Effect of self-regulatory behaviour change techniques and predictors of physical activity maintenance in cancer survivors: a 12-month follow-up of the Phys-Can RCT.

BACKGROUND: Current knowledge about the promotion of long-term physical activity (PA) maintenance in cancer survivors is limited. The aims of this study were to 1) determine the effect of self-regulatory BCTs on long-term PA maintenance, and 2) identify predictors of long-term PA maintenance in cancer survivors 12 months after participating in a six-month exercise intervention during cancer treatment. METHODS: In a multicentre study with a 2 × 2 factorial design, the Phys-Can RCT, 577 participants with curable breast, colorectal or prostate cancer and starting their cancer treatment, were randomized to high intensity exercise with or without self-regulatory behaviour change techniques (BCTs; e.g. goal-setting and self-monitoring) or low-to-moderate intensity exercise with or without self-regulatory BCTs. Participants' level of PA was assessed at the end of the exercise intervention and 12 months later (i.e. 12-month follow-up), using a PA monitor and a PA diary. Participants were categorized as either maintainers (change in minutes/week of aerobic PA ≥ 0 and/or change in number of sessions/week of resistance training ≥0) or non-maintainers. Data on potential predictors were collected at baseline and at the end of the exercise intervention. Multiple logistic regression analyses were performed to answer both research questions. RESULTS: A total of 301 participants (52%) completed the data assessments. A main effect of BCTs on PA maintenance was found (OR = 1.80, 95%CI [1.05-3.08]) at 12-month follow-up. Participants reporting higher health-related quality-of-life (HRQoL) (OR = 1.03, 95%CI [1.00-1.06] and higher exercise motivation (OR = 1.02, 95%CI [1.00-1.04]) at baseline were more likely to maintain PA levels at 12-month follow-up. Participants with higher exercise expectations (OR = 0.88, 95%CI [0.78-0.99]) and a history of tobacco use at baseline (OR = 0.43, 95%CI [0.21-0.86]) were less likely to maintain PA levels at 12-month follow-up. Finally, participants with greater BMI increases over the course of the exercise intervention (OR = 0.63, 95%CI [0.44-0.90]) were less likely to maintain their PA levels at 12-month follow-up. CONCLUSIONS: Self-regulatory BCTs improved PA maintenance at 12-month follow-up and can be recommended to cancer survivors for long-term PA maintenance. Such support should be considered especially for patients with low HRQoL, low exercise motivation, high exercise expectations or with a history of tobacco use at the start of their cancer treatment, as well as for those gaining weight during their treatment. However, more experimental studies are needed to investigate the efficacy of individual or combinations of BCTs in broader clinical populations. TRIAL REGISTRATION: NCT02473003 (10/10/2014).

Efeito agudo da corrida aeróbica na pressão arterial em jovens adultos normotensos / Acute effects of aerobic running on blood pressure in young normotens adults

RESUMO O objetivo do presente estudo foi investigar o efeito hipotensivo induzido pela corrida aeróbica em jovens adultos. Trinta e um indivíduos (18 mulheres e 13 homens) foram submetidos a uma avaliação antropométrica e o protocolo de corrida proposto em uma esteira ergométrica durante 40 min entre 60 a 70% da frequência cardíaca de reserva. Realizaram-se medidas da pressão arterial sistólica (PAS) e pressão arterial diastólica (PAD) que posteriormente foram comparados antes e ao final do protocolo de corrida através do teste t de Student para as variáveis dependentes. Todos os testes foram assumidos com α = 0,05. Em comparação com a PAS antes (127,1 ± 11,5 mmHg) e após (119,9 ± 10,2 mmHg) a corrida, os resultados obtidos evidenciaram uma diminuição da pressão arterial sistólica, o qual resultou uma diferença média de -7,2 ± 6,2 mmHg, demonstrando uma diferença significativa (p = 0,00001). Entretanto, na PAD antes (73,6 ± 8,6 mmHg) e após (72,5 ± 7,8 mmHg) não demonstrou uma diferença significativa (p = 0,36) como efeito agudo na diminuição após a corrida. Portanto, conclui-se que a corrida em moderada intensidade e longa duração pode ser auxiliado no tratamento não farmacológico da hipertensão arterial e como melhoria na saúde cardiovascular.

ABSTRACT The aim of the present study was to investigate the acute effects of blood pressure induced by moderate intensity aerobic exercise in young adults. Thirty-one individuals (18 women and 13 men) were submitted an anthropometric evaluation and a 40-min running protocol between 60% and 70% of the reserve heart rate. Hemodynamic measurements, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were carried out before and after the running protocol through Student's t-test for the dependent variables. All tests assumed α = 0.05. Significant differences were recorded between SBP before (127.1 ± 11.5 mmHg) and after (119.9 ± 10.2 mmHg) the running protocol. The results showed a decrease in systolic blood pressure, which resulted in a mean difference of -7.2 ± 6.2 mmHg, demonstrating a significant difference (p = 0.00001). However, in the DBP before (73.6 ± 8.6 mmHg) and after (72.5 ± 7.8 mmHg) no showing a significant difference (p = 0.36) as an acute effect on the decrease the running protocol. In conclusion, that moderate intensity and long duration running exercise can be aided in the non-pharmacological treatment of arterial hypertension and as an improvement in cardiovascular health.

Is Endurance Exercise Safe? The Myth of Pheidippides.

With the increase in participation in endurance events in the general population, patient concern may arise as to whether endurance exercise is safe. Acute but not chronic increases in blood urea nitrogen, creatinine, and urine albumin occur in endurance exercise. Iron-deficiency anemia may be observed in female athletes. Upper respiratory illness is increased in elite athletes but decreased in intense recreational athletes. No convincing evidence of developing osteoarthritis exists. Common gastrointestinal symptoms occur and isolated reports of gastrointestinal bleeding exist. Nevi are increased and the minimal erythematous dose is decreased. Exercising in the presence of air pollution has negative pulmonary effects, but overall, benefit exists. Numerous reports pertain to the cardiovascular system. The risk of cardiac arrest increases during exercise, troponin is elevated after exercise, and a predisposition for atrial fibrillation exists. Ventricular myocardial scar formation as assessed by gadolinium enhancement on magnetic resonance imaging is inconsistently observed, and increased coronary plaque of a more stable variety is reported. Left ventricular compliance is chronically increased and no decrease in longevity is found. Although some concerns exist, endurance exercise is safe.

Efeitos de exercícios resistidos, de equilíbrio e alongamentos sobre a mobilidade funcional de idosas com baixa massa óssea / Effects of resistance, balance and stretching on functional mobility in elderly with low bone mass

O envelhecimento é caracterizado por degeneração da função neuromuscular traduzida por diminuição da força muscular, do equilíbrio e da coordenação. Este estudo visou avaliar os efeitos de programas de exercícios resistidos, de equilíbrio e de alongamentos sobre a mobilidade funcional em idosas com baixa massa óssea. 36 voluntárias foram aleatorizadas em dois grupos: G1 [n=18; 69,4 ± 6,8 anos] e G2 [n=18; 69,4 ± 5,7 anos] e avaliadas através do Teste Sentar-levantar com 5 repetições (STS-5), Teste de Caminhada de seis metros (SMW) e Teste de Alcance funcional (FRT). O programa de exercício foi aplicado durante 4 meses, 2 vezes por semana, com treinamento de força muscular e mobilidade funcional para G1, e alongamentos e palestras informativas para G2. Após a intervenção os indivíduos de ambos os grupos diminuíram o tempo de realização do STS-5 (G1= 12,6±3,5 vs. 8,4±1,3 s, p=0,01; G2= 12,2±2,6 vs. 8,1±1,3 s, p= 0,00), bem como do SMW (G1= 4,4±1,2 vs. 3,9±0,8 s, p=0,014; G2= 4,2±0,5 vs. 3,6±0,4s, p= 0,000), enquanto se evidenciou aumento do alcance no FRT (G1=26,4±4,9 vs. 31,6±5,0 cm, p= 0,001; G2= 24,6±4,8 vs. 30,3±4,3 cm, p=0,001). Os nossos resultados permitem concluir que foram encontradas melhoras em ambos os grupos estudados e que os exercícios físicos propostos são capazes de trazer benefícios para idosas com baixa massa óssea, através de melhora na sua mobilidade funcional.

Aging is characterized by neuromuscular function degeneration reflected on a decrease of muscle strength, balance and coordination. This study aimed to evaluate the effects of resistance, balance and stretching exercise programs on functional mobility in community-dwelling elderly with low bone mass. 36 volunteers were randomized into two groups: G1 [n=18; 69.4 ± 6.8 years] e G2 [n=18; 69.4 ± 5.7 years] which were evaluated using the Sit-to-stand-5 Test (STS-5), Six metre walk test (SMW) and Functional Reach Test (FRT). The exercise program was applied for 4 months, two times per week, with muscle strength and functional mobility training for G1, and stretching and informative lectures for G2. After the intervention, individuals from both groups decreased their time of performance in STS-5 (G1= 12.6±3.5 vs. 8.4±1.3 s, p=0.01; G2= 12.2±2.6 vs. 8.1±1.3 s, p= 0.00), as well as in SMW (G1= 4.4±1.2 vs. 3.9±0.8 s, p=0.014; G2= 4.2±0.5 vs. 3.6±0.4 s, p= 0,000), while an increase in the reach of FRT was evident (G1 = 26.4±4.9 vs. 31.6±5.0 cm, p= 0.001; G2 = 24.6±4.8 vs. 30.3±4.3 cm, p=0.001). The results indicate that improvements were found in both studied groups and that the proposed exercise programs are able to provide benefits for elderly with low bone mass, throughout the improvement in their functional mobility.

Reprodutibilidade interavaliadores da identificação da redução da cadência em exercícios de força / Inter-rater reliability of reduction in cadence identification during resistance exercises

O objetivo deste estudo foi verificar a concordância interavaliadores na identificação da redução da cadência em exercícios de força. Dez universitários, com experiência prévia em treinamento de força realizaram 3 séries até a fadiga concêntrica, com 2 minutos de intervalo em 6 exercícios (leg press 45°, supino horizontal, extensão do joelho, remada baixa, flexão do joelho e elevação frontal). Dois avaliadores independentes registraram o momento da redução da cadência. Para a análise estatística utilizou o teste de Wilcoxon e o Coeficiente de correlação intraclasse (CCI), com p < 0,05. Verificou-se que a redução da cadência identificada pelos dois avaliadores foi similar em todos os exercícios (p>0,05). O CCI variou de 0,77 a 0,96. Conclui-se que a identificação da redução da cadência nos exercícios de força apresenta boa reprodutibilidade interavaliadores.

The aim of this study was to analyze the inter-rater reliability of the reduction of cadence identification. Ten subjects with previous experience in strength training performed three sets in six exercises (leg press 45°, bench press, leg extension, low rowing, seated leg curl and frontal raises) until concentric failure. Two independent raters analyzed the moment of the reduction in cadence. Statistical analysis was performed with Wilcoxon test and the intraclass correlation coefficient (ICC), with p <0.05. The identification of the reduction in cadence was similar between raters in all exercises. The ICC ranged from 0,77 to 0,96 .In conclusion, the results of this study suggests that the identification of the reduction in cadence present good inter-rater reliability.