Does a Resistance Training Program Affect Between-arms Volume Difference and Shoulder-arm Disabilities in Female Breast Cancer Survivors? The Role of Surgery Type and Treatments. Secondary Outcomes of the EFICAN Trial.

OBJECTIVE: The aims were (i) to assess the effects of a 12-week resistance training program on between-arms volume difference and shoulder-arm disabilities in breast cancer survivors and (ii) to evaluate whether the main risk factors for developing cancer-related lymphedema and shoulder-arm disabilities were associated with the effects of the training program. DESIGN: Randomized controlled trial. SETTING: University facilities. PARTICIPANTS: 60 female breast cancer survivors participated. ELIGIBILITY CRITERIA: to be a breast cancer survivor, and to have completed surgery, chemotherapy, and/or radiotherapy up to 10 years before recruitment. EXCLUSION CRITERIA: metastatic breast cancer, a breast reconstruction intervention planned within 6 months, any absolute contraindication for exercise, to perform more than 300 minutes/week of structured exercise. INTERVENTIONS: Participants were randomized to an exercise group (12-week resistance training program) or a control group. MAIN OUTCOME MEASURES: Between-arms volume difference, shoulder-arm disabilities, and upper-limb muscular strength were evaluated at baseline and at week 12. Treatment-related information was registered from medical history. RESULTS: No between-group differences were observed on between-arms volume difference (1.207; 95% CI -0.964, 3.377; P=.270) or shoulder-arm disabilities (2.070; 95% CI -4.362, 8.501; P=.521) after the training program. Likewise, there was no association of surgery type, presence of lymph node resection, chemotherapy, radiotherapy, and hormone therapy with the changes in between-arms volume and perceived shoulder-arm disabilities after the intervention. However, a higher increase in upper limb muscular strength was associated with a reduced shoulder-arm disabilities (-0.429; P=.020) in the exercise group. CONCLUSIONS: The findings suggest that resistance training does not affect between-arms volume difference and shoulder-arm disabilities in female breast cancer survivors. The main risk factors for developing lymphedema were not associated with the effects of the intervention, although a higher increase in upper-limb muscular strength was associated with reduced shoulder-arm disabilities.

Association of physical fitness and fatness with cognitive function in women with fibromyalgia.

This study assessed the association of fitness and fatness with cognitive function in women with fibromyalgia, and the independent influence of their single components on cognitive tasks. A total of 468 women with fibromyalgia were included. Speed of information processing and working memory (Paced Auditory Serial Addition Task), as well as immediate and delayed recall, verbal learning and delayed recognition (Rey Auditory Verbal Learning Test) were assessed. Aerobic fitness, muscle strength, flexibility and motor agility were assessed with the Senior Fitness Test battery. Body mass index, percent body fat, fat-mass index and waist circumference were measured. Aerobic fitness was associated with attention and working memory (all, p < 0.05). All fitness components were generally associated with delayed recall, verbal learning and delayed recognition (all, p < 0.05). Aerobic fitness showed the most powerful association with attention, working memory, delayed recall and verbal learning, while motor agility was the most powerful indicator of delayed recognition. None of the fatness parameters were associated with any of the outcomes (all, p > 0.05). Our results suggest that fitness, but not fatness, is associated with cognitive function in women with fibromyalgia. Aerobic fitness appears to be the most powerful fitness component regarding the cognitive tasks evaluated.

Estimating the one-repetition maximum on the leg-press exercise in female breast cancer survivors.

We examined the accuracy of twelve different velocity-based methods for predicting the bilateral leg-press exercise one-repetition maximum (1RM) in breast cancer survivors. Twenty-one female breast cancer survivors (age 50.2 ± 10.8 years) performed an incremental loading test up to the 1RM. Individual load-velocity relationships were modeled by linear and quadratic polynomial regression models considering the mean velocity (MV) and peak velocity (PV) values recorded at five incremental loads (~45-55-65-75-85% of 1RM) (multiple-point methods) and by a linear regression model considering only the two distant loads (~45-85% of 1RM) (two-point method). The 1RM was always estimated through these load-velocity relationships as the load associated with a general (MV: 0.24 m/s; PV: 0.60 m/s) and an individual (MV and PV of the 1RM trial) minimal velocity threshold (MVT). Compared to the actual 1RM, the 1RMs estimated by all linear regression models showed trivial differences (Hedge's g ranged from 0.08 to 0.17), very large to nearly perfect correlations (r ranged from 0.87 to 0.95), and no heteroscedasticity of the errors (coefficient of determination (r2) < 0.10 obtained from the relationship of the raw differences between the actual and predicted 1RMs with their average value). Given the acceptable and comparable accuracy for all 1RM linear prediction methods, the two-point method and a general MVT could be recommended to simplify the testing procedure of the bilateral leg-press 1RM in breast cancer survivors.

Effects of a 12-week supervised resistance training program, combined with home-based physical activity, on physical fitness and quality of life in female breast cancer survivors: the EFICAN randomized controlled trial.

PURPOSE: This study assessed the effects of 12-week supervised resistance training combined with home-based physical activity on physical fitness, cancer-related fatigue, depressive symptoms, health-related quality of life (HRQoL), and life satisfaction in female breast cancer survivors. METHODS: A parallel-group, outcome assessor-blinded, randomized controlled trial included 60 female breast cancer survivors who had completed their core treatments within the previous 10 years. Through computer-generated simple randomization, participants were assigned to resistance training (RTG; two sessions/week for 12 weeks plus instructions to undertake ≥ 10,000 steps/d) or control (CG; ≥ 10,000 steps/d only). Outcomes were evaluated at baseline and week 12. Muscular strength was assessed with electromechanical dynamometry. A standardized full-body muscular strength score was the primary outcome. Secondary outcomes included cardiorespiratory fitness, shoulder mobility, cancer-related fatigue, depressive symptoms, HRQoL, and life satisfaction. RESULTS: Thirty-two participants were assigned to RTG (29 achieved ≥ 75% attendance) and 28 to CG (all completed the trial). Intention-to-treat analyses revealed that the standardized full-body muscular strength score increased significantly in the RTG compared to the CG (0.718; 95% CI 0.361-1.074, P < 0.001, Cohen's d = 1.04). This increase was consistent for the standardized scores of upper-body (0.727; 95% CI 0.294-1.160, P = 0.001, d = 0.87) and lower-body (0.709; 95% CI 0.324-1.094, P = 0.001, d = 0.96) strength. There was no effect on cardiorespiratory fitness, shoulder flexion, cancer-related fatigue, depressive symptoms, HRQoL, or life satisfaction. The sensitivity analyses confirmed these results. CONCLUSION: and implication for cancer survivors. In female breast cancer survivors who had completed their core treatments within the past 10 years, adding two weekly sessions of supervised resistance training to a prescription of home-based physical activity for 12 weeks produced a large increase in upper-, lower-, and full-body muscular strength, while other fitness components and patient-reported outcomes did not improve. TRIAL REGISTRATION NUMBER: ISRCTN14601208.

Absolute and Relative Handgrip Strength as Indicators of Self-Reported Physical Function and Quality of Life in Breast Cancer Survivors: The EFICAN Study.

BACKGROUND: Although breast cancer (BC) is the most prevalent type of cancer in the world, its high survival rate implies that many people live long after the treatments and face their side effects. The physical function (PF) and health-related quality of life (HRQoL) of people surviving BC decreases significantly, which makes important to identify markers that may be associated with a better health status and prognosis. Previous studies suggest that handgrip strength (HGS) and HGS relative to the body mass index (rHGS) are good indicators of PF and HRQoL in different populations. However, it is unknown whether this applies to BC survivors. This study aimed to evaluate the association of HGS and rHGS with PF and HRQoL in this population. METHODS: Sixty female BC survivors participated. Handgrip strength was assessed with a dynamometer. Arm volume was estimated and upper limb impairments, as well as cancer-related fatigue, depression, life satisfaction and HRQoL, were assessed using standardized questionnaires. RESULTS: Higher levels of HGS and rHGS were associated with higher levels of HRQoL, lower cancer-related fatigue, and fewer problems with the affected arm. CONCLUSIONS: These results suggest that HGS may be a good indicator of self-reported PF and HRQoL in female BC survivors.

Physical Exercise following bariatric surgery in women with Morbid obesity: Study protocol clinical trial (SPIRIT compliant).

BACKGROUND: Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life. METHODS: This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured. DISCUSSION: This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery. TRIAL REGISTRATION NUMBER: ISRCTN registry (ISRCTN27697878).

Effects of a 12-week resistance and aerobic exercise program on muscular strength and quality of life in breast cancer survivors: Study protocol for the EFICAN randomized controlled trial.

BACKGROUND: The number of people living with the side effects of breast cancer treatment (eg, loss of muscular mass and muscular strength, upper-limb mobility and disability, lymphedema, cardiac toxicity, and reduced quality of life) is increasing yearly. These consequences can be improved through exercise, specially combining resistance and aerobic training. Previous exercise trials have not been consistent in applying training principles and standardized reporting, and this partly explains the variability in obtained results. The aim of this study is to assess the effect of a 12-week supervised resistance exercise program combined with home-based aerobic exercise, compared with home-based aerobic exercise only, on muscular strength and several aspects of health-related quality of life in breast cancer survivors. To maximize transparency, replicability, and clinical applicability, the intervention is described following the consensus on exercise reporting template. METHODS: This study is a parallel-group randomized controlled trial in which 60 female breast cancer survivors, who have completed central treatments of the disease in the last 5 years, will be randomly assigned to either an experimental group that will perform a total of 24 progressive resistance training sessions for 12 weeks (ie, 2 weeks of individual training and 10 weeks of micro-group training) and will be requested to undertake 10,000 steps/d, or a control group that will be requested to undertake 10,000 steps/d, only. Outcomes will be evaluated at baseline and at week 12. Primary outcome measure is peak isometric muscular strength of the lower- and upper-body, assessed with several exercises through an electromechanical dynamometer. Secondary outcomes include cardiorespiratory fitness, upper-joint mobility and disability, health-related quality of life, cancer-related fatigue, depression, life satisfaction, and presence of lymphedema. DISCUSSION: This study aims to investigate the extent to which a 12-week supervised and progressive resistance exercise program, in addition to home-based aerobic physical activity, might improve muscular strength and health-related quality of life in breast cancer survivors. The comprehensive description of the intervention will likely contribute to enhancing exercise prescription in this population. TRIAL REGISTRATION NUMBER: ISRCTN14601208.

Efecto de un programa de intervención sobre el estrés percibido, autoestima y rendimiento en jóvenes pilotos de motociclismo de elite / Effect of an intervention program on perceived stress, self-esteem and performance in young elite motorcyclists

En la especialidad deportiva de motociclismo la literatura científica se ha centrado en aspectos tecnológicos, de seguridad, incluso patrones de lesiones, existiendo poca información sobre variables psicológicas de los deportistas. El objetivo de nuestro estudio fue evaluar si el efecto de una intervención en habilidades técnicas y condición física sobre la percepción de estrés, autoestima, la autovaloración, la valoración de otros, y finalmente la ejecución. La muestra estuvo compuesto por 27 pilotos jóvenes de élite, participantes del Red Bull Moto GP Rookies Cup, de los cuales 16 sujetos realizaron un programa de intervención (Grupo Experimental, GE), mientras que el resto fue el Grupo Control (GC), se recogieron diversas variables en la primera y la última carrera de la temporada. Nuestros resultados indican que el GE mantuvo controlado el nivel de estrés, una mejor técnica, condición física y psicológica y además obtuvo mejores resultados en las competiciones, en comparación con el GC. Por tanto, concluimos que el programa de intervención ha sido eficaz para mantener los niveles de estrés, mejorar sus habilidades técnicas, tácticas y psicológicas, y además para mejorar la ejecución a lo largo de la temporada deportiva (AU)

In the motorcycling sport specialty, scientific literature has focused on technology, safety or even on injury variables; however there is little information regarding psychological variables. The aim of our study was to evaluate the effect of a technical and physical intervention on psychological variables such as self-esteem, self-assessment, appraisal of others and, finally, performance. The sample was made up of twenty-seven young elite road-race motorcyclists who competed in the Red Bull Moto GP Rookies Cup. 16 of whom completed an intervention program (Experimental Group, EG), while the other 14 belonged to the Control Group (CG). We collected the measurements in the first and last race of the season. Our results indicate the EG had controlled the stress level, had a better technique, physical, and psychological conditions, besides better competition performance, in comparison with the CG. We conclude that our intervention program has been effective at maintaining stress levels, bettering technical, tactical and psychological skills, and also improving performance throughout the competition period (AU)