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Nicol JL, Cunningham BJ, Woodrow C, Adlard KN, Papinczak ZE, Spence RR, Boytar AN, Mollee P, Weber N, Nicol AJ, Hill MM, Skinner TL. Safety, Feasibility, and Acceptability of a Multisite Individualized Exercise Intervention for People with Multiple Myeloma. Med Sci Sports Exerc 2023; 55:2214-2227. [PMID: 37535331 DOI: 10.1249/mss.0000000000003267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
INTRODUCTION High rates of disease- and treatment-related symptoms, such as bone lesions, in people with multiple myeloma (MM) create uncertainty on the safety and feasibility of exercise. This study determined the safety, feasibility, and acceptability of an individualized exercise medicine program for people with MM at any disease stage. METHODS A multisite, randomized waitlist-controlled trial was conducted of an individualized, high-intensity aerobic, resistance, and impact-loading exercise program. The exercise sessions were supervised twice weekly by accredited exercise physiologists, with one additional unsupervised session per week, for 12 wk. Safety was determined by number of adverse and serious adverse events. Feasibility outcome measures were study eligibility, recruitment, adherence, and attrition. Acceptability was determined by qualitative interviews and subjective levels of enjoyment. RESULTS Of 203 people with MM screened, 88% were eligible, with 34% accepting participation (60 people) and 20% attrition for the between-group analysis, meeting a priori criteria (≥25% and <25%, respectively). No adverse or serious adverse events attributed to testing and/or exercise training were reported. Attendance at supervised exercise sessions was 98%, with 45% completion of the home-based exercise sessions. Adherence rates were 35%, 63%, and 34% for the aerobic, resistance, and impact-loading protocols, with 55%, 80%, and 37% of participants meeting a priori criteria (75% of protocol). Acceptability of the exercise program was high (mean, 82%; 95% confidence interval, 78%-87%) and highly supported by qualitative responses. CONCLUSIONS An individualized, high-intensity aerobic, resistance, and impact-loading exercise medicine program is safe and acceptable, and feasible by some measures for people with MM. Adherence to the prescribed exercise protocols was limited by comorbidities and disease symptoms. Strategies to improve unsupervised exercise completion are warranted in this population.
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Affiliation(s)
| | - Brent J Cunningham
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | - Carmel Woodrow
- Haematology Department, Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Queensland, AUSTRALIA
| | - Kirsten N Adlard
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | - Zoe E Papinczak
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | | | - Alexander N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | | | - Nicholas Weber
- Haematology, Cancer Care Services, Royal Brisbane and Women's Hospital, Queensland, AUSTRALIA
| | - Andrew J Nicol
- Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane, Queensland, AUSTRALIA
| | | | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
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2
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Hart NH, Wallen MP, Farley MJ, Haywood D, Boytar AN, Secombe K, Joseph R, Chan RJ, Kenkhuis MF, Buffart LM, Skinner TL, Wardill HR. Exercise and the gut microbiome: implications for supportive care in cancer. Support Care Cancer 2023; 31:724. [PMID: 38012463 DOI: 10.1007/s00520-023-08183-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE Growing recognition of the gut microbiome as an influential modulator of cancer treatment efficacy and toxicity has led to the emergence of clinical interventions targeting the microbiome to enhance cancer and health outcomes. The highly modifiable nature of microbiota to endogenous, exogenous, and environmental inputs enables interventions to promote resilience of the gut microbiome that have rapid effects on host health, or response to cancer treatment. While diet, probiotics, and faecal microbiota transplant are primary avenues of therapy focused on restoring or protecting gut function in people undergoing cancer treatment, the role of physical activity and exercise has scarcely been examined in this population. METHODS A narrative review was conducted to explore the nexus between cancer care and the gut microbiome in the context of physical activity and exercise as a widely available and clinically effective supportive care strategy used by cancer survivors. RESULTS Exercise can facilitate a more diverse gut microbiome and functional metabolome in humans; however, most physical activity and exercise studies have been conducted in healthy or athletic populations, primarily using aerobic exercise modalities. A scarcity of exercise and microbiome studies in cancer exists. CONCLUSIONS Exercise remains an attractive avenue to promote microbiome health in cancer survivors. Future research should elucidate the various influences of exercise modalities, intensities, frequencies, durations, and volumes to explore dose-response relationships between exercise and the gut microbiome among cancer survivors, as well as multifaceted approaches (such as diet and probiotics), and examine the influences of exercise on the gut microbiome and associated symptom burden prior to, during, and following cancer treatment.
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Affiliation(s)
- Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia.
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.
| | - Matthew P Wallen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Institute for Health and Wellbeing, Federation University, Ballarat, VIC, Australia
| | - Morgan J Farley
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia
- Mental Health Division, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Alexander N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Kate Secombe
- The University of Queensland Diamantina Institute, Faculty of Medicine, The University of Queensland, St. Lucia, QLD, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Ria Joseph
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tina L Skinner
- Human Performance Research Centre, INSIGHT Research Institute, University of Technology Sydney (UTS), Moore Park, NSW, 2030, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Hannah R Wardill
- School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
- Supportive Oncology Research Group, Precision Cancer Medicine, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Jenkins DG, Devin JL, Weston KL, Jenkins JG, Skinner TL. Benefits beyond cardiometabolic health: the potential of frequent high intensity 'exercise snacks' to improve outcomes for those living with and beyond cancer. J Physiol 2023; 601:4691-4697. [PMID: 37732418 DOI: 10.1113/jp284985] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023] Open
Abstract
High intensity interval training (HIIT) has been shown to consistently elicit rapid and significant adaptations in a number of physiological systems, across many different healthy and clinical populations. In addition, there is increasing interest in how some acute, yet transient responses to high intensity exercise potentially reduce the risks of particular diseases. Recent work has shown that discrete, brief bouts of high intensity exercise (termed 'exercise snacks') can improve glucose control and vascular health and thus counter the negative cardiometabolic consequences of prolonged, uninterrupted periods of inactivity. In this brief review, we advance the case, using evidence available from pre-clinical studies in the exercise oncology literature, that brief, frequently completed bouts of high intensity exercise embedded within an individual's overall daily and weekly physical activity schedule, may transiently impact the tumour microenvironment and improve the health outcomes for those who have been diagnosed and treated for cancer.
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Affiliation(s)
- David G Jenkins
- University of the Sunshine Coast, Maroochydore, Australia
- Applied Sports Science Technology and Medicine Research Centre, Swansea University, Swansea, UK
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - James L Devin
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Kathryn L Weston
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Joseph G Jenkins
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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4
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Salisbury CE, Hyde MK, Cooper ET, Stennett RC, Gomersall SR, Skinner TL. Physical activity behaviour change in people living with and beyond cancer following an exercise intervention: a systematic review. J Cancer Surviv 2023; 17:569-594. [PMID: 37074621 PMCID: PMC10209249 DOI: 10.1007/s11764-023-01377-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/31/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Exercise interventions can increase physical activity and wellbeing of people living with/beyond cancer. However, little is known about maintenance of physical activity in this population ≥ 6 months post-exercise intervention, when theoretical evidence suggests behaviour maintenance occurs. Study aims are to (i) systematically review maintenance of physical activity ≥ 6-month post-exercise intervention, and (ii) investigate the influence of behaviour change techniques (BCTs) on physical activity maintenance in people living with/beyond cancer. METHODS CINAHL, CENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials up to August 2021. Trials including adults diagnosed with cancer that assessed physical activity ≥ 6 months post-exercise intervention were included. RESULTS Of 142 articles assessed, 21 reporting on 18 trials involving 3538 participants were eligible. Five (21%) reported significantly higher physical activity ≥ 6 months post-exercise intervention versus a control/comparison group. Total number of BCTs (M = 8, range 2-13) did not influence intervention effectiveness. The BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, were important, but not sufficient, components for long-term physical activity maintenance. CONCLUSIONS Evidence for long-term physical activity maintenance post-exercise intervention for people living with/beyond cancer is limited and inconclusive. Further research is required to ensure the physical activity and health benefits of exercise interventions do not quickly become obsolete. IMPLICATIONS FOR CANCER SURVIVORS Implementation of the BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, may enhance physical activity maintenance and subsequent health outcomes in people living with/beyond cancer.
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Affiliation(s)
- Chloe E Salisbury
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Melissa K Hyde
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Ella T Cooper
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Rebecca C Stennett
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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5
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Swain CT, Drummond AE, Milne RL, English DR, Brown KA, Lou MW, Boing L, Bageley A, Skinner TL, van Roekel EH, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer Risk via Inflammation, Part 1: The Effect of Physical Activity on Inflammation. Cancer Epidemiol Biomarkers Prev 2023; 32:588-596. [PMID: 36867865 PMCID: PMC10150243 DOI: 10.1158/1055-9965.epi-22-0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/10/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
The protective effect of physical activity on breast cancer incidence may partially be mediated by inflammation. Systematic searches of Medline, EMBASE, and SPORTDiscus were performed to identify intervention studies, Mendelian randomization studies, and prospective cohort studies that examined the effects of physical activity on circulating inflammatory biomarkers in adult women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the overall quality of the evidence. Thirty-five intervention studies and one observational study met the criteria for inclusion. Meta-analyses of randomized controlled trials (RCT) indicated that, compared with control groups, exercise interventions reduced levels of C-reactive protein (CRP) [standardized mean difference (SMD) = -0.27, 95% confidence interval (CI) = -0.62 to 0.08), tumor necrosis factor alpha (TNFα, SMD = -0.63, 95% CI = -1.04 to -0.22), interleukin-6 (IL6, SMD = -0.55, 95% CI = -0.97 to -0.13) and leptin (SMD = -0.50, 95% CI = -1.10 to 0.09). Owing to heterogeneity in effect estimates and imprecision, evidence strength was graded as low (CRP, leptin) or moderate (TNFα and IL6). High-quality evidence indicated that exercise did not change adiponectin levels (SMD = 0.01, 95% CI = -0.14 to 0.17). These findings provide support for the biological plausibility of the first part of the physical activity-inflammation-breast cancer pathway.
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Affiliation(s)
| | - Ann E. Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dallas R. English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kristy A. Brown
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Makayla W.C. Lou
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Leonessa Boing
- Laboratory of Research in Leisure and Physical Activity, Santa Catarina State University, Florianopolis, Brazil
| | - Amy Bageley
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Tina L. Skinner
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia, Australia
| | - Eline H. van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Melissa M. Moore
- Medical Oncology, St Vincent's Hospital, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Tom R. Gaunt
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard M. Martin
- Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Sarah J. Lewis
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Brigid M. Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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6
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Lou MW, Drummond AE, Swain CT, Milne RL, English DR, Brown KA, van Roekel EH, Skinner TL, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer via Inflammation, Part 2: The Effect of Inflammation on Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2023; 32:597-605. [PMID: 36867866 PMCID: PMC10150245 DOI: 10.1158/1055-9965.epi-22-0929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/09/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
This review synthesized and appraised the evidence for an effect of inflammation on breast cancer risk. Systematic searches identified prospective cohort and Mendelian randomization studies relevant to this review. Meta-analysis of 13 biomarkers of inflammation were conducted to appraise the evidence for an effect breast cancer risk; we examined the dose-response of these associations. Risk of bias was evaluated using the ROBINS-E tool and the quality of evidence was appraised with Grading of Recommendations Assessment, Development, and Evaluation. Thirty-four observational studies and three Mendelian randomization studies were included. Meta-analysis suggested that women with the highest levels of C-reactive protein (CRP) had a higher risk of developing breast cancer [risk ratio (RR) = 1.13; 95% confidence interval (CI), 1.01-1.26] compared with women with the lowest levels. Women with highest levels of adipokines, particularly adiponectin (RR = 0.76; 95% CI, 0.61-0.91) had a reduced breast cancer risk, although this finding was not supported by Mendelian randomization analysis. There was little evidence of an effect of cytokines, including TNFα and IL6, on breast cancer risk. The quality of evidence for each biomarker ranged from very low to moderate. Beyond CRP, the published data do not clearly support the role of inflammation in the development of breast cancer.
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Affiliation(s)
- Makayla W.C. Lou
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Ann E. Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
| | | | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dallas R. English
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kristy A. Brown
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Eline H. van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Melissa M. Moore
- Medical Oncology, St Vincent's Hospital, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Tom R. Gaunt
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Sarah J. Lewis
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Brigid M. Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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7
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Vear NK, Moon Y, Mielke GI, Skinner TL, Coombes JS, McCarthy AL, Abbott CR, Bailey TG. Efficacy of exercise training for improving vascular dysfunction in people with cancer: a systematic review with meta-analyses. J Cancer Surviv 2023:10.1007/s11764-023-01372-7. [PMID: 37079184 DOI: 10.1007/s11764-023-01372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Cancer treatments exert vascular toxic effects that can lead to the development of cardiovascular disease. Exercise training has the potential to prevent or reduce cancer treatment-induced damage to vascular structure and function. This systematic review with meta-analyses aimed to determine the isolated effects of exercise training on vascular outcomes in people with cancer. METHODS Seven electronic databases were searched on 20 September 2021 to identify randomised controlled trials, quasi-randomised trials, pilot and cohort studies. Included studies implemented a structured exercise intervention and assessed vascular structure and/or function in people during or following cancer treatment. Meta-analyses examined the effects of exercise training on endothelial function (via brachial artery flow-mediated dilation) and arterial stiffness (via pulse wave velocity). Methodological quality was assessed using the Cochrane Quality Assessment tool and modified Newcastle-Ottawa Quality Appraisal tool. Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence. RESULTS Ten studies (discussed across 11 articles) met the inclusion criteria. Methodological quality of the included studies was moderate (71% average). Exercise improved vascular function when compared to control (standardised mean difference = 0.34, 95% CI (0.01, 0.67); p = 0.044: studies = 5, participants = 171), but not pulse wave velocity (standardised mean difference = - 0.64, 95% CI (- 1.29, 0.02); p = 0.056: studies = 4, participants = 333). The certainty of evidence was moderate for flow-mediated dilation and low for pulse wave velocity. CONCLUSIONS Compared to usual care, exercise training significantly improves flow-mediated dilation (endothelial function) but not pulse wave analysis, in people treated for cancer. IMPLICATIONS FOR CANCER SURVIVORS Exercise may improve vascular health in individuals during and following cancer treatment.
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Affiliation(s)
- Natalie K Vear
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia.
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
| | - Yubin Moon
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Tina L Skinner
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Mater Research Institute, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, Queensland, 4101, Australia
| | - Claudia R Abbott
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Tom G Bailey
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
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8
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Boytar AN, Skinner TL, Wallen RE, Jenkins DG, Dekker Nitert M. The Effect of Exercise Prescription on the Human Gut Microbiota and Comparison between Clinical and Apparently Healthy Populations: A Systematic Review. Nutrients 2023; 15:nu15061534. [PMID: 36986264 PMCID: PMC10054511 DOI: 10.3390/nu15061534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
This study systematically reviewed all human longitudinal exercise interventions that reported changes in the gut microbiota; frequency, intensity, duration and type of exercise were assessed to determine the influence of these variables on changes to the gut microbiota in both healthy individuals and clinical populations (PROPERO registration: CRD42022309854). Using PRISMA guidelines, trials analysing gut microbiota change with exercise interventions were included independent of trial randomisation, population, trial duration or analysis technique. Studies were excluded when microbiota abundance was not reported or when exercise was combined with other interventions. Twenty-eight trials were included, of which twelve involved healthy populations only and sixteen involved mixed or clinical-only populations. The findings show that participation in exercise of moderate to high-intensity for 30-90 min ≥3 times per week (or between 150-270 min per week) for ≥8 weeks is likely to produce changes in the gut microbiota. Exercise appears to be effective in modifying the gut microbiota in both clinical and healthy populations. A more robust methodology is needed in future studies to improve the certainty of the evidence.
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Affiliation(s)
- Alexander N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Ruby E Wallen
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia
- Applied Sports Science Technology and Medicine Research Centre, Swansea University, Wales SA1 8EN, UK
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia
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9
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Farley MJ, Bartlett DB, Skinner TL, Schaumberg MA, Jenkins DG. Immunomodulatory Function of Interleukin-15 and Its Role in Exercise, Immunotherapy, and Cancer Outcomes. Med Sci Sports Exerc 2023; 55:558-568. [PMID: 36730979 DOI: 10.1249/mss.0000000000003067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Exercise has been shown to improve physical and psychosocial outcomes for people across the cancer care continuum. A proposed mechanism underpinning the relationship between exercise and cancer outcomes is exercise-induced immunomodulation via secretion of anti-inflammatory myokines from skeletal muscle tissue. Myokines have the potential to impair cancer growth through modulation of natural killer (NK) cells and CD8+ T cells while improving the effectiveness of cancer therapies. Interleukin-15 (IL-15), one of the most abundant myokines found in skeletal muscle, has a key immunoregulatory role in supporting the proliferation and maturation of T cells and NK cells, which have a key role in the host's immune response to cancer. Furthermore, IL-15 is being explored clinically as an immunotherapy agent with doses similar to the IL-15 concentrations released by skeletal muscle during exercise. Here we review the role of IL-15 within the immune system, examine how IL-15 is produced as a myokine during exercise, and how it may improve outcomes for people with cancer, specifically as an adjuvant or neoadjuvant to immunotherapy. We summarize the available evidence showing changes in IL-15 in response to both acute exercise and training, and the results are inconsistent; higher quality research is needed to advance the understanding of how exercise-mediated increases in IL-15 potentially benefit those who are being treated for, or who have had, cancer.
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Affiliation(s)
- Morgan J Farley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, AUSTRALIA
| | - David B Bartlett
- School of Biosciences and Medicine, University of Surrey, Surrey, UNITED KINGDOM
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, AUSTRALIA
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10
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Nicol JL, Chong JE, McQuilten ZK, Mollee P, Hill MM, Skinner TL. Safety, Feasibility, and Efficacy of Exercise Interventions for People With Multiple Myeloma: A Systematic Review. Clin Lymphoma Myeloma Leuk 2023; 23:86-96. [PMID: 36450625 DOI: 10.1016/j.clml.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/08/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Bone lesions and other disease- and treatment-related side effects commonly experienced by people with multiple myeloma (MM) may impede their ability to exercise. This systematic review evaluated the safety, feasibility, and efficacy of exercise program participation on the physiological and/or psychological health of people with MM. Literature searches were conducted through five electronic databases and appraised using the Delphi list of criteria. Controlled trials that assessed the safety and feasibility of an exercise intervention and its effects on disease- or treatment-related symptoms in people with MM were included. Seven studies of varying quality involving 563 participants were included. All studies concluded that exercise was safe, reporting zero serious and 4 adverse events attributable to exercise testing or training. Attendance ranged from 58% to 96%, however no study reported adherence to the exercise prescription. Compared to a control group, exercise did not appear to affect fatigue, depression, anxiety, body composition, quality of life, or sleep. Isolated studies identified between-group differences favoring exercise in lower limb strength (+8.4 kg, 95% CI 0.5, 16.3, P= .04), peak oxygen uptake (+1.2 mL/kg/min, 95% CI 0.3, 3.7, P= .02), physical activity (+6.5MET-hs/wk, P< .001), stem cell collection attempts (1.1 ± 0.2 vs. 1.5 ± 0.9, P< .01), and red blood cell (1.8 ± 2.2 vs. 2.4 ± 2.6, P< .05) and platelet transfusions (2.3 ± 1.6 vs. 3.5 ± 3.4, P < .05) during transplantation. Exercise interventions appear safe and well attended by people with MM. The lack of improvements in disease- and treatment-related symptoms requires further exploration to determine whether exercise is a sufficient stimulus to elicit benefits in this unique population.
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Affiliation(s)
- Jennifer L Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia; QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Jamie E Chong
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Zoe K McQuilten
- Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Peter Mollee
- Haematology Department, Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, The University of Queensland, Brisbane, Australia
| | - Michelle M Hill
- QIMR Berghofer Medical Research Institute, Brisbane, Australia; UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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11
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Drummond AE, Swain CT, Milne RL, English DR, Brown KA, Skinner TL, Lay J, van Roekel EH, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer Risk via the Insulin/Insulin-like Growth Factor Signaling System, Part 2: The Effect of Insulin/Insulin-like Growth Factor Signaling on Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2022; 31:2116-2125. [PMID: 36464995 PMCID: PMC7613928 DOI: 10.1158/1055-9965.epi-22-0505] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/05/2022] [Accepted: 10/05/2022] [Indexed: 12/11/2022] Open
Abstract
Perturbation of the insulin/insulin-like growth factor (IGF) signaling system is often cited as a mechanism driving breast cancer risk. A systematic review identified prospective cohort studies and Mendelian randomization studies that examined the effects of insulin/IGF signaling (IGF, their binding proteins (IGFBP), and markers of insulin resistance] on breast cancer risk. Meta-analyses generated effect estimates; risk of bias was assessed and the Grading of Recommendations Assessment, Development and Evaluation system applied to evaluate the overall quality of the evidence. Four Mendelian randomization and 19 prospective cohort studies met our inclusion criteria. Meta-analysis of cohort studies confirmed that higher IGF-1 increased risk of breast cancer; this finding was supported by the Mendelian randomization studies. IGFBP-3 did not affect breast cancer. Meta analyses for connecting-peptide and fasting insulin showed small risk increases, but confidence intervals were wide and crossed the null. The quality of evidence obtained ranged from 'very low' to 'moderate'. There were insufficient studies to examine other markers of insulin/IGF signaling. These findings do not strongly support the biological plausibility of the second part of the physical activity-insulin/IGF signaling system-breast cancer pathway. Robust conclusions cannot be drawn due to the dearth of high quality studies. See related article by Swain et al., p. 2106.
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Affiliation(s)
- Ann E. Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Australia
| | | | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dallas R. English
- Cancer Epidemiology Division, Cancer Council Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Kristy A. Brown
- Department of Medicine, Weill Cornell Medicine, New York, USA
| | - Tina L. Skinner
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia, Australia
| | - Jannelle Lay
- Cancer Epidemiology Division, Cancer Council Victoria, Australia
| | - Eline H. van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Melissa M. Moore
- Medical Oncology, St Vincent’s Hospital, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Australia
| | - Tom R. Gaunt
- Bristol Medical School, University of Bristol, UK
| | - Richard M. Martin
- Bristol Medical School, University of Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | | | - Brigid M. Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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12
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Swain CTV, Drummond AE, Milne RL, English DR, Brown KA, Chong JE, Skinner TL, van Roekel EH, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer Risk via Insulin/Insulin-Like Growth Factor Signaling System, Part 1: The Effect of Physical Activity on the Insulin/Insulin-Like Growth Factor Signaling System. Cancer Epidemiol Biomarkers Prev 2022; 31:2106-2115. [PMID: 36464996 DOI: 10.1158/1055-9965.epi-22-0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 12/12/2022] Open
Abstract
Physical activity may reduce the risk of developing breast cancer via its effect on the insulin/insulin-like growth factor (IGF) signaling system. A systematic review searched for randomized controlled trials (RCT), Mendelian randomization and prospective cohort studies that examined the effects of physical activity on insulin/IGF signaling [IGFs, their binding proteins (IGFBP), and markers of insulin resistance] in adult women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the Grading of Recommendations Assessment, Development, and Evaluation system used to determine the overall quality of the evidence. Fifty-eight RCTs met our inclusion criteria, no observational or Mendelian randomization studies met the criteria for inclusion. Meta-analyses indicated that physical activity interventions (vs. control) reduced fasting insulin, the Homeostatic Model Assessment for Insulin Resistance and fasting glucose. Physical activity increased IGF-1, but there was no clear effect on IGFBP-3 or the ratio of IGF-1:IGFBP-3. Strong evidence was only established for fasting insulin and insulin resistance. Further research is needed to examine the effect of physical activity on C-peptide and HBA1c in women. Reductions in fasting insulin and insulin resistance following exercise suggest some biological plausibility of the first part of the physical activity-insulin/IGF signaling-breast cancer pathway. See related article by Drummond et al., p. 2116.
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Affiliation(s)
| | - Ann E Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kristy A Brown
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Jamie E Chong
- The University of Queensland, School of Human Movement and Nutrition Sciences, St. Lucia, Australia
| | - Tina L Skinner
- The University of Queensland, School of Human Movement and Nutrition Sciences, St. Lucia, Australia
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Melissa M Moore
- Medical Oncology, St. Vincent's Hospital, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Tom R Gaunt
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard M Martin
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- IHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Sarah J Lewis
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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13
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Boytar AN, Nitert MD, Morrision M, Skinner TL, Jenkins DG. Exercise-induced changes to the human gut microbiota and implications for colorectal cancer: a narrative review. J Physiol 2022; 600:5189-5201. [PMID: 36369926 PMCID: PMC10099575 DOI: 10.1113/jp283702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/18/2022] [Indexed: 11/15/2022] Open
Abstract
Physical activity is associated with reduced risks of colorectal cancer (CRC) incidence, recurrence and mortality. While these findings are consistent, the mechanism/s underlying this association remain unclear. Growing evidence supports the many ways in which differing characteristics of the gut microbiota can be tumourigenic or protective against CRC. CRC is characterised by significant dysbiosis including reduced short chain fatty acid-producing bacteria. Recent findings suggest that exercise can modify the gut microbiota, and these changes are inverse to the changes seen with CRC; however, this exercise-microbiota interaction is currently understudied in CRC. This review summarises parallel areas of research that are rapidly developing: The exercise-gut microbiota research and cancer-gut microbiota research and highlights the salient similarities. Preliminary evidence suggests that these areas are linked, with exercise mediating changes that promote the antitumorigenic characteristics of the gut microbiota. Future mechanistic and population-specific studies are warranted to confirm the physiological mechanism/s by which exercise changes the gut microbiota, and the influence of the exercise-gut interaction on cancer specific outcomes in CRC.
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Affiliation(s)
- Alexander N Boytar
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mark Morrision
- The University of Queensland Diamantina Institute, Faculty of Medicine, Translational Research Institute, The University of Queensland, Brisbane, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,University of the Sunshine Coast, Maroochydore, Australia.,Applied Sports Science Technology and Medicine Research Centre, Swansea University, Wales, UK
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Rose GL, Farley MJ, Flemming NB, Skinner TL, Schaumberg MA. Between-day reliability of cytokines and adipokines for application in research and practice. Front Physiol 2022; 13:967169. [PMID: 36072844 PMCID: PMC9444151 DOI: 10.3389/fphys.2022.967169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/18/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose: This study assessed the biological reliability of peripheral human cytokines and adipokines, and the influence of participant characteristics on total error. This has essential application to interventional cytokine measurement to ensure that reported results are interpreted with confidence. Methods: Participants (49% female, 18–85 years, n = 84) completed two consecutive-day testing sessions. Participants provided a venous blood sample at the same time of day across two consecutive days, under standardized participant presentation, including 24-h rested and 12-h fasted conditions. Multiplex immunoassay was used to assess inflammatory analytes from samples (predominantly plasma). Repeat measurements were conducted between-day for total precision quantification, and technical (technique) error was negated from the total to provide an estimate of biological (attributed to participant presentation) error. Results: Whilst there was no evidence of statistically significant biological error, a small amount of biological error was consistently present across most analytes (∼3.3%/0.07 pg/ml), which was largest for measurement of leptin (7.3%/210 pg/ml). There was also an influence of sex on reliability of leptin and adiponectin (total model explained 6–7% of error variation), where females demonstrated the greatest error. Conclusion: Biological error reported in this study should be applied to any future study or individual with a repeated measurement of cytokine concentrations over time that maintain best practice procedures (12-h fasted, 24-h rested). In most cases, raw error should be used, with exceptions for women for measurement of leptin and adiponectin. This approach will ensure that results are reported with certainty for improved reporting of intervention efficacy.
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Affiliation(s)
- Grace L. Rose
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- The School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- *Correspondence: Grace L. Rose,
| | - Morgan J. Farley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Nicole B. Flemming
- The School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Birtinya, QLD, Australia
- Sunshine Coast Health Institute, Birtinya, QLD, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Mia A. Schaumberg
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- The School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- Sunshine Coast Health Institute, Birtinya, QLD, Australia
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15
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Baguley BJ, Adlard K, Jenkins D, Wright ORL, Skinner TL. Mediterranean Style Dietary Pattern with High Intensity Interval Training in Men with Prostate Cancer Treated with Androgen Deprivation Therapy: A Pilot Randomised Control Trial. Int J Environ Res Public Health 2022; 19:ijerph19095709. [PMID: 35565100 PMCID: PMC9099512 DOI: 10.3390/ijerph19095709] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 01/25/2023]
Abstract
Background: Androgen deprivation therapy (ADT) in prostate cancer has been shown to deteriorate body composition (reduced lean mass and increased body and fat mass) and increase the risk of cardiovascular morbidity. The Mediterranean style dietary pattern (MED-diet) and high intensity interval training (HIIT) may synergistically alleviate these side effects and improve quality of life in men treated with ADT. Methods: Twenty-three men (65.9 ± 7.8 years; body mass index: 29.6 ± 2.7 kg/m2; ADT duration: 33.8 ± 35.6 months) receiving ADT for ≥3 months were randomly assigned (1:1) to 20 weeks of usual care or the MED-diet (10 nutrition consults) with HIIT (4 × 4 min 85−95% heart rate peak, 3× week, starting at 12 weeks). Results: The MED-diet with HIIT significantly improved cardiorespiratory fitness (+4.9 mL·kg−1·min, p < 0.001), and body mass (−3.3 kg, p < 0.001) compared to the usual care group at 20 weeks. Clinically meaningful (≥3 points) improvements were seen in quality of life and cancer-related fatigue after 20 weeks. Conclusions: The MED-diet with HIIT increased cardiorespiratory fitness and reduced body weight in men with prostate cancer treated with ADT. Larger trials determining whether the MED-diet with HIIT translates to cardiovascular benefits are warranted.
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Affiliation(s)
- Brenton J. Baguley
- Institute for Physical Activity and Nutrition, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (K.A.); (D.J.); (O.R.L.W.); (T.L.S.)
- Correspondence: ; Tel.: +61-392-468-525
| | - Kirsten Adlard
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (K.A.); (D.J.); (O.R.L.W.); (T.L.S.)
| | - David Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (K.A.); (D.J.); (O.R.L.W.); (T.L.S.)
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia
- Applied Sports Science Technology and Medicine Research Centre, Swansea University, Swansea SA1 8EN, Wales, UK
| | - Olivia R. L. Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (K.A.); (D.J.); (O.R.L.W.); (T.L.S.)
- Mater Research Institute, The University of Queensland, Brisbane, QLD 4101, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4067, Australia; (K.A.); (D.J.); (O.R.L.W.); (T.L.S.)
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16
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Rose GL, Farley MJ, Ward LC, Slater GJ, Skinner TL, Keating SE, Schaumberg MA. Accuracy of body composition measurement techniques across the age span. Appl Physiol Nutr Metab 2022; 47:482-494. [PMID: 35041556 DOI: 10.1139/apnm-2021-0587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study investigated the acceptable accuracy of common body composition techniques compared with the reference 4-compartment (4C-R) model, which has not been investigated in a sample with diverse characteristics, including age and sex. Techniques included components of the 4C-R model [dual-energy X-ray absorptiometry, air displacement plethysmography, deuterium dilution (DD)] and surrogate compartment models, which utilised bioelectrical impedance spectroscopy (BIS) rather than DD. Men and women (sex = 1:1, 18-85 years, n = 90) completed body composition testing under best-practice guidance. For measurement of individuals, only the reference 3-compartment (3C-R) equation met acceptable error limits (<5% error among individuals) within the a priori cut-point (80%) for fat-free mass (FFM; CV = 0.52%) and fat mass (FM; CV = 1.61%). However, all investigated techniques reached equivalency to the 4C-R model for FFM on average (CV = 0.52-4.31%), but for FM only the 3C and 4C equations that included quantification of total body water (TBW) by DD or BIS reached equivalency overall (CV = 1.61-6.68%). Sex and age minimally influenced accuracy. Only the 3C-R or 4C-R equations are supported for acceptable individual accuracy for both FFM and FM. For group estimates any investigated technique could be used with acceptable accuracy for FFM; however, for FM, inclusion of TBW measurement within a compartment model is necessary. Novelty: Only the referent 3C and 4C models (including deuterium dilution) provide accurate body composition results that are acceptable for measurement of individuals in the general population. For group estimates of lean mass in the general population, compartments models that include TBW must be used for accurate measurement.
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Affiliation(s)
- Grace L Rose
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Nursing Midwifery and Social Work, The University of Queensland, Brisbane, Australia
| | - Morgan J Farley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Gary J Slater
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Mia A Schaumberg
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia.,Sunshine Coast Health Institute, Birtinya, Australia
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17
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Nicol JL, Woodrow C, Cunningham BJ, Mollee P, Weber N, Smith MD, Nicol AJ, Gordon LG, Hill MM, Skinner TL. An Individualized Exercise Intervention for People with Multiple Myeloma—Study Protocol of a Randomized Waitlist-Controlled Trial. Curr Oncol 2022; 29:901-923. [PMID: 35200576 PMCID: PMC8870457 DOI: 10.3390/curroncol29020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.
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Affiliation(s)
- Jennifer L. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Correspondence:
| | - Carmel Woodrow
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
| | - Brent J. Cunningham
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
| | - Peter Mollee
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Nicholas Weber
- Haematology, Cancer Care Services, Royal Brisbane and Women’s Hospital, Brisbane 4006, Australia;
| | - Michelle D. Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
| | - Andrew J. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane 4120, Australia
| | - Louisa G. Gordon
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
- Palliative Care Outcomes Centre, School of Nursing and Cancer, Queensland University of Technology, Brisbane 4059, Australia
| | - Michelle M. Hill
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
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Rose GL, Skinner TL, Keating SE, Friedrich NK, Bolam KA. The effects of exercise on the bone health of people with cancer: a systematic review and meta-analysis. Osteoporos Int 2022; 33:327-338. [PMID: 34532766 DOI: 10.1007/s00198-021-06131-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/20/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the pooled effect of exercise on the bone health of people diagnosed with cancer. METHODS Four electronic databases were systematically searched. Controlled trials that assessed the effect of exercise on the bone mineral density (BMD) or content (BMC) measured by dual-energy x-ray absorptiometry or peripheral quantitative computed tomography in people who had been diagnosed with cancer were included in the study. Random-effect meta-analyses of effect size (ES) were conducted. Sub-group analyses were performed to explore the influence of intervention duration, prescription and participant characteristics. RESULTS Of 66 full-text articles screened, 22 studies, from 21 interventions, were included (primarily breast/prostate cancer, sample range n = 36-498). When all interventions were grouped, a significant pooled ES was observed for exercise on hip (ES = 0.112, 95% CI: 0.026 to 0.198; p = 0.011) and lumbar spine BMD (ES = 0.269, 95% CI: 0.036 to 0.501; p = 0.024) compared to control. There was also an influence of sex, where females had greater improvements in hip (ES = 0.120, 95% CI: 0.017 to 0.223; p = 0.022) and spine BMD (ES = 0.415, 95% CI: 0.056 to 0.774; p = 0.23) compared to males. CONCLUSION Overall, exercise regimens of studies included in this review appear to improve bone health at the hip and spine in people diagnosed with cancer. Sub-analyses suggest some influence of sex, where females had greater improvements in BMD compared to males. It is essential that future studies evaluate the dose-response of exercise training on bone health and create exercise protocols that better align with the laws of bone modelling to enhance osteogenic potential.
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Affiliation(s)
- Grace L Rose
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Nina K Friedrich
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
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Rose GL, Farley MJ, Slater GJ, Ward LC, Skinner TL, Keating SE, Schaumberg MA. How body composition techniques measure up for reliability across the age-span. Am J Clin Nutr 2021; 114:281-294. [PMID: 33829234 DOI: 10.1093/ajcn/nqab046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Reliability of body composition measurement techniques is essential to the accurate reporting of intervention outcomes. However, the between-day precision error of commonly used techniques, as well as the reference multi-compartment model, in a population-representative sample are currently unknown. OBJECTIVES To quantify technical and biological precision error of body composition techniques in comparison to the referent 4-compartment (4C) model. METHODS Men and women (1:1 ratio; 18-85 years old; n = 90) completed 2 consecutive-day body composition testing sessions, including individual components of the referent 4C model. Testing was undertaken in accordance with best practice guidance for each technique, including standardized presentation and a consistent time of day. Repeat measurements were conducted on day 1 for technical precision, and between-day measurements were conducted for biological precision quantification. RESULTS On average, all measurements met acceptable error limits and presented typically low technical and biological error [<2% fat-free mass (FFM) and < 3% fat mass (FM) precision error]. For technical precision of FFM, all techniques met a priori cut points (80%; CV = 0.45-0.81%). For FM, all techniques were equivalent to the best-rating method on average (CV = 0.78-1.35%), except air displacement plethysmography (CV = 2.13%). For biological precision, only 3-compartment (3C) and 4C equations sufficiently met the a priori determined cut point for estimates for FFM (CV = 0.77-0.79%), and only DXA met the 80% cut point (CV = 1.17%) for FM. CONCLUSIONS The primary purpose of a study design is imperative when deciding on body composition assessment techniques used for longitudinal measurements. If reliable longitudinal assessments of FFM are central, a 3C or 4C model may be indicated. If FM is a primary outcome, DXA may be preferable. However, considering the low error rates presented within the current study across a broad age span of healthy adults with implementation of best-practice guidelines, any technique assessed here may be used, provided that strict protocols are adhered to.
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Affiliation(s)
- Grace L Rose
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Morgan J Farley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Gary J Slater
- School of Health and Behavioral Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Mia A Schaumberg
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,School of Health and Behavioral Sciences, University of the Sunshine Coast, Sippy Downs, Australia.,Sunshine Coast Health Institute, Birtinya, Australia
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20
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Nicol JL, Hill MM, Burton NW, Skinner TL. Promoting exercise for patients with multiple myeloma: attitudes and practices of clinical haematologists. J Cancer Surviv 2021; 16:688-695. [PMID: 34114194 DOI: 10.1007/s11764-021-01062-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore the attitudes and practices of clinical haematologists towards promoting physical activity (PA) and exercise for patients with multiple myeloma (MM). METHODS Using a quantitative cross-sectional survey, clinical haematologists reported on the perceived benefits and acceptability of PA and exercise and frequency, confidence and barriers to providing exercise advice. RESULTS Clinical haematologists (n=34; 68% response rate), who cumulatively treated ~340 patients with MM each week, completed the survey. Almost all (97%) agreed that PA was important, with benefits for quality of life, activities of daily living, mental health and fatigue. Whilst 88% discussed PA at least occasionally with their patients, approximately two-thirds were not confident advising specific exercises (68%) or identifying PA resources (62%). Despite this, 44% never referred patients to exercise professionals, with 18% only doing so if the patient asked. Over half did not recommend exercise when patients had spine fractures or were physically unwell. No differences were observed in individual factors (age, gender, practice type and own PA participation) and promotion of PA. CONCLUSIONS Clinical haematologists perceive PA as important, but lack confidence on what exercise/s to recommend and if exercise is appropriate for specific disease complications. They tend to not refer patients to exercise professionals. IMPLICATIONS FOR CANCER SURVIVORS Patients with MM often suffer from symptoms and toxicities that may be alleviated through PA. However, PA participation rates are low. Support for clinical haematologists for when and how to discuss exercise, and clearer referral pathways to exercise professionals may improve PA uptake and hence ensure access to optimal care, thereby improving patient outcomes.
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Affiliation(s)
- Jennifer L Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Michelle M Hill
- Precision and Systems Biomedicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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21
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Hoffmann S, Skinner TL, van Rosendal SP, Emmerton LM, Jenkins DG. Comparison of training responses and performance adaptations in endurance-trained men and women performing high-intensity interval training. J Sports Sci 2020; 39:1010-1020. [PMID: 33320059 DOI: 10.1080/02640414.2020.1853960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The efficacy of high-intensity interval training (HIIT) to elicit physiological and performance adaptations in endurance athletes has been established in men and to a lesser extent in women. This study compared lactate threshold (LT2) and performance adaptations to HIIT between men and women. Nine male and eight female cyclists and triathletes completed trials to determine their LT2 and 40 km cycling performance before, and after 10 HIIT sessions. Each HIIT session consisted of 10 × 90 s at peak power output, separated by 60 s active recovery. Main effects showed that HIIT improved peak power output (p = 0.05; ES: 0.2); relative peak power output (W.kg-1; p = 0.04; ES: 0.3 and W.kg-0.32; p = 0.04; ES: 0.3); incremental time to fatigue (p = 0.01; ES: 0.4), time trial time (p < 0.001; ES: 0.7) and time trial power output (p < 0.001; ES: 0.7) equally in both sexes. Although LT2 power output explained 77% of the performance improvement in women, no variable explained the performance improvement in men, suggesting another mechanism(s) was involved. Although HIIT improved cycling performance in men and women, it might not be appropriate to evaluate the effectiveness of HIIT using the same variables for both sexes.
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Affiliation(s)
- Samantha Hoffmann
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Centre for Sport Research (CSR), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Simon P van Rosendal
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Lynne M Emmerton
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Australia
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,School of Health and Sports Sciences, University of the Sunshine Coast, Australia
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22
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Hoffmann SM, Skinner TL, van Rosendal SP, Osborne MA, Emmerton LM, Jenkins DG. The Efficacy of the Lactate Threshold: A Sex-Based Comparison. J Strength Cond Res 2020; 34:3190-3198. [PMID: 33105370 DOI: 10.1519/jsc.0000000000002654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Hoffmann, SM, Skinner, TL, van Rosendal, SP, Osborne, MA, Emmerton, LM, and Jenkins, DG. The efficacy of the lactate threshold: A sex-based comparison. J Strength Cond Res 34(11): 3190-3198, 2020-The second lactate threshold (LT2) has previously been associated with endurance performance; however, comparisons between sexes are lacking regarding its efficacy. The aim of this study was to compare LT2 between men and women, specifically regarding its (a) relationship with endurance performance and (b) capacity to establish training and competition intensities. Competitive male (mean ± SD: age, 27.7 ± 4.7 years; V[Combining Dot Above]O2max, 59.7 ± 5.2 ml·kg·min; n = 10) and female (mean ± SD: age, 27.3 ± 6.2 years; V[Combining Dot Above]O2max, 54.5 ± 5.3 ml·kg·min; n = 12) cyclists and triathletes completed an incremental cycle trial to volitional fatigue (for determination of V[Combining Dot Above]O2max and LT2 via the modified D-max method), a constant load (±5%) exercise trial of 30 minutes at LT2 power output, and a 40-km cycle time trial. The LT2 significantly correlated with 40-km cycling performance in both men (r = -0.69 to -0.77; p < 0.01-0.05) and women (r = -0.63 to -0.75; p < 0.01-0.05). All men sustained LT2 power output for 30 minutes, compared with 82% of women. Despite LT2 reflecting a similar heart rate, V[Combining Dot Above]O2, and [La] to those elicited during a 40-km time trial in both men and women, power output at LT2 was 6% higher (p < 0.05) than mean time trial power output in women, with no significant difference in men. Based on these findings, sex-specific recommendations have been suggested in regard to the use of LT2 for establishing performance potential, prescribing endurance training intensities and setting 40-km performance intensity.
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Affiliation(s)
- Samantha M Hoffmann
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Center for Sport Research (CSR), Deakin University, Geelong, Australia; and
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Simon P van Rosendal
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Mark A Osborne
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Lynne M Emmerton
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Australia
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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23
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Rose GL, Skinner TL, Mielke GI, Schaumberg MA. The effect of exercise intensity on chronic inflammation: A systematic review and meta-analysis. J Sci Med Sport 2020; 24:345-351. [PMID: 33153926 DOI: 10.1016/j.jsams.2020.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Chronic inflammation is independently associated with the incidence and progression of chronic disease. Exercise has been found to reduce chronic inflammation, however the role of exercise intensity (work rate) is unknown. This review aimed to determine the pooled effect of higher- compared to lower-intensity aerobic and resistance exercise on chronic inflammation in adults. DESIGN Systematic review and meta-analysis. METHODS Five electronic databases were searched. Intervention trials that assessed the effect of ≥2 different exercise intensities on peripheral markers of chronic inflammation [c-reactive protein (CRP), interleukin (IL)-6, tumour necrosis factor (TNF)-α and IL-10] in adults were included. Random-effect meta-analyses were conducted to calculate the mean difference in change scores between groups [effect size (ES)]. Sub-group analyses were performed to explore the influence of age, chronic disease, body mass index and intervention duration on inflammation heterogeneity. RESULTS Of 3952 studies identified, 27 were included. There were no significant effects of exercise intensity on IL-6 (ES=-0.039, 95%CI=-0.353-0.275; p=0.806), TNF-α (ES=0.296, 95%CI=-0.184-0.777; p=0.227) and IL-10 (ES=0.007, 95%CI=-0.904-0.919; p=0.987). A significant pooled ES was observed for higher- versus lower-intensity exercise on CRP concentrations, in studies of middle-aged adults (ES=-0.412, 95%CI=-0.821- -0.004, p=0.048) or interventions >9 weeks in duration (ES=-0.520, 95%CI=-0.882--0.159, p=0.005). CONCLUSIONS Exercise intensity did not influence chronic inflammatory response. However, sub-analyses suggest that higher-intensity training may be more efficacious than lower-intensity for middle-aged adults, or when longer duration interventions are implemented (>9 weeks), in the most commonly-reported analyte (CRP).
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Affiliation(s)
- Grace L Rose
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Gregore I Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Mia A Schaumberg
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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24
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Nicol JL, Hill MM, Smith M, Shevill M, Pickersgill D, Larsen D, Donaghue A, Pashley A, Pollard C, Skarparis M, Leis M, Skinner TL. Improved Physical Function And Quality Of Life In People With Blood Cancer After An Exercise Intervention. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686264.90859.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Mitchell LJ, Morris KS, Bolam KA, Pritchard-Peschek KR, Skinner TL, Shephard ME. The non-linear relationship between sum of 7 skinfolds and fat and lean mass in elite swimmers. J Sports Sci 2020; 38:2307-2313. [DOI: 10.1080/02640414.2020.1779491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Kirstin S. Morris
- Performance Science, Queensland Academy of Sport, Brisbane, Australia
| | - Kate A. Bolam
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Megan E. Shephard
- Performance Science, Queensland Academy of Sport, Brisbane, Australia
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26
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Schaumberg MA, Stanley J, Jenkins DG, Hume EA, Janse de Jonge XAK, Emmerton LM, Skinner TL. Oral Contraceptive Use Influences On-Kinetic Adaptations to Sprint Interval Training in Recreationally-Active Women. Front Physiol 2020; 11:629. [PMID: 32595523 PMCID: PMC7303366 DOI: 10.3389/fphys.2020.00629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/18/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Oral contraceptive (OC) use influences peak exercise responses to training, however, the influence of OC on central and peripheral adaptations to exercise training are unknown. This study investigated the influence of OC use on changes in time-to-fatigue, pulmonary oxygen uptake, cardiac output, and heart rate on-kinetics, as well as tissue saturation index to 4 weeks of sprint interval training in recreationally active women. METHODS Women taking an oral contraceptive (OC; n = 25) or experiencing natural menstrual cycles (MC; n = 22) completed an incremental exercise test to volitional exhaustion followed by a square-wave step-transition protocol to moderate (90% of power output at ventilatory threshold) and high intensity (Δ50% of power output at ventilatory threshold) exercise on two separate occasions. Time-to-fatigue, pulmonary oxygen uptake on-kinetics, cardiac output, and heart rate on-kinetics, and tissue saturation index responses were assessed prior to, and following 12 sessions of sprint interval training (10 min × 1 min efforts at 100-120% PPO in a 1:2 work:rest ratio) completed over 4 weeks. RESULTS Time-to-fatigue increased in both groups following training (p < 0.001), with no difference between groups. All cardiovascular on-kinetic parameters improved to the same extent following training in both groups. Greater improvements in pulmonary oxygen up-take kinetics were seen at both intensities in the MC group (p < 0.05 from pre-training) but were blunted in the OC group (p > 0.05 from pre-training). In contrast, changes in tissue saturation index were greater in the OC group at both intensities (p < 0.05); with the MC group showing no changes at either intensity. DISCUSSION Oral contraceptive use may reduce central adaptations to sprint interval training in women without influencing improvements in exercise performance - potentially due to greater peripheral adaptation. This may be due to the influence of exogenous oestradiol and progestogen on cardiovascular function and skeletal muscle blood flow. Further investigation into female-specific influences on training adaptation and exercise performance is warranted.
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Affiliation(s)
- Mia Annalies Schaumberg
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- Sunshine Coast Health Institute, Birtinya, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Jamie Stanley
- South Australian Sports Institute, Kidman Park, SA, Australia
- Australian Cycling Team, Gepps Cross, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - David G. Jenkins
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Emily A. Hume
- School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - Lynne M. Emmerton
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, WA, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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27
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Skinner TL, Kelly VG, Boytar AN, Peeters GG, Rynne SB. Aviation Rescue Firefighters physical fitness and predictors of task performance. J Sci Med Sport 2020; 23:1228-1233. [PMID: 32507623 DOI: 10.1016/j.jsams.2020.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Aviation Rescue Firefighters (ARFF) require physical fitness specific to the aviation environment. This study aims to determine the physical fitness of ARFF and predictors of performance on ARFF-specific tasks from laboratory-based fitness measures. DESIGN Cross-sectional, observational study. METHODS Forty-two male ARFF (mean±SD; age 38.4±7.6 years, body mass index 26.2±2.2kgm-2) completed a physical fitness testing battery, comprising maximal aerobic capacity (V˙O2max), lactate threshold, anaerobic power, body composition (dual-energy X-ray absorptiometry), muscular strength (3 repetition maximum (3RM) bench and leg press) and muscular endurance (maximum curl ups and push ups) under controlled laboratory conditions. On a separate occasion, ARFF completed timed work-related tasks including a hose drag, dummy drag, Stihl saw hold, stair climb and simulated ARFF emergency protocol. RESULTS All participants finished the simulated ARFF emergency protocol under the criterion time (5min 50s); the average completion time was 4min and 31s. Performance time on the simulated ARFF emergency protocol was inversely correlated to V˙O2max (r=-0.514; p<0.001), anaerobic step test performance (r=-0.549; p<0.001), height (r=-0.325; p=0.038) and lean mass (r=-0.429; p=0.005). Higher fat mass (r=0.318; p=0.043) and % body fat (r=0.481; p=0.001) were associated with slower performance time. Muscular strength, muscular endurance and flexibility were not related to performance on the simulated ARFF emergency protocol. CONCLUSIONS Aerobic and anaerobic capacities, as well as body composition are the strongest predictors of simulated ARFF emergency protocol performance. This study highlights the importance of aerobic and anaerobic fitness, compared to muscular strength or muscular endurance, for ARFF job-specific performance, employment and training.
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Affiliation(s)
- Tina L Skinner
- The University of Queensland, School of Human Movement and Nutrition Sciences, Australia.
| | - Vincent G Kelly
- The University of Queensland, School of Human Movement and Nutrition Sciences, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Australia
| | - Alexander N Boytar
- The University of Queensland, School of Human Movement and Nutrition Sciences, Australia
| | | | - Steven B Rynne
- The University of Queensland, School of Human Movement and Nutrition Sciences, Australia
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28
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Baguley BJ, Skinner TL, Jenkins DG, Wright ORL. Mediterranean-style dietary pattern improves cancer-related fatigue and quality of life in men with prostate cancer treated with androgen deprivation therapy: A pilot randomised control trial. Clin Nutr 2020; 40:245-254. [PMID: 32534948 DOI: 10.1016/j.clnu.2020.05.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS Cancer-related fatigue (CRF) is a prevalent and persistent symptom from androgen deprivation therapy (ADT) in prostate cancer. The Mediterranean-style dietary pattern (MED-diet) offers a plausible mechanism to mitigate CRF through reducing inflammation and improving body composition. This study aimed to evaluate the effects of a 12-week MED-diet, compared to usual care, on CRF and quality of life in men with prostate cancer treated with ADT. METHODS Twenty-three men (65.9 ± 7.8 years; body mass index: 29.6 ± 2.7 kg/m2; ADT duration: 33.8 ± 35.6 months) receiving ADT for ≥3 months were randomly assigned (1:1) to 12-weeks of usual care or the MED-diet involving six individualised nutrition consults. Primary outcomes included CRF [Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale (FACIT-F) and quality of life [FACIT-General (FACIT-G)], secondary outcomes included body mass/composition and interleukin (IL)-6 and IL-8 concentrations measured at baseline, 8-weeks and 12 weeks. Intervention feasibility was measured by intervention safety, study completion rate, consult attendance, and adherence to the MED-diet through the Mediterranean-diet adherence screener (MEDAS). Intention to treat linear mixed models were used to determine changes in outcomes between the MED-diet and usual care at baseline, 8-weeks and 12-weeks. RESULTS The MED-diet improved CRF (FACIT-F) at 8-weeks [+4.8 (0.0, 9.8); P = 0.05] and 12-weeks [+7.2 (2.2, 12.0); P = 0.005], quality of life (FACIT-G) at 12-weeks [+9.2 (2.7, 15.8); P = 0.006], reduced total body mass at 8-weeks [-2.51 kg (-4.25, -0.78); P = 0.005] and 12-weeks [-2.97 kg (-4.71, -1.25); P = 0.001], lean mass at 8-weeks [-1.50 kg (-2.91, -0.10); P = 0.036], and IL-8 at 8-weeks [-0.18 ng/ml (-0.34, -0.02); P = 0.029] compared to usual care. The MED-diet demonstrated zero adverse events, 91% study completion, 100% attendance, and 81% adherence to the MEDAS. CONCLUSION The MED-diet is safe and feasible, and has the potential to improve CRF and quality of life in overweight men treated with ADT compared to usual care. Further exploration of the MED-diet is warranted in a larger powered sample size to consolidate these findings.
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Affiliation(s)
- Brenton J Baguley
- Institute of Physical Activity and Nutrition, Deakin University, Geelong, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
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29
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Vear NK, Coombes JS, Bailey TG, Skinner TL. The Interplay between Vascular Function and Sexual Health in Prostate Cancer: The Potential Benefits of Exercise Training. Med Sci (Basel) 2020; 8:medsci8010011. [PMID: 32053955 PMCID: PMC7151583 DOI: 10.3390/medsci8010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer and its associated treatments can cause significant and lasting morbidities, such as cardiovascular and sexual dysfunctions. Various interventions have attempted to prevent or mitigate these dysfunctions. This review summarises the available evidence on the effects of exercise training on markers of cardiovascular disease (as assessed via vascular health outcomes) and sexual health in this prevalent cancer population. Current studies predominantly report blood pressure outcomes as a marker of vascular health, as well as various questionnaires assessing sexual health parameters, in men on active treatment (i.e., hormone or radiation therapies) or post-treatment. Preliminary evidence suggests that exercise interventions may elicit improvements in sexual function, but not blood pressure, in these populations. Future studies in more advanced and varied prostate cancer populations (i.e., those on chemotherapies or immunotherapies, or undergoing active surveillance) are required to ascertain the duration, intensity and frequency of exercise that optimises the effects of exercise training on cardiovascular and sexual dysfunctions (and their relationship) in men during and following treatment for prostate cancer.
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Skinner TL, Desbrow B, Arapova J, Schaumberg MA, Osborne J, Grant GD, Anoopkumar-Dukie S, Leveritt MD. Women Experience the Same Ergogenic Response to Caffeine as Men. Med Sci Sports Exerc 2019; 51:1195-1202. [PMID: 30629046 DOI: 10.1249/mss.0000000000001885] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine whether 1) consumption of caffeine improves endurance cycling performance in women and 2) sex differences exist in the magnitude of the ergogenic and plasma responses to caffeine supplementation. METHODS Twenty-seven (11 women and 16 men) endurance-trained cyclists and triathletes participated in this randomized, double-blind, placebo-controlled, crossover study. Participants completed an incremental exercise test to exhaustion, two familiarization trials, and two performance trials. Ninety minutes before the performance trials, participants ingested opaque capsules containing either 3 mg·kg body mass of anhydrous caffeine or a placebo. They then completed a set amount of work (75% of peak sustainable power output) in the fastest possible time. Plasma was sampled at baseline, preexercise, and postexercise for caffeine. Strict standardization and verification of diet, hydration, training volume and intensity, and contraceptive hormone phase (for women) were implemented. RESULTS Performance time was significantly improved after caffeine administration in women (placebo: 3863 ± 419 s, caffeine: 3757 ± 312 s; P = 0.03) and men (placebo: 3903 ± 341 s, caffeine: 3734 ± 287 s; P < 0.001). The magnitude of performance improvement was similar for women (mean = 4.3%, 95% CI = 0.4%-8.2%) and men (4.6%, 2.3%-6.8%). Plasma caffeine concentrations were similar between sexes before exercise, but significantly greater in women after exercise (P < 0.001). CONCLUSIONS Ingestion of 3 mg·kg body mass of caffeine enhanced endurance exercise performance in women. The magnitude of the performance enhancement observed in women was similar to that of men, despite significantly greater plasma caffeine concentrations after exercise in women. These results suggest that the current recommendations for caffeine intake (i.e., 3-6 mg·kg caffeine before exercise to enhance endurance performance), which are derived almost exclusively from studies on men, may also be applicable to women.
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Affiliation(s)
- Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, AUSTRALIA
| | - Ben Desbrow
- School of Allied Health Sciences, Griffith University, Queensland, AUSTRALIA.,Menzies Health Institute Queensland, Griffith University, Queensland, AUSTRALIA
| | - Julia Arapova
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, AUSTRALIA
| | - Mia A Schaumberg
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, AUSTRALIA.,School of Health and Sports Sciences, University of the Sunshine Coast, Queensland, AUSTRALIA
| | - John Osborne
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, AUSTRALIA.,School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, AUSTRALIA
| | - Gary D Grant
- Menzies Health Institute Queensland, Griffith University, Queensland, AUSTRALIA.,Quality Use of Medicines Network, School of Pharmacy and Pharmacology, Griffith University, Queensland, AUSTRALIA
| | - Shailendra Anoopkumar-Dukie
- Menzies Health Institute Queensland, Griffith University, Queensland, AUSTRALIA.,Quality Use of Medicines Network, School of Pharmacy and Pharmacology, Griffith University, Queensland, AUSTRALIA
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, AUSTRALIA
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Wallen MP, Keating SE, Hall A, Hickman IJ, Pavey TG, Woodward AJ, Skinner TL, Macdonald GA, Coombes JS. Exercise Training Is Safe and Feasible in Patients Awaiting Liver Transplantation: A Pilot Randomized Controlled Trial. Liver Transpl 2019; 25:1576-1580. [PMID: 31357256 DOI: 10.1002/lt.25616] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Matthew P Wallen
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Adrian Hall
- Department of Anesthesia, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Toby G Pavey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Aidan J Woodward
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Tina L Skinner
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Graeme A Macdonald
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
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Adlard KN, Jenkins DG, Salisbury CE, Bolam KA, Gomersall SR, Aitken JF, Chambers SK, Dunn JC, Courneya KS, Skinner TL. Peer support for the maintenance of physical activity and health in cancer survivors: the PEER trial - a study protocol of a randomised controlled trial. BMC Cancer 2019; 19:656. [PMID: 31269917 PMCID: PMC6610872 DOI: 10.1186/s12885-019-5853-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022] Open
Abstract
Background Despite an overwhelming body of evidence showing the benefits of physical activity (PA) and exercise for cancer survivors, few survivors meet the exercise oncology guidelines. Moreover, initiating, let alone maintaining exercise programs with cancer survivors continues to have limited success. The aim of this trial is to evaluate the influence of peer support on moderate-to-vigorous PA (MVPA) and various markers of health 12 months following a brief supervised exercise intervention in cancer survivors. Methods Men and women previously diagnosed with histologically-confirmed breast, colorectal or prostate cancer (n = 226), who are >1-month post-treatment, will be invited to participate in this trial. Once enrolled, participants will complete 4 weeks (12 sessions) of supervised high intensity interval training (HIIT). On completion of the supervised phase, both groups will be provided with written recommendations and verbally encouraged to achieve three HIIT sessions per week, or equivalent exercise that meets the exercise oncology guidelines. Participants will be randomly assigned to receive 12 months of peer support, or no peer support (control). Primary and secondary outcomes will be assessed at baseline, after the 4-week supervised HIIT phase and at 3-, 6- and 12-months. Primary outcomes will include accelerometry-derived MVPA and prescribed HIIT session adherence; whilst secondary outcomes will include cardiorespiratory fitness (\documentclass[12pt]{minimal}
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\begin{document}$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$\end{document}V˙O2peak), body composition, quality of life and select cytokines, myokines and inflammatory markers. Random effects mixed modelling will be used to compare mean changes in outcomes between groups at each time point. A group x time interaction will be used to formally test for differences between groups (alpha =0.05); utilising intention-to-treat analyses. Discussion If successful, peer support may be proposed, adopted and implemented as a strategy to encourage cancer survivors to maintain exercise beyond the duration of a short-term, supervised intervention. A peer support-exercise model has the long-term potential to reduce comorbidities, improve physical and mental wellbeing, and significantly reduce the burden of disease in cancer survivors. Ethics Human Research Ethics Committee of Bellberry Ltd. (#2015–12-840). Trial registration Australian New Zealand Clinical Trial Registry 12618001855213. Retrospectively registered 14 November 2018. Trial registration includes all components of the WHO Trial Registration Data Set, as recommended by the ICMJE.
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Affiliation(s)
- Kirsten N Adlard
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Chloe E Salisbury
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Kate A Bolam
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sjaan R Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern QLD, Springfield, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.,School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Suzanne K Chambers
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.,Institute for Resilient Regions, University of Southern QLD, Springfield, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jeff C Dunn
- Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern QLD, Springfield, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.,School of Social Science, The University of Queensland, Brisbane, QLD, Australia
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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Gomersall SR, Skinner TL, Winkler E, Healy GN, Eakin E, Fjeldsoe B. Feasibility, acceptability and efficacy of a text message-enhanced clinical exercise rehabilitation intervention for increasing 'whole-of-day' activity in people living with and beyond cancer. BMC Public Health 2019; 19:542. [PMID: 31159752 PMCID: PMC6546618 DOI: 10.1186/s12889-019-6767-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Exercise interventions are typically delivered to people with cancer and survivors via supervised clinical rehabilitation. However, motivating and maintaining activity changes outside of the clinic setting remains challenging. This study investigated the feasibility, acceptability and efficacy of an individually-tailored, text message-enhanced intervention that focused on increasing whole-of-day activity both during and beyond a 4-week, supervised clinical exercise rehabilitation program for people with cancer and survivors. Methods Participants (n = 36; mean ± SD age 64.8 ± 9.6 years; 44.1 ± 30.8 months since treatment) were randomized 1:1 to receive the text message-enhanced clinical exercise rehabilitation program, or the standard clinical exercise rehabilitation program alone. Activity was assessed at baseline, 4-weeks (end of the standard program) and 12-weeks (end of enhanced program) using both device (activPAL accelerometer; sitting, standing, light-stepping, moderate-stepping) and self-report [Multimedia Activity Recall for Children and Adults (MARCA); sedentary, light, moderate-to-vigorous physical activity (MVPA)] methods. The MARCA also assessed time use domains to provide context to activity changes. Changes and intervention effects were evaluated using linear mixed models, adjusting for baseline values and potential confounders. Results The study had high retention (86%) and participants reported high levels of satisfaction [4.3/5 (±0.8)] with the intervention. Over the first 4 weeks, MARCA-assessed MVPA increased [+ 53.2 (95%CI: 2.9, 103.5) min/d] between groups, favoring the text message-enhanced program, but there were no significant intervention effects on sedentary behavior. By 12 weeks, relative to the standard group, participants in the text message-enhanced group sat less [activPAL overall sitting: − 48.2 (− 89.9, − 5.6) min/16 h awake; MARCA: -80.1 (− 156.5, − 3.8) min/d] and were participating in more physical activity [activPAL light stepping: + 7.0 (0.4, 13.6: min/16 h awake; MARCA MVPA: + 67.3 (24.0, 110.6) min/d]. The time-use domains of Quiet Time [− 63.3 (− 110.5, − 16.0) min/d] and Screen Time [− 62.0 (− 109.7, − 14.2) min/d] differed significantly between groups. Conclusions Results demonstrate feasibility, acceptability and efficacy of a novel, text message-enhanced clinical exercise rehabilitation program to support changes in whole-of-day activity, including both physical activity and sedentary behavior. Changes were largely seen at 12-week follow-up, indicating potential for the intervention to result in continued improvement and maintenance of behavior change following a supervised exercise intervention. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000641493; date registered 17/5/16). Electronic supplementary material The online version of this article (10.1186/s12889-019-6767-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sjaan R Gomersall
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia.
| | - Tina L Skinner
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Elisabeth Winkler
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Public Health, Brisbane, Australia.,Baker Heart and Diabetes Institute, Melbourne, Australia.,Curtin University, School of Physiotherapy and Exercise Science, Perth, Australia
| | - Elizabeth Eakin
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Brianna Fjeldsoe
- The University of Queensland, School of Public Health, Brisbane, Australia
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Holland JJ, Irwin C, Skinner TL, Leveritt MD. Dehydration Has No Influence on Simulated Motor-race Performance Despite Greater Cardiovascular and Thermoregulatory Demand. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562177.62698.cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Devin JL, Hill MM, Mourtzakis M, Quadrilatero J, Jenkins DG, Skinner TL. Acute high intensity interval exercise reduces colon cancer cell growth. J Physiol 2019; 597:2177-2184. [PMID: 30812059 DOI: 10.1113/jp277648] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 02/14/2019] [Indexed: 12/21/2022] Open
Abstract
KEY POINTS Physical activity is associated with reduced mortality rates for survivors of colorectal cancer. Acute high intensity interval exercise (HIIE) reduced colon cancer cell number in vitro and promoted increases in inflammatory cytokines immediately following exercise. This acute suppression of colon cancer cell number was transient and not observed at 120 minutes post-acute HIIE. The acute effects of exercise may constitute an important mechanism by which exercise can influence colorectal cancer outcomes. ABSTRACT Physical activity is associated with significant reductions in colorectal cancer mortality. However, the mechanisms by which exercise mediates this anti-oncogenic effect are not clear. In the present study, colorectal cancer survivors completed acute (n = 10) or chronic (n = 10) exercise regimes. An acute high intensity interval exercise session (HIIE; 4 × 4 min at 85-95% peak heart rate) was completed with serum samples collected at baseline, as well as 0 and 120 min post-exercise. For the 'chronic' intervention, resting serum was sampled before and after 4 weeks (12 sessions) of HIIE. The effect of serum on colon cancer cell growth was evaluated by incubating cells (CaCo-2 and LoVo) for up to 72 h and assessing cell number. Serum obtained immediately following HIIE, but not 120 min post-HIIE, significantly reduced colon cancer cell number. Significant increases in serum interleukin-6 (P = 0.023), interleukin-8 (P = 0.036) and tumour necrosis factor-α (P = 0.003) were found immediately following acute HIIE. At rest, short-term HIIE training did not promote any changes in cellular growth or cytokine concentrations. The acute effects of HIIE and the cytokine flux may be important mediators of reducing colon cancer cell progression. Repetitive exposure to these acute effects may contribute to the relationship between exercise and improved colorectal cancer survival.
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Affiliation(s)
- James L Devin
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Michelle M Hill
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Joe Quadrilatero
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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Heywood R, McCarthy AL, Skinner TL. Efficacy of Exercise Interventions in Patients With Advanced Cancer: A Systematic Review. Arch Phys Med Rehabil 2018; 99:2595-2620. [DOI: 10.1016/j.apmr.2018.04.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/13/2018] [Accepted: 04/07/2018] [Indexed: 12/14/2022]
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Bootsman NJ, Skinner TL, Lal R, Glindemann D, Lagasca C, Peeters G(G. The relationship between physical activity, and physical performance and psycho-cognitive functioning in older adults living in residential aged care facilities. J Sci Med Sport 2018; 21:173-178. [DOI: 10.1016/j.jsams.2017.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 06/23/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
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Devin JL, Jenkins DG, Sax AT, Hughes GI, Aitken JF, Chambers SK, Dunn JC, Bolam KA, Skinner TL. Cardiorespiratory Fitness and Body Composition Responses to Different Intensities and Frequencies of Exercise Training in Colorectal Cancer Survivors. Clin Colorectal Cancer 2018; 17:e269-e279. [PMID: 29397328 DOI: 10.1016/j.clcc.2018.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 12/11/2017] [Accepted: 01/09/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Deteriorations in cardiorespiratory fitness (V˙o2peak) and body composition are associated with poor prognosis after colorectal cancer treatment. However, the optimal intensity and frequency of aerobic exercise training to improve these outcomes in colorectal cancer survivors is unknown. PATIENTS AND METHODS This trial compared 8 weeks of moderate-intensity continuous exercise (MICE; 50 minutes; 70% peak heart rate [HRpeak]; 24 sessions), with high-intensity interval exercise (HIIE; 4 × 4 minutes; 85%-95% HRpeak) at an equivalent (HIIE; 24 sessions) and tapered frequency (HIIE-T; 16 sessions) on V˙o2peak and on lean and fat mass, measured at baseline, 4, 8, and 12 weeks. RESULTS Increases in V˙o2peak were significantly greater after both 4 (+3.0 mL·kg-1·min-1, P = .008) and 8 (+2.3 mL·kg-1·min-1, P = .049) weeks of HIIE compared to MICE. After 8 weeks, there was a significantly greater reduction in fat mass after HIIE compared to MICE (-0.7 kg, P = .038). Four weeks after training, the HIIE group maintained elevated V˙o2peak (+3.3 mL·kg-1·min-1, P = .006) and reduced fat mass (-0.7 kg, P = .045) compared to the MICE group, with V˙o2peak in the HIIE-T also being superior to the MICE group (+2.8 mL·kg-1·min-1, P = .013). CONCLUSION Compared to MICE, HIIE promotes superior improvements and short-term maintenance of V˙o2peak and fat mass improvements. HIIE training at a reduced frequency also promotes maintainable cardiorespiratory fitness improvements. In addition to promoting accelerated and superior benefits to the current aerobic exercise guidelines, HIIE promotes clinically relevant improvements even with a substantial reduction in exercise training and for a period after withdrawal.
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Affiliation(s)
- James L Devin
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Andrew T Sax
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Gareth I Hughes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Joanne F Aitken
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Institute for Resilient Regions, University of Southern Queensland, Darling Heights, QLD, Australia
| | - Suzanne K Chambers
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Institute for Resilient Regions, University of Southern Queensland, Darling Heights, QLD, Australia; Prostate Cancer Foundation of Australia, Sydney, NSW, Australia; Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia
| | - Jeffrey C Dunn
- School of Social Science, The University of Queensland, Brisbane, QLD, Australia; Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Institute for Resilient Regions, University of Southern Queensland, Darling Heights, QLD, Australia
| | - Kate A Bolam
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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Schaumberg MA, Jenkins DG, Janse DE Jonge XAK, Emmerton LM, Skinner TL. Oral Contraceptive Use Dampens Physiological Adaptations to Sprint Interval Training. Med Sci Sports Exerc 2017; 49:717-727. [PMID: 27898641 DOI: 10.1249/mss.0000000000001171] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Oral contraceptive (OC) use reduces peak aerobic capacity (V˙O2peak); however, whether it also influences adaptations to training has yet to be determined. This study aimed to examine the influence of OC use on peak performance (peak power output [PPO]) and physiological adaptations (V˙O2peak and peak cardiac output [Q˙peak]) after sprint interval training (SIT) in recreationally active women. METHODS Women taking an OC (n = 25) or experiencing natural regular menstrual cycles (MC; n = 16) completed an incremental exercise test to assess V˙O2peak, PPO, and Q˙peak before, immediately after, and 4 wk after 12 sessions of SIT. The SIT consisted ten 1-min efforts at 100% to 120% PPO in a 1:2 work-rest ratio. RESULTS Though V˙O2peak increased in both groups after SIT (both P < 0.001), the MC group showed greater improvement (OC, +8.5%; MC, +13.0%; P = 0.010). Similarly, Q˙peak increased in both groups, with greater improvement in the MC group (OC, +4.0%; MC, +16.1%; P = 0.013). PPO increased in both groups (OC, +13.1%; MC, +13.8%; NS). All parameters decreased 4 wk after SIT cessation, but remained elevated from pretraining levels; the OC group showed more sustained training effects in V˙O2peak (OC, -4.0%; MC, -7.7%; P = 0.010). CONCLUSION SIT improved peak exercise responses in recreationally active women. However, OC use dampened V˙O2peak and Q˙peak adaptation. A follow-up period indicated that OC users had spared V˙O2peak adaptations, suggesting that OC use may influence the time course of physiological training adaptations. Therefore, OC use should be verified, controlled for, and considered when interpreting physiological adaptations to exercise training in women.
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Affiliation(s)
- Mia A Schaumberg
- 1School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, AUSTRALIA; 2Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, AUSTRALIA; 3School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, AUSTRALIA; and 4School of Pharmacy, Curtin University, Perth, Western Australia, AUSTRALIA
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Wallen MP, Hall A, Dias KA, Ramos JS, Keating SE, Woodward AJ, Skinner TL, Macdonald GA, Arena R, Coombes JS. Impact of beta-blockers on cardiopulmonary exercise testing in patients with advanced liver disease. Aliment Pharmacol Ther 2017; 46:741-747. [PMID: 28805258 DOI: 10.1111/apt.14265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/14/2017] [Accepted: 07/23/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta-blockers reduce portal pressure and minimise haemorrhage risk. These medications may attenuate measures of cardiopulmonary performance, such as the ventilatory threshold and peak oxygen uptake measured via cardiopulmonary exercise testing. AIM To determine the effect of beta-blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease. METHODS This was a cross-sectional analysis of 72 participants who completed a cardiopulmonary exercise test before liver transplantation. All participants remained on their usual beta-blocker dose and timing prior to the test. Variables measured during cardiopulmonary exercise testing included the ventilatory threshold, peak oxygen uptake, heart rate, oxygen pulse, the oxygen uptake efficiency slope and the ventilatory equivalents for carbon dioxide slope. RESULTS Participants taking beta-blockers (n = 28) had a lower ventilatory threshold (P <.01) and peak oxygen uptake (P = .02), compared to participants not taking beta-blockers. After adjusting for age, the model of end-stage liver-disease score, liver-disease aetiology, presence of refractory ascites and ventilatory threshold remained significantly lower in the beta-blocker group (P = .04). The oxygen uptake efficiency slope was not impacted by beta-blocker use. CONCLUSIONS Ventilatory threshold is reduced in patients with advanced liver disease taking beta-blockers compared to those not taking the medication. This may incorrectly risk stratify patients on beta-blockers and has implications for patient management before and after liver transplantation. The oxygen uptake efficiency slope was not influenced by beta-blockers and may therefore be a better measure of cardiopulmonary performance in this patient population.
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Affiliation(s)
- M P Wallen
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health(CRExPAH), The University of Queensland, Brisbane, Qld, Australia
| | - A Hall
- Department of Anaesthesia, Princess Alexandra Hospital, Brisbane, Qld, Australia
| | - K A Dias
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health(CRExPAH), The University of Queensland, Brisbane, Qld, Australia
| | - J S Ramos
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health(CRExPAH), The University of Queensland, Brisbane, Qld, Australia
| | - S E Keating
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health(CRExPAH), The University of Queensland, Brisbane, Qld, Australia
| | - A J Woodward
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia.,School of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - T L Skinner
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health(CRExPAH), The University of Queensland, Brisbane, Qld, Australia
| | - G A Macdonald
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Qld, Australia.,School of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - R Arena
- Translational Research Institute, Brisbane, Qld, Australia
| | - J S Coombes
- School of Human Movement and Nutrition Sciences, Centre for Research on Exercise, Physical Activity and Health(CRExPAH), The University of Queensland, Brisbane, Qld, Australia
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Holland JJ, Ray M, Irwin C, Skinner TL, Leveritt M, Desbrow B. Tear osmolarity is sensitive to exercise-induced fluid loss but is not associated with common hydration measures in a field setting. J Sports Sci 2017; 36:1220-1227. [PMID: 28812943 DOI: 10.1080/02640414.2017.1365157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This investigation (i) examined changes in tear osmolarity in response to fluid loss that occurs with exercise in a field setting, and (ii) compared tear osmolarity with common field and laboratory hydration measures. Sixty-three participants [age 27.8 ± 8.4 years, body mass 72.15 ± 10.61 kg] completed a self-paced 10 km run outside on a predetermined course. Body mass, tear fluid, venous blood and urine samples were collected immediately before and after exercise. Significant (p < 0.001) reductions in body mass (1.71 ± 0.44%) and increases in tear osmolarity (8 ± 15 mOsm.L-1), plasma osmolality (7 ± 8 mOsm.kg-1), and urine specific gravity (0.0014 ± 0.0042 g.mL-1; p = 0.008) were observed following exercise. Pre- to post-exercise change in tear osmolarity was not significantly correlated (all p > 0.05) with plasma osmolality (rs = 0.24), urine osmolality (rs = 0.14), urine specific gravity (rs = 0.13) or relative body mass loss (r = 0.20). Tear osmolarity is responsive to exercise-induced fluid loss but does not correlate with the changes observed using other common measures of hydration status in the field setting. Practitioners shouldn't directly compare or replace other common hydration measures with tear osmolarity in the field. ABBREVIATIONS BML: Body Mass Loss; CV: Coefficient of Variation; Posm: Plasma osmolality; SD: Standard Deviation; Tosm: Tear Osmolarity; Uosm: Urine Osmolality; USG: Urine Specific Gravity; WBGT: Wet bulb globe thermometer.
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Affiliation(s)
- Justin J Holland
- a School of Exercise and Nutrition Sciences , Queensland University of Technology , Kelvin Grove , Australia.,b School of Human Movement and Nutrition Sciences , The University of Queensland , St Lucia , Australia
| | - Michelle Ray
- c School of Allied Health Sciences and Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
| | - Christopher Irwin
- c School of Allied Health Sciences and Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
| | - Tina L Skinner
- b School of Human Movement and Nutrition Sciences , The University of Queensland , St Lucia , Australia
| | - Michael Leveritt
- b School of Human Movement and Nutrition Sciences , The University of Queensland , St Lucia , Australia
| | - Ben Desbrow
- c School of Allied Health Sciences and Menzies Health Institute Queensland , Griffith University , Gold Coast , Australia
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Heywood R, McCarthy AL, Skinner TL. Safety and feasibility of exercise interventions in patients with advanced cancer: a systematic review. Support Care Cancer 2017; 25:3031-3050. [PMID: 28741176 DOI: 10.1007/s00520-017-3827-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 07/10/2017] [Indexed: 01/24/2023]
Abstract
GOALS OF WORK The beneficial effects of exercise in cancer patients are reasonably well-established, although research in this field has predominantly investigated cancer patients in the earlier stages of disease. However, the most recent evidence surrounding exercise interventions in advanced cancer populations has yet to be systematically evaluated. This review critically analyses the safety and feasibility of exercise interventions in patients with advanced cancer. METHODS All randomised, non-randomised and prospective observational trials of exercise training interventions in patients with advanced cancer were included. 'Safety' was defined as the number and severity of reported adverse events during exercise training. 'Feasibility' was determined by participant adherence, attendance and/or study completion rates. RESULTS A total of 25 studies involving 1088 patients were included: 16 randomised controlled and nine prospective observational cohort trials. Seven studies included advanced lung cancer patients exclusively, while eight involved patients with various cancer diagnoses. Aerobic exercise was investigated in five studies, resistance training in two studies and combination training (aerobic and resistance) in 14 studies. Six minor adverse events were reported due to exercise. All of these were musculoskeletal in nature, resulting in two participants' withdrawal from the study. Exercise adherence ranged from 65 to 89% but was only described in nine studies. Attendance at each exercise session was described in a further nine studies, ranging from 59 to 100%. CONCLUSIONS Implementation of exercise interventions appears to be safe and feasible in advanced cancer clinical practice, although targeted studies are required to determine the optimal exercise dose for specific cancer diagnoses.
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Affiliation(s)
- Reginald Heywood
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | | | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Shearer J, Graham TE, Skinner TL. Nutra-ergonomics: influence of nutrition on physical employment standards and the health of workers. Appl Physiol Nutr Metab 2017; 41:S165-74. [PMID: 27277565 DOI: 10.1139/apnm-2015-0531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The importance of ergonomics across several scientific domains, including biomechanics, psychology, sociology, and physiology, have been extensively explored. However, the role of other factors that may influence the health and productivity of workers, such as nutrition, is generally overlooked. Nutra-ergonomics describes the interface between workers, their work environment, and performance in relation to their nutritional status. It considers nutrition to be an integral part of a safe and productive workplace that encompasses physical and mental health as well as the long-term wellbeing of workers. This review explores the knowledge, awareness, and common practices of nutrition, hydration, stimulants, and fortified product use employed prior to physical employment standards testing and within the workplace. The influence of these nutra-ergonomic strategies on physical employment standards, worker safety, and performance will be examined. Further, the roles, responsibilities, and implications for the applicant, worker, and the employer will be discussed within the context of nutra-ergonomics, with reference to the provision and sustainability of an environment conducive to optimize worker health and wellbeing. Beyond physical employment standards, workplace productivity, and performance, the influence of extended or chronic desynchronization (irregular or shift work) in the work schedule on metabolism and long-term health, including risk of developing chronic and complex diseases, is discussed. Finally, practical nutra-ergonomic strategies and recommendations for the applicant, worker, and employer alike will be provided to enhance the short- and long-term safety, performance, health, and wellbeing of workers.
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Affiliation(s)
- Jane Shearer
- a Department of Biochemistry and Molecular Biology, Cumming School of Medicine. Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Terry E Graham
- b Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Tina L Skinner
- c Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland QLD 4072, Australia
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Baguley BJ, Skinner TL, Leveritt MD, Wright ORL. Nutrition therapy with high intensity interval training to improve prostate cancer-related fatigue in men on androgen deprivation therapy: a study protocol. BMC Cancer 2017; 17:1. [PMID: 28049525 PMCID: PMC5206780 DOI: 10.1186/s12885-016-3022-6] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 12/17/2016] [Indexed: 12/14/2022] Open
Abstract
Background Cancer-related fatigue is one of the most prevalent, prolonged and distressing side effects of prostate cancer treatment with androgen deprivation therapy. Preliminary evidence suggests natural therapies such as nutrition therapy and structured exercise prescription can reduce symptoms of cancer-related fatigue. Men appear to change their habitual dietary patterns after prostate cancer diagnosis, yet prostate-specific dietary guidelines provide limited support for managing adverse side effects of treatment. The exercise literature has shown high intensity interval training can improve various aspects of health that are typically impaired with androgen deprivation therapy; however exercise at this intensity is yet to be conducted in men with prostate cancer. The purpose of this study is to examine the effects of nutrition therapy beyond the current healthy eating guidelines with high intensity interval training for managing cancer-related fatigue in men with prostate cancer treated with androgen deprivation therapy. Methods/design This is a two-arm randomized control trial of 116 men with prostate cancer and survivors treated with androgen deprivation therapy. Participants will be randomized to either the intervention group i.e. nutrition therapy and high intensity interval training, or usual care. The intervention group will receive 20 weeks of individualized nutrition therapy from an Accredited Practising Dietitian, and high intensity interval training (from weeks 12–20 of the intervention) from an Accredited Exercise Physiologist. The usual care group will maintain their standard treatment regimen over the 20 weeks. Both groups will undertake primary and secondary outcome testing at baseline, week 8, 12, and 20; testing includes questionnaires of fatigue and quality of life, objective measures of body composition, muscular strength, cardiorespiratory fitness, biomarkers for disease progression, as well as dietary analysis. The primary outcomes for this trial are measures of fatigue and quality of life. Discussion This study is the first of its kind to determine the efficacy of nutrition therapy above the healthy eating guidelines and high intensity interval training for alleviating prostate-cancer related fatigue. If successful, nutrition therapy and high intensity interval training may be proposed as an effective therapy for managing cancer-related fatigue and improving quality of life in men during and after prostate cancer treatment. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12615000512527. Trial registered on the 22/5/2015.
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Affiliation(s)
- Brenton J Baguley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Mater Research Institute, University of Queensland, Kent Street, Woolloongabba, Brisbane, QLD 4102, Australia
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Wallen MP, Skinner TL, Pavey TG, Hall A, Macdonald GA, Coombes JS. Safety, adherence and efficacy of exercise training in solid-organ transplant candidates: A systematic review. Transplant Rev (Orlando) 2016; 30:218-26. [DOI: 10.1016/j.trre.2016.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/06/2016] [Accepted: 07/13/2016] [Indexed: 01/24/2023]
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Schaumberg MA, Jenkins DG, Janse de Jonge XAK, Emmerton LM, Skinner TL. Three-step method for menstrual and oral contraceptive cycle verification. J Sci Med Sport 2016; 20:965-969. [PMID: 28684053 DOI: 10.1016/j.jsams.2016.08.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Fluctuating endogenous and exogenous ovarian hormones may influence exercise parameters; yet control and verification of ovarian hormone status is rarely reported and limits current exercise science and sports medicine research. The purpose of this study was to determine the effectiveness of an individualised three-step method in identifying the mid-luteal or high hormone phase in endogenous and exogenous hormone cycles in recreationally-active women and determine hormone and demographic characteristics associated with unsuccessful classification. DESIGN Cross-sectional study design. METHODS Fifty-four recreationally-active women who were either long-term oral contraceptive users (n=28) or experiencing regular natural menstrual cycles (n=26) completed step-wise menstrual mapping, urinary ovulation prediction testing and venous blood sampling for serum/plasma hormone analysis on two days, 6-12days after positive ovulation prediction to verify ovarian hormone concentrations. RESULTS Mid-luteal phase was successfully verified in 100% of oral contraceptive users, and 70% of naturally-menstruating women. Thirty percent of participants were classified as luteal phase deficient; when excluded, the success of the method was 89%. Lower age, body fat and longer menstrual cycles were significantly associated with luteal phase deficiency. CONCLUSIONS A step-wise method including menstrual cycle mapping, urinary ovulation prediction and serum/plasma hormone measurement was effective at verifying ovarian hormone status. Additional consideration of age, body fat and cycle length enhanced identification of luteal phase deficiency in physically-active women. These findings enable the development of stricter exclusion criteria for female participants in research studies and minimise the influence of ovarian hormone variations within sports and exercise science and medicine research.
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Affiliation(s)
- Mia A Schaumberg
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia; Queensland Brain Institute, The University of Queensland, Australia.
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | | | | | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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47
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Lassemillante ACM, Skinner TL, Hooper JD, Prins JB, Wright ORL. Osteoporosis-Related Health Behaviors in Men With Prostate Cancer and Survivors: Exploring Osteoporosis Knowledge, Health Beliefs, and Self-Efficacy. Am J Mens Health 2016; 11:13-23. [PMID: 26712535 DOI: 10.1177/1557988315615956] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This descriptive study aimed to (a) determine the extent of osteoporosis knowledge, perceived health beliefs, and self-efficacy with bone healthy behaviors in men with prostate cancer and survivors and (b) identify how dietary bone healthy behaviors are associated with these psychobehavioral and psychosocial factors. Three different questionnaires were used to measure osteoporosis knowledge, health beliefs, and self-efficacy in a group of men with prostate cancer and survivors. Bone health was assessed via dual-energy X-ray absorptiometry and calcium intake using a diet history. The prevalence of osteoporosis and low bone mass was high at over 70%. Participants had inadequate osteoporosis knowledge with a mean score of 43.3% ( SD = 18%) on the Facts on Osteoporosis Quiz. Participants scored low on the subscale measuring barriers to exercise (median = 11; interquartile range [IQR] = 6.5), indicating minimal barriers to exercise participation, and the subscale measuring the benefits of exercise scored the highest (median = 24; IQR = 3.5) compared with the other subscales. Men with prostate cancer and survivors were highly confident in their exercise and calcium self-efficacy (83.0%, IQR = 24.0% and 85.7%, IQR = 27.0%, respectively). Participants did not meet their calcium requirements or consume enough dairy products for optimum bone health. Men with prostate cancer and survivors have poor osteoporosis knowledge, but are confident in their self-efficacy of undertaking bone healthy behaviors. This confidence did not translate to specific dietary behaviors as they did not meet their calcium or dairy intake requirements. Implications for cancer survivors is that there is a need for bone health education programs among prostate cancer survivors. These programs should go beyond education and empowerment to provide practical guidance to maximize uptake of bone healthy behaviors.
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Affiliation(s)
- Annie-Claude M Lassemillante
- 1 Centre for Dietetics Research, School of Human Movement and Nutrition Sciences,The University of Queensland, Australia.,2 Mater Research Institute - University of Queensland, Australia
| | - Tina L Skinner
- 3 Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - John D Hooper
- 2 Mater Research Institute - University of Queensland, Australia
| | - John B Prins
- 2 Mater Research Institute - University of Queensland, Australia.,4 The University of Queensland Diamantina Institute, The University of Queensland, Australia
| | - Olivia R L Wright
- 1 Centre for Dietetics Research, School of Human Movement and Nutrition Sciences,The University of Queensland, Australia.,2 Mater Research Institute - University of Queensland, Australia
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48
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Bolam KA, Skinner TL, Sax AT, Adlard KN, Taaffe DR. A Comparison of Bone Mineral Density in Amateur Male Boxers and Active Non-boxers. Int J Sports Med 2016; 37:694-9. [PMID: 27203576 DOI: 10.1055/s-0042-104200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To examine the site-specific osteogenic effect of upper limb impact-loading activity we compared the forearm and arm bone mineral density (BMD) of male boxers to that of active controls. A cross-sectional study was performed with 30 amateur male boxers (aged 18-44 years) and 32 age-matched, non-boxing, active controls. Participants had their regional and whole body BMD and bone mineral content (BMC) assessed by dual-energy X-ray absorptiometry. Hand grip strength, testosterone, oestradiol, sex hormone-binding globulin, vitamin D, lean and fat mass, and past and current physical activity were also assessed. Forearm and arm BMD were 1.5-2.2% higher in boxers than the control group although this was not statistically significant (p>0.05), with no significant difference for BMC (p>0.05). There were no differences between groups for spine, hip, or whole body BMD or BMC, or for body composition or hormone status. Within the arms, lean mass was associated with BMD and BMC in both boxers and the control group (BMD, r=0.60-0.76, p<0.001; BMC, r=0.67-0.82, p<0.001). There were no significant differences between amateur boxers and the control group for upper limb BMD and BMC. However, muscle mass appears to be particularly important to bone health of the upper limbs.
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Affiliation(s)
- K A Bolam
- Swedish School of Sport and Health Sciences, Astrand Laboratory of Physiology, Stockholm, Sweden
| | - T L Skinner
- Swedish School of Sport and Health Sciences, Astrand Laboratory of Physiology, Stockholm, Sweden
| | - A T Sax
- Swedish School of Sport and Health Sciences, Astrand Laboratory of Physiology, Stockholm, Sweden
| | - K N Adlard
- Swedish School of Sport and Health Sciences, Astrand Laboratory of Physiology, Stockholm, Sweden
| | - D R Taaffe
- Swedish School of Sport and Health Sciences, Astrand Laboratory of Physiology, Stockholm, Sweden
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Wallen MP, Hall A, Dias KA, Ramos JS, Keating SE, Skinner TL, Woodward AJ, Macdonald GA, Arena R, Coombes JS. The Oxygen Uptake Efficiency Slope Is Not Influenced By Beta-blockade In End-stage Liver Disease Patients. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487136.76612.ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Skinner TL, Peeters GG, Croci I, Bell KR, Burton NW, Chambers SK, Bolam KA. Impact of a brief exercise program on the physical and psychosocial health of prostate cancer survivors: A pilot study. Asia Pac J Clin Oncol 2016; 12:225-34. [PMID: 26923217 DOI: 10.1111/ajco.12474] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/11/2015] [Accepted: 01/13/2016] [Indexed: 12/31/2022]
Abstract
AIM It is well established that exercise is beneficial for prostate cancer survivors. The challenge for health professionals is to create effective strategies to encourage survivors to exercise in the community. Many community exercise programs are brief in duration (e.g. <5 exercise sessions); whilst evidence for the efficacy of exercise within the literature are derived from exercise programs ≥8 weeks in duration, it is unknown if health benefits can be obtained from a shorter program. This study examined the effect of a four-session individualized and supervised exercise program on the physical and psychosocial health of prostate cancer survivors. METHODS Fifty-one prostate cancer survivors (mean age 69±7 years) were prescribed 1 h, individualized, supervised exercise sessions once weekly for 4 weeks. Participants were encouraged to increase their physical activity levels outside of the exercise sessions. Objective measures of muscular strength, exercise capacity, physical function and flexibility; and self-reported general, disease-specific and psychosocial health were assessed at baseline and following the intervention. RESULTS Improvements were observed in muscle strength (leg press 17.6 percent; P < 0.001), exercise capacity (400-m walk 9.3 percent; P < 0.001), physical function (repeated chair stands 20.1 percent, usual gait speed 19.3 percent, timed up-and-go 15.0 percent; P < 0.001), flexibility (chair sit and reach +2.9 cm; P < 0.001) and positive well-being (P = 0.014) following the exercise program. CONCLUSION A four-session exercise program significantly improved the muscular strength, exercise capacity, physical function and positive well-being of prostate cancer survivors. This short-duration exercise program is safe and feasible for prostate cancer survivors and a randomized controlled trial is now required to determine whether a similar individualized exercise regimen improves physical health and mental well-being over the short, medium and long term.
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Affiliation(s)
- Tina L Skinner
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Gmme Geeske Peeters
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,The University of Queensland, School of Public Health, Brisbane, Queensland, Australia
| | - Ilaria Croci
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Katherine R Bell
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Nicola W Burton
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Suzanne K Chambers
- The University of Queensland, Centre for Clinical Research, Brisbane, Queensland, Australia.,Griffith University, Griffith Health Institute, Southport, Queensland, Australia.,Cancer Council Queensland, Brisbane, Queensland, Australia.,Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,Edith Cowan University, Edith Cowan University Health and Wellness Institute, Joondalup, Western Australia, Australia
| | - Kate A Bolam
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,The Swedish School of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Stockholm, Sweden
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