Hydration status and fluid and sodium balance in elite Canadian junior women's soccer players in a cool environment.

Dehydration can impair mental and on-field performance in soccer athletes; however, there is little data available from the female adolescent player. There is a lack of research investigating fluid and electrolyte losses in cool temperatures. Therefore, the purpose of this study was to investigate the pretraining hydration status, fluid balance, and sweat sodium loss in 34 female Canadian junior elite soccer athletes (mean age ± SD, 15.7 ± 0.7 years) in a cool environment. Data were collected during two 90 min on-field training sessions (9.8 ± 3.3 °C, 63% ± 12% relative humidity). Prepractice urine specific gravity (USG), sweat loss (pre- and post-training body mass), and sweat sodium concentration (regional sweat patch method) were measured at each session. Paired t tests were used to identify significant differences between training sessions and Pearson's product moment correlation analysis was used to assess any relationships between selected variables (p ≤ 0.05). We found that 45% of players presented to practice in a hypohydrated state (USG > 1.020). Mean percent body mass loss was 0.84% ± 0.07% and sweat loss was 0.69 ± 0.54 L. Although available during each training session, fluid intake was low (63.6% of players consumed <250 mL). Mean sweat sodium concentration was 48 ± 12 mmol·L⁻¹. Despite low sweat and moderate sodium losses, players did not drink enough to avoid mild fluid and sodium deficits during training. The findings from this study highlights the individual variations that occur in hydration management in athletes and thus the need for personalized hydration guidelines.

Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy.

OBJECTIVE: To evaluate tolerability and compliance to a walking exercise program and its effect on fatigue during and after radical external beam radiation therapy (EBRT) for prostate cancer. METHODS: A total of 50 subjects with prostate cancer undergoing EBRT over 6 to 8 weeks were prospectively accrued to an exercise intervention group, matched for age and clinical characteristics to 30 subjects in a historical control group who underwent EBRT with no specific exercise intervention. Starting 1 week before EBRT, exercise participants performed moderate-intensity walking targeting 60% to 70% age-predicted maximum heart rate, at least 20 min/d, 3 d/wk over 12 weeks. The Brief Fatigue Inventory was administered at baseline, mid-EBRT (week 3-4), end-EBRT (week 6-8), and 6 months post-EBRT. RESULTS: Of 50, 42 (84%) of exercise participants completed the walking program. There were no cardiovascular complications, musculoskeletal injuries, or other adverse events. A total of 89% subjects reported "Good-Excellent" satisfaction during and up to 6 months post-EBRT. Fatigue in control subjects escalated from baseline to end-EBRT, remaining high at 6 months post-EBRT (P[r] = 0.03). In contrast, mean total fatigue scores in exercise subjects were stable from baseline up to 6 months post-EBRT (P = 0.52). Trends for higher fatigue interference with quality of life were observed in the control group as compared with the exercise group. CONCLUSIONS: Moderate-intensity walking exercise during radical EBRT is safe and feasible. The high convenience and satisfaction ratings, in conjunction with the observed fatigue trends, indicate that this activity has the potential to attenuate fatigue and improve quality of life for patients with localized prostate cancer undergoing curative therapy.

Progressive resistance training in breast cancer: a systematic review of clinical trials.

BACKGROUND: Progressive resistance training (PRT) may be effective for targeting the sequelae of breast cancer and its treatment given the unique anabolic nature of this exercise modality. Therefore, our objectives were: (1) to systematically review studies that have prescribed PRT after breast cancer surgery, (2) to summarize the efficacy of PRT in this cohort, and (3) to delineate areas for future investigations. METHOD: A systematic review using computerized databases was performed. RESULTS: The systematic review located 10 trials: Four uncontrolled trials, one controlled trial and five randomized controlled trials (RCTs). PRT was prescribed with aerobic training in 8/10 trials reviewed, and in isolation in 2/10 trials reviewed. Upper body PRT was prescribed in 7/10 trials, including 4/5 RCTs. No exacerbation of objectively measured or subjectively reported lymphedema symptoms was reported in any of these trials. Adverse events were rare, generally musculoskeletal in nature, and were managed effectively by conservative means. Overall, the studies we reviewed suggest that women surgically treated for breast cancer can derive health-related and clinical benefits by performing PRT after breast cancer surgery. Further research may be required to stimulate greater advocacy for PRT among oncologists, and in community care settings. CONCLUSIONS: Robustly designed RCTs prescribing targeted PRT regimens throughout various phases of breast cancer treatment are warranted. RCTs with thorough, standardized reporting of interventions and adverse events are required to establish the efficacy of this intervention for the post-treatment management of breast cancer patients and survivors as a means to improve health status and quality of life.

Reliability and validity testing of the Patient and Observer Scar Assessment Scale in evaluating linear scars after breast cancer surgery.

BACKGROUND: The Patient and Observer Scar Assessment Scale is a promising new method incorporating observer and patient ratings in evaluating burn scars. The authors compared this tool to the Vancouver Scar Scale in a cohort of women with linear scars from breast cancer surgery. METHODS: Twenty women with newly diagnosed breast cancer were prospectively accrued. Thirty-one scars were evaluated. The median time from surgery to scar assessment was 8 weeks (range, 3 to 25 weeks). Observer assessment was performed by three independent raters using the Vancouver scale and the observer component of the new tool. Patient self-assessment was performed using the patient component of the tool. Internal consistency, interobserver reliability, and convergent validity were examined. RESULTS: Internal consistency was acceptable for the Vancouver scale and both components of the new tool (Cronbach's alpha, 0.71, 0.74, and 0.77, respectively). Interobserver reliability was substantial with both the Vancouver scale and the observer tool (average measure intraclass coefficient correlation, 0.78 and 0.60, respectively). The observer tool and Vancouver scale correlated significantly with each other (p < 0.001), but only the observer tool correlated well with patients' ratings (p = 0.04). CONCLUSIONS: In surgical scar assessment, the new Patient and Observer Scar Assessment Scale and Vancouver Scar Scale were both associated with acceptable internal consistency and interobserver reliability. The new tool is more comprehensive and has higher correlation with patients' ratings. These findings support the use of the new tool as a reliable, valid, and comprehensive approach to assess linear surgical scars.

Prospective evaluation of the prevalence and severity of fatigue in patients with prostate cancer undergoing radical external beam radiotherapy and neoadjuvant hormone therapy.

OBJECTIVE: To prospectively evaluate the prevalence and severity of fatigue and its impact on quality of life (QOL) during and after radical external beam radiotherapy (RT) for prostate cancer. METHOD AND MATERIALS: Twenty-eight men with prostate cancer undergoing RT over 6-8 consecutive weeks were prospectively accrued. The Brief Fatigue Inventory (BFI), a validated fatigue assessment tool, was administered at five time points: baseline (week 1), middle of RT (week 3-4), end of RT (last week of RT), and follow-up (median 6.5 weeks after RT). The BFI contained nine questions, each using 0-10 ratings to quantify fatigue severity and interference with six QOL domains. The prevalence of moderate-severe fatigue was plotted as a function of time. Mean sum and subscale scores at each time point were compared to baseline scores using Wilcoxon tests. Linear regression analyses were performed to assess associations between fatigue scores and age, tumor and treatment characteristics. RESULTS: The median age was 69 years (range 57-84), Gleason score 7 (range 6-10), and presenting PSA 9.0 ng/mL (range 2.5 ng/mL-103.0 ng/mL). Patients were treated once daily to a median dose of 74 Gy (range 60 Gy-78 Gy) over a median of 37 fractions (range 30-39). Hormone therapy was used in all patients (median duration 12.2 months). The prevalence of moderate-severe present fatigue increased from 7% at baseline to 8% at mid-RT and 32% at RT completion. Compared to baseline (mean score 11.5), fatigue increased significantly mid-RT (mean score 14.6, p = 0.03) and peaked at the end of RT (mean score 23.5, p = 0.001). Fatigue significantly interfered with walking ability, normal work, daily chores, and enjoyment of life only at the end of RT. After RT completion, fatigue improved but remained higher compared to baseline at 6.5 weeks of follow-up (mean score 15.0, p = 0.02). On linear regression analysis, age, Gleason score, PSA, T-stage, hormone therapy duration, RT dose and fractions were not significantly associated with mean fatigue scores. CONCLUSION: Patients undergoing 6-8 weeks of RT experienced significant fatigue adversely affecting QOL persisting after therapy completion. Since walking ability was not affected until the end of RT, a walking exercise intervention to combat fatigue is likely feasible and is being investigated.

Full-body exercise training improves fitness and quality of life in survivors of breast cancer.

This study evaluated the safety and effectiveness of an 8-week full-body resistance and aerobic exercise program for 27 survivors of breast cancer (age, 57.7 +/- 7.2 years; years posttreatment, 0.8- 21.0) with prior upper-body conditioning. Physical fitness and quality-of-life (QOL) measures were obtained before and after the training period. Lymphedema, evaluated via arm volume measurement at baseline, was self-monitored throughout the trial. Sum of skinfolds, waist girth, and hip girth were significantly reduced posttraining (p < 0.01), although body weight did not change. Significant improvements (p < 0.01) were observed in upper-body strength (35.6 +/- 16.4%) and endurance (167.4 +/- 55.4%), lower-body strength (50.7 +/- 32.3%) and endurance (273.1 +/- 120.7%), Vo(2peak), trunk flexibility, and flexibility of the ipsilateral (surgical) and contralateral shoulder joint. Psychological QOL and overall QOL, evaluated via the World Health Organization Quality of Life Assessment Scale-Abbreviated Version. Inventory also improved significantly (p < 0.01). No incidents of lymphedema or injury were reported. These findings suggest that survivors of breast cancer can safely benefit from engaging in a full-body exercise regimen.