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Adipose tissue inflammation in breast cancer survivors: effects of a 16-week combined aerobic and resistance exercise training intervention.
Dieli-Conwright, CM, Parmentier, JH, Sami, N, Lee, K, Spicer, D, Mack, WJ, Sattler, F, Mittelman, SD
Breast cancer research and treatment. 2018;168(1):147-157
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Obese breast cancer patients have double the mortality compared to non-obese patients. This is thought to be mediated by low grade inflammation of the adipose (fat) tissue. The main type of immune cells involved in the process are called adipose tissue macrophages (ATMs), of which there are two types: M1 and M2 ATMs, with the M2 ATMs having a mostly anti-inflammatory effect, whilst the M1 ATMs are more pro-inflammatory and are thought to promote cancer growth and recurrence. This 16-week randomised pilot study assessed whether exercise can positively influence adipose tissue inflammation in breast cancer survivors. Participants were randomised to either an exercise (EX) group, who had three supervised exercise sessions per week with a combination of aerobic and resistance exercise, or a control (CON) group. Outcome measures included body composition, blood biomarkers for systemic inflammation and adipose tissue biopsies which were analysed for tissue inflammatory markers, including M1 and M2 ATMs. The EX group had significant improvements in body weight and composition, as well as in metabolic blood parameters (including those for lipid and glucose metabolism) and inflammatory markers, whilst the CON group experienced a worsening of these parameters. The EX participants also had a decrease in the pro-inflammatory M1 ATMs and an increase in the anti-inflammatory M2 ATMs. The authors state that the results were not only statistically, but also clinically significant. The authors conclude that moderate-to-vigorous intensity resistance and aerobic exercise can improve adipose tissue inflammation in obese breast cancer survivors.
Abstract
PURPOSE Obesity is a leading modifiable contributor to breast cancer mortality due to its association with increased recurrence and decreased overall survival rate. Obesity stimulates cancer progression through chronic, low-grade inflammation in white adipose tissue, leading to accumulation of adipose tissue macrophages (ATMs), in particular, the pro-inflammatory M1 phenotype macrophage. Exercise has been shown to reduce M1 ATMs and increase the more anti-inflammatory M2 ATMs in obese adults. The purpose of this study was to determine whether a 16-week exercise intervention would positively alter ATM phenotype in obese postmenopausal breast cancer survivors. METHODS Twenty obese postmenopausal breast cancer survivors were randomized to a 16-week aerobic and resistance exercise (EX) intervention or delayed intervention control (CON). The EX group participated in 16 weeks of supervised exercise sessions 3 times/week. Participants provided fasting blood, dual-energy X-ray absorptiometry (DXA), and superficial subcutaneous abdominal adipose tissue biopsies at baseline and following the 16-week study period. RESULTS EX participants experienced significant improvements in body composition, cardiometabolic biomarkers, and systemic inflammation (all p < 0.03 vs. CON). Adipose tissue from EX participants showed a significant decrease in ATM M1 (p < 0.001), an increase in ATM M2 (p < 0.001), increased adipose tissue secretion of anti-inflammatory cytokines such as adiponectin, and decreased secretion of the pro-inflammatory cytokines IL-6 and TNF- α (all p < 0.055). CONCLUSIONS A 16-week aerobic and resistance exercise intervention attenuates adipose tissue inflammation in obese postmenopausal breast cancer survivors. Future large randomized trials are warranted to investigate the impact of exercise-induced reductions in adipose tissue inflammation and breast cancer recurrence.
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The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial.
Myette-Côté, É, Durrer, C, Neudorf, H, Bammert, TD, Botezelli, JD, Johnson, JD, DeSouza, CA, Little, JP
American journal of physiology. Regulatory, integrative and comparative physiology. 2018;315(6):R1210-R1219
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Inflammation is associated with the pathogenesis of insulin resistance, type 2 diabetes (T2D), and related complications. Lifestyle therapy is a frontline treatment for improving glucose control in people with T2D. The main aim of this study was to determine whether reducing hyperglycaemia with a low-carbohydrate high-fat (LC) diet could lower markers of innate immune cell activation and systemic inflammation in people with T2D. A secondary aim was to examine if the combination of an LCHF diet with strategically timed postmeal walking was superior to an LCHF diet alone. The study is a randomised cross over study which enrolled Individuals with physician-diagnosed T2D to complete three short-term controlled-intervention periods. Sixteen participants were enrolled (men = 8 and women = 8) who were aged between 48 and 72 years. Results indicate that while LC and LC together with exercise (LC+Ex) led to superior improvements in glucose control and fasting proinsulin (the pro-hormone precursor to insulin) levels as compared with low-fat low glycaemic index diet (GL), all three diets (GL, LC and LC+Ex), appeared to lower a particular marker of cellular inflammation over the short-term. Authors conclude that an LCHF diet with or without daily postmeal walks improved four-day glycaemic control and fasting proinsulin levels compared with a GL diet.
Abstract
Lowering carbohydrate consumption effectively lowers glucose, but impacts on inflammation are unclear. The objectives of this study were to: 1) determine whether reducing hyperglycemia by following a low-carbohydrate, high-fat (LC) diet could lower markers of innate immune cell activation in type 2 diabetes (T2D) and 2) examine if the combination of an LC diet with strategically timed postmeal walking was superior to an LC diet alone. Participants with T2D ( n = 11) completed a randomized crossover study involving three 4-day diet interventions: 1) low-fat low-glycemic index (GL), 2) and 3) LC with 15-min postmeal walks (LC+Ex). Four-day mean glucose was significantly lower in the LC+Ex group as compared with LC (-5%, P < 0.05), whereas both LC+Ex (-16%, P < 0.001) and LC (-12%, P < 0.001) conditions were lower than GL. A significant main effect of time was observed for peripheral blood mononuclear cells phosphorylated c-Jun N-terminal kinase ( P < 0.001), with decreases in all three conditions (GL: -32%, LC: -45%, and LC+Ex: -44%). A significant condition by time interaction was observed for monocyte microparticles ( P = 0.040) with a significant decrease in GL (-76%, P = 0.035) and a tendency for a reduction in LC (-70%, P = 0.064), whereas there was no significant change in LC+Ex (0.5%, P = 0.990). Both LC (-27%, P = 0.001) and LC+Ex (-35%, P = 0.005) also led to significant reductions in circulating proinsulin. An LC diet improved 4-day glycemic control and fasting proinsulin levels when compared with GL, with added glucose-lowering benefits when LC was combined with postmeal walking.
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Nutritional issues in patients with obesity and cirrhosis.
Schiavo, L, Busetto, L, Cesaretti, M, Zelber-Sagi, S, Deutsch, L, Iannelli, A
World journal of gastroenterology. 2018;24(30):3330-3346
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Non-alcoholic fatty liver disease (NAFLD) occurs when fats accumulate in the liver in the absence of excess alcohol intake and if unmanaged can advance to severe liver disease known as cirrhosis. NAFLD and cirrhosis can be associated with obesity, muscle wastage and nutrient deficiencies. This review of 165 papers aimed to discuss muscle wastage and nutrient deficiencies in patients with obesity and cirrhosis with a view to making supplementation recommendations. The authors first discussed that the risk of muscle wastage in patients with obesity and cirrhosis is high and when combined with obesity may affect other chronic diseases and impact the progression of NAFLD to cirrhosis. The paper then discusses that vitamin and mineral deficiencies are common in patients with cirrhosis possibly due to reduced intake, poor absorption and the reduction of carrier protein production in the liver. Deficiencies in vitamins D and E and zinc and magnesium were extensively featured. Protein and calorie intake were also reviewed and although weight loss should be encouraged in patients with obesity and cirrhosis, over-restriction could exacerbate muscle breakdown. Any low-calorie diets should contain adequate protein content. Bariatric surgery, in patients with obesity and cirrhosis needs to be performed on a case-by-case basis involving many different medical disciplines. It was concluded that obesity and cirrhosis are commonly occurring simultaneously and poses a management challenge for medical professionals. This paper could be used by health care professionals to understand the possible nutritional deficiencies that need to be monitored in patients with obesity and cirrhosis and where bariatric surgery may be indicated.
Abstract
Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis. Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis. Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronic liver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation. Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble, water-soluble vitamins and trace elements and should be supplemented appropriately. Diet, physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations. Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation. The risk of sarcopenia, micronutrient status, and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review. Furthermore, the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.
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Patient-Reported Outcome of Physical Therapy in Amyotrophic Lateral Sclerosis: Observational Online Study.
Meyer, R, Spittel, S, Steinfurth, L, Funke, A, Kettemann, D, Münch, C, Meyer, T, Maier, A
JMIR rehabilitation and assistive technologies. 2018;5(2):e10099
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Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. The disease is characterized by a loss of motor neurons resulting in progressive motor deficits and paralysis of the muscles that control limb movement, swallowing, and breathing. The aim of the study was to evaluate the frequency and duration of physical therapy sessions among ALS patients, determine the most bothersome motor symptoms, and identify recommendation levels for physical therapy. The study was a prospective, longitudinal, observational study that recruited a consecutive cohort of participants. The mean age of all participants at baseline was 59.2 years with a relatively long disease duration of 27 months. Results did not show a significant correlation between the recommendation of physical therapy and the extent (duration and frequency) of its application. There was no evidence that decline in well-being, motor function, or levels of activity significantly degrade the overall recommendation of physical therapy. Authors conclude that palliative (relieving pain without dealing with the cause of the condition) and multidisciplinary approaches should be encouraged during the education, training, and qualification of physical therapists to implement the changing perceptions of physical therapy.
Abstract
BACKGROUND Physical therapy is an essential component of multidisciplinary treatment in amyotrophic lateral sclerosis (ALS). However, the meaning of physical therapy beside preservation of muscular strength and functional maintenance is not fully understood. OBJECTIVE The purpose of this study was to examine patients' perception of physical therapy during symptom progression using an internet assessment approach. METHODS A prospective, longitudinal, observational study was performed. Recruitment took place in an ALS center in Berlin, Germany. Online self-assessment was established on a case management platform over 6 months. Participants self-assessed the progression of the disease with the ALS Functional Rating Scale-Revised (ALSFRS-R) and tracked the efficacy of targeted physical therapy using Measure Yourself Medical Outcome Profile (MYMOP). We used the net promoter score (NPS) to inquire into recommendation levels of physical therapy. RESULTS Forty-five participants with ALS were included in the study. Twenty-seven (60.0%) started the online assessment. The mean duration of physical therapy sessions per week was 142.7 minutes (SD 60.4) with a mean frequency of 2.9 (SD 1.2) per week. As defined by MYMOP input, the most concerning symptoms were reported in the legs (62.2%), arms (31.1%), and less frequently in the torso (6.7%). As expected for a progressive disease, there was a functional decline of 3 points in the ALSFRS-R at the end of the observation period (n=20). Furthermore, the MYMOP showed a significant loss of 0.8 in the composite score, 0.9 in the activity score and 0.8 in the targeted symptom. In spite of functional decline, the recommendation for physical therapy jumped from a baseline value of 20 NPS points to a very high 50 points at the end of study (P=.05). CONCLUSIONS Physical therapy is perceived as an important treatment method by patients with ALS. Despite functional deterioration, patients are satisfied with physical therapy and recommend this intervention. The results also underline how the meaning of physical therapy changes throughout the disease. Physical therapy in ALS has to be regarded as a supportive and palliative health care intervention beyond functional outcome parameters.
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Anti-Obesity Effects of Medicinal and Edible Mushrooms.
Ganesan, K, Xu, B
Molecules (Basel, Switzerland). 2018;23(11)
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Medicinal mushrooms have long been considered healthful due to of their anti-oxidant and anti-inflammatory properties, such as high-quality proteins, polyunsaturated fatty acids, polyphenols etc. More recently they have been analysed for their anti-obesity effects. The health implications of obesity are extensive, often affecting all bodily systems. The purpose of this review was to analyse previous animal studies to determine whether consuming edible mushrooms has a positive effect on obesity related illnesses, such as Type 2 diabetes and cardiovascular disease etc. The authors explore and summarise the different methods used to treat obesity including pharmacotherapy (weight loss drugs), natural products such as Ayurveda medicine and exercise. They present promising results that suggest the therapeutic properties of edible mushrooms have anti-obesity potentials and propose that the findings from animal studies could likely be mirrored in humans and recommend consuming mushrooms to aid weight loss and therefore improve health.
Abstract
Obesity is a group of metabolic disorders caused by multiple factors, including heredity, diet, lifestyle, societal determinants, environment, and infectious agents, which can all lead to the enhancement of storage body fat. Excess visceral fat mass in adipose tissue generate several metabolic disorders, including cardiovascular diseases with chronic inflammation based pathophysiology. The objective of the current review is to summarize the cellular mechanisms of obesity that attenuate by antioxidant potentials of medicinal and edible mushrooms. Studies have showed that mushrooms potentially have antioxidant capacities, which increase the antioxidant defense systems in cells. They boost anti-inflammatory actions and thereby protect against obesity-related hypertension and dyslipidemia. The practice of regular consumption of mushrooms is effective in the treatment of metabolic syndrome, including obesity, and thus could be a good candidate for use in future pharmaceutical or nutraceutical applications.
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Prevalence and determinants of physical activity in a mixed sample of psychiatric patients in Saudi Arabia.
Alosaimi, FD, Abalhasan, MF, Alhabbad, AA, Fallata, EO, Haddad, BA, AlQattan, NI, Alassiry, MZ
Saudi medical journal. 2018;39(4):401-411
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Physical activity has been shown to considerably reduce the burden of several non-communicable disorders (are diseases of long duration and generally slow progression), such as heart disease, stroke, diabetes, and breast and colon cancers. The aim of the study is to estimate the prevalence of physical activity among a mixed group of patients with psychiatric illnesses in Saudi Arabia. Furthermore, the study sought to evaluate the associations between physical activity, patients with different psychiatric diagnoses and the use of psychotropic medications. The study is a cross-sectional observational study that recruited 1185 patients seeking psychiatric advice, with an average age of 38.0±13.0 years. Results indicate a low prevalence of physical activity in a large, mixed sample of patients with psychiatric illnesses in both inpatient and outpatient settings in Saudi Arabia. Authors conclude that physical activity levels vary according to the type of psychiatric disease and the medications used. They outline that it is important to assess the physical activity status in patients with psychiatric illnesses and promote physical activity programs among psychiatric patients.
Abstract
OBJECTIVES To estimate prevalence of physical activity and its associations with various psychiatric disorders and the use of psychotropic medications. METHODS A cross-sectional observational study was carried out between July 2012 and June 2014. Patients were enrolled from a number of hospitals located in 5 regions of the Kingdom of Saudi Arabia. RESULTS A total of 1185 patients were included in current analysis: 796 were outpatients, and 389 were inpatients. Out of 1,185 patients, 153 (12.9%) were physically active. Much higher rates of physical activity were reported among males than females (15.9% versus 9.6%, p less than 0.001). According to the univariate analysis, higher rates of physical activity were positively correlated with primary bipolar disorders, the use of antianxiety medications and, to a lesser extent, use of antipsychotic medications, but they were negatively correlated with primary anxiety disorders, use of antidepressant medications, and use of multiple psychotropic medications. The associations between physical activity and primary bipolar disorders (odds ratio [OR]=2.47, p=0.002), use of antianxiety medications (OR=3.58, p=0.003), and use of multiple psychotropic medications (OR=0.33, p less than 0.001) remained significant after adjusting for demographic and clinical characteristics. CONCLUSION We report a variable but generally low prevalence of physical activity among a large, mixed sample of psychiatric patients in Saudi Arabia. These findings may highlight the importance of assessing physical activity status of psychiatric patients and the critical need for physical activity promotion programs among this group of disadvantaged patients.
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Impact of implementation intentions on physical activity practice in adults: A systematic review and meta-analysis of randomized clinical trials.
Silva, MAVD, São-João, TM, Brizon, VC, Franco, DH, Mialhe, FL
PloS one. 2018;13(11):e0206294
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Many behavioural interventions have been implemented in order to increase physical activity levels among adults. Despite these efforts, there is often a large gap between setting goals and attaining goals. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of using theory-based strategies on goal attainment in promoting physical activity among adults (specifically implementation intentions or if-then planning). Particular interest was given to the impact of reinforcements during the intervention and follow-up period for coping with obstacles. A total of 13 randomised controlled trials were included. Implementation intentions consisted of two strategies. Firstly, action planning which was designed to increase awareness of possible future situations where behaviours could be achieved. Secondly, coping planning which focused on barriers that might impede the goal behaviour, and ways to overcome these possible barriers. According to the current literature, application of the theory-based goal setting promoted physical activity behaviours, and this was heightened among those who received reinforcement of plans to increase physical activity during the follow-up period.
Abstract
OBJECTIVE The aim of this study was to verify the efficacy of using theory-based strategies on implementation intentions in promoting physical activity (PA) among adults. METHODS This review was conducted in accordance with the PRISMA recommendations. The search was carried out in seven electronic databases (LILACS, PubMed, SciELO, Cochrane, Web of Science) and two searches of the "grey literature" were performed (Openthesis and OpenGrey). Randomized clinical trials (RCT), published up to September 2016, were considered eligible for this study. Two reviewers independently and systematically evaluated the eligibility criteria, and performed data extraction. A meta-analysis was performed for the purpose of comparing the effect between the intervention and control groups. The effect sizes were grouped in two subgroups with the purpose of more accurately verifying the effect caused by reinforcing the implementation intentions strategy, and using the inverse variance statistical method with random effects models to estimate the main effect of the implementation intention strategy on the PA behavior. Heterogeneity among the studies was evaluated by using I-square statistics, and the Jadad scale to evaluate the quality of included papers. RESULTS The search resulted in 12,147 records, of which 13 RCTs were considered eligible for this review. Sample age ranged from 18 to 76 years, and participants had conditions such as medullary lesion, coronary disease, obesity, diabetes mellitus, sedentarism or occupational stress. When the summary of the effect was analyzed in the meta-analysis, the result found in the subgroup with reinforcement of the implementation intentions strategy was 0.25 (IC 95% = 0.05-0.45) in favor of the intervention group. This demonstrated that application of the implementation intentions strategy was capable of increasing PA practice in the participants of these studies, in comparison with others that did not use this reinforcement. CONCLUSION The findings of this review indicated that application of the theory of implementation intentions promoted PA behavior among the adults who received reinforcement of this strategy. The systematic review protocol was registered in the PROSPERO database under the number CRD42018090482.
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Carbohydrate restriction with postmeal walking effectively mitigates postprandial hyperglycemia and improves endothelial function in type 2 diabetes.
Francois, ME, Myette-Cote, E, Bammert, TD, Durrer, C, Neudorf, H, DeSouza, CA, Little, JP
American journal of physiology. Heart and circulatory physiology. 2018;314(1):H105-H113
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Prevention of cardiovascular disease in individuals with type 2 diabetes (T2D) is a major treatment goal. Within this, diet and exercise remain the cornerstone lifestyle therapies. The aim of this study was to examine the effects of 4 days of a low-carbohydrate diet, with or without daily post-meal walking, on vascular health in individuals with T2D. The study recruited sixteen individuals with physician-diagnosed T2D to complete 3 short-term controlled intervention periods in a randomised crossover design. Results indicate that attenuating postprandial hyperglycaemia (a very high rise in blood sugar following a meal) by restricting carbohydrates and post-meal walking can improve vascular health in individuals with T2D. Authors conclude that carbohydrate restriction and post-meal exercise may represent an effective strategy to mitigate the negative effects of postprandial hyperglycaemia and reduce cardiovascular disease risk in individuals with T2D.
Abstract
Postprandial hyperglycemia has deleterious effects on endothelial function. Restricting carbohydrate intake and postmeal walking have each been shown to reduce postprandial hyperglycemia, but their combination and subsequent effects on endothelial function have not been investigated. Here, we sought to examine the effect of blunting postprandial hyperglycemia by following a low-carbohydrate diet, with or without postmeal walking exercise, on markers of vascular health in type 2 diabetes (T2D). In a randomized crossover design, individuals with T2D ( n = 11) completed three 4-day controlled diet interventions consisting of 1) low-carbohydrate diet alone (LC), 2) low-carbohydrate diet with 15-min postmeal walks (LC + Ex), and 3) low-fat control diet (CON). Fasting blood samples and brachial artery flow-mediated dilation (%FMD) were measured before and after each intervention. Total circulating microparticles (MPs), endothelial MPs, platelet MPs, monocyte-platelet aggregates, and adhesion molecules were assessed as biomarkers of vascular health. There was a significant condition × time interaction for %FMD ( P = 0.01), with post hoc tests revealing improved %FMD after LC + Ex (+0.8 ± 1.0%, P = 0.02), with no change after LC or CON. Endothelial MPs were significantly reduced with the LC diet by ~45% (from 99 ± 60 to 44 ± 31 MPs/μl, P = 0.02), with no change after LC + Ex or CON (interaction: P = 0.04). Total MPs were lower (main effect time: P = 0.02), whereas monocyte-platelet aggregates were higher (main effect time: P < 0.01) after all interventions. Plasma adhesion molecules and C-reactive protein were unaltered. Attenuating postprandial hyperglycemic excursions using a low-carbohydrate diet combined with postmeal walking appears to be an effective strategy to improve endothelial function in individuals with T2D. NEW & NOTEWORTHY Carbohydrate restriction and postmeal walking lower postprandial hyperglycemia in individuals with type 2 diabetes. Here, we show that the combination significantly improved endothelial function and that carbohydrate restriction alone reduced circulating endothelial microparticles in individuals with type 2 diabetes. Listen to this article's corresponding podcast at http://ajpheart.podbean.com/e/low-carb-diet-and-exercise-improve-endothelial-health/ .
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Exercise Preserves Physical Function in Prostate Cancer Patients with Bone Metastases.
Galvão, DA, Taaffe, DR, Spry, N, Cormie, P, Joseph, D, Chambers, SK, Chee, R, Peddle-McIntyre, CJ, Hart, NH, Baumann, FT, et al
Medicine and science in sports and exercise. 2018;50(3):393-399
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Existing research indicates cancer patients with bone metastases should not participate in exercise due to potential risks to the skeletal system. However, current oncology guidelines suggest that all cancer patients should avoid inactivity, including those with bone metastases. The purpose of this study is to determine the safety and efficacy of exercise among 57 prostate cancer patients with bone metastases. Participants were randomised to either participate in exercise or receive usual care for three months. Exercise consisted of supervised aerobic activity, resistance training and stretching three days a week. Overall health status and physical function was measured by self-reported questionnaire. This study found self-reported physical functioning and lower muscle strength was improved significantly in the exercise group. There were no difference in bone pain between groups, and no adverse events occurred. Based on these results, the authors conclude exercise is safe and can help improve physical functioning among prostate cancer patients with bone metastasis.
Abstract
PURPOSE The presence of bone metastases has excluded participation of cancer patients in exercise interventions and is a relative contraindication to supervised exercise in the community setting because of concerns of fragility fracture. We examined the efficacy and safety of a modular multimodal exercise program in prostate cancer patients with bone metastases. METHODS Between 2012 and 2015, 57 prostate cancer patients (70.0 ± 8.4 yr; body mass index, 28.7 ± 4.0 kg·m) with bone metastases (pelvis, 75.4%; femur, 40.4%; rib/thoracic spine, 66.7%; lumbar spine, 43.9%; humerus, 24.6%; other sites, 70.2%) were randomized to multimodal supervised aerobic, resistance, and flexibility exercises undertaken thrice weekly (EX; n = 28) or usual care (CON; n = 29) for 3 months. Physical function subscale of the Medical Outcomes Study Short-Form 36 was the primary end point as an indicator of patient-rated physical functioning. Secondary end points included objective measures of physical function, lower body muscle strength, body composition, and fatigue. Safety was assessed by recording the incidence and severity of any adverse events, skeletal complications, and bone pain throughout the intervention. RESULTS There was a significant difference between groups for self-reported physical functioning (3.2 points; 95% confidence interval, 0.4-6.0 points; P = 0.028) and lower body muscle strength (6.6 kg; 95% confidence interval, 0.6-12.7; P = 0.033) at 3 months favoring EX. However, there was no difference between groups for lean mass (P = 0.584), fat mass (P = 0.598), or fatigue (P = 0.964). There were no exercise-related adverse events or skeletal fractures and no differences in bone pain between EX and CON (P = 0.507). CONCLUSIONS Multimodal modular exercise in prostate cancer patients with bone metastases led to self-reported improvements in physical function and objectively measured lower body muscle strength with no skeletal complications or increased bone pain. TRIAL REGISTRATION ACTRN12611001158954.
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Health Effects of 12 Weeks of Team-Sport Training and Fitness Training in a Community Health Centre for Sedentary Men with Lifestyle Diseases.
Møller, TK, Nielsen, TT, Andersen, R, Lundager, I, Hansen, HF, Ottesen, L, Krustrup, P, Randers, MB
BioMed research international. 2018;2018:1571807
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Physical activity helps to prevent and manage chronic disease, particularly in the aging population. Existing research shows physical activity programmes improve physical capacity and body composition, however participants report difficulty maintaining their training habits once the intervention is finished. The aim of this study was to produce a pragmatic, real-life setup to compare the health effects of team-sport activities with traditional fitness training among men with lifestyle disease in the community health centre context. This study took place over two years. During the first year, 32 men participated in the traditional fitness training to obtain baseline effects. For the second year, all training sessions were replaced with team-sport training and 36 men participated. This study found that team-sport activities produced comparable effects on various health parameters to the traditional fitness-training programme. Based on these results, the authors conclude that team sport activities are a worthy alternative to fitness training in community health centres.
Abstract
This study compares the effects of team-sport training, for sedentary men with lifestyle diseases, with fitness training in a pragmatic set-up in a community health centre (CHC). Thirty-two men in the fitness group (FiG) and 36 men in the team-sport group (TsG) completed the training and trained for 60-90 min, two times/week for 12-16 weeks. In FiG and TsG, mean heart rate (HR) during training was 73.2% and 74.5% of HRmax, respectively. Percentage of training time above 90%HRmax was 6 ± 9% and 10 ± 15% and the percentage of participants who spent > 10% of total training time with HR > 90%HRmax was 20% and 41%, in FiG and TsG, respectively. In FiG, total fat mass was reduced by 3.5% (P < 0.01), while performance in the 6 min walking test (6MWT) increased by 11% (P < 0.001). In TsG, total fat mass was reduced by 2.2% (P < 0.01), while 6MWT performance improved by 5% (P < 0.05). Between-group differences were observed for systolic BP (P = 0.041) and mean arterial pressure (P = 0.050) in favour of TsG and for sit-to-stand test (P = 0.031) in favour of FiG. In conclusion, small-sided team sport is a worthy alternative to fitness training since the overall health effects are comparable, for example, improved balance and reduced fat mass. Team sport elicits high heart rates and improves cardiovascular health by reducing blood pressure, while fitness training improves sit-to-stand test performance related to activity of daily living.