Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial.

OBJECTIVE: Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. METHODS: This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). RESULTS: The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). CONCLUSION: Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

OBJETIVO: Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. MéTODOS:: Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). RESULTADOS: Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). CONCLUSãO:: O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial / Efeito do treinamento combinado na imagem corporal, composição corporal e capacidade funcional em pacientes com câncer de mama: ensaio clínico controlado

Abstract Objective Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. Methods This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). Results The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). Conclusion Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.

Resumo Objetivo Avaliar o efeito do treinamento combinado na imagem corporal (IB), composição corporal e capacidade funcional em pacientes com câncer de mama. Assim como a relação do IB com a composição corporal e capacidade funcional. Métodos Este foi um estudo de Ensaio Clínico Controlado, este estudo incluiu 26 pacientes com câncer de mama (30 a 59 anos). O grupo de treinamento (n = 13) foi submetido a 12 semanas de treinamento, incluindo três sessões de 60 min de exercício aeróbio e treinamento de resistência, e duas sessões de treinamento de flexibilidade por semana; cada exercício de flexibilidade durou 20s. O Grupo Controle (n = 13) recebeu apenas o tratamento hospitalar padrão. Os participantes foram avaliados no início e após 12 semanas. O IB (desfechos primários) foi avaliado por meio do Body Image After Breast Cancer Questionnaire; A composição corporal foi estimada com os indicadores: índice de massa corporal; Peso, relação cintura-quadril; Relação da altura da cintura; Índice de conicidade; Índice ponderal recíproco; Porcentagem de gordura; Circunferência do abdômen e cintura; Capacidade funcional por aptidão cardiorrespiratória (cicloergômetro) e força (dinamômetro manual). A estatística foi realizada na Bioestatística e no Stata 14.0 (α = 5%). Resultados Os pacientes do grupo de treinamento apresentaram redução da dimensão da limitação (p = 0,036) no IB, porém, foi observado aumento da circunferência da cintura em ambos os grupos. Além disso, um aumento do VO2máx (p <0,001) e da força nos braços direito (p = 0,005) e esquerdo (p = 0,033). Conclusão O treinamento combinado demonstra ser uma estratégia eficaz e não farmacológica para pacientes com câncer de mama, com melhora do IB e da capacidade funcional, alterando variáveis relacionadas negativamente quando não há treinamento físico.

Linear and undulating resistance training programming induce similar outcomes on physical fitness in elderly women / Programações linear e ondulatória do treinamento de força induzem a mesmos resultados na aptidão física em mulheres idosas

Abstract The aim of the present study was to analyze the effect of two different types of resistance training programming (linear and daily undulating) on submaximal strength and functional capacity in elderly women. Twenty-two participants (64 ± 3 years) were randomly assigned to 2 training groups: linear programming (LP; n=12) and daily undulating programming (DUP; n =10). Functional capacity and submaximal strength (10RM) were analyzed before and after 12 weeks of resistance training. The results demonstrated improvement on strength and functional capacity after the resistance training period (p ≤ 0.05), except for the Bench Press (p = 0.30), for both groups DUP and LP. The Effect Size was, respectively, high for DUP (timed up and go test = -2.07, and timed sit test= 4.69), and high for LP (horizontal leg press = 2.35). For all other results, the effect size was trivial or small. No statistical difference was observed between programming models. The LP and DUP trainnings have similar results in increasing submaximal muscle strength in elderly women inexperienced in RT after 12 weeks of intervention (p ≤ 0,05). However, DUP appears to be more effective in increasing functional capacity. In practice, the professional can use both the LP and the DUP to improve the level of fitness in the early stages of training in this population. However, when the goal of programming is to increase functional capacity, DUP can be prioritized.

Resumo O objetivo do presente estudo foi analisar o efeito de dois tipos diferentes de programação do treinamento de força (linear e ondulatório diário) na força submáxima e na capacidade funcional de mulheres idosas. Vinte e duas participantes (64 ± 3 anos) foram randomizados em 2 grupos experimentais: programação linear (PL; n=12) e programação ondulatória diária (POD; n=10). A capacidade funcional e a força submáxima (10RM) foram avaliadas antes e depois das 12 semanas de treinamento de força. Os resultados demonstraram melhora da força submáxima e da capacidade funcional após o período de treinamento (p ≤ 0,05), exceto para o exercício supino (p = 0,30), para ambos os grupos POD e PL. Foi encontrado um tamanho de efeito grande para a POD nos testes de sentar e caminhar = -2,07 e teste de sentar e levantar = 4,69, bem como na PL para o exercício leg press horizontal = 2,35. Não foi observada diferença estatística entre os modelos de programação. As programações LP e DUP têm resultados semelhantes no aumento da força muscular submáxima em mulheres idosas inexperientes em TR após 12 semanas de intervenção (p ≤ 0,05). No entanto, o DUP parece ser mais eficaz para aumentar a capacidade funcional. Na prática, o profissional pode usar tanto o LP quanto o DUP para melhorar o nível de condicionamento físico nos estágios iniciais do treinamento nessa população. Porém, quando o objetivo da programação é aumentar a capacidade funcional, o DUP pode ser priorizado.

The use of guarana (Paullinia cupana) as a dietary supplement for fatigue in cancer patients: a systematic review with a meta-analysis.

OBJECTIVE: The objective of the present study was to carry out a systematic review with a meta-analysis to assess evidence about the use of guarana fruit to manage fatigue in cancer patients. METHODOLOGY: The data were extracted from the EMBASE, Scopus, MEDLINE, CENTRAL, and CINAHL databases, in any language, using the descriptors "neoplasms" and "Paullinia" or "guarana powder" and "placebos" and "fatigue". Searches were also conducted to identify any grey literature. Clinical studies with patients who presented cancer-related fatigue as a primary outcome and who used guarana as a dietary supplement were included. The risk of bias in randomized clinical trials was analyzed according to the Cochrane recommendations. The quality of the evidence was assessed using the GRADE system. For studies with the same types of tumors and treatments, meta-analysis was also conducted. RESULTS: A total of 383 studies were found and, of these, seven were included in the review, for a total of 427 cancer patients. The instruments used to analyze fatigue were the Brief Fatigue Inventory (BFI), the Chalder Fatigue Scale, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FATIGUE), and the Piper Scale. Some studies presented a low risk of bias for all the categories. Meta-analysis was conducted for three studies about breast cancer, which presented sufficient data. The use of guarana did not reduce cancer-related fatigue compared with placebo groups (mean of - 0.02 [95% CI - 1.54, 1.50]; p = 0.98) and the quality of evidence according to GRADE was very low. CONCLUSION: Dietary supplements are used to improve cancer-related fatigue. The results of this review showed that the use of guarana was not superior to the placebo groups, pointing to the need for further studies with better methodological quality.

Dietary supplements and fatigue in patients with breast cancer: a systematic review.

PURPOSE: Cancer-related fatigue (CRF) is defined as a distressing, persistent, and subjective sense of physical or emotional and/or cognitive exhaustion. The treatment of CRF includes pharmacological and non-pharmacological therapies; dietary strategies with promising results have also been used. This study aimed to identify dietary supplements that improve fatigue in patients with breast cancer. METHODS: A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were obtained from PubMed, Scopus, MEDLINE, CENTRAL, and CINAHL databases using the following MeSH terms: breast neoplasms, dietary supplements, diet, and fatigue. In addition, the Google and Google Scholar search engines were used to find grey literature. Methodological quality was evaluated using the risk of bias in randomised clinical trials in the systematic Cochrane reviews, and the quality of the evidence was also analysed using the GRADE system. RESULTS: A total of 893 studies were assessed, of which eight were included in the review, with 932 women diagnosed with breast cancer. The most commonly used supplements that improve fatigue were guarana, acetyl-L-carnitine, and co-enzyme Q10. Two studies had a low risk of bias in all categories and three had high-quality evidence. CONCLUSIONS: Dietary supplements or diet patterns are seldom used to treat fatigue in patients with breast cancer. The results of this review showed that guarana extract and a diet rich in whole foods, omega-3 fatty acids, fruits, and vegetables could be used to treat CRF in patients with breast cancer. The studies had a low risk of bias with high-quality evidence on the efficacy of the interventions in treating fatigue in the study population.

Effect of exercise on pain and functional capacity in breast cancer patients.

PURPOSE: To assess the influence of combined training on pain, fatigue, maximal oxygen uptake (VO2 max), body mass index (BMI), flexibility, and strength in patients with breast cancer. METHODS: A controlled pilot study with 28 patients undergoing chemotherapy, radiation therapy, and clinical observation in a renowned cancer treatment center; the patients were aged from 30 to 59 years old and were not engaged in physical training for three months previously. The Study Group (SG) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20 s and was performed in sets of three repetitions. The Control Group (CG) received only the standard hospital treatment. Participants were evaluated at the beginning of the study to establish a baseline and reevaluated at the end of 12 weeks. RESULTS: Patients in the SG showed a significant decrease in total pain points (p = 0.0047), pain intensity (p = 0.0082), and the extent to which pain interfered with their daily life (p = 0.0047). There was an increase in maximum oxygen uptake (p = 0.0001), flexibility (p = 0.0001), and strength on both sides (right p = 0.0001 and left p = 0.0008). No significant differences were observed in fatigue (p = 0.0953) or BMI (p = 0.6088). CONCLUSION: Combined training was effective in decreasing pain and increasing VO2 max, flexibility and static strength in patients with breast cancer. TRIAL REGISTRATION: NCT03061773 . Registered on February 19, 2017, 'retrospectively registered'.