuvant chemotherapy for HER2-positive breast cancer.Trial Registration NumberClinicaltrials.gov: NCT02963363, registered on July 11, 2016. Identifier with the French National Agency for the Safety of Medicines and Health Products N°ID RCB 2016-A01344-47, registered in August 2016. Protocol: version 8, 24 February 2021.

PELATIHAN SENAM REMATIK UNTUK MENURUNANKAN NYERI PADA PENDERITA RHEUMATOID ARTHRITIS DIDESA PERIGI KECAMATAN PULAU PINANG KABUPATEN LAHAT TAHUN 2020

ABSTRAKRheumatoid arthritis (RA) merupakan permasalahan sistem muskuloskeletal yang paling banyak terjadi di seluruh dunia, dampak dari RA menyebabkan gangguan kenyamanan, nyeri, keterbatasan mobilitas sampai dengan resiko kecacatan dan kelumpuhan. Program aktifitas fisik yang efektif sangat direkomendasikan bagi penderita RA adalah senam rematik yang sudah terbukti mampu mengurangi skala nyeri bagi para penderita RA. Berdasarkan studi pendahuluan ternyata penderita RA belum mengetahui cara melakukan senam rematik untuk mengurangi nyeri sendi. Sehingga pengenalan dan pemeberian senam rematik bagi para penderita RA wilayah kerja Puskesmas Pulau Pinang perlu untuk dilakukan sebagai program aktifitas fisik yang diharapkan mampu menurungkan skala nyeri bagi para penderita RA. Metode yang dilakukkan adalah melakukan studi pendahuluan, bekerjasama dengan tenaga kesehatan, tokoh masyarakat dan kader yang ada di wilayah Puskesmas Pulau Pinang, pelaksanaan kegiatan dengan memberikan pelatihan dengan cara menonton video dan praktek secara langsung senam rematik, selanjutnya dlakukan pemantaun sebelum dan sesudah intervensi dengan menggunakan lembar observasi Numerical Rating scale (NRS). Hasilnya setelah diberikan senam rematik selama 1 bulan, dengan 1x kegiatan setiap minggu dengan durasi 8 menit, terjadi penurunan skala nyeri 15 orang peserta yang mengalami nyeri sedang menjadi nyeri ringan. Senam rematik mampu mempengaruhi kerja cerebral cortex meliputi aspek kognitif maupun emosi, sehingga dapat memberikan persepsi positif dan relaksasi, yang berdampak pada perasaan bahagia dan mengurangi nyeri. Kata Kunci : senam rematik; rheumatoid arthritis; nyeri; komunitas. ABSTRACT Rheumatoid arthritis (RA) is the most common musculoskeletal system problem worldwide, the impact of RA causing discomfort, pain, limited mobility, and the risk of disability and paralysis. An effective physical activity program highly recommended for RA sufferers is rheumatic gymnastics, which has been proven to reduce pain scales for RA sufferers. Based on preliminary studies, RA patients do not know how to do rheumatic gymnastics to reduce joint pain. The introduction and intervention of rheumatic gymnastics for patients with RA in the Pulau Pinang Health Center need to be carried out as a physical activity program to reducing the pain scale for the sufferer of RA. The method used is conducting a preliminary study, collaboration with health workers, community leaders, and cadres in the Pulau Pinang Health Center area, implementing activities by providing training by watching videos and practicing rheumatic gymnastic, and then monitoring before and after the intervention using Numerical Rating scale (NRS) observation. The result was that after being given rheumatic exercise for one month, with one activity per week in 8 minutes duration, there was a decrease in the pain scale of 15 participants who experienced moderate pain to mild pain. Rheumatic gymnastics can affect the work of the cerebral cortex, including cognitive and emotional aspects, providing positive perceptions and relaxation, which has an impact on feelings of happiness and reduces pain. Keywords: rheumatic gymnastics; rheumatoid arthritis; pain; community.

Effects of a Web-Based Parent–Child Physical Activity Program on Mental Health in Parents of Children with ASD

Parents of children with ASD experience a higher incidence of mental health difficulties, including stress, depression, and anxiety, than parents of children without ASD. According to studies related to ASD, parent–child physical activity programs are an effective approach to encourage both parents and their children with ASD to exercise together, thus improving the mental health of parents due to this interactive family activity. The purpose of the present study was to explore the effects of this web-based parent–child physical activity program on the mental health of parents of children with ASD. A total of 94 parent–child pairs consented to participate in this study, and 75 parent–child pairs completed the study. Three instruments—DASS-21, PSI-4-SF, and WHOQOL-26—were used to measure mental health, parental stress, and quality of life, respectively. A randomized controlled trial design was implemented to examine the effectiveness of the 10-week web-based parent–child physical activity program on improving the mental health of parents of children with ASD. The results showed that after the 10-week parent–child physical activity program, there were significant differences in overall DASS-21 and PSI-4-SF for the experimental group, compared with control group (p < 0.05), which indicated that the parent–child physical activity program has a positive influence on mental health in parents of children with ASD. One sub-area of WHOQOL-26 between the experimental and control groups across pre-/post-testing intervals also showed greater reductions in the item of psychological health (p < 0.05). In conclusion, the findings demonstrated the efficacy of the web-based parent–child physical activity program for improving mental health in parents of children with ASD.