Objective To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. Design Single group implementation feasibility study using a pre–posttest design. Setting Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). Participants Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. Intervention A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. Main Measure Paired t-tests were used to assess pre–post changes and analyses of covariance were used to compare effects based on selected participant characteristics. Results Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min ( p < 0.001), chest strength ( p < 0.001), leg strength ( p < 0.001), lean body mass ( p = 0.003), skeletal muscle mass ( p < 0.002), % body fat ( p = 0.02), quality of life by 5.3 points ( p = 0.009), fatigue by 3.2 points ( p = 0.012), and physical activity by 1680 METs/week ( p < 0.001). Conclusions Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. Implications for Cancer Survivors With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.
Introduction: eHealth programs is an emerging area because of the restricted measures for controlling COVID19 pandemic a such as avoiding close contact or group activities, especially indoor. For these reasons, Spanish Cancer Association of Madrid (AECCmad), transformed all exercise-oncology programs into online version with the objective of maintaining the exercise attention to the breast cancer patients (BCP). This abstract shows the first results from this adapted intervention, evaluating the effectiveness in physical outcomes as well as the feasibility of the new model. Methodology: Since 1st of September of 2020 a total of 64 patients with breast cancer (BC) in different stages were attended in the exercise-oncology unit of the AECCmad using the online model. Firstly, a specialized nurse checked that all patients fulfilled the inclusion criteria to ensure BCP safeness. After this, all women had a one-to-one interview with the exercise-oncology professionals, face-to-face (F-F) or online, where anthropometrics (weight and high in virtual and bioimpedance in F-F interview) and functional capacity (6 minutes walking test, sit and stand in online interview, and that two as well as cardiorespiratory fitness, maximal strength and bioimpedance in F-F interview) were assessed to individualized exercise interventions. Then, BCP were enrolled in a 8-weeks online program adapted to their characteristics, where a specialist in exercise-oncology supervised each session, performing a combined exercise intervention from 50 to 90% of maximal heart rate. At the end, a final assessment was carried out with a twofold purpose: to inform patients of the achieved changes and to give them a personalized final report that would help women to continue exercising. Adherence of the program and physical variables collected in pre-post tests were analyzed. T test of related samples were used to compare pre-post assessments. Results 59 BCP with a mean of 45.7(10.03) years old completed the online program: 31.3% were survivors, 56.7% were under treatment and 12.5% had metastatic disease and 59% of the women had a F-F assessment, while the 41% were online. Related to the feasibility, program adherence was 92.2% (only 5 patients doped out the program) and classes assistance rate was 81%. BCP showed significant improvements in cardiorespiratory fitness (DifMean (ΔM): 8.56 ml.kg.min; CI95% 5.76 - 11.37; p=0.0001), strength in upper limbs (DifMean:11.38 kg; CI95%: 8.97 - 13.79; p=0.0001), and in legs (ΔM: 29.37 kg; CI95%: 23.93 - 34.82; p=0.0001) and in sit and stand test (ΔM: 4.53 squats; CI95%: 2.19 - 6.88; p=0.0001); and almost significant in distance of six minutes walking test (ΔM: 76.70 meters; CI95%: -4.80 - 158.21; p=0.064) Conclusions: Exercise-oncology online programs adapted to BCP characteristics are feasible and effective to significantly improve cardiorespiratory fitness and functional capacity. In addition, this type of programs might be a useful tool to achieve a healthy balance in BCP’s body composition. This new model of intervention not only presents high levels of adherence, but also, allows patients to access supervised exercise programs that otherwise would not be possible. Online intervention in exercise oncology might be a feasible, safe, and effective tool not only to improve BCP’s health but also for other cancer patients, in any stage of cancer. Citation Format: Soraya Casla-Barrio, Lucia Gil-Herrero, Monica Castellanos. Effectiveness and feasibility of exercise-oncology programs in breast cancer patients using new technologies adapted to the COVID 19 new normality [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-10.
Introduction: Cardiorespiratory Fitness (CRF) has been described as an independent factorassociated with better survival in Breast Cancer Survivors (BCS). In addition, an altered BodyComposition (BodComp) impacts in a worst prognosis and increase treatment side effects.Despite this, BCS present lower levels of CRF than women without previous history of breastcancer (BC) and around 3% of BCS are obese, with an average of 1.8 to 5.0 kg of weight gainduring chemotherapy treatments and weight keeps rising during hormonotherapy.Exercise has been proved as an effective tool to help BCS not only to reduce treatments sideeffects improving significantly CRF, but also, to allow controlling and improving BodCom duringand after treatments.However, it is not clear if active BCS could achieve similar values of CRF and BodCom than activehealthy women and the impact of a sedentary behavior in them. Purpose: To establish the impact of physical exercise in CRF and BodComp recovery in BCS withinthe last five years compared to women without a BC diagnosis. Material and Methods: in this cross-sectional study, women with and without BC were invitedinto a sport centre in Madrid, (Spain) to evaluate their general physical condition and bodycomposition. Participants were classified into four different groups: sedentary-BC, active-BC,sedentary healthy and active healthy (Sed-BCW, Act-BCW, Sed-HW, Act-HW, respectively).VO2max, speed level, isometric strength, lower body maximum strength, explosive strength andbalance were assessed with different physical test. Body composition was measured bybioimpedance.In terms of statistical analysis, analyses of variance (ANOVA) were used with continuousvariables to compare groups and post- hoc comparisons used Bonferroni test. Results: A total of ninety two women were recruited (23 in each group).In terms of VO2max, significant differences were found between active and sedentary BC (Difmean (ΔM)= 5.86, IC 95% 3.16 - 8.55; p<0.001). No differences in VO2max were observed betweenthe active groups (ΔM = 0.42, IC 95% -2.26 to 3.12; p= 0.753). In terms of BodCom, it wasobserved significant differences in FM% comparing Act-BCW with Act-HW (ΔM= -11.57; IC 95%-16.80 - -6.33), Sed-BC (ΔM= -6.78; IC 95% -12.52 to -1.54) and Sed-HW (ΔM= -12.07; IC 95% -17.31 to -6.83). In terms of percentage lean mass (LM%), results are presented in (table 1).Active-BC showed significant better results than sedentary groups in other parameters of thephysical condition compared with sedentary women, but not with the Active healthy group(Table 1).Significant differences between Active-BC and sedentary groups were found regarding totalweight, water and visceral mass (p<0,01 for all). Table 1. Mean differences, significance and CI 95% in physical and body composition variablesbetween groups.Act-BCW- Sed-BCWAct-BCW - Act-HWAct-BCW - Sed-HW6MWT (m)71.52**37.36 -105.68-3.04-37.20 - 31.1176.57**42.41 - 110.7235m (sec)-1.87*-3.44 - 0.300.17-1.40 - 1.74-2.39**-3.96 - -0.82Jump (cm)5.48**1.47 - 9.49-2.87-6.88 - 1.144.91*0.90 - 8.92Strength Index0.63**0.31 - 0.95-0.09-0.40 - 0.210.376*0.07 - 0.68LM(%)5.20*-1.62 - 8.780.72-2.86 - 4.38.59**3.72 - 13.45*=p<0,05; **=p<0,01. Conclusions: This study provide two main contributions related to the importance of physicalactivity in BC survivors: BC women who maintain an active lifestyle can achieve the same valuesin physical condition as active healthy women, and significant better values than the sedentarygroups. These results suggest than physical exercise might be a stronger determinant of bodycomposition than a previous history of BC. Citation Format: Lucía Gil Herrero, Marina Pollán Santamaría, Miguel Martín Jimenez, Sara López Tarruella, Mónica Castellanos Montealegre, Soraya Casla Barrio. The importance of physical exercise in cardiovascular fitness in breast cancer survivors. A cross sectional study: WIM 2.0 [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-26.
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