Exercise Recommendation for People with Bone Metastases
Authors: Campbell et al. Publication Date: Jan 2022
The International Bone Metastases Exercise Working Group (IBMEWG) has developed best practice recommendations for improving the integration exercise programming into clinical care for people with bone metastases on the basis of published research, clinical experience and expert opinion.
- Risk assessment should be performed pre-testing/training to inform potential skeletal complications from exercise.
- Consultation with medical team is strongly encouraged pre-exercise, and exercise should be delivered by qualified exercise professionals with oncology education and exercise prescription experience.
- Exercise prescription should emphasize postural alignment, controlled movement and proper technique. Location and presentation of the bone lesion(s) should be considered.
- The authors propose that regular exercise has the potential to maintain or improve physical function and health-related quality of life in people with bone metastases. The perceived risk of skeletal complication should be weighed against the potential health benefits.
Nighttime compression supports improved self-management of breast cancer-related lymphedema
Authors: McNeely et al. Publication Date: Oct 2021
A multicenter randomized controlled trial examining the efficacy of nighttime compression as a self-management strategy for women with chronic breast cancer-related lymphedema. Primary outcomes examined change in arm lymphedema volume and quality of life outcomes.
- Nighttime compression (through self-applied compression bandaging or through nighttime compression system garment) is superior to a daytime compression sleeve in reducing arm lymphedema volume.
- Significant within-group changes in quality of life across all groups but no between-group differences were found.
The Exercise Oncology Knowledge Mobilization Initiative
Authors: Adams et al. Publication Date: Jul 2021
The authors aimed to (1) develop and refine a list of highly important exercise oncology research and knowledge mobilization themes and (2) establish the relative importance of the themes for supporting the implementation of exercise as a standard of care for people living with and beyond cancer.
- Themes related to QEP and HCP education, exercise support infrastructure, and survivor referrals were consistently rated among the most important across survey rounds.
- These themes were consistently ranked among the most important, providing strong preliminary support for the relative importance of these themes compared to the remaining seven themes.
Attention to the Principles of Exercise Training in Exercise Studies of Persons with Lung Cancer
Authors: Medysky et al. Publication Date: May 2021
A systematic review that summarizes exercise trials in persons with lung cancer on attention to the principles of exercise training, methodological reporting of FITT components, and reporting on participant adherence to prescribed FITT.
- Principles of exercise training and FITT components are inconsistently utilized and reported in exercise randomized controlled trials.
- The authors propose that including the principles of training and reporting FITT components will contribute to a better understanding of the efficacy of exercise for persons with lung cancer and support evidence-based exercise prescriptions.
Physical activity recommendations for cancer survivors living with bony metastases
Authors: Adams et al. Publication Date: Feb 2021
The authors surveyed oncologic healthcare providers (OHPs) to understand attitudes towards physical activity for individuals living with bony metastases and to assess requirements to confidently provide physical activity recommendations.
- The majority of OHPs believed physical activity is important and safe for persons living with bony metastases; however, less than half of OHPs would be confident in prescribing physical activity.
- The authors suggest a need to create physical activity guidelines for this population and to improve access to rehabilitation services.
Recruitment strategies and design considerations in a trial of resistance training to prevent dose-limiting toxicities in colon cancer patients undergoing chemotherapy
Authors: Caan et al. Publication Date: Feb 2021
A multicenter, randomized clinical trial examining the effects of resistance training on (1) relative dose intensity (RDI) and (2) moderate and severe chemotoxicities in non-metastatic colon cancer patients receiving adjuvant chemotherapy. Results will provide information on the benefit of resistance exercise as a treatment to increase RDI.
Impact of Exercise on Chemotherapy Tolerance and Survival in Early-Stage Breast Cancer
Authors: Kirkham et al. Publication Date: Dec 2020
A nonrandomized clinical trial examining. chemotherapy treatment tolerance and survival among women receiving adjuvant chemotherapy for early-stage breast cancer. The intervention group participated in a single-arm trial of supervised aerobic and resistance exercise programming, while a historical control group did not receive structured exercise programming.
- The relative risk of a chemotherapy dose reduction or delay did not differ between groups.
- There were no differences between groups in risk of anemia, neutropenia, or weight gain.
- Exercise programming during adjuvant chemotherapy does not appear to impact treatment tolerance or survival in women receiving common modern regimens of adjuvant chemotherapy for early-stage breast cancer. Exercise may provide selective benefits based on treatment regimen provided.
ACSM Roundtable: Report on Physical Activity, Sedentary Behaviour, and Cancer Prevention and Control
Authors: Patel et al. Publication Date: Nov 2019
In 2018, the American College of Sports Medicine conducted a roundtable to evaluate and translate the evidence linking physical activity with cancer prevention, treatment, and control.
- There are several mechanisms that physical activity can influence cancer risk
- Physical activity facilitates the prevention of various cancer types including breast, colon, endometrial, kidney, colon and lung.
- Being physically active before and after diagnosis is likely an important factor for improved survival in those diagnosed with breast and colon cancer.
Engaging Clinicians to Help Patients Move Through Cancer
Authors: Schmitz et al. Publication Date: Oct 2019
Although exercise has been shown to be of benefit to people living with and beyond cancer for the prevention and treatment of a variety of cancer health-related outcomes, many individuals are not regularly physically active. The authors of this propose the use of the American College of Sports Medicine’s Exercise is Medicine initiative to address the gap in physical activity levels amongst individuals living with and beyond cancer.
- The authors propose that clinicians should readily assess, advise, and refer patients to various modalities of outpatient rehabilitation, including home-based, community-based, and/or virtual programs.
- Call to Action: Implementation challenges include limited capacity for triage and referral, need for program registry, costs and compensation, and workforce development. These challenges will require the engagement of key stakeholders to create an infrastructure and implement the appropriate modifications and adaptations so individuals living with and beyond cancer can be as active as can be.
Exercise Guidelines for Cancer Survivors
Authors: Campbell et al. Publication Date: June 2019
A consensus statement from an ACSM roundtable states that exercise training is safe for cancer survivors and can improve physical fitness, restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue.
- Aerobic, resistance, and combined aerobic plus resistance training can improve common cancer-related health outcomes when performed in specific doses
- Moderate-intensity aerobic training three times per week or twice weekly combined aerobic plus resistance training can reduce anxiety, depressive symptoms, and fatigue during and after treatment.
- Combined moderate-intensity aerobic and resistance exercise performed two to three times per week results in improvements in health-related quality of life.
- A general supervised progressive program (“start low, progress slow”) performed two to three times per week is safe for individuals living with lymphedema.
- Moderate-intensity aerobic, resistance, and/or combined training performed three times weekly can significantly improve self-reported physical function.
Exercise as part of routine cancer care
Authors: Santa Mina et al. Publication Date: Sept 2018
The authors consider evidence of concerns about delivering exercise services for people with cancer, and the growing desire for exercise services by patients and their health-care teams.