'Just because I have prostate cancer doesn't mean that I can't do things' - men's experiences of the acceptability of an exercise intervention for prostate cancer during treatment.

BACKGROUND: Structured exercise has an important role in mitigating the extensive side effects caused by ongoing prostate cancer treatments, specifically androgen deprivation therapy (ADT) and radiation therapy (RT). Little is known about men's experiences of, and preferences for, structured exercise programmes during active cancer treatment. This study aimed to inform the acceptability of a 6-month supervised intervention that emphasised increasing and varied intensities of aerobic and resistance exercise, by exploring the experiences of men who participated. METHODS: Individual semi-structured interviews were conducted with an interviewer independent of the exercise study and data was analysed using a descriptive qualitative design. RESULTS: Twelve prostate cancer patients were interviewed including participants who completed (n = 9) and withdrew from (n = 3) the intervention. Four main themes captured how men experienced the intervention: (1) Navigating the Unknown: Building confidence amidst vulnerability (subtheme- pushing the limits), (2) Building Trust: The credibility and approach of the exercise instructor (subtheme- appropriateness of supervised vs. independent exercise), (3) Flexibility in Delivery, (4) Finding Purpose: Exercise as a means of escapism and regaining control during treatment. CONCLUSION: While an initial lack of self-confidence can be a barrier to exercise participation, exercise programmes have the potential to provide psychosocial benefits, rebuild confidence and empower men throughout their cancer treatment and into recovery. Structured exercise is acceptable during treatment including RT and can offer a form of escapism and sense of control for men navigating their cancer journey. Trust building, flexible delivery and credibility alongside a challenging exercise prescription are important facilitators of acceptability for men. Strategies to embed exercise from the point of diagnosis through ADT and RT should reflect men's experiences of exercise during treatment. TRIAL REGISTRATION: The trial has been registered on ClinicalTrials.gov as of the 14th of December 2021 (NCT05156424).

Evaluating individual level change in physical function response following an exercise program for cancer survivors.

PURPOSE: Cancer survivors physical function response to exercise programs at the group level is well-established. However, to advance toward a more personalized approach in exercise oncology, a greater understanding of individual response is needed. This study utilized data from a well-established cancer-exercise program to evaluate the heterogeneity of physical function response and explore characteristics of participants who did vs. did not achieve a minimal clinically important difference (MCID). METHODS: Physical function measures (grip strength, 6-min walk test (6MWT), and sit-to-stand) were completed pre/post the 3-month program. Change scores for each participant and the proportion achieving the MCID for each physical function measure were calculated. The independent t-tests, Fisher's exact test, and decision tree analyses were used to explore differences in age, body mass index (BMI), treatment status, exercise session attendance, and baseline value between participants who achieved the MCID vs. those who did not. RESULTS: Participants (N = 250) were 55 ± 14 years old, majority female (69.2%), white (84.1%), and diagnosed with breast cancer (36.8%). Change in grip strength ranged from - 42.1 to + 47.0 lb, and 14.8% achieved the MCID. Change in 6MWT ranged from - 151 to + 252 m, and 59% achieved the MCID. Change in sit-to-stand ranged from - 13 to + 20 reps, and 63% achieved the MCID. Baseline grip strength, age, BMI, and exercise session attendance were related to achieving MCID. CONCLUSIONS: Findings illustrate wide variability in the magnitude of cancer survivors' physical function response following an exercise program, and that a variety of factors predict response. Further investigation into the biological, behavioral, physiological, and genetic factors will inform tailoring of exercise interventions and programs to maximize the proportion of cancer survivors who can derive clinically meaningful benefits.

Implementation During a Pandemic: Findings, Successes, and Lessons Learned from Community Grantees.

Funding communities through mini-grant programs builds community capacity by fostering leadership among community members, developing expertise in implementing evidence-based practices, and increasing trust in partnerships. The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities among high-risk populations in rural areas of the state. One community-based organization and one faith-based organization were funded during the most recent call for proposals. The organizations implemented National Cancer Institute evidence-based strategies and programs focused on health and cancer screenings and physical activity and promotion of walking trails. Despite the potential for the COVID-19 pandemic to serve as a major barrier to implementation, grantees successfully recruited and engaged community members in evidence-based activities. These initiatives added material benefits to their local communities, including promotion of walking outdoors where it is less likely to contract the virus when socially distanced and provision of COVID-19 testing and vaccines along with other health and cancer screenings. Future mini-grants programs will benefit from learning from current grantees' flexibility in program implementation during a pandemic as well as their intentional approach to modifying program aspects as needed.

Effects of a Group-Mediated Exercise and Dietary Intervention in the Treatment of Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: Results From the IDEA-P Trial.

Background: Although androgen-deprivation therapy (ADT) is the foundation of treatment for prostate cancer, the physiological impacts of ADT result in functional decline and enhanced risk of chronic disease and metabolic syndrome. Purpose: The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is a single-blind, randomized, pilot trial comparing the effects of a group-mediated, cognitive-behavioral (GMCB) exercise and dietary intervention (EX+D) with those of a standard-of-care (SC) control during the treatment of prostate cancer patients undergoing ADT. Methods: A total of 32 prostate cancer patients (M age = 66.28, SD = 7.79) undergoing ADT were randomly assigned to the 12-week EX+D intervention (n = 16) or control (n = 16). The primary outcome in IDEA-P was change in mobility performance with secondary outcomes including body composition and muscular strength. Blinded assessment of outcomes were obtained at baseline and at 2- and 3-month follow-ups. Results: Favorable adherence and retention rates were observed, and no serious intervention-related adverse events were documented. Intent-to-treat ANCOVA controlling for baseline value and ADT duration demonstrated that EX+D resulted in significantly greater improvements in mobility performance (p < .02), muscular strength (p < .01), body fat percentage (p < .05), and fat mass (p < .03) at 3-month follow-up, relative to control. Conclusion: Findings from the IDEA-P trial suggest that a GMCB-based EX+D intervention resulted in significant, clinically meaningful improvements in mobility performance, muscular strength, and body composition, relative to controls. Collectively, these results suggest that the EX+D was a safe and well-tolerated intervention for prostate cancer patients on ADT. The utility of implementing this approach in the treatment of prostate cancer patients on ADT should be evaluated in future large-scale efficacy trials. Clinical Trial information: NCT02050906.

Monitoring Resistance Exercise Intensity Using Ratings of Perceived Exertion in Previously Untrained Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy.

Fairman, CM, LaFountain, RL, Lucas, AR, and Focht, BC. Monitoring resistance exercise intensity using ratings of perceived exertion (RPE) in previously untrained patients with prostate cancer undergoing androgen deprivation therapy. J Strength Cond Res 32(5): 1360-1365, 2018-Exercise has been shown to be safe and effective for patients with prostate cancer (PrCa). The monitoring of resistance exercise (RE) intensity is an emerging area of interest in RE prescription. Rating of perceived exertion (RPE) is one of the most commonly used methods but has not yet been validated in this population. Thus, the purpose of this study was to examine the relationship between RPE and RE intensity in PrCa. Data for this study were abstracted from baseline upper- and lower-body strength assessments from 2 previous trials (Individual Diet and Exercise Adherence Pilot Trial; Livestrong, Austin, TX, USA) in our laboratory investigating functional outcomes in patients with PrCa undergoing androgen deprivation therapy (ADT). A total of 75 participants from both trials were included in this study. Ratings of perceived exertion corresponding to 50, 70, and 90% 1 repetition maximum (1RM) were extracted from the results of participants' upper- and lower-body 1RM strength tests. The changes in RPE across increasing intensities were assessed using separate univariate analysis of variance (ANOVA). For each ANOVA, RPE was used as the dependent variable and intensity (50, 70, and 90%) used as the fixed factor. A univariate ANOVA revealed a significant difference (p ≤ 0.05) among the RPE values for each intensity for both upper- and lower-body lifts. The results of our analyses suggest that RPE values rise linearly in response to increases in exercise intensity. Our study supports the concept that RPE may be a practical training tool to accurately estimate RE intensity in PrCa survivors undergoing ADT. Practitioners may consider using RPE to monitor and adjust RE intensity in this population.

A group-mediated physical activity intervention in older knee osteoarthritis patients: effects on social cognitive outcomes.

The objective of the present study was to compare a group-mediated cognitive behavioral (GMCB) physical activity intervention with traditional exercise therapy (TRAD) upon select social cognitive outcomes in sedentary knee osteoarthritis (knee OA) patients. A total of 80 patients (mean age = 63.5 years; 84% women) were recruited using clinic and community-based strategies to a 12-month, single-blind, two-arm, randomized controlled trial. Mobility-related self-efficacy, self-regulatory self-efficacy (SRSE), and satisfaction with physical function (SPF) were assessed at baseline, 3, and 12 months. Results of intent-to-treat 2 (Treatment: GMCB and TRAD) × 2 (Time: 3 and 12 month) analyses of covariance yielded significantly greater increases in SRSE and SPF (P < 0.01) relative to TRAD. Partial correlations revealed that changes in SRSE and SPF were significantly related (P < 0.05) to improvements in physical activity and mobility at 3 and 12-months. The GMCB intervention yielded more favorable effects on important social cognitive outcomes than TRAD; these effects were related to improvements in physical activity and mobility.

Ratings of Perceived Exertion During Acute Resistance Exercise Performed at Imposed and Self-Selected Loads in Recreationally Trained Women.

Cotter, JA, Garver, MJ, Dinyer, TK, Fairman, CM, and Focht, BC. Ratings of perceived exertion during acute resistance exercise performed at imposed and self-selected loads in recreationally trained women. J Strength Cond Res 31(8): 2313-2318, 2017-Resistance exercise (RE) is commonly used to elicit skeletal muscle adaptation. Relative intensity of a training load links closely with the outcomes of regular RE. This study examined the rating of perceived exertion (RPE) responses to acute bouts of RE using imposed (40% and 70% of 1 repetition maximum [1RM]) and self-selected (SS) loads in recreationally trained women. Twenty physically active women (23.15 ± 2.92 years), who reported regular RE training of at least 3 weekly sessions for the past year, volunteered to participate. During the initial visit, participants completed 1RM testing on 4 exercises in the following order: leg extension, chest press, leg curl, and lat pull-down. On subsequent visits, the same exercises were completed at the SS or imposed loads. The RPE was assessed after the completion of each set of exercises during the 3 RE conditions using the Borg-15 category scale. Self-selected loads corresponded to an average of approximately 57%1RM (±7.62). Overall, RPE increased with load (40%1RM = 11.26 [±1.95]; SS 57%1RM = 13.94 [±1.58]; and, 70%1RM = 15.52 [±2.05]). Reflecting the linear pattern found between load and perceived effort, the present data provide evidence that RPE levels less than 15 likely equate to loads which are not consistent with contemporary American College of Sports Medicine (ACSM) guidelines for enhancing musculoskeletal health which includes strength and hypertrophy. Women desiring increases in strength and lean mass likely need to train at an exertion level at or surpassing a rating of 15 on the Borg-15 category. This article examined the modification of training load on perceived exertion, but other variables, such as the number of repetitions completed, may also be targeted to achieve a desired RPE. The primary understanding is that women who engage in RE may not self-select loads that are consistent with the ACSM recommendations for musculoskeletal health.

Use of B-Mode Ultrasound as a Body Fat Estimate in Collegiate Football Players.

Hyde, PN, Kendall, KL, Fairman, CM, Coker, NA, Yarbrough, ME, and Rossi, SJ. Utilization of B-mode ultrasound as a body fat estimate in collegiate football players. J Strength Cond Res 30(12): 3525-3530, 2016-The purpose of the present study was to validate a 7-site ultrasound imaging protocol to predict the percent body fat (%BF) in a division I football team. Body composition was estimated by ultrasound, 7-site skinfolds, and the 3-compartment-water (3C-W) model of Siri, using bioimpedance spectroscopy to estimate the total body water and air displacement plethysmography (using BODPOD) to determine the body density. Pearson's product-moment correlation analyses were run to determine correlations between ΣUltrasound and the criterion 3C-W, and between the ΣSkinfold and ΣUltrasound. Strong positive correlations were observed between ΣSkinfold and ΣUltrasound (r = 0.984; p < 0.001). Furthermore, a strong positive correlation was observed between ΣUltrasound and %BF from 3C-W (r = 0.878; p < 0.001). Based on the significant correlation analysis, a linear regression equation was developed to predict the %BF from ΣUltrasound, using %BF from the 3C-W model as the dependent variable: %BF = 6.194 + (0.096 × ΣUltrasound); standard error of the estimate (SEE) = 2.97%. Cross-validation analyses were performed using an independent sample of 29 players. The mean observed %BF from the 3C-W model and the mean predicted %BF were 18.32 ± 6.26% and 18.78 ± 6.22%, respectively. The constant error, SEE, and validity coefficient (r) were 0.87%, 2.64%, and 0.91%, respectively. The total error was 2.87%. The positive relationship between ultrasound measurements and the 3C-W model suggests that ultrasound imaging may be a practical alternative to predicting %BF in division I football players.

Affective Responses to Acute Resistance Exercise Performed at Self-Selected and Imposed Loads in Trained Women.

The purpose of this study was to examine the affective responses to acute resistance exercise (RE) performed at self-selected (SS) and imposed loads in recreationally trained women. Secondary purposes were to (a) examine differences in correlates of motivation for future participation in RE and (b) determine whether affective responses to RE were related to these select motivational correlates of RE participation. Twenty recreationally trained young women (mean age = 23 years) completed 3 RE sessions involving 3 sets of 10 repetitions using loads of 40% of 1 repetition maximum (1RM), 70% 1RM, and an SS load. Affective responses were assessed before, during, and after each RE session using the Feeling Scale. Self-efficacy and intention for using the imposed and SS loads for their regular RE participation during the next month were also assessed postexercise. Results revealed that although the SS and imposed load RE sessions yielded different trajectories of change in affect during exercise (p < 0.01), comparable improvements in affect emerged after RE. Additionally, the SS condition was associated with the highest ratings of self-efficacy and intention for future RE participation (p < 0.01), but affective responses to acute RE were unrelated to self-efficacy or intention. It is concluded that acute bouts of SS and imposed load RE resulted in comparable improvements in affect; recreationally trained women reported the highest self-efficacy and intention to use the load chosen in SS condition in their own resistance training; and affective responses were unrelated to motivational correlates of resistance training.