Development, implementation, and effects of a cancer center's exercise-oncology program.

BACKGROUND: National and international bodies acknowledge the benefit of exercise for people with cancer, yet limited accessibility to related programing remains. Given their involvement in managing the disease, cancer centers can play a central role in delivering exercise-oncology services. The authors developed and implemented a clinically integrated exercise-oncology program at a major cancer center and evaluated its effectiveness and participant experience. METHODS: A hospital-based program with prescribed at-home exercise was developed and accepted referrals over a 42-month period (3.5 years). Implementation was conducted in 2 phases: a pilot phase for women with breast cancer and men with genitourinary cancer and a roll-out phase for all patients with cancer. Enrolled patients were assessed and received an exercise prescription as well as a program manual, resistance bands, and a stability ball from a kinesiologist. Program participation and effectiveness were evaluated up to 48 weeks after the baseline assessment using intention-to-treat analyses. Participants in the roll-out phase were asked to complete a program experience questionnaire at the completion of the 48-week follow-up. RESULTS: In total, 112 participants enrolled in the pilot, and 150 enrolled in the roll-out phase. Program attrition to 48 weeks was 48% and 65% in the pilot and roll-out phases, respectively. In participants who consented to research evaluation of their performance, objective and patient-reported measures of functional capacity improved significantly from baseline in both phases. Participants were highly satisfied with the program. CONCLUSIONS: Despite significant drop-out to program endpoints, our cancer-exercise program demonstrated clinically relevant improvement in functional outcomes and was highly appreciated by participants.

Internal social processes of discipline formation: the case of kinanthropometry.

In 1972, the term 'kinanthropometry', derived from the Greek words 'kinein' (to move), 'anthropos' (human) and 'metrein' (to measure), was launched in the international, Francophone journal Kinanthropologie by the Canadian William Ross and the Belgians, Marcel Hebbelinck, Bart Van Gheluwe and Marie-Louise Lemmens. The authors defined this neologism as 'the scientific discipline for the study of the size, shape, proportion, scope and composition of the human being and its gross motor functions'. Presenting a theoretical framework for the analysis of the internal social processes of discipline formation - derived from the social history-of-science tradition - this article critically examines whether kinanthropometry was indeed promoted and developed by its community members as a scientific discipline. Therefore, the focus will be on its conceptualisation and positioning within the field of kinanthropology/kinesiology and on its development by a scholarly association, i.e. the International Working Group on Kinanthropometry (IWGK). The strong emphasis of the kinanthropometry community on the standardisation of measurement techniques and its practical and professional application hampered its disciplinary development. Findings of this study could serve as a basis for future 'fundamental' investigations addressing questions of disciplinary development within the field(s) of physical education, kinesiology and sport science(s).

Multidisciplinary chronic pain management in a rural Canadian setting.

INTRODUCTION: Chronic pain is prevalent, complex and most effectively treated by a multidisciplinary team, particularly if psychosocial issues are dominant. The limited access to and high costs of such services are often prohibitive for the rural patient. We describe the development and 18-month outcomes of a small multidisciplinary chronic pain management program run out of a physician's office in rural Alberta. METHODS: The multidisciplinary team consisted of a family physician, physiatrist, psychologist, physical therapist, kinesiologist, nurse and dietician. The allied health professionals were involved on a part-time basis. The team triaged referral information and patients underwent either a spine or medical care assessment. Based on the findings of the assessment, the team managed the care of patients using 1 of 4 methods: consultation only, interventional spine care, supervised medication management or full multidisciplinary management. We prospectively and serially recorded self-reported measures of pain and disability for the supervised medication management and full multidisciplinary components of the program. RESULTS: Patients achieved clinically and statistically significant improvements in pain and disability. CONCLUSION: Successful multidisciplinary chronic pain management services can be provided in a rural setting.

The effectiveness of a peer-mentored older adult fitness program on perceived physical, mental, and social function.

PURPOSE: The purpose of this research was to compare changes in perceived physical, mental, and social function measured by the Short Form-36 (SF36vr2) in a group of older adults who were trained by peer mentors (PMs) versus a similar group trained by qualified kinesiology student mentors (SMs). DATA SOURCES: We conducted a two-arm repeated measures longitudinal intervention and collected data for 87 PM and 44 SM participants. Pre- and post-training subscale scores were computed for all eight subscales and the two summary physical and mental component scores. The percentage differences in the 10 scores were used as the response variables. CONCLUSIONS: After a 14-week physical fitness intervention, perceived physical, mental, and social functioning improved significantly (p < .05) for the PM group, but not for the SM group (p > .06). Thus, older adults who participated in a physical fitness program with peer support perceived (a) overall improvement in physical and mental well-being; (b) better social functioning, (c) enhanced ability to carry out physical and emotional roles, (d) improved general health, and (e) increased level of vitality. Thus, we conclude that peer-mentored exercise programs for older adults are superior to programs mentored by young professionals and may lead to increased adherence. IMPLICATIONS FOR PRACTICE: Nurse practitioners routinely prescribe exercise while educating older adults about the benefits of an active lifestyle; however, older adults often remain sedentary and exhibit poor adherence to exercise. One potential solution is to use peer support. Two factors that can improve adherence are availability of structured exercise programs for the older adult and peer mentoring.