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Lahousse A, Reynebeau I, Nijs J, Beckwée D, van Wilgen P, Fernández-de-Las-Peñas C, Mostaqim K, Roose E, Leysen L. The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis. J Cancer Surviv 2024; 18:854-899. [PMID: 36701101 PMCID: PMC9878499 DOI: 10.1007/s11764-022-01270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/01/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice (PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP alone or (4) BGA alone in cancer patients and survivors (CPaS). METHODS PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to 6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach. RESULTS Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity of PIP + BGA comparing to WLC were found for anxiety (SMD - 1.29 [-1.71; - 0.86]), depression (SMD - 0.79 [- 1.10; - 0.48]), functional impairment (SMD - 0.72 [- 0.95; - 0.50]), PA (self-reported: (SMD - 0.58 [- 0.84; - 0.32]) and objectively measured: (SMD - 0.51 [- 0.90; - 0.13])) and social impairment (SMD - 0.33 [- 0.58; - 0.08]). When comparing PIP + BGA to OI, fatigue (SMD - 0.35 [- 0.51; - 0.20]) and PA (SMD - 0.26 [- 0.41; - 0.11]) at PI, and fatigue (SMD - 0.34 [- 0.58; - 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone. CONCLUSIONS PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions such as WLC, usual care and education. However, further research is needed on 'how' and 'when' PIP + BGA should be provided in cancer rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA and reduce DS.
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Affiliation(s)
- Astrid Lahousse
- Research Foundation - Flanders (FWO), Brussels, Belgium.
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Iris Reynebeau
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - David Beckwée
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Paul van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Transdisciplinary Pain Management Centre, Groningen, the Netherlands
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Valle CG, Heiling HM, Deal AM, Diamond MA, Hales DP, Nezami BT, Rini CM, Pinto BM, LaRose JG, Tate DF. Examining sociodemographic and health-related characteristics as moderators of an mHealth intervention on physical activity outcomes in young adult cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01577-4. [PMID: 38607515 DOI: 10.1007/s11764-024-01577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE This study explored whether sociodemographic and health-related characteristics moderated mHealth PA intervention effects on total and moderate-to-vigorous physical activity (MVPA) at 6 months, relative to a self-help condition among young adult cancer survivors (YACS). METHODS We conducted exploratory secondary analyses of data from a randomized controlled trial among 280 YACS. All participants received digital tools; intervention participants also received lessons, adaptive goals, tailored feedback, text messages, and Facebook prompts. Potential moderators were assessed in baseline questionnaires. PA was measured at baseline and 6 months with accelerometers. Linear model repeated measures analyses examined within- and between-group PA changes stratified by levels of potential moderator variables. RESULTS Over 6 months, the intervention produced MVPA increases that were ≥ 30 min/week compared with the self-help among participants who were males (28.1 vs. -7.7, p = .0243), identified with racial/ethnic minority groups (35.2 vs. -8.0, p = .0006), had baseline BMI of 25-30 (25.4 vs. -7.2, p = .0034), or stage III/IV cancer diagnosis (26.0 vs. -6.8, p = .0041). Intervention participants who were ages 26-35, college graduates, married/living with a partner, had a solid tumor, or no baseline comorbidities had modest MVPA increases over 6 months compared to the self-help (ps = .0163-.0492). Baseline characteristics did not moderate intervention effects on total PA. CONCLUSIONS The mHealth intervention was more effective than a self-help group at improving MVPA among subgroups of YACS defined by characteristics (sex, race, BMI, cancer stage) that may be useful for tailoring PA interventions. IMPLICATIONS FOR CANCER SURVIVORS These potential moderators can guide future optimization of PA interventions for YACS. CLINICALTRIALS GOV IDENTIFIER NCT03569605.
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Affiliation(s)
- Carmina G Valle
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hillary M Heiling
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Molly A Diamond
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Derek P Hales
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine M Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Deborah F Tate
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Gell NM, Dittus K, Caefer J, Martin A, Bae M, Patel KV. Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial. J Cancer Surviv 2024; 18:596-605. [PMID: 36374436 PMCID: PMC9662104 DOI: 10.1007/s11764-022-01292-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The study aimed to determine the feasibility of remotely delivered exercise (tele-exercise) for older, rural cancer survivors and to explore the effects of tele-exercise on physical function, physical activity, and patient-reported outcomes. METHODS Participants were rural cancer survivors age ≥ 60 years (79% female; mean age 70.4 ± 5.7) randomly assigned to the remotely delivered EnhanceFitness (tele-EF) exercise program, inclusive of aerobic, strength, and balance training and led by American Council on Exercise certified instructors for 1 h, 3 days/week for 16 weeks (n = 20) or to a waitlist control group (n = 19). We assessed feasibility, physical function, accelerometer-measured physical activity, and patient-reported outcomes at baseline and post intervention. RESULTS Among those screened as eligible, 44 (64%) consented to participate with 39 randomized after completing baseline measures. Attrition was equivalent between groups (n = 1, each) with 95% completing the study. The median class attendance rate was 86.9% (interquartile range: 79-94%). Compared to controls, tele-EF participants had statistically significant improvement in the five-time sit-to-stand test (- 3.4 vs. - 1.1 s, p = 0.03, effect size = 0.44), mean daily light physical activity (+ 38.5 vs 0.5 min, p = 0.03, effect size = 0.72) and step counts (+ 1977 vs. 33, p = 0.01, effect size = 0.96). There were no changes in self-efficacy for exercise, fatigue, or sleep disturbance between groups. CONCLUSIONS Findings indicate that tele-EF is feasible in older, rural cancer survivors and results in positive changes in physical function and physical activity. IMPLICATIONS FOR CANCER SURVIVORS Tele-EF addresses common barriers to exercise for older, rural cancer survivors, including limited accessible opportunities for professional instruction and supervision.
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Affiliation(s)
- Nancy M Gell
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA.
- University of Vermont Cancer Center, Burlington, VT, USA.
| | - Kim Dittus
- University of Vermont Cancer Center, Burlington, VT, USA
- Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Jacqueline Caefer
- Department of Physical Therapy Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Anita Martin
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA
| | - Myeongjin Bae
- Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA
| | - Kushang V Patel
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, USA
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Villumsen BR, Frystyk J, Jørgensen MG, Hørdam B, Borre M. Exergaming Improves Cardiac Risk Factors in Prostate Cancer Patients: A Single-Blinded Randomized Controlled Trial. Games Health J 2024; 13:93-99. [PMID: 37917926 DOI: 10.1089/g4h.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Purpose: Androgen deprivation therapy (ADT) may induce unfavorable changes in metabolic outcomes, insulin sensitivity, insulin-like growth factors (IGFs), and in serum levels of adipocyte-derived hormones. In this preplanned randomized ancillary study, we aimed to investigate the ability of exercise to counteract alterations in triglyceride, cholesterol, waist circumference, and insulin caused by ADT in men with locally advanced and metastatic prostate cancer (PCa). Materials and Methods: Forty-six PCa patients undergoing treatment were randomized to 12 weeks of 180 minutes of weekly unsupervised home-based exergaming or usual care. Blood glucose, lipids, cholesterol, adiponectin, leptin, insulin sensitivity, and the insulin growth factor axis were measured at baseline, and after 12 and 24 weeks. Biomarkers were analyzed using a linear mixed-effect model of the difference between the groups from baseline to week 24. In addition, blood pressure, body mass index, body weight, and waist circumference were measured at baseline and after 12 weeks/end of intervention and analyzed using adjusted linear regression analysis. Results: After 24 weeks, a significant difference was seen between the intervention and usual care groups in plasma triglyceride (diff: 0.5 mmol/L, P = 0.02) and high-density lipoprotein (HDL; diff: 0.2 mmol/L, P = 0.01) favoring the intervention group, whereas IGF-binding protein-3 (diff: 148 μg/L, P = 0.01) favored the usual care group. The remaining outcomes were unaffected. Conclusion: Improvement in HDL cholesterol could be used as a primary biomarker in future randomized controlled trials investigating the cardiovascular protecting properties of exergaming.
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Affiliation(s)
- Brigitta R Villumsen
- Department of Urology, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus C, Denmark
| | - Jan Frystyk
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus C, Denmark
- Department of Endocrinology, Odense University Hospital & Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark
| | - Martin Grønbech Jørgensen
- Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Denmark
| | - Britta Hørdam
- Department of Political Science, University of Copenhagen, København, Denmark
| | - Michael Borre
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus C, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus N, Denmark
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Lally P, Kennedy F, Smith S, Beeken RJ, Buck C, Thomas C, Counsell N, Wyld L, Martin C, Williams S, Roberts A, Greenfield DM, Gath J, Potts HWW, Latimer N, Smith L, Fisher A. The feasibility and acceptability of an app-based intervention with brief behavioural support (APPROACH) to promote brisk walking in people diagnosed with breast, prostate and colorectal cancer in the UK. Cancer Med 2024; 13:e7124. [PMID: 38529687 DOI: 10.1002/cam4.7124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Increased moderate to vigorous physical activity (MVPA) can improve clinical and psychosocial outcomes for people living with and beyond cancer (LWBC). This study aimed to assess the feasibility and acceptability of trial procedures in a pilot randomised controlled trial (RCT) of a theory-driven app-based intervention with behavioural support focused on promoting brisk walking (a form of MVPA) in people LWBC (APPROACH). METHODS Participants diagnosed with breast, prostate or colorectal cancer were recruited from a single UK hospital site. Assessments at baseline and 3 months included online questionnaires, device-measured brisk walking (activPAL accelerometer) and self-reported weight and height. Participants were randomised to intervention or control (care as usual). The intervention comprised a non-cancer-specific app to promote brisk walking (National Health Service 'Active 10') augmented with print information about habit formation, a walking planner and two behavioural support telephone calls. Feasibility and acceptability of trial procedures were explored. Initial estimates for physical activity informed a power calculation for a phase III RCT. A preliminary health economics analysis was conducted. RESULTS Of those medically eligible, 369/577 (64%) were willing to answer further eligibility questions and 90/148 (61%) of those eligible were enrolled. Feasibility outcomes, including retention (97%), assessment completion rates (>86%) and app download rates in the intervention group (96%), suggest that the trial procedures are acceptable and that the intervention is feasible. The phase III RCT will require 472 participants to be randomised. As expected, the preliminary health economic analyses indicate a high level of uncertainty around the cost-effectiveness of the intervention. CONCLUSIONS This pilot study demonstrates that a large trial of the brisk walking intervention with behavioural support is both feasible and acceptable to people LWBC. The results support progression onto a confirmatory phase III trial to determine the efficacy and cost-effectiveness of the intervention.
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Affiliation(s)
- Phillippa Lally
- Department of Psychological Sciences, University of Surrey, Guildford, Surrey, UK
| | - Fiona Kennedy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Susan Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, London, UK
| | - Chloe Thomas
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Nicholas Counsell
- Cancer Research UK & Cancer Trials Centre, Cancer Institute, University College London, London, UK
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Charlene Martin
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Sarah Williams
- Department of Behavioural Science and Health, University College London, London, UK
| | - Anna Roberts
- Department of Behavioural Science and Health, University College London, London, UK
| | - Diana M Greenfield
- Sheffield Teaching Hospitals NHS FT, Weston Park Hospital, Sheffield, UK
| | - Jacqui Gath
- Independent Cancer Patients' Voice (ICPV), London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Nicholas Latimer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lee Smith
- The Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
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Smith S, Lally P, Steptoe A, Chavez-Ugalde Y, Beeken RJ, Fisher A. Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study. BMC Public Health 2024; 24:635. [PMID: 38419011 PMCID: PMC10903019 DOI: 10.1186/s12889-024-17797-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND A cancer diagnosis and its treatment may be an especially isolating experience. Despite evidence that positive health behaviours can improve outcomes for people living with and beyond cancer (LWBC), no studies have examined associations between loneliness and different health behaviours in this population. This study aimed to describe the prevalence of loneliness in a large sample of UK adults LWBC and to explore whether loneliness was associated with multiple health behaviours. METHODS Participants were adults (aged ≥ 18 years) diagnosed with breast, prostate or colorectal cancer who completed the Health and Lifestyle After Cancer Survey. Loneliness was reported using the UCLA loneliness score, dichotomised into higher (≥ 6) versus lower (< 6) loneliness. Engagement in moderate-to-vigorous physical activity, dietary intake, smoking status, alcohol use, and self-reported height and weight were recorded. Behaviours were coded to reflect meeting or not meeting the World Cancer Research Fund recommendations for people LWBC. Logistic regression analyses explored associations between loneliness and health behaviours. Covariates were age, sex, ethnicity, education, marital status, living situation, cancer type, spread and treatment, time since treatment, time since diagnosis and number of comorbid conditions. Multiple imputation was used to account for missing data. RESULTS 5835 participants, mean age 67.4 (standard deviation = 11.8) years, completed the survey. 56% were female (n = 3266) and 44% (n = 2553) male, and 48% (n = 2786) were living with or beyond breast cancer, 32% (n = 1839) prostate, and 21% (n = 1210) colorectal. Of 5485 who completed the loneliness scale, 81% (n = 4423) of participants reported lower and 19% (n = 1035) higher loneliness. After adjustment for confounders, those reporting higher levels of loneliness had lower odds of meeting the WCRF recommendations for moderate-to-vigorous physical activity (Odds Ratio [OR] 0.78, 95% Confidence Internal [CI], 0.67, 0.97, p =.028), fruit and vegetable intake (OR 0.81, CI 0.67, 1.00, p =.046), and smoking (OR 0.62, 0.46, 0.84, p =.003). No association was observed between loneliness and the other dietary behaviours, alcohol, or body mass index. CONCLUSIONS Loneliness is relatively common in people LWBC and may represent an unmet need. People LWBC who experience higher levels of loneliness may need additional support to improve their health behaviours.
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Affiliation(s)
- Susan Smith
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK
| | - Phillippa Lally
- Department of Psychological Sciences, University of Surrey, GU2 7XH, Guildford, Surrey, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK
| | - Yanaina Chavez-Ugalde
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, CB2 0QQ, Cambridge, Box 285, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, LS2 9JT, Leeds, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK.
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Gale N, Jones U, Rees T, Hicks A, Davies J, Holliday S, Hopkinson J. A cancer personalised activity and lifestyle tool (CAN-PAL): A codesign study with patients and healthcare professionals. J Clin Nurs 2024; 33:572-579. [PMID: 38062580 DOI: 10.1111/jocn.16931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/21/2023] [Accepted: 11/01/2023] [Indexed: 01/19/2024]
Abstract
AIMS To codesign a cancer personalised activity and lifestyle tool (CAN-PAL) based on an existing tool. To help cancer care workers support people affected by cancer to plan and integrate physical activity into lifestyles. DESIGN Mixed-methods codesign study. METHODS Phase 1: Focus groups with people affected by cancer (n = 10) or interviews (n = 2) to discuss suitable physical activities and adaptation of the existing tool. Data were recorded, transcribed and analysed thematically. Themes informed the design of the prototype CAN-PAL and user guide. Phase 2: Healthcare professionals considered the potential use of the CAN-PAL prototype and completed an online survey including the system usability scale and free text responses. RESULTS Phase 1: Identified suitable physical activities and four themes were identified including: Capability, benefits, barriers and resources which informed the prototype CAN-PAL and user guide. Phase 2: The user survey was completed by 12 healthcare professionals. Median (range) system usability scale was 80 (50-95) (best score 100), scores >68 indicate good or better usability. Themes from the free text comments included strengths, amendments, considerations and limitations. Results were used to finalise CAN-PAL and the user guide. CONCLUSION The codesigned CAN-PAL tool had good usability. Further work is needed to evaluate the impact of CAN-PAL on activity levels and behaviour in people affected by cancer. RELEVANCE TO CLINICAL PRACTICE People affected by cancer need support to undertake physical activity. The purpose of CAN-PAL is to assist cancer care workers to support people affected by cancer to plan and integrate physical activity into lifestyles. PATIENT OR PUBLIC CONTRIBUTION Public partners considered the findings from Phase 1 and 2 and informed the design of the prototype, final CAN-PAL and user guide and coauthored the paper. REPORTING METHOD The study adhered to relevant EQUATOR guidelines; the study was reported according to the COREQ checklist.
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Affiliation(s)
- Nichola Gale
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Una Jones
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Tracy Rees
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Alexandra Hicks
- Public Partner, School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Janet Davies
- Public Partner, School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Jane Hopkinson
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Xu B, Qian M, Zhu L, Lu Z. Study on the Relationship Between Uncertainty Tolerance and Positive Acceptance in Postoperative Patients With Cervical Cancer. Cureus 2024; 16:e54414. [PMID: 38510856 PMCID: PMC10950615 DOI: 10.7759/cureus.54414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE The objective of this study is to clarify the correlation between uncertainty tolerance (UT) and positive acceptance (PA) in patients with cervical cancer (CC) after surgical treatment. METHODS A total of 233 patients with CC who had undergone surgery were included and were scored on the UT Scale and Positive Acceptance Scale. In addition, patients were classified according to the length of stay ≥1 week and length of stay <1 week, and the UT score and satisfaction and enterprising score of the two groups were compared. This was performed in order to analyze the effect of length of hospital stay on UT and PA. RESULTS The mean UT score of 233 patients was 3.74±0.34 and the mean PA score was 1.96±0.20, with a negative correlation and a significant correlation coefficient (r=-0.342, P 0.05). The UT score of post-operative CC patients with length of stay ≥1 week was significantly higher than that of patients with length of stay <1 week, P<0.05. The score of PA in patients with post-operative CC whose hospital stay was ≥1 week was significantly lower than for patients with hospital stays <1 week (P<0.05). UT was negatively correlated with PA in patients with hospital stays < 1 week (r=-0.358, P<0.05). There was a significant negative correlation between UT and PA in patients with hospital stay ≥1 week (r =-0.493, P<0.05). Increased hospitalization time correlated with increased scores of UT, with reductions in scores of PA. CONCLUSION Post-operative patients with CC had higher scores of UT and lower scores of PA, which were negatively correlated. Increased hospitalization time was linked to a detriment in patient UT and reduced PA. Targeted interventions to improve the level of UT and PA within postoperative CC cases should be developed.
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Affiliation(s)
- Binbin Xu
- Gynecologic Oncology, Ningbo Women and Children's Hospital, Ningbo, CHN
| | - Miaohong Qian
- Gynecology, Ningbo Women and Children's Hospital, Ningbo, CHN
| | - Lanfen Zhu
- Gynecology, Ningbo Women and Children's Hospital, Ningbo, CHN
| | - Zhaie Lu
- Obstetrics and Gynaecology, Ningbo Women and Children's Hospital, Ningbo, CHN
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Azhar Hilmy SH, Nordin N, Yusof MYPM, Soh TYT, Yusof N. Components in downstream health promotions to reduce sugar intake among adults: a systematic review. Nutr J 2024; 23:11. [PMID: 38233923 PMCID: PMC10792802 DOI: 10.1186/s12937-023-00884-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 10/19/2023] [Indexed: 01/19/2024] Open
Abstract
Excessive sugar consumption is well documented as a common risk factor for many Non-Communicable Diseases (NCDs). Thus, an adequate intervention description is important to minimise research waste and improve research usability and reproducibility. A systematic review was conducted to identify components in published evidence interventions pertaining to the health promotions on reducing sugar intake among adults. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and used the Mixed Methods Appraisal Tool (MMAT) for quality appraisal. The period for the selected study was from 2000 to 2022, and articles were retrieved from Web of Science (WOS), Medline, Scopus, and PubMed. The target population was adults aged 18 years old and above who underwent intervention to assess the changes in their sugar intake. Data sources and all human epidemiologic studies were included. Out of the 9,333 papers identified, 25 were included. The overall quality of evidence of the studies was considered moderate. Apart from the characteristics of the reviewed studies, components of interventions are including the basis of theoretical or model for the intervention, which majority use Social Cognitive Theory, followed by PRECEDE-PROCEED model, socio-ecological and process-improvement theories and Transtheoretical Model; providers, who are commercial provider, qualified nutritionist, professor of nutrigenomics and nutrigenetics, doctor, dietitian nutritionist, lifestyle coaches, and junior public health nurses; duration of the intervention and follow-up time, varies from as short as one month to as long as 24 months; material provided either softcopy or hardcopy; tailoring approach, based on the individual goals, the process of change, genotype analysis, beliefs, barriers, and sociocultural norms; delivery mechanism either face-to-face or technology-mediated; and tools to measure the sugar consumption outcome mostly used Food Frequency Questionnaire (FFQ), besides 24-h dietary recalls, and food diaries. There are various components in downstream health promotion to reduce sugar intake among adults that can be adapted according to the local health promotion and intervention context. More well-designed interventions using integration components are encouraged in further studies.
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Affiliation(s)
- Syathirah Hanim Azhar Hilmy
- Centre of Population Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, 47000, Malaysia
- Department of Periodontology & Community Oral Health, Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, 57000, Malaysia
| | - Norhasnida Nordin
- Centre of Comprehensive Care, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Selangor, Malaysia
| | - Mohd Yusmiaidil Putera Mohd Yusof
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Selangor, Malaysia
| | - Tuan Yuswana Tuan Soh
- Centre of Population Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, 47000, Malaysia
| | - Norashikin Yusof
- Centre of Population Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, 47000, Malaysia.
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Lyu DW. Immunomodulatory effects of exercise in cancer prevention and adjuvant therapy: a narrative review. Front Physiol 2024; 14:1292580. [PMID: 38239881 PMCID: PMC10794543 DOI: 10.3389/fphys.2023.1292580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Successful application of cancer immunotherapy has rekindled hope in cancer patients. However, a number of patients are unresponsive to immunotherapy and related treatments. This unresponsiveness in cancer patients toward different treatment regimens can be mainly attributed to severe immune dysfunction in such patients. Several reports indicate that physical exercise can significantly lead to improved cancer patient outcomes. Since exercise gets immense response from the immune system, it can be utilized to improve immune function. Leukocytes with enhanced functions are substantially mobilized into the circulation by a single bout of intense physical exercise. Chronic physical exercise results in greater muscle endurance and strength and improved cardiorespiratory function. This exercise regime is also useful in improving T-cell abundance and reducing dysfunctional T cells. The current available data strongly justify for future clinical trials to investigate physical exercise use as an adjuvant in cancer therapy; however, optimal parameters using exercise for a defined outcome are yet to be established. The components of the immune system associate with almost every tumorigenesis step. The inter-relationship between inflammation, cancer, and innate immunity has recently gained acceptance; however, the underlying cellular and molecular mechanisms behind this relationship are yet to be solved. Several studies suggest physical exercise-mediated induction of immune cells to elicit anti-tumorigenic effects. This indicates the potential of exercising in modulating the behavior of immune cells to inhibit tumor progression. However, further mechanistic details behind physical exercise-driven immunomodulation and anticancer effects have to be determined. This review aims to summarize and discuss the association between physical exercise and immune function modulation and the potential of exercise as an adjuvant therapy in cancer prevention and treatment.
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Affiliation(s)
- Da-wei Lyu
- Physical Education and Health School, East China Jiaotong University, Nanchang, Jiangxi, China
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11
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Edbrooke L, Jones TL. Behavior Change Techniques for the Maintenance of Physical Activity in Cancer. JMIR Cancer 2023; 9:e53602. [PMID: 38015601 DOI: 10.2196/53602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
Ester et al report the findings from a 2-arm cluster randomized controlled trial nested within a hybrid effectiveness-implementation study, which involved a 12-week exercise and behavior change program for rural and remote Canadians (Exercise for Cancer to Enhance Living Well [EXCEL]). The addition of 23 weeks of app-based physical activity monitoring to the EXCEL program did not result in significant between-group differences in physical activity at 6 months. While several behavior change techniques were included in the initial 12-week intervention, additional techniques were embedded within the mobile app. However, there is currently a lack of evidence regarding how many and which behavior change techniques are the most effective for people with cancer and if these differ based on individual characteristics. Potentially, the use of the mobile app was not required in addition to the behavior change support delivered to both groups as part of the EXCEL program. Further research should involve participants who may be in most need of behavioral support, for example, those with lower levels of self-efficacy. Suggestions for future research to tailor behavior change support for people with cancer are discussed.
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Affiliation(s)
- Lara Edbrooke
- The University of Melbourne, Melbourne, Australia
- The Peter MacCallum Cancer Centre, Melbourne, Australia
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12
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What Does Cochrane Say About Rehabilitation for Cancer? Physiother Can 2023; 75:395. [PMID: 38037583 PMCID: PMC10686307 DOI: 10.3138/ptc-75.4-cochrane] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
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Ha DM, Comer A, Dollar B, Bedoy R, Ford M, Gozansky WS, Zeng C, Arch JJ, Leach HJ, Malhotra A, Prochazka AV, Keith RL, Boxer RS. Telemedicine-based inspiratory muscle training and walking promotion with lung cancer survivors following curative intent therapy: a parallel-group pilot randomized trial. Support Care Cancer 2023; 31:546. [PMID: 37656252 PMCID: PMC10474183 DOI: 10.1007/s00520-023-07999-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE Following curative-intent therapy of lung cancer, many survivors experience dyspnea and physical inactivity. We investigated the feasibility, acceptability, safety, and potential efficacy of inspiratory muscle training (IMT) and walking promotion to disrupt a postulated "dyspnea-inactivity" spiral. METHODS Between January and December 2022, we recruited lung cancer survivors from Kaiser Permanente Colorado who completed curative-intent therapy within 1-6 months into a phase-IIb, parallel-group, pilot randomized trial (1:1 allocation). The 12-week intervention, delivered via telemedicine, consisted of exercise training (IMT + walking), education, and behavior change support. Control participants received educational materials on general exercise. We determined feasibility a priori: enrollment of ≥ 20% eligible patients, ≥ 75% retention, study measure completion, and adherence. We assessed acceptability using the Telemedicine-Satisfaction-and-Usefulness-Questionnaire and safety events that included emergency department visits or hospitalizations. Patient-centered outcome measures (PCOMs) included dyspnea (University-of-California-San-Diego-Shortness-of-Breath-Questionnaire), physical activity (activPAL™ steps/day), functional exercise capacity (mobile-based-six-minute-walk-test), and health-related quality of life (HRQL, St.-George's-Respiratory-Questionnaire). We used linear mixed-effects models to assess potential efficacy. RESULTS We screened 751 patients, identified 124 eligible, and consented 31 (25%) participants. Among 28 participants randomized (14/group), 22 (11/group) completed the study (79% retention). Intervention participants returned > 90% of self-reported activity logs, completed > 90% of PCOMs, and attended > 90% of tele-visits; 75% of participants performed IMT at the recommended dose. Participants had high satisfaction with tele-visits and found the intervention useful. There was no statistically significant difference in safety events between groups. Compared to control participants from baseline to follow-up, intervention participants had statistically significant and clinically meaningful improved HRQL (SGRQ total, symptom, and impact scores) (standardized effect size: -1.03 to -1.30). CONCLUSIONS Among lung cancer survivors following curative-intent therapy, telemedicine-based IMT + walking was feasible, acceptable, safe, and had potential to disrupt the "dyspnea-inactivity" spiral. Future efficacy/effectiveness trials are warranted and should incorporate IMT and walking promotion to improve HRQL. TRIAL REGISTRATION ClinicalTrials.gov NCT05059132.
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Affiliation(s)
- Duc M Ha
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA.
- Section of Pulmonary and Critical Care, Medical & Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Angela Comer
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Blythe Dollar
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Ruth Bedoy
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Morgan Ford
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Wendolyn S Gozansky
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Chan Zeng
- Institute for Health Research, Kaiser Permanente Colorado2550 S Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Joanna J Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, CO, USA
| | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California San Diego, San Diego, CA, USA
| | - Allan V Prochazka
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert L Keith
- Section of Pulmonary and Critical Care, Medical & Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rebecca S Boxer
- Division of Geriatrics, Hospice and Palliative Care Medicine, University of California Davis, Sacramento, CA, USA
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Ha DM, Nunnery MA, Klocko RP, Haverhals LM, Bekelman DB, New ML, Randhawa SK, Stevens-Lapsley JE, Studts JL, Prochazka AV, Keith RL. Lung cancer survivors' views on telerehabilitation following curative intent therapy: a formative qualitative study. BMJ Open 2023; 13:e073251. [PMID: 37355268 PMCID: PMC10314696 DOI: 10.1136/bmjopen-2023-073251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/09/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES To inform personalised home-based rehabilitation interventions, we sought to gain in-depth understanding of lung cancer survivors' (1) attitudes and perceived self-efficacy towards telemedicine; (2) knowledge of the benefits of rehabilitation and exercise training; (3) perceived facilitators and preferences for telerehabilitation; and (4) health goals following curative intent therapy. DESIGN We conducted semi-structured interviews guided by Bandura's Social Cognitive Theory and used directed content analysis to identify salient themes. SETTING One USA Veterans Affairs Medical Center. PARTICIPANTS We enrolled 20 stage I-IIIA lung cancer survivors who completed curative intent therapy in the prior 1-6 months. Eighty-five percent of participants had prior experience with telemedicine, but none with telerehabilitation or rehabilitation for lung cancer. RESULTS Participants viewed telemedicine as convenient, however impersonal and technologically challenging, with most reporting low self-efficacy in their ability to use technology. Most reported little to no knowledge of the potential benefits of specific exercise training regimens, including those directed towards reducing dyspnoea, fatigue or falls. If they were to design their own telerehabilitation programme, participants had a predominant preference for live and one-on-one interaction with a therapist, to enhance therapeutic relationship and ensure correct learning of the training techniques. Most participants had trouble stating their explicit health goals, with many having questions or concerns about their lung cancer status. Some wanted better control of symptoms and functional challenges or engage in healthful behaviours. CONCLUSIONS Features of telerehabilitation interventions for lung cancer survivors following curative intent therapy may need to include strategies to improve self-efficacy and skills with telemedicine. Education to improve knowledge of the benefits of rehabilitation and exercise training, with alignment to patient-formulated goals, may increase uptake. Exercise training with live and one-on-one therapist interaction may enhance learning, adherence, and completion. Future work should determine how to incorporate these features into telerehabilitation.
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Affiliation(s)
- Duc M Ha
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mary A Nunnery
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Robert P Klocko
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Leah M Haverhals
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Division of Health Care Policy and Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - David B Bekelman
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Melissa L New
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Simran K Randhawa
- Surgical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Division of Thoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer E Stevens-Lapsley
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Geriatric Research, Education, and Clinical Center, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Jamie L Studts
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Allan V Prochazka
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Robert L Keith
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Macías-Valle A, Rodríguez-López C, González-Senac NM, Mayordomo-Cava J, Vidán MT, Cruz-Arnés ML, Jiménez-Gómez LM, Dujovne-Lindenbaum P, Pérez-Menéndez ME, Ortiz-Alonso J, Valenzuela PL, Rodríguez-Romo G, Serra-Rexach JA. Exercise effects on functional capacity and quality of life in older patients with colorectal cancer: study protocol for the ECOOL randomized controlled trial. BMC Geriatr 2023; 23:314. [PMID: 37211611 DOI: 10.1186/s12877-023-04026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Surgery and treatment for colorectal cancer (CRC) in the elderly patient increase the risk of developing post-operative complications, losing functional independence, and worsening health-related quality of life (HRQoL). There is a lack of high-quality randomized controlled trials evaluating the potential benefit of exercise as a countermeasure. The primary aim of this study is to evaluate the effectiveness of a home-based multicomponent exercise program for improving HRQoL and functional capacity in older adults undergoing CRC surgery and treatment. METHODS This randomized, controlled, observer-blinded, single-center trial aims to randomize 250 patients (>74 years) to either an intervention or a control group (i.e., usual care). The intervention group will perform an individualized home-based multicomponent exercise program with weekly telephone supervision from diagnosis until three months post-surgery. The primary outcomes will be HRQoL (EORTC QLQ-C30; CR29; and ELD14) and functional capacity (Barthel Index and Short Physical Performance Battery), which will be assessed at diagnosis, at discharge, and one, three, and six months after surgery. Secondary outcomes will be frailty, physical fitness, physical activity, inspiratory muscle function, sarcopenia and cachexia, anxiety and depression, ambulation ability, surgical complications, and hospital length of stay, readmission and mortality. DISCUSSION This study will examine the effects of an exercise program in older patients with CRC across a range of health-related outcomes. Expected findings are improvement in HRQoL and physical functioning. If proven effective, this simple exercise program may be applied in clinical practice to improve CRC care in older patients. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05448846.
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Affiliation(s)
- Angela Macías-Valle
- Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Madrid, Spain
| | - Carlos Rodríguez-López
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain.
| | - Nicolas María González-Senac
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain
| | - Jennifer Mayordomo-Cava
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain
| | - María Teresa Vidán
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain
- School of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain
| | - María Luisa Cruz-Arnés
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain
| | - Luis Miguel Jiménez-Gómez
- Colorectal Surgery Unit - General Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Paula Dujovne-Lindenbaum
- Colorectal Surgery Unit - General Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maria Elena Pérez-Menéndez
- Colorectal Surgery Unit - General Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Ortiz-Alonso
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain
- School of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of the Hospital Universitario 12 de Octubre ("Imas12"), Madrid, Spain
| | - Gabriel Rodríguez-Romo
- Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Jose Antonio Serra-Rexach
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Department of Geriatrics, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM), Dr.Esquerdo 46, 28007, Madrid, Spain
- School of Medicine, Department of Medicine, Universidad Complutense, Madrid, Spain
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Qiu L, Ye M, Tong Y, Jin Y. Promoting physical activity among cancer survivors: an umbrella review of systematic reviews. Support Care Cancer 2023; 31:301. [PMID: 37097500 PMCID: PMC10129958 DOI: 10.1007/s00520-023-07760-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE Exercise is the core element of rehabilitation for cancer patients. However, most of the patients' exercise levels failed to meet the indicators recommended by the guidelines or even decreased. Therefore, this umbrella review aims to provide an overview of review articles addressing the evidence of interventions to promote physical activity behavior change and increase physical activity among cancer patients. METHODS We searched nine databases from inception to 12 May 2022 to obtain systematic reviews and meta-analyses of interventions to promote physical activity among cancer patients. The AMSTAR-2 was used for the quality assessment. RESULTS Twenty-six individual systematic reviews including 13 studies performed meta-analyses. A total of 16 studies' designs were all in randomized controlled trial. Most reviews included studies that were mainly delivered in home settings. The most frequent and mean duration of the interventions was 12 weeks. Interventions mainly included electronic, wearable health technology-based, behavior change techniques (BCTs), and theory-based strategies. CONCLUSIONS Electronic, wearable health technology-based, BCTs, and theory-based interventions were effective and feasible in promoting physical activity in cancer survivors. Clinical practitioners should take corresponding intervention measures according to the characteristics of patients in different groups. IMPLICATIONS FOR CANCER SURVIVORS Future research may benefit cancer survivors by more comprehensively applying electronic, wearable health technology-based, BCTs, and theory-based interventions.
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Affiliation(s)
- Lin Qiu
- Department of Nursing, 7Th Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Maodie Ye
- Department of Nursing, 7Th Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yang Tong
- Department of Nail-Breast Hernia Surgery, 7Th Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongmei Jin
- Department of Nursing, 7Th Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Hirschey R, Wangen M, Okanlawon Bankole A, Hoover B, Wheeler SB, Leeman J, Leak Bryant A. Implementing Physical Activity Recommendations in Clinical Practice: A Survey of Oncology Nurses' Perspectives. Oncol Nurs Forum 2023; 50:325-336. [PMID: 37155975 PMCID: PMC10290493 DOI: 10.1188/23.onf.325-336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PROBLEM STATEMENT Better understanding of oncology nurses' perspectives about how interventions should be designed can promote physical activity (PA) in clinical settings. DESIGN 75 oncology nurses completed online surveys. DATA SOURCES A published survey, guided by the Consolidated Framework for Implementation Research, was used to assess multilevel factors that influence implementation of evidence-based interventions. ANALYSIS Descriptive statistics were applied to quantitative data; directed content analyses were applied to qualitative data. FINDINGS Participants believed it was important to discuss PA with patients; however, they had limited self-efficacy and resources to provide PA counseling. Barriers to providing counseling included competing clinical demands and a lack of education about PA for cancer survivors and resources. IMPLICATIONS FOR PRACTICE Findings inform how interventions can be designed for implementation and sustained practice change in clinical settings. Integration of PA education in routine clinical practice will lead to increased PA and, ultimately, improved quality of life among cancer survivors.
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McCourt O, Fisher A, Land J, Ramdharry G, Roberts AL, Bekris G, Yong K. "What I wanted to do was build myself back up and prepare": qualitative findings from the PERCEPT trial of prehabilitation during autologous stem cell transplantation in myeloma. BMC Cancer 2023; 23:348. [PMID: 37069548 PMCID: PMC10107576 DOI: 10.1186/s12885-023-10799-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/31/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The addition of qualitative methodology to randomised controlled trials evaluating complex interventions allows better understanding of contextualised factors and their potential influence on trial delivery and outcomes, as well as opportunities for feedback on trial participation to improve future trial protocols. This study explored the experiences of participation in cancer rehabilitation research during active cancer treatment. Participants were people living with haematological cancer myeloma, undergoing autologous stem cell transplantation (ASCT) recruited to the PERCEPT myeloma pilot trial. METHODS A qualitative semi-structured interview study, embedded within a pilot randomised controlled trial of a physiotherapist-led exercise intervention delivered before, during and after ASCT among people living with myeloma. Transcripts were analysed using reflexive thematic analysis. RESULTS Interviews from 16 trial participants (n = 8 intervention group; n = 8 control group; mean age 61 years, 56% male) were analysed. Four main themes were identified: (1) "It's not just beneficial for me, it's for people after me as well"; (2) Disparities in experience of recovery - expectations, feeling prepared and support; (3) "What I wanted to do was build myself back up and prepare"; (4) Active ingredients - participants' experience of the trial intervention. Participants reported both altruistic and perceived personal gain as motivators for enrolling in the trial. Disappointment caused by allocation to control arm may have led to participants seeking exercise elsewhere, indicating possible contamination of control condition. Disparities in experience of recovery from transplant were evident with intervention participants reporting greater trajectory of recovery. CONCLUSIONS The findings from this embedded qualitative study highlight numerous considerations required when designing pilot and efficacy trials of complex interventions. The addition of qualitative investigation offers greater understanding of motivations for participation, intervention mechanisms at play as well as effects of participation that may impact interpretation of quantitative outcomes. TRIAL REGISTRATION Qualitative findings from a prospectively registered pilot trial (ISRCTN15875290), registered 13/02/2019.
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Affiliation(s)
- Orla McCourt
- Therapies & Rehabilitation, Inpatient Therapy Office, University College London Hospitals NHS Foundation Trust, University College Hospital, T-1/Lower Ground Floor, 235 Euston Road, London, NW1 2BU, UK.
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK.
| | - Abigail Fisher
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Joanne Land
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Gita Ramdharry
- Queens Square Centre for Neuromuscular diseases, National Hospital for Neurology & Neurosurgery, UCL Institute of Neurology, UCLH NHS Trust, University College London, London, UK
| | - Anna L Roberts
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Georgios Bekris
- UCL Department of Behavioural Science and Health, University College London, London, UK
| | - Kwee Yong
- Research Department of Haematology, UCL Cancer Institute, University College London, London, UK
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19
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Toohey K, Chapman M, Rushby AM, Urban K, Ingham G, Singh B. The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv 2023; 17:399-415. [PMID: 35040076 DOI: 10.1007/s11764-021-01153-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this systematic review with meta-analysis was to evaluate the safety, feasibility and effectiveness of exercise in the palliative care phase for people with advanced cancer. METHODS Electronic databases were searched for exercise randomised controlled trials involving individuals with incurable cancer that were published prior to April 14, 2021. Meta-analyses were performed to evaluate the effects of exercise on health outcomes. Subgroup effects for exercise mode, supervision, intervention duration and cancer diagnosis were assessed. RESULTS Twenty-two trials involving interventions ranging between 2 weeks and 6 months were included. Interventions comprised of aerobic (n = 3), resistance (n = 4), mixed-mode (n = 14) and other exercise (n = 1) modalities. Cancer types consisted of lung (n = 6), breast (n = 3), prostate (n = 2), multiple myeloma (n = 1) and mixed cancer types (n = 10). Meta-analysis of 20 RCTs involving 1840 participants showed no difference in the risk of a grade 2-4 adverse event between exercise and usual care (n = 110 adverse events (exercise: n = 66 events; usual care: n = 44 events), RD = - 0.01 (91% CI = - 0.01, 0.02); p = 0.24). Overall median recruitment, retention and adherence rates were 56%, 80% and 69%, respectively. Meta-analysis of health outcomes showed effects in favour of exercise for quality of life, fatigue, aerobic fitness and lower-body strength (SMD range = 0.27-0.48, all p < 0.05). CONCLUSIONS Participants who engaged in exercise experienced an increase in quality of life, fitness and strength and a decrease in fatigue. IMPLICATIONS FOR CANCER SURVIVORS Physical activity programs were found to be safe and feasible for people with advanced cancer in the palliative care phase.
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Affiliation(s)
- Kellie Toohey
- Faculty of HealthCanberra Specialist Medical CentreACT, University of Canberra, Level C Office 3, Bruce, 2617, Australia.
- Exercise and Survivorship (PACES) Research Group, University of Canberra, ActivityBruce ACT, Cancer, Australia.
| | - Michael Chapman
- Palliative Care, Canberra Hospital, ACT Health Services, Canberra ACT, Australia
- ANU Medical School, Australian National University, Canberra, Australia
| | - Anne-Marie Rushby
- Faculty of HealthCanberra Specialist Medical CentreACT, University of Canberra, Level C Office 3, Bruce, 2617, Australia
- University of South Australia, Adelaide, SA, Australia
- Australian Institute of Health and Welfare, Canberra, Australia
| | - Kat Urban
- Palliative Care, Lismore Base Hospital, Lismore, NSW, Australia
| | - Gemma Ingham
- Palliative Care, Prince of Wales Hospital, Randwick, NSW, Australia
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20
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Fernandez-Rodriguez EJ, Sanchez-Gomez C, Mendez-Sanchez R, Recio-Rodriguez JI, Puente-Gonzalez AS, Gonzalez-Sanchez J, Cruz-Hernandez JJ, Rihuete-Galve MI. Multimodal Physical Exercise and Functional Rehabilitation Program in Oncological Patients with Cancer-Related Fatigue-A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4938. [PMID: 36981846 PMCID: PMC10049732 DOI: 10.3390/ijerph20064938] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The increase in life expectancy and survival time implies an increase in the possible side-effects of pharmacological treatments in patients. Cancer-related fatigue is one of these side-effects. The main objective of this study was to evaluate the effects of a multimodal program of physical exercise and functional rehabilitation on asthenia, pain, functional capacity, and quality of life in cancer patients with cancer-related fatigue. METHODS This was a randomized, parallel-controlled clinical trial, with two arms (experimental and control group), and it was conducted over the course of a year in the Oncology Hospitalization Unit at the University Hospital of Salamanca, Spain. Participants (n = 48) were assessed at three points during the study. The first assessment was prior to hospital discharge, the second assessment was after 15 days, and the final assessment was at one month post-hospital follow-up. The intervention lasted one month. The main variables studied were the dependency levels (Barthel), cancer-related fatigue (FACT-An), health-related quality of life (EuroQoL-5D), functional capacity (SPPB), and kinesiophobia (TSK-F). RESULTS Sample size (n = 44). Mean age 63.46 ± 12.36 years. Significant differences between control and experimental group participants in Barthel, FACT-An, TSK-F, and SPPB scores at follow-up and final assessment. CONCLUSIONS There are beneficial effects of a multimodal physical exercise and functional rehabilitation program in improving the autonomy of cancer-related fatigue patients.
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Affiliation(s)
- Eduardo J. Fernandez-Rodriguez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Celia Sanchez-Gomez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
- Department of Developmental and Educational Psychology, University of Salamanca, 37005 Salamanca, Spain
| | - Roberto Mendez-Sanchez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Jose I. Recio-Rodriguez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - A. Silvia Puente-Gonzalez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Jesus Gonzalez-Sanchez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Juan J. Cruz-Hernandez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Medical Oncology Unit, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Maria I. Rihuete-Galve
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
- Medical Oncology Unit, University Hospital of Salamanca, 37007 Salamanca, Spain
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21
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Hoekstra F, Martin Ginis KA, Collins D, Dinwoodie M, Ma JK, Gaudet S, Rakiecki D, Gainforth HL. Applying state space grids methods to characterize counsellor-client interactions in a physical activity behavioural intervention for adults with disabilities. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 65:102350. [PMID: 37665832 DOI: 10.1016/j.psychsport.2022.102350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 09/06/2023]
Abstract
BACKGROUND Physical activity (PA) counselling research has mainly focused on identifying which behaviour change techniques (BCTs) are delivered by a counsellor. Less is known about how BCTs are received by clients. State Space Grids (SSGs) is a dynamic system method that can be used to study counsellor-client interactions by examining frequencies, durations and sequences of BCT delivery and receipt. In this methods paper, we show how SSG methods can be pragmatically used to characterize counsellor-client interactions during a PA behavioural support intervention for adults with disabilities. METHODS Methods were demonstrated through a secondary analysis of data from adults with spinal cord injury (age: 45.79 ± 13.63; females: n = 5; males: n = 9) who received PA counselling. Transcripts of 30 audio-recorded counselling sessions (total duration: ∼8.3 h) were double-coded for BCT delivery and receipt statements using a reliable coding method (>84% agreement) and analyzed in two different ways using SSGs methods. RESULTS Applying the SSG analyses to our data demonstrated that frequencies, durations, and sequences of BCT delivery and receipt varied largely within and between dyads. Across all sessions, the counsellor and client spent on average 32-34% of their time on talking about BCTs related to goals and planning, ∼29% of their time talking about other BCTs (e.g., self-belief, support strategies), and the remaining 27-29% of their time talking about other topics (not BCT-specific). CONCLUSION This paper showed how dynamic system methods can be pragmatically used to characterize counsellor-client interactions and illustrate the variability of how BCTs are delivered by a counsellor and received by clients in a PA behavioural support intervention. We demonstrated that SSGs methods can facilitate the examination of frequencies, durations and sequences of BCT delivery and receipt can help advance our understanding of PA behavioural support for adults with and without disabilities.
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Affiliation(s)
- Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, BC, Canada; Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, BC, Canada
| | - Delaney Collins
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Miranda Dinwoodie
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Jasmin K Ma
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Arthritis Research Canada, Vancouver, BC, Canada; School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Sonja Gaudet
- Spinal Cord Injury British Columbia, Vancouver, BC, Canada; The Thompson Okanagan Tourism Association, Vernon, BC, Canada
| | - Diane Rakiecki
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; School District, Vernon, BC, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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22
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Long-term effects of exercise interventions on physical activity in breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2023; 31:130. [PMID: 36692626 PMCID: PMC9873715 DOI: 10.1007/s00520-022-07485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/04/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Benefits of exercise interventions for cancer patients are well established. This systematic review aimed to investigate the sustainability of exercise interventions with respect to physical activity behaviour of breast cancer patients in the longer term. METHODS The databases Pubmed, Cochrane, Embase, and Web of Science were systematically searched for randomized controlled trials (RCTs) investigating aerobic exercise, resistance exercise, or combined exercise interventions in breast cancer patients and assessing physical activity at least 2 months after the intervention. Random-effect models were used to calculate standardized mean differences (SMD). RESULTS A total of 27 RCTs with 4120 participants were included in the review, of which 11 RCTs with 1545 participants had appropriate data for the meta-analyses. Physical activity was mainly self-reported, and most exercise interventions were supervised. Exercise interventions tended to show a moderate significant effect up to 6 months for moderate to vigorous physical activity (SMD [95% CI] = 0.39 [0.07, 0.70]) and small, non-significant effects on total physical activity at 6 months (SMD [95% CI] = 0.14 [- 0.00, 0.28]) and up to 60 months after the intervention (SMD = 0.29 [-0.31, 0.90]). Differences between intervention characteristics, such as supervised versus unsupervised, were inconclusive due to the small number of RCTs. CONCLUSIONS The physical activity behaviour in breast cancer patients remained improved for several months beyond the end of exercise interventions, but effects were small to moderate and diminished over time. Future studies should clarify how to maintain a healthy level of physical activity after completion of an exercise intervention.
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23
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Humphreys L, Frith G, Humphreys H, Crank H, Dixey J, Greenfield DM, Reece LJ. Evaluation of a city-wide physical activity pathway for people affected by cancer: the Active Everyday service. Support Care Cancer 2023; 31:101. [PMID: 36622460 PMCID: PMC9829638 DOI: 10.1007/s00520-022-07560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE The primary goal of this article is to present an evaluation of a UK-based city-wide physical activity pathway for patients with a cancer diagnosis, the Active Everyday service. Active Everyday was a co-produced physical activity service for people affected by cancer. The service was underpinned by a behaviour change care pathway model developed by Macmillan Cancer Support charity. METHODS This was a retrospective evaluation assessing physical activity levels and changes to outcome measures (fatigue, perceived health, and self-efficacy) over 6 months. Each participant self-reported their levels of physical activity for the previous 7 days at three-time points: baseline (T1), at 12-week exit from the scheme (T2), and at 6-month follow-up (T3). RESULTS The Active Everyday service received 395 referrals, of which 252 attended a baseline assessment. Participants' fatigue and self-efficacy improved between T1 and T2 and T1 and T3. Perceived health improved across all time points. Participant exercise levels showed significant differences between T1 and T2. CONCLUSION The service, provided over 3 years, resulted in positive health and wellbeing outcomes in people affected by cancer who engaged in the service. Future services must routinely include exercise referrals/prescriptions as a standard part of care to help engage inactive individuals. Services should focus on targeted promotion to people from ethnic minority groups, and a wide socioeconomic population.
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Affiliation(s)
- Liam Humphreys
- Academy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP, UK. .,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Gabriella Frith
- grid.5884.10000 0001 0303 540XAcademy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK ,grid.5884.10000 0001 0303 540XAdvanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Helen Humphreys
- grid.5884.10000 0001 0303 540XCentre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Helen Crank
- grid.5884.10000 0001 0303 540XAcademy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
| | - Joanne Dixey
- grid.31410.370000 0000 9422 8284Therapy Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Diana M Greenfield
- grid.31410.370000 0000 9422 8284Specialised Cancer Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK ,grid.11835.3e0000 0004 1936 9262Department of Oncology and Metabolism, University of Sheffield Medical School Beech Hill Road, Sheffield, UK
| | - Lindsey J Reece
- grid.5884.10000 0001 0303 540XAdvanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK ,grid.1013.30000 0004 1936 834XSPRINTER Research Group, Prevention Research Collaboration, Charles Perkins centre, School of Public Health, University of Sydney, Sydney, Australia
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24
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Campanini I, Ligabue MB, Bò MC, Bassi MC, Lusuardi M, Merlo A. Self-managed physical activity in cancer survivors for the management of cancer-related fatigue: A scoping review. PLoS One 2022; 17:e0279375. [PMID: 36542639 PMCID: PMC9770433 DOI: 10.1371/journal.pone.0279375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) is a disabling chronic condition that cancer survivors could experience during and after recovery and that might benefit from self-managed physical activity (PA) programs. This scoping review aimed to map self-managed PA interventions found in literature for the management of CRF. METHODS Given the heterogeneity of the topic, scoping review methodological frameworks were used. Pubmed, Cinahl and Cochrane databases were searched for primary literature. Inclusion criteria: self-managed PA meant as any exercise program prescribed by a professional either with or without initial supervision and training which then continued independently for a given time frame; patient-reported fatigue assessment included in the outcome measures. Articles dealing with entirely supervised interventions, dietary or psychological-only therapies, and with palliative care were excluded. RESULTS Of the 543 experimental or observational studies screened, 63 were included. Of these forty-three studies were randomized controlled trials. Data were summarized in tables describing self-managed interventions according to: type of self-managed activity, frequency and duration, strategies to promote adherence, professionals supervising the treatment, outcome measures, and efficacy. A narrative synthesis was also added to further explain findings. CONCLUSIONS We collected the available evidence on PA when this was self-managed by patients after prescription by a healthcare provider. Clinicians and researchers should consider incorporating self-care programs in CRF patients' recovery journey gradually, identifying the best strategies to integrate them into daily life. Researchers should specify the characteristics of PA programs when designing new studies. This review highlighted the areas to be investigated for future studies pertaining to self-managed PA.
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Affiliation(s)
- Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Merlo
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
- Merlo Bioengineering, Parma, Italy
- * E-mail:
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25
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Tlusty GC, Alonso WW, Berger AM. Exercise Interventions During Hospitalization for Stem Cell Transplantation: An Integrative Review. West J Nurs Res 2022; 44:1167-1182. [PMID: 36154334 DOI: 10.1177/01939459221124433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Exercise interventions may influence adverse effects experienced during hospitalization for hematopoietic stem cell transplantation (HSCT). Adherence to exercise interventions is challenging. This review aimed to synthesize the literature to identify exercise interventions implemented during hospitalization for HSCT, including intervention characteristics, adherence, barriers and facilitators, and behavior change techniques using the behavior change technique taxonomy. A review of PubMed, CINAHL, PsycINFO, and Embase was completed. The sample included 19 studies. Exercise interventions demonstrated heterogeneity in prescription components, definitions, measures, and reporting of adherence. Barriers and facilitators of adherence to exercise were reported infrequently. Behavior change techniques most frequently used in studies reporting adherence rates of ≥75% included instruction on how to perform the behavior, graded tasks, and adding objects to the environment. The heterogeneity in definitions and measures of adherence limit forming conclusions to identify barriers and facilitators and determine which behavior change techniques increase adherence to exercise during HSCT.
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Affiliation(s)
- Gisele C Tlusty
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Windy W Alonso
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Ann M Berger
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
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26
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Co-designed weight management intervention for women recovering from oestrogen-receptor positive breast cancer. BMC Cancer 2022; 22:1202. [PMID: 36418985 PMCID: PMC9682743 DOI: 10.1186/s12885-022-10287-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Weight gain is commonly observed during and after breast cancer treatment and is associated with poorer survival outcomes, particularly in women with oestrogen receptor-positive (ER +) disease. The aim of this study was to co-design (with patients) a programme of tailored, personalised support (intervention), including high-quality support materials, to help female breast cancer patients (BCPs) with ER + disease to develop the skills and confidence needed for sustainable weight loss. METHODS: ER + BCPs were recruited from two UK National Health Service (NHS) Trusts. The selection criteria included (i) recent experience of breast cancer treatment (within 36 months of completing primary treatment); (ii) participation in a recent focus group study investigating weight management perceptions and experiences; (iii) willingness to share experiences and contribute to discussions on the support structures needed for sustainable dietary and physical activity behaviour change. Co-design workshops included presentations and interactive activities and were facilitated by an experienced co-design researcher (HH), assisted by other members of the research team (KP, SW and JS). RESULTS Two groups of BCPs from the North of England (N = 4) and South Yorkshire (N = 5) participated in a two-stage co-design process. The stage 1 and stage 2 co-design workshops were held two weeks apart and took place between Jan-March 2019, with each workshop being approximately 2 h in duration. Guided by the Behaviour Change Wheel, a theoretically-informed weight management intervention was developed on the basis of co-designed strategies to overcome physical and emotional barriers to dietary and physical activity behaviour change. BCPs were instrumental in designing all key features of the intervention, in terms of Capability (e.g., evidence-based information, peer-support and shared experiences), Opportunity (e.g., flexible approach to weight management based on core principles) and Motivation (e.g., appropriate use of goal-setting and high-quality resources, including motivational factsheets) for behaviour change. CONCLUSION This co-design approach enabled the development of a theoretically-informed intervention with a content, structure and delivery model that has the potential to address the weight management challenges faced by BCPs diagnosed with ER + disease. Future research is required to evaluate the effectiveness of the intervention for eliciting clinically-important and sustainable weight loss in this population.
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27
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Smits A, Galaal K, Winnan S, Lopes A, Bekkers RLM. Feasibility and Effectiveness of the Exercise Program in Endometrial Cancer; Feasibility and Acceptability Survivorship Trial (EPEC-FAST). Cancers (Basel) 2022; 14:cancers14225579. [PMID: 36428675 PMCID: PMC9688636 DOI: 10.3390/cancers14225579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
To evaluate the feasibility of an individualized exercise program in the standard care for endometrial cancer patients aimed to improve quality of life and other health outcomes. This was a single-arm prospective intervention trial to assess the feasibility of an individualized exercise intervention in endometrial cancer patients after treatment. The exercise intervention consisted of weekly individualized training sessions, for 10 weeks, at a local gym facility. The program started six weeks post-operatively. Primary outcomes were feasibility aspects including number of eligible patients, recruitment and adherence rates. Secondary outcomes included quality of life outcomes and anthropometric measures. A total of 54 women were eligible for participation, of which 22 (41%) consented to the study. Overall attendance was 86%, and there were no adverse events. There was a significant improvement in quality of life outcomes, including role (p = 0.02), emotional (p = 0.02) and cognitive functioning (p = 0.04). In addition, there was a significant improvement in visceral fat percentage (p = 0.039) and physical fitness (six-minute walk test p < 0.001). The maximum weight loss achieved was 6.0 kg after 3 months and 8.4 kg after 6 months. An individualized one-to-one exercise intervention in endometrial cancer patients is feasible in terms of recruitment, adherence and safety.
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Affiliation(s)
- Anke Smits
- Gynecological Oncology, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-24-309-79-58
| | - Khadra Galaal
- Gynecological Oncology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Seeb 999046, Oman
| | - Steve Winnan
- Royal Cornwall Hospital Trust, Penryn TR10 9FE, UK
| | - Alberto Lopes
- Gynecological Oncology, Royal Cornwall Hospital Trust, Truro TR1 3HD, UK
| | - Ruud L. M. Bekkers
- Gynecological Oncology, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
- Gynecological Oncology, Catharina Hospital Eindhoven, 5623 EJ Eindhoven, The Netherlands
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28
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Baillot A, St-Pierre M, Bernard P, Burkhardt L, Chorfi W, Oppert JM, Bellicha A, Brunet J. Exercise and bariatric surgery: A systematic review and meta-analysis of the feasibility and acceptability of exercise and controlled trial methods. Obes Rev 2022; 23:e13480. [PMID: 35695385 DOI: 10.1111/obr.13480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 01/22/2023]
Abstract
This systematic review and meta-analysis assessed the feasibility and acceptability of exercise and controlled trial methods in adults awaiting or having undergone bariatric surgery (BS). Search methods used to identify relevant articles were inclusion of articles identified in a systematic review, new database search of articles published 2019-2021, and hand searching reference lists. Titles/abstracts and full-texts were screened by two reviewers independently against inclusion criteria: adults awaiting or having undergone BS, controlled trial, exercise group compared with a comparison group without exercise. Twenty-eight articles were reviewed; most interventions were supervised, performed after BS, and lasted ≤13 weeks. Pooled data for exercise intervention attendance and dropout rates were 84% (k = 10) and 5% (k = 19), respectively, though possibly misestimated due to poor/selective reporting. Median study and recruitment duration were 18 weeks and 24 months, respectively, with a pooled enrollment rate of 2.5 participants/month. Pooled data for refusal to participate, enrollment, and retention rates were 23% (k = 16), 43% (k = 18), and 87% (k = 26), respectively. Despite the lack of data available in studies included, exercise and controlled trial methods seem feasible and acceptable for adults awaiting or having undergone BS. To better identify methodological or practical challenges, and assess bias, better reporting of feasibility and acceptability indicators is needed in future studies.
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Affiliation(s)
- Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, Québec, Canada.,Institut du savoir de l'hôpital Montfort-recherche, Ottawa, Ontario, Canada.,Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services Sociaux de l'Outaouais, Gatineau, Québec, Canada
| | - Maxime St-Pierre
- Basic science department, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada.,Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Laura Burkhardt
- Nursing Department, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Wafaa Chorfi
- Nursing Department, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière hospital, Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
| | - Alice Bellicha
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Jennifer Brunet
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, Ontario, Canada.,Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.,Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Influencing Factors of Physical Activity in Patients with Lung Cancer Surgery and Its Correlation with Exercise Self-Efficacy and Perceived Social Support. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7572530. [PMID: 35911150 PMCID: PMC9325606 DOI: 10.1155/2022/7572530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
Purpose The aim of the study is to understand the current status of physical activity in patients with lung cancer surgery, explore its influencing factors, and analyze the correlation between physical activity and exercise self-efficacy and perception of social support. Methods The General Information Questionnaire was designed for 145 patients, Chinese version of EPIC-PAQ physical activity scale for lung cancer patients. The Exercise Self-Efficacy Scale (SEE) is used to evaluate the ability of people to organize and execute motor behaviors in various difficult situations. The Perceived Social Support Scale (PSSS) was used to emphasize individual self-understanding and self-feeling. Results The median and quartile of total physical activity scores in lung cancer surgery patients were 73.0 (34.8, 129.7) points; univariate analysis showed that there were statistically significant differences in physical activity levels among lung cancer surgery patients with different ages, work status before hospitalization, and perceived disease severity. The results of multivariate analysis showed that age, perceived disease severity, exercise self-efficacy, and total score of perceived social support affected the physical activity level of patients (P < 0.05). Efficacy were positively correlated with perceived social support (P < 0.01). Conclusion The level of physical activity of patients undergoing lung cancer surgery needs to be further improved. Physical activity is affected by patient age, perceived disease severity, exercise self-efficacy, and perceived social support and is positively correlated with exercise self-efficacy and perceived social support. Medical staff should provide targeted activity guidance according to the age and other characteristics of patients undergoing lung cancer surgery, enhance patients' exercise self-efficacy and comprehend social support, and improve their physical activity level, thereby promoting patients' early recovery.
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Dhanis J, Keidan N, Blake D, Rundle S, Strijker D, van Ham M, Pijnenborg JMA, Smits A. Prehabilitation to Improve Outcomes of Patients with Gynaecological Cancer: A New Window of Opportunity? Cancers (Basel) 2022; 14:cancers14143448. [PMID: 35884512 PMCID: PMC9351657 DOI: 10.3390/cancers14143448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Surgery is an important mainstay in the treatment of gynaecological cancers but is associated with operative complications, especially for those with poor physical and mental health. Prehabilitation is a new and upcoming strategy to optimise patients’ functional capacity, nutritional status and psychosocial wellbeing in order to reduce complications and enhance recovery. In this review, we assessed the evidence on prehabilitation programmes for patients with gynaecological cancer. The limited evidence shows that prehabilitation may reduce length of hospital stay for ovarian cancer patients, and may result in significant weight loss in patients with endometrial and cervical cancer. Comparative prospective studies are required to determine the effectiveness of prehabilitation on reducing operative complications and improving quality of life, and to further specify the content of such a programme for patients with gynaecological cancer. Abstract The literature evaluating the effect of prehabilitation programmes on postoperative outcomes and quality of life of patients with gynaecological cancer undergoing surgery was reviewed. Databases including Pubmed, Medline, EMBASE (Ovid) and PsycINFO were systematically searched to identify studies evaluating the effect of prehabilitation programmes on patients with gynaecological cancer. Both unimodal and multimodal prehabilitation programmes were included encompassing physical exercise and nutritional and psychological support. Primary outcomes were surgical complications and quality of life. Secondary outcomes were anthropometric changes and adherence to the prehabilitation programme. Seven studies fulfilled the inclusion criteria, comprising 580 patients. Included studies were nonrandomised prospective studies (n = 4), retrospective studies (n = 2) and one case report. Unimodal programmes and multimodal programmes were included. In patients with ovarian cancer, multimodal prehabilitation resulted in significantly reduced hospital stay and time to chemotherapy. In patients with endometrial and cervical cancer, prehabilitation was associated with significant weight loss, but had no significant effects on surgical complications or mortality. No adverse events of the programmes were reported. Evidence on the effect of prehabilitation for patients with gynaecological cancer is limited. Future studies are needed to determine the effects on postoperative complications and quality of life.
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Affiliation(s)
- Joëlle Dhanis
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
- Faculty of Medical Sciences, Radboud University, 6526 GA Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-644404756
| | - Nathaniel Keidan
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
| | - Dominic Blake
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
| | - Stuart Rundle
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
| | - Dieuwke Strijker
- Department of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands;
| | - Maaike van Ham
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
| | - Johanna M. A. Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
| | - Anke Smits
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
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Chen L, Chen F, Niu H, Li J, Pu Y, Yang C, Wang Y, Huang R, Li K, Lei Y, Huang Y. Chimeric Antigen Receptor (CAR)-T Cell Immunotherapy Against Thoracic Malignancies: Challenges and Opportunities. Front Immunol 2022; 13:871661. [PMID: 35911706 PMCID: PMC9334018 DOI: 10.3389/fimmu.2022.871661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Different from surgery, chemical therapy, radio-therapy and target therapy, Chimeric antigen receptor-modified T (CAR-T) cells, a novel adoptive immunotherapy strategy, have been used successfully against both hematological tumors and solid tumors. Although several problems have reduced engineered CAR-T cell therapeutic outcomes in clinical trials for the treatment of thoracic malignancies, including the lack of specific antigens, an immunosuppressive tumor microenvironment, a low level of CAR-T cell infiltration into tumor tissues, off-target toxicity, and other safety issues, CAR-T cell treatment is still full of bright future. In this review, we outline the basic structure and characteristics of CAR-T cells among different period, summarize the common tumor-associated antigens in clinical trials of CAR-T cell therapy for thoracic malignancies, and point out the current challenges and new strategies, aiming to provide new ideas and approaches for preclinical experiments and clinical trials of CAR-T cell therapy for thoracic malignancies.
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Affiliation(s)
- Long Chen
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Fukun Chen
- Department of Nuclear Medicine, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Huatao Niu
- Department of Neurosurgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Jindan Li
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Yongzhu Pu
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Conghui Yang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Yue Wang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Rong Huang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Ke Li
- Department of Cancer Biotherapy Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
- *Correspondence: Yunchao Huang, ; Yujie Lei, ; Ke Li,
| | - Yujie Lei
- Department of Thoracic Surgery I, Key Laboratory of Lung Cancer of Yunnan Province, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
- *Correspondence: Yunchao Huang, ; Yujie Lei, ; Ke Li,
| | - Yunchao Huang
- Department of Thoracic Surgery I, Key Laboratory of Lung Cancer of Yunnan Province, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
- *Correspondence: Yunchao Huang, ; Yujie Lei, ; Ke Li,
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Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature. Cancers (Basel) 2022; 14:cancers14133163. [PMID: 35804933 PMCID: PMC9264833 DOI: 10.3390/cancers14133163] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Rehabilitation plays a crucial role in cancer care, as the functioning of cancer survivors is frequently compromised by impairments that can result from the disease itself but also from the long-term sequelae of the treatment. Nevertheless, the current literature shows that only a minority of patients receive physical and/or cognitive rehabilitation. This lack of rehabilitative care is a consequence of many factors, one of which includes the transportation issues linked to disability that limit the patient’s access to rehabilitation facilities. The recent COVID-19 pandemic has further shown the benefits of improving telemedicine and home-based rehabilitative interventions to facilitate the delivery of rehabilitation programs when attendance at healthcare facilities is an obstacle. In recent years, researchers have been investigating the benefits of the application of virtual reality to rehabilitation. Virtual reality is shown to improve adherence and training intensity through gamification, allow the replication of real-life scenarios, and stimulate patients in a multimodal manner. In our present work, we offer an overview of the present literature on virtual reality-implemented cancer rehabilitation. The existence of wide margins for technological development allows us to expect further improvements, but more randomized controlled trials are needed to confirm the hypothesis that VRR may improve adherence rates and facilitate telerehabilitation.
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Cases MG, Blair CK, Hendricks PS, Smith K, Snyder S, Demark-Wahnefried W. Sustainability capacity of a vegetable gardening intervention for cancer survivors. BMC Public Health 2022; 22:1238. [PMID: 35733142 PMCID: PMC9215023 DOI: 10.1186/s12889-022-13644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Health behavior interventions, especially those that promote improved diet and physical activity, are increasingly directed toward cancer survivors given their burgeoning numbers and high risk for comorbidity and functional decline. However, for health behavior interventions to achieve maximal public health impact, sustainability at both the individual and organizational levels is crucial. The current study aimed to assess the individual and organizational sustainability of the Harvest for Health mentored vegetable gardening intervention among cancer survivors. METHODS Telephone surveys were conducted among 100 cancer survivors (mean age 63 years; primarily breast cancer) completing one-of-two Harvest for Health feasibility trials. Surveys ascertained whether participants continued gardening, and if so, whether they had expanded their gardens. Additionally, surveys were emailed to 23 stakeholders (Cooperative Extension county agents, cancer support group leaders, and healthcare representatives) who were asked to rate the intervention's ability to generate sustained service and produce benefits over time using the eight-domain Program Sustainability Assessment Tool (PSAT). RESULTS The survey among cancer survivors (91.9% response rate) indicated that 85.7% continued gardening throughout the 12 months following intervention completion; 47.3% expanded their gardens beyond the space of the original intervention. Moreover, 5.5% of cancer survivors enrolled in the certification program to become Extension Master Gardeners. The survey among stakeholders generated a similar response rate (i.e., 91.3%) and favorable scores. Of the possible maximum of 7 points on the PSAT, the gardening intervention's "Overall Capacity for Sustainability" scored 5.7 (81.4% of the maximum score), with subscales for "Funding Stability" scoring the lowest though still favorably (5.0) and "Program Evaluation" scoring the highest (6.3). CONCLUSIONS Data support the sustainability capacity of the Harvest for Health vegetable gardening intervention for cancer survivors. Indeed, few interventions have proven as durable in terms of individual sustainability. Furthermore, Harvest for Health's overall organizational score of 5.7 on the PSAT is considered strong when compared to a previous review of over 250 programs, where the mean overall organizational PSAT score was 4.84. Thus, solutions for long-term funding are currently being explored to support this strong, holistic program that is directed toward this vulnerable and growing population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02150148.
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Affiliation(s)
- Mallory G Cases
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Cindy K Blair
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM, 87131, USA.
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kerry Smith
- Alabama Cooperative Extension System, Auburn University, Auburn, AL, USA
| | - Scott Snyder
- School of Education, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, School of Health Professions, UAB, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center at UAB, Birmingham, AL, USA
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Moschopoulou E, Brewin D, Ridge D, Donovan S, Taylor SJC, Bourke L, Eva G, Khan I, Chalder T. Evaluating an interactive acceptance and commitment therapy (ACT) workshop delivered to trained therapists working with cancer patients in the United Kingdom: a mixed methods approach. BMC Cancer 2022; 22:651. [PMID: 35698089 PMCID: PMC9195438 DOI: 10.1186/s12885-022-09745-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 05/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background SURECAN (SUrvivors’ Rehabilitation Evaluation after CANcer) is a multi-phase study developing and evaluating an Acceptance and Commitment Therapy (ACT) intervention integrated with exercise and work when highly valued (thus we called the intervention ACT+), for people who have completed treatment for cancer but who have low quality of life. We developed a training programme for therapists working in different psychological services to be delivered over 2–3 days. Our aim was to evaluate the extent to which the training could improve therapists’ knowledge and confidence to deliver ACT+ to cancer patients in a trial setting. Methods Three interactive workshops were delivered to 29 therapists from three clinical settings in London and in Sheffield. A mixed-methods approach was used. Questionnaires were designed to assess knowledge and confidence in using ACT+ with people who have low quality of life after cancer treatment. They were self-administered immediately prior to and after each workshop. Open text-based questions were used to elicit feedback about the workshops alongside a satisfaction scale. Semi-structured interviews were conducted with a purposive sample of therapists (n = 12) to explore their views about the training more deeply, and how it might be optimised. Results Quantitative analysis showed that knowledge of ACT, as well as confidence in using the ACT+ intervention in this setting increased significantly after training (28.6 and 33.5% increase in the median score respectively). Qualitative analysis indicated that most therapists were satisfied with the content and structure of the programme, valued the rich resources provided and enjoyed the practice-based approach. Potential barriers/facilitators to participation in the trial and to the successful implementation of ACT+ were identified. For some therapists, delivering a manualised intervention, as well as supporting exercise- and work-related goals as non-specialists was seen as challenging. At the same time, therapists valued the opportunity to be involved in research, whilst training in a new therapy model. Conclusions Training can effectively improve the knowledge and confidence of therapists from different clinical backgrounds to deliver a modified ACT intervention to cancer patients in a trial setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09745-4.
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Affiliation(s)
- Elisavet Moschopoulou
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Debbie Brewin
- Mind-Growth Mastery, Epsom, Surrey, KT19 0AA, England
| | - Damien Ridge
- College of Liberal Arts and Sciences, University of Westminster, London, UK
| | - Sheila Donovan
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stephanie J C Taylor
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Liam Bourke
- Allied Health Professionals, Radiotherapy & Oncology, College of Health Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Gail Eva
- Department of Sport and Health Sciences, Oxford Brookes University, Oxford, UK
| | - Imran Khan
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Dybeck MM, Adamsen L, Sørensen V, Lillelund C, Møller T, Andersen C. Can supervised group-based multimodal exercise improve health-related quality of life in women with ovarian cancer undergoing chemotherapy? Eur J Cancer Care (Engl) 2022; 31:e13607. [PMID: 35555831 PMCID: PMC9539582 DOI: 10.1111/ecc.13607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/30/2021] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Lis Adamsen
- The University Hospitals Centre for Health Research, Copenhagen, Denmark
| | - Victor Sørensen
- The University Hospitals Centre for Health Research, Copenhagen, Denmark
| | | | - Tom Møller
- The University Hospitals Centre for Health Research, Copenhagen, Denmark
| | - Christina Andersen
- The University Hospitals Centre for Health Research, Copenhagen, Denmark
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36
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Gould R, Roberts NW, Murtagh EM, Hillsdon M, Foster C. Remote, face-to-face, and group-based interventions for promoting strength training in healthy community-based adults. Hippokratia 2022. [DOI: 10.1002/14651858.cd014825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Nia W Roberts
- Bodleian Health Care Libraries; University of Oxford; Oxford UK
| | - Elaine M Murtagh
- Department of Physical Education and Sport Sciences; University of Limerick; Limerick Ireland
| | - Melvyn Hillsdon
- School of Sport and Health Sciences; University of Exeter; Exeter UK
| | - Charles Foster
- Centre for Exercise Nutrition and Health Sciences, School for Policy Studies; University of Bristol; Bristol UK
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Gouez M, Pérol O, Pérol M, Caux C, Ménétrier-Caux C, Villard M, Walzer T, Delrieu L, Saintigny P, Marijnen P, Pialoux V, Fervers B. Effect of acute aerobic exercise before immunotherapy and chemotherapy infusion in patients with metastatic non-small-cell lung cancer: protocol for the ERICA feasibility trial. BMJ Open 2022; 12:e056819. [PMID: 35393316 PMCID: PMC8990709 DOI: 10.1136/bmjopen-2021-056819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Patients with metastatic non-small cell lung cancer (mNSCLC) suffer from numerous symptoms linked to disease and treatment which may further impair the patient's overall condition. In addition to its benefits on quality of life and fatigue, physical exercise may improve treatment response, notably due to its known effects on the immune system. The ERICA study is designed to assess the feasibility of a supervised acute physical exercise therapy realised immediately prior immune-chemotherapy infusion in patients with mNSCLC. Secondary objectives will examine the effects of acute exercise combined with an unsupervised home-walking programme on clinical, physical, psychosocial and biological parameters. METHODS AND ANALYSIS ERICA is a prospective, monocentric, randomised controlled, open-label feasibility study conducted at the Centre Léon Bérard Comprehensive Cancer Center (France). Thirty patients newly diagnosed with mNSCLC will be randomised (2:1 ratio) to the 'exercise' or the 'control' group. At baseline and during the last treatment cycle, participants in both groups will receive Physical Activity recommendations, and two nutritional assessments. In the exercise group, participants will receive a 3-month programme consisting of a supervised acute physical exercise session prior to immune-chemotherapy infusion, and an unsupervised home-based walking programme with an activity tracker. The acute exercise consists of 35 min interval training at submaximal intensity scheduled to terminate 15 min prior to infusion. Clinical, physical, biological and psychosocial parameters will be assessed at baseline, 3 and 6 months after inclusion. Biological measures will include immune, inflammatory, metabolic, oxidative stress biomarkers and molecular profiling. ETHICS AND DISSEMINATION The study protocol was approved by the French ethics committee (Comité de protection des personnes Ile de France II, N°ID-RCB 20.09.04.65226, 8 December 2020). The study is registered on ClinicalTrials.gov (NCT number:NCT04676009) and is at the pre-results stage. All participants will sign an informed consent form. The findings will be disseminated in peer-reviewed journals and academic conferences.
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Affiliation(s)
- Manon Gouez
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
- Inter-University Laboratory of Human Movement Biology, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Olivia Pérol
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Maurice Pérol
- Department of Medical Oncology, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Christophe Caux
- INSERM U1052, Lyon, Rhône-Alpes, France
- Laboratory of Cancer Immunotherapy of LYON, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Christine Ménétrier-Caux
- INSERM U1052, Lyon, Rhône-Alpes, France
- Laboratory of Cancer Immunotherapy of LYON, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Marine Villard
- Inserm, U1111, CNRS UMR5308, Centre International de Recherche en Infectiologie, Lyon, Rhône-Alpes, France
| | - Thierry Walzer
- Inserm, U1111, CNRS UMR5308, Centre International de Recherche en Infectiologie, Lyon, Rhône-Alpes, France
| | - Lidia Delrieu
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
- Inter-University Laboratory of Human Movement Biology, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Pierre Saintigny
- INSERM U1052, Lyon, Rhône-Alpes, France
- Department of Translational Medicine, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Philippe Marijnen
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Béatrice Fervers
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
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Lally P, Miller N, Roberts A, Beeken RJ, Greenfield DM, Potts HWW, Counsell N, Latimer N, Thomas C, Smith L, Gath J, Kennedy F, Martin C, Wyld L, Fisher A. An app with brief behavioural support to promote physical activity after a cancer diagnosis (APPROACH): study protocol for a pilot randomised controlled trial. Pilot Feasibility Stud 2022; 8:74. [PMID: 35351187 PMCID: PMC8961486 DOI: 10.1186/s40814-022-01028-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/09/2022] [Indexed: 11/22/2022] Open
Abstract
Background There are multiple health benefits from participating in physical activity after a cancer diagnosis, but many people living with and beyond cancer (LWBC) are not meeting physical activity guidelines. App-based interventions offer a promising platform for intervention delivery. This trial aims to pilot a theory-driven, app-based intervention that promotes brisk walking among people living with and beyond cancer. The primary aim is to investigate the feasibility and acceptability of study procedures before conducting a larger randomised controlled trial (RCT). Methods This is an individually randomised, two-armed pilot RCT. Patients with localised or metastatic breast, prostate, or colorectal cancer, who are aged 16 years or over, will be recruited from a single hospital site in South Yorkshire in the UK. The intervention includes an app designed to encourage brisk walking (Active 10) supplemented with habit-based behavioural support in the form of two brief telephone/video calls, an information leaflet, and walking planners. The primary outcomes will be feasibility and acceptability of the study procedures. Demographic and medical characteristics will be collected at baseline, through self-report and hospital records. Secondary outcomes for the pilot (assessed at 0 and 3 months) will be accelerometer measured and self-reported physical activity, body mass index (BMI) and waist circumference, and patient-reported outcomes of quality of life, fatigue, sleep, anxiety, depression, self-efficacy, and habit strength for walking. Qualitative interviews will explore experiences of participating or reasons for declining to participate. Parameters for the intended primary outcome measure (accelerometer measured average daily minutes of brisk walking (≥ 100 steps/min)) will inform a sample size calculation for the future RCT and a preliminary economic evaluation will be conducted. Discussion This pilot study will inform the design of a larger RCT to investigate the efficacy and cost-effectiveness of this intervention in people LWBC. Trial registration ISRCTN registry, ISRCTN18063498. Registered 16 April 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01028-w.
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Affiliation(s)
- P Lally
- Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK.
| | - N Miller
- Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - A Roberts
- Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - R J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - D M Greenfield
- Sheffield Teaching Hospitals NHS FT, Weston Park Hospital, Sheffield, S10 2SJ, UK
| | - H W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - N Counsell
- Cancer Research UK & UCL Cancer Trials Centre, Cancer Institute, University College London, London, UK
| | - N Latimer
- School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
| | - C Thomas
- School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
| | - L Smith
- The Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - J Gath
- Yorkshire and Humberside Consumer Research Panel
| | - F Kennedy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - C Martin
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - L Wyld
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - A Fisher
- Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
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Lopez-Garzon M, Cantarero-Villanueva I, Legerén-Alvarez M, Gallart-Aragón T, Postigo-Martin P, González-Santos Á, Lozano-Lozano M, Martín-Martín L, Ortiz-Comino L, Castro-Martín E, Ariza-García A, Fernández-Lao C, Arroyo-Morales M, Galiano-Castillo N. Prevention of Chemotherapy-Induced Peripheral Neuropathy With PRESIONA, a Therapeutic Exercise and Blood Flow Restriction Program: A Randomized Controlled Study Protocol. Phys Ther 2022; 102:6497838. [PMID: 35079838 DOI: 10.1093/ptj/pzab282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/27/2021] [Accepted: 10/25/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE This trial will analyze the acute and cumulative effects of a tailored program called PRESIONA that combines therapeutic exercise and blood flow restriction to prevent chemotherapy-induced peripheral neuropathy (CIPN) in individuals with early breast cancer undergoing neoadjuvant chemotherapy. METHODS PRESIONA will be a physical therapist-led multimodal exercise program that uses blood flow restriction during low-load aerobic and strength exercises. For the acute study, only 1 session will be performed 1 day before the first taxane cycle, in which 72 women will be assessed before intervention and 24 hours post intervention. For the cumulative study, PRESIONA will consist of 24 to 36 sessions for 12 weeks following an undulatory prescription. At least 80 women will be randomized to the experimental group or control group. Feasibility will be quantified based on the participant recruitment to acceptance ratio; dropout, retention, and adherence rates; participant satisfaction; tolerance; and program security. In the efficacy study, the main outcomes will be CIPN symptoms assessed with a participant-reported questionnaire (EORTC QLQ-CIPN20). In addition, to determine the impact on other participant-reported health and sensorimotor and physical outcomes, the proportion of completed scheduled chemotherapy sessions will be examined at baseline (t0), after anthracycline completion (t1), after intervention (t2), and at the 2-month (t3) and 1-year follow-ups (t4). CONCLUSION The proposed innovative approach of this study could have a far-reaching impact on therapeutic options, and the physical therapist role could be essential in the oncology unit to improve quality of life in individuals with cancer and reduce side effects of cancer and its treatments. IMPACT Physical therapists in the health care system could be essential to achieve the planned doses of chemotherapy to improve survival and decrease the side effects of individuals with breast cancer. The prevention of CIPN would have an impact on the quality of life in these individuals, and this protocol potentially could provide an action guide that could be implemented in any health care system.
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Affiliation(s)
- Maria Lopez-Garzon
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Marta Legerén-Alvarez
- FEA Oncología Médica, San Cecilio University Hospital, Andalusian Health Service, Granada, Spain
| | | | - Paula Postigo-Martin
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Ángela González-Santos
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Lydia Martín-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | | | - Eduardo Castro-Martín
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Angélica Ariza-García
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Carolina Fernández-Lao
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Manuel Arroyo-Morales
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
| | - Noelia Galiano-Castillo
- Health Sciences Faculty, University of Granada, Granada, Spain.,'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain.,Sport and Health Research Center (IMUDs), Granada, Spain
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Bressi B, Iotti C, Cagliari M, Fugazzaro S, Cavuto S, Bergamaschi FAM, Moscato A, Costi S. Physical exercise habits, lifestyle behaviors, and motivation to change among men with prostate cancer: a cross-sectional study. Support Care Cancer 2022; 30:5017-5026. [PMID: 35194723 DOI: 10.1007/s00520-022-06911-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/12/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE To describe the physical exercise (PE) habits, lifestyle, and motivation to change toward healthier behaviors in patients newly diagnosed with prostate cancer (PCa). METHODS A cross-sectional study was conducted in an Italian hospital setting. Men newly diagnosed with PCa were consecutively invited to participate in a structured interview that was conducted either in person or by telephone. RESULTS The mean age of the 40 participants was 70.5 ± 6.6 (range 50-84). Most participants (65%) reported they were physically active, but more than half of the sample did not reach the recommended PE level. However, 40% of participants would be interested in participating in an exercise program. Only 10% of participants were current smokers, but 90% drank alcohol, and 62.5% were overweight/obese. Almost all participants were not willing to change their habits. CONCLUSIONS A high proportion of Italian men are insufficiently active when diagnosed with PCa. Moreover, even when exposed to behavioral risk factors, they are not willing to change their lifestyle. Health-care professionals who deal with men newly diagnosed with PCa should take advantage of the teachable moment and apply strategies that support patients' motivation to exercise and adherence to healthier lifestyles. TRIAL REGISTRATION The study was prospectively registered in ClinicalTrial.gov NCT03982095 on June 11, 2019.
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Affiliation(s)
- Barbara Bressi
- Ph.D Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, 41125, Italy.
- Physical Medicine and Rehabilitation Unit, Department of Neuromotor Physiopathology and Rehabilitation Medicine, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy.
| | - Cinzia Iotti
- Department of Oncology and Advanced Technologies, Radiotherapy Unit, AziendaUnità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Maribel Cagliari
- Department of Medicine, Surgery, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, 41124, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Department of Neuromotor Physiopathology and Rehabilitation Medicine, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Silvio Cavuto
- Clinical Trials and Statistics Unit, S.C. Infrastructure, Research and Statistics, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Franco Antonio Mario Bergamaschi
- Department of General and Specialist Surgeries, Urology and Mininvasive Surgery, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Alfredo Moscato
- Department of General and Specialist Surgeries, Urology and Mininvasive Surgery, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Stefania Costi
- Department of Medicine, Surgery, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, 41124, Italy
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, 42123, Italy
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Pinto BM, Dunsiger SI, Kindred MM, Mitchell S. Peer mentoring for physical activity adoption and maintenance among breast cancer survivors: moderators of physical activity outcomes. J Cancer Surviv 2022:10.1007/s11764-021-01162-z. [PMID: 34994945 DOI: 10.1007/s11764-021-01162-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We aimed to identify the moderators of maintenance strategies' effects to assist cancer care organizations that offer peer mentoring physical activity programs. METHODS A total of 161 inactive breast cancer survivors participated in a 12-month study and were randomized to one of three conditions at baseline. American Cancer Society's Reach to Recovery coaches delivered weekly calls to participants for the first 3 months. During Months 4-9, participants self-monitored PA and received feedback (Reach Plus) or additionally received monthly calls from coaches (Reach Plus Phone) or weekly text/email messages (Reach Plus Message). Moderate-to-vigorous PA (MVPA) was assessed using self-report and accelerometry at baseline, 3, 6, 9, and 12 months. We examined baseline demographics, cancer-specific, and social cognitive variables as potential moderators of MVPA. Using Latent Class Models, we identified three participant profiles. The profile was used as a moderator in longitudinal mixed-effects models of MVPA. RESULTS Profile 1 (44%) were married, White, in preparation, with higher income and higher social support. Profile 2 (41%) were older, office employees, African American, with higher PA self-efficacy. Profile 3 (15%) were diagnosed with stage 1 cancer, in contemplation, with higher MVPA and lower social support. At follow-ups, among those with Profile 1, Reach Plus participants had higher MVPA than other groups (f2 [Formula: see text].10). Among those with Profile 2, Reach Plus Message participants had higher mean MVPA than other groups (f2 [Formula: see text].11). Among those with Profile 3, Reach Plus Phone participants had higher MVPA than other groups, f2 [Formula: see text].11 (all ps < .05). CONCLUSIONS Organizations can choose PA maintenance strategies that are most effective for survivors with specific profiles. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors with specific profiles increase PA when receiving certain PA maintenance programs. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02694640 (Feb. 26, 2016).
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Affiliation(s)
- Bernardine M Pinto
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC, 29209, USA.
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André N, Gastinger S, Rébillard A. Chronic Fatigue in Cancer, Brain Connectivity and Reluctance to Engage in Physical Activity: A Mini-Review. Front Oncol 2022; 11:774347. [PMID: 34988017 PMCID: PMC8721035 DOI: 10.3389/fonc.2021.774347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
A large amount of evidence shows that after a cancer diagnosis, patients significantly reduce their level of physical activity. Usually, this reduction is attributed to cancer-related fatigue. However, to our knowledge, no study has clearly demonstrated that fatigue alters effort-based decision-making in cancer. This mini-review aimed to provide evidence that chronic fatigue in cancer patients causes changes in brain connectivity that impact effort-based decision-making. Indeed, three patterns of activation to compensate for dysfunctional networks have been reported: greater variability in the executive network and hyperactivation in the executive network, which account for less efficient and costly processes in the frontal cortex, and reduced deactivation in the default mode network. Nevertheless, these activation patterns are also observed with other factors, such as anticipatory stressors (worry, rumination or sleep loss), that might also cause reluctance to engage in physical activity. Effort-based decision-making involving weighing costs against benefits and physical activity interventions should increase immediate benefits to facilitate engagement in effortful activities.
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Affiliation(s)
- Nathalie André
- Research Centre on Cognition and Learning (UMR CNRS 7295), University of Poitiers, Sport Sciences Faculty, Poitiers, France.,Maison des Sciences de l'Homme et de la Société (USR CNRS 3565), Université de Poitiers, Poitiers, France
| | - Steven Gastinger
- M2S-EA7470, University of Rennes, Rennes, France.,APCoSS - Institut de Formation en Education Physique et en Sport (IFEPSA), UCO Angers, Angers, France
| | - Amélie Rébillard
- M2S-EA7470, University of Rennes, Rennes, France.,Institut Universitaire de France (IUF), Paris, France
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Millet N, McDermott HJ, Munir F, Edwardson CL, Moss EL. ACCEPTANCE: protocol for a feasibility study of a multicomponent physical activity intervention following treatment for cervical cancer. BMJ Open 2022; 12:e048203. [PMID: 34980607 PMCID: PMC8724712 DOI: 10.1136/bmjopen-2020-048203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Cervical cancer treatment can have life changing sequelae and be associated with poor short-term and long-term quality of life. Physical activity (PA; that is, bodily movement) is known to improve health outcomes and quality of life for cancer survivors, both physically and psychologically. To date, no interventions to increase PA following cervical cancer have been evaluated. This study aims to (1) determine the feasibility of conducting a PA intervention after cervical cancer and (2) to explore the acceptability of the programme and evaluation measures. METHODS AND ANALYSIS The design is a pre study and post study design. Thirty participants aged between 18 and 60 years from the Midlands region, UK, who have completed primary treatment for cervical cancer at least 6 months previously and do not meet the national PA guidelines will be recruited. Identification of potential participants will take place through the University Hospitals of Leicester National Health Service (NHS) Trust. Participants will receive an intervention focused on increasing PA through the provision of education, action planning, goal setting, problem solving and self-monitoring of PA behaviour, particularly steps per day. Device assessed PA and questionnaires will be completed at baseline, week 6, week 12 and week 24. Feasibility will be assessed in terms of recruitment, retention, attrition, completion of measures and intervention compliance, for which specific feasibility criteria have been established. The process evaluation will explore the experiences and acceptability of the intervention components and evaluation measures. ETHICS AND DISSEMINATION Ethical approval has been granted by the West of Scotland Research Ethics Committee 1 for this study. Results will inform intervention refinement for the design of a definitive pilot trial. These results will be disseminated via peer-reviewed publications and international conferences while input from a patient and public involvement (PPI) group will inform effective ways to circulate results among the wider community. TRIAL REGISTRATION NUMBER ISRCTN16349793, Registered 30 September 2020.
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Affiliation(s)
- Nessa Millet
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Hilary J McDermott
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
- NIHR Leicester Biomedical Research Centre, Leicester, Leicestershire, UK
| | - Esther L Moss
- Leicester Cancer Research Centre, University of Leicester, Leicester, Leicestershire, UK
- Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK
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Rees-Punia E, Leach CR, Westmaas JL, Dempsey LF, Roberts AM, Nocera JR, Patel AV. Pilot Randomized Controlled Trial of Feasibility, Acceptability, and Preliminary Efficacy of a Web-Based Physical Activity and Sedentary Time Intervention for Survivors of Physical Inactivity-Related Cancers. Int J Behav Med 2022; 29:220-229. [PMID: 33954891 PMCID: PMC8099708 DOI: 10.1007/s12529-021-09999-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND This pilot study explored the feasibility, acceptability, and usability of a web-based intervention for survivors of physical inactivity-related cancers through a two-arm, 12-week randomized controlled trial. Secondarily, this study tested the change in physical activity (PA) and sedentary time with intervention exposure. METHODS Prior to randomization to the intervention (n = 45) or behavior "as usual" wait-listed control (n = 40) groups, participants completed baseline surveys and an accelerometer protocol. The intervention focused on increasing PA and decreasing sedentary time through social cognitive theory techniques. Follow-up acceptability/usability surveys (intervention group only) and accelerometers were sent after the intervention period. Information on intervention completion, adverse events, and user statistics were collected to determine feasibility. Median login time and mean acceptability/usability scores were calculated. RESULTS Participants (mean age = 60 ± 7 years) included female (n = 80, 94%) and male survivors of breast (82%), colon (6%), endometrial (6%), bladder (4%), and kidney (2%) cancer. Seventy-eight (91.7%) participants returned partially or fully complete post-intervention data. There were no reported injuries or safety concerns. Intervention participants logged into the website for a total of 95 min (Q1, Q3 = 11, 204). System usability scores (72 ± 3) indicated above average usability of the website. Changes in time spent active and sedentary were not statistically significantly different between groups (p = 0.45), but within-group changes suggested intervention group participants spent more time active and less time sedentary after the intervention. CONCLUSION Results of this pilot study suggest its feasibility and acceptability for survivors of several inactivity-related cancers. Additional research to determine long-term efficacy is warranted. This low-cost online-only intervention has the potential to have a very broad reach. TRIAL REGISTRATION Clinical Trials Number: NCT03983083. Date registered: June 12th, 2019.
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Affiliation(s)
- Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, GA, USA.
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - J. Lee Westmaas
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Lauren F. Dempsey
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Amelia M. Roberts
- Department of Population Science, American Cancer Society, Atlanta, GA USA
| | - Joe R. Nocera
- Departments of Neurology and Rehabilitation Medicine, Emory University, Atlanta, GA USA ,Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA USA ,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, GA USA
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, GA USA
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Mur-Gimeno E, Postigo-Martin P, Cantarero-Villanueva I, Sebio-Garcia R. Systematic review of the effect of aquatic therapeutic exercise in breast cancer survivors. Eur J Cancer Care (Engl) 2022; 31:e13535. [PMID: 34729835 DOI: 10.1111/ecc.13535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/19/2021] [Accepted: 10/04/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Aquatic therapeutic exercise can be equally effective or even superior to land-based exercise in improving several clinical variables. However, there is still a lack of knowledge on the effects compared to land-based interventions particularly in breast cancer (BC) patients. OBJECTIVE The objective of this study is to examine the effects of aquatic therapeutic exercise on pain, shoulder mobility, lymphedema, cardiorespiratory fitness, muscle strength, body composition, pulmonary function, cancer-related fatigue (CRF) and health-related quality of life (HRQoL) and which parameters are effective compared to similar land-based interventions. METHODS The databases used were PubMed, Scopus, Web of Science, Cochrane Library and CINAHL, retrieving 145 articles. RESULTS Eleven studies were included. Aquatic therapeutic exercise is feasible, safe, well tolerated and achieved high percentages of adherence. As for the assessed outcomes, moderate to large improvements were found compared to usual care or to land-based physical exercise interventions in pain, shoulder range of motion, pulmonary function, HRQoL, cardiorespiratory fitness and muscle strength. Inconclusive results were found for lymphedema, body composition and CRF. CONCLUSIONS Aquatic therapeutic exercise interventions using a combination of endurance, strength, mobility, stretching and breathing exercises resulted in improvements in common side effects of BC and its treatments. More studies on CRF, body composition and lymphedema need to be done to further evaluate the impact of the intervention on these outcomes.
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Affiliation(s)
- Esther Mur-Gimeno
- Tecnocampus, Research Group in Attention to Chronicity and Innovation in Health (GRACIS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Paula Postigo-Martin
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- 'CUIDATE' from Biomedical Group (BIO277), University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Granada Institute for Biomedical Research (ibs. GRANADA), University Hospital Complex of Granada/University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- 'CUIDATE' from Biomedical Group (BIO277), University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Granada Institute for Biomedical Research (ibs. GRANADA), University Hospital Complex of Granada/University of Granada, Granada, Spain
- Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Raquel Sebio-Garcia
- Tecnocampus, Research Group in Attention to Chronicity and Innovation in Health (GRACIS), Universitat Pompeu Fabra, Barcelona, Spain
- Department of Rehabilitation, Hospital Clinic de Barcelona, Barcelona, Spain
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Ramsey I, Chan A, Charalambous A, Cheung YT, Darling HS, Eng L, Grech L, Hart NH, Kirk D, Mitchell SA, Poprawski D, Rammant E, Fitch MI, Chan RJ. Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners' knowledge, practices, barriers, and facilitators. Support Care Cancer 2022; 30:9379-9391. [PMID: 36173560 PMCID: PMC9521001 DOI: 10.1007/s00520-022-07342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/22/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Evidence supports the role of prescribed exercise for cancer survivors, yet few are advised to exercise by a healthcare practitioner (HCP). We sought to investigate the gap between HCPs' knowledge and practice from an international perspective. METHODS An online questionnaire was administered to HCPs working in cancer care between February 2020 and February 2021. The questionnaire assessed knowledge, beliefs, and practices regarding exercise counselling and referral of cancer survivors to exercise programs. RESULTS The questionnaire was completed by 375 participants classified as medical practitioners (42%), nurses (28%), exercise specialists (14%), and non-exercise allied health practitioners (16%). Between 35 and 50% of participants self-reported poor knowledge of when, how, and which cancer survivors to refer to exercise programs or professionals, and how to counsel based on exercise guidelines. Commonly reported barriers to exercise counselling were safety concerns, time constraints, cancer survivors being told to rest by friends and family, and not knowing how to screen people for suitability to exercise (40-48%). Multivariable logistic regression models including age, gender, practitioner group, leisure-time physical activity, and recall of guidelines found significant effects for providing specific exercise advice (χ2(7) = 117.31, p < .001), discussing the role of exercise in symptom management (χ2(7) = 65.13, p < .001) and cancer outcomes (χ2(7) = 58.69, p < .001), and referring cancer survivors to an exercise program or specialist (χ2(7) = 72.76, p < .001). CONCLUSION Additional education and practical support are needed to equip HCPs to provide cancer survivors with exercise guidelines, resources, and referrals to exercise specialists.
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Affiliation(s)
- Imogen Ramsey
- Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Alexandre Chan
- School of Pharmacy & Pharmaceutical Sciences, Department of Clinical Pharmacy Practice, University of California, Irvine, CA USA
| | - Andreas Charalambous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus ,Department of Nursing, University of Turku, Turku, Finland
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H. S. Darling
- Department of Medical Oncology, Command Hospital Air Force, Bangalore, India
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - Lisa Grech
- School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Medicine Monash Health, Monash University, Melbourne, Australia ,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia ,Health Sciences, Swinburne University, Melbourne, Australia ,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicolas H. Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA Australia ,Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA Australia ,School of Nursing, Queensland University of Technology, Kelvin Grove, QLD Australia ,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA Australia
| | - Deborah Kirk
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA Australia
| | - Sandra A. Mitchell
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD USA
| | - Dagmara Poprawski
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia ,College of Medicine and Public Health, Flinders University, Bedford Park, South Australia Australia
| | - Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | - Raymond J. Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA Australia
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Ginzac A, Bernadach M, Molnar I, Duclos M, Thivat E, Durando X. Adapted Physical Activity for Breast Cancer Patients Treated with Neoadjuvant Chemotherapy and Trastuzumab Against HER2 (APACAN2): A Protocol for a Feasibility Study. Front Oncol 2021; 11:744609. [PMID: 34966667 PMCID: PMC8710679 DOI: 10.3389/fonc.2021.744609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022] Open
Abstract
Background The 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. Methods The 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. Discussion In 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 Number Clinicaltrials.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.
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Affiliation(s)
- Angeline Ginzac
- INSERM U1240 IMoST, Université Clermont Auvergne, Clermont-Ferrand, France.,Département de Recherche Clinique, Délégation Recherche Clinique et Innovation, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Maureen Bernadach
- Centre d'Investigation Clinique UMR501, Clermont-Ferrand, France.,Service d'Oncologie Médicale, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Ioana Molnar
- INSERM U1240 IMoST, Université Clermont Auvergne, Clermont-Ferrand, France.,Département de Recherche Clinique, Délégation Recherche Clinique et Innovation, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Martine Duclos
- CHU Clermont-Ferrand, Service de Médecine du Sport et des Explorations Fonctionnelles, Université Clermont Auvergne, INRAE, UNH, Clermont-Ferrand, France
| | - Emilie Thivat
- INSERM U1240 IMoST, Université Clermont Auvergne, Clermont-Ferrand, France.,Département de Recherche Clinique, Délégation Recherche Clinique et Innovation, Centre Jean PERRIN, Clermont-Ferrand, France
| | - Xavier Durando
- INSERM U1240 IMoST, Université Clermont Auvergne, Clermont-Ferrand, France.,Service d'Oncologie Médicale, Centre Jean PERRIN, Clermont-Ferrand, France
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Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions. J Clin Med 2021; 11:jcm11010195. [PMID: 35011937 PMCID: PMC8745758 DOI: 10.3390/jcm11010195] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023] Open
Abstract
This review discusses chronic pain, multiple modifiable lifestyle factors, such as stress, insomnia, diet, obesity, smoking, alcohol consumption and physical activity, and the relationship between these lifestyle factors and pain after cancer. Chronic pain is known to be a common consequence of cancer treatments, which considerably impacts cancer survivors' quality of life when it remains untreated. Improvements in lifestyle behaviour are known to reduce mortality, comorbid conditions (i.e., cardiovascular diseases, other cancer, and recurrence) and cancer-related side-effects (i.e., fatigue and psychological issues). An inadequate stress response plays an important role in dysregulating the body's autonomic, endocrine, and immune responses, creating a problematic back loop with pain. Next, given the high vulnerability of cancer survivors to insomnia, addressing and treating those sleep problems should be another target in pain management due to its capacity to increase hyperalgesia. Furthermore, adherence to a healthy diet holds great anti-inflammatory potential for relieving pain after cancer. Additionally, a healthy diet might go hand in hand with weight reduction in the case of obesity. Consuming alcohol and smoking have an acute analgesic effect in the short-term, with evidence lacking in the long-term. However, this acute effect is outweighed by other harms on cancer survivors' general health. Last, informing patients about the benefits of an active lifestyle and reducing a sedentary lifestyle after cancer treatment must be emphasised when considering the proven benefits of physical activity in this population. A multimodal approach addressing all relevant lifestyle factors together seems appropriate for managing comorbid conditions, side-effects, and chronic pain after cancer. Further research is needed to evaluate whether modifiable lifestyle factors have a beneficial influence on chronic pain among cancer survivors.
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Riani Costa LA, F Barreto R, de Leandrini SMM, Gurgel ARB, de Sales GT, Voltarelli VA, de Castro G, Fenton SAM, Turner JE, Klausener C, Neves LM, Ugrinowitsch C, Farah JC, Forjaz CLDM, Brito CMM, Brum PC. The influence of a supervised group exercise intervention combined with active lifestyle recommendations on breast cancer survivors' health, physical functioning, and quality of life indices: study protocol for a randomized and controlled trial. Trials 2021; 22:934. [PMID: 34922621 PMCID: PMC8684206 DOI: 10.1186/s13063-021-05843-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/18/2021] [Indexed: 12/09/2022] Open
Abstract
Background Most cancer patients, under active treatment or not, are sedentary, despite increasing scientific and clinical understanding of the benefits of exercise and physical activity, such as improving quality of life, limiting disease symptoms, decreasing cancer recurrence, and increasing overall survival. Studies have shown that both supervised exercise and unsupervised physical activity programs have low adherence and limited long-term benefits among cancer survivors. Therefore, interventions focused on increasing physical activity levels have clinical and psychological relevance. The present study will examine the feasibility and efficacy of an intervention that combines supervised group exercise with active lifestyle recommendations, analyzing its clinical, psychological, physiological, functional, and immunological effects in breast cancer survivors. Methods Women aged 35–75 years who have completed chemotherapy, radiotherapy, and surgery for breast cancer will be recruited from the Cancer Institute of the State of Sao Paulo (ICESP) and take part in a 16-week, parallel-group, randomized, and controlled trial. They will receive a booklet with recommendations for achieving a physically active lifestyle by increasing overall daily movement and undertaking at least 150 min/week of structured exercise. Then, they will be randomized into two groups: the supervised group will take part in two canoeing group exercise sessions every week, and the unsupervised group will increase their overall physical activity level by any means, such as active commuting, daily activities, or home-based exercise. Primary outcome includes aerobic capacity. Secondary outcomes are physical activity, physical functioning, self-reported quality of life, fatigue, presence of lymphedema, body composition, immune function, adherence to physical activity guidelines, and perceptions of self-image. Discussion Results should contribute to advance knowledge on the impact of a supervised group exercise intervention to improve aspects related to health, physical functioning, and quality of life in female breast cancer survivors. Trial registration Brazilian Registry of Clinical Trials Number: RBR-3fw9xf. Retrospectively Registered on 27 December 2018. Items from the World Health Organization Trial Registration Data Set can be accessed on http://www.ensaiosclinicos.gov.br/rg/RBR-3fw9xf/. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05843-z.
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Affiliation(s)
- Luiz Augusto Riani Costa
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Raphael F Barreto
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Sarah Milani Moraes de Leandrini
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Aline Rachel Bezerra Gurgel
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Gabriel Toledo de Sales
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Vanessa Azevedo Voltarelli
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Gilberto de Castro
- Instituto do Cancer do Estado de Sao Paulo, ICESP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Christian Klausener
- Centro de Práticas Esportivas da Universidade de Sao Paulo (CEPEUSP), Sao Paulo, Brazil
| | - Lucas Melo Neves
- Master's Program in Health Sciences at Santo Amaro University - UNISA, Sao Paulo, Brazil.,Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo - USP, Sao Paulo, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Jose Carlos Farah
- Centro de Práticas Esportivas da Universidade de Sao Paulo (CEPEUSP), Sao Paulo, Brazil
| | - Cláudia Lúcia de Moraes Forjaz
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Christina May Moran Brito
- Instituto do Cancer do Estado de Sao Paulo, ICESP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Patricia Chakur Brum
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil. .,Departamento de Biodinamica do Movimento do Corpo Humano, Escola de Educação Física e Esporte da Universidade de São Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil.
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Feasibility of Implementing Physical Activity Behavior Change Counseling in an Existing Cancer-Exercise Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312705. [PMID: 34886430 PMCID: PMC8657067 DOI: 10.3390/ijerph182312705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This study examined the feasibility and acceptability of implementing research-tested physical activity (PA) behavior change counseling (BCC) sessions in an existing cancer-exercise program, and the preliminary effects on cancer survivor's self-efficacy and PA. METHODS Participants were cancer survivors undergoing or within six-months of completing cancer treatment(s), and exercise program staff. Cancer survivors were randomized to receive the exercise program plus PABCC, or the standard exercise program. Feasibility and acceptability were assessed by recruitment, adherence, satisfaction, and a focus group with program staff. Qualitative data were analyzed using descriptive thematic analysis. Self-report questionnaires measured PA and exercise self-efficacy. RESULTS Recruitment was 33 out of 93 (36.7%), and n = 13 (39%) provided post-program data. Cancer survivors enjoyed PABCC sessions, but reported face-to-face delivery was an added time burden. Program staff expressed desire to implement PABCC, but perceived staff capacity and time as barriers to sustainability. Exercise self-efficacy increased by 21.5% in the PABCC group vs. 4.2% in the control. PA increased by 81.3% in the PABCC group vs. 16.6% in the control group. CONCLUSIONS Implementing PABCC in an existing cancer-exercise program was acceptable and promising for increasing moderate to vigorous PA, but additional research is needed to enhance the feasibility and sustainability of translating efficacious behavioral interventions into existing cancer-exercise programs.
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