Association between Phase Angle and Subjective Perceptions of Health Variables in Cancer Patients.

The phase angle, an increasingly studied healthcare tool, was studied to explore its relationship with psychological factors in cancer patients. The aim of this study was to investigate the relationship between the phase angle (PhA), obtained by the bioimpedance analysis of body composition, and psychological factors measured by questionnaire in cancer patients. The study included 311 patients who underwent bioimpedance testing to determine their PhA value; their psychological profiles were assessed using SF-36, FACIT, QLQ-C30, and GHQ-12 questionnaires. Mixed linear regression models were used to analyze the relationship between PhA and the psychological tests. The results showed a statistical correlation between PhA and the GHQ-12, FACIT, and SF-36 questionnaires, with higher PhA values associated with better results on the questionnaires. In the QLQ-C30 questionnaire, a correlation was observed between PhA and the functioning scales (p < 0.001), except for emotional and cognitive functioning (p = 0.148 and p = 0.544, respectively), but not in most of the symptom scales. The PhA is a useful tool for assessing the subjective health perception of cancer patients, especially with regard to psychological factors. While there is a statistically significant correlation, further research is required before confidently applying it in clinical practice. The current predictive value of this predictor for certain psychological aspects is limited, underscoring the need for additional research.

Association between PhA and Physical Performance Variables in Cancer Patients.

Maintaining the physical performance of cancer patients is increasingly considered due to the growing number of cancer patients and the aggressiveness of the treatments. For this reason, bioimpedance is now being used to record patients' body composition by obtaining the phase angle (PhA). Although there is a direct relationship between PhA, age, sex and disease prognosis, it has not been measured as an analysis of physical performance in oncology patients and is a valid tool in the follow-up of cancer patients. For this purpose, 311 patients were evaluated, and both bioelectrical impedance analysis (BIA) and physical performance measurements were performed. The modification of the results concerning PhA was found to be highly relational, as a variation in one of the variables affected the other. It was concluded that each degree increase in PhA modified -22.57 s [-27.58; -17.53] in 400-m walking test (400 mWT); 13.25 kg [10.13; 16.35] in upper-body strength (UBS); 6.3 [4.95; 7.65] in lower-body strength (LBS); 1.55 mL/kg/min [0.98; 2.12] in VO2peak; 6.53 Watts [3.83; 9.20] in ventilatory threshold 1 (VT1); 10.36 Watts [7.02; 13.64] in ventilatory threshold 2 (VT2). It was also noted that age was a factor that affected the relationship between PhA and 400 mWT; the older the age, the higher the relationship. PhA data has been shown to be highly correlated with physical performance. This is of great importance in clinical practice because a cancer patient's physical performance levels can be assessed during treatment.

Physiological and mental health changes in cancer patients during the COVID-19 state of emergency.

Backgrounds: Due to the COVID-19 pandemic that we are currently facing, many governments across the world have declared a state of emergency and even confinements. This stressful situation, in addition to prolonged stays at home, may imply a radical change in lifestyle behavior and physical activity (PA). The aim of this study is to evaluate the physiological and psychological effects in cancer patients who changed their PA habits during the COVID-19 state of emergency in Spain. Methods: Thirty-three participants were evaluated pre- and post-state of emergency. A series of questionnaires was used to assess cancer-specific quality of life. Results: The most relevant results revealed significantly lower walking time (p < 0.001) and sitting time (p = 0.014). Upper and lower body strength also decreased significantly (p = 0.009 and 0.012, respectively) and oxygen consumption (VO2 peak) (p = 0.023). None of the parameters analysed showed significant differences for psychological aspects (QLQ-C-30 and SF-36) and body composition. Conclusion: Lower physical activity leads to negative physiological adaptation, particularly affecting cardiovascular and strength levels. While it is important to maintain the general population's amount and intensity of exercise, this particularly vulnerable group's physical capacity is vital to their health and well-being.

Implementing Exercise in Standard Cancer Care (Bizi Orain Hybrid Exercise Program): Protocol for a Randomized Controlled Trial.

BACKGROUND: Despite the established benefits of regular exercise for patients with cancer to counteract the deleterious effects of the disease itself and treatment-related adverse effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programs that are accessible and generalizable to a large proportion of patients with cancer into routine cancer care. OBJECTIVE: We intend to examine the effects attributable to the implementation of a community-based exercise program on cardiorespiratory functional capacity and quality of life for patients with cancer. METHODS: This will be a hybrid study. In the first experimental phase, patients diagnosed with any type of cancer will be randomized into two parallel groups. One group immediately performs Bizi Orain, a 3-month supervised exercise program (3 times a week), in addition to behavioral counseling in a primary health care setting; the other is a reference group that starts the exercise program 3 months later (delayed treatment). In the second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the program. The program evaluation involves the uptake, safety, adherence, and effectiveness assessed after completion of the program and with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months. The primary outcomes of the experimental study, to be compared between groups, are improved physical function and quality of life, whereas overall survival is the main objective of the prospective study. To analyze the association between changes in physical activity levels and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures. RESULTS: A total of 265 patients have been enrolled into the study since January 2019, with 42 patients from the hematology service and 223 from the oncology service. CONCLUSIONS: Bizi Orain is the first population-based exercise program in Spain that will offer more insight into the implementation of feasible, generalizable, and sustainable supportive care services involving structured exercise to extend survival of patients with cancer, improve their physical function and quality of life, and reverse the adverse effects of their disease and related treatments, thereby reducing the clinical burden. TRIAL REGISTRATION: ClinicalTrials.gov NCT03819595; http://clinicaltrials.gov/ct2/show/NCT03819595. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/24835.

Physical Activity Change during COVID-19 Confinement.

Background: The lockdown and social distancing caused by COVID-19 may influence common health behavior. The unprecedent worldwide confinement, in which Spain has been one of the most affected-with severe rules governing confinement-may have changed physical activity (PA) and sedentary habits due to prolonged stays at home. Purpose: The aim of this study is to evaluate how self-reported PA and sedentary time (ST) have changed during confinement in the Spanish population. Methods: 3800 healthy adults (age 18-64 years) residing in Spain answered the international physical activity questionnaire short (IPAQ-S) twice between 23 March and 1 April (confinement). Data analysis was carried out taking into consideration meeting general PA recommendations before confinement, age and gender. Results: Self-reported PA decreased significantly during confinement in our sample. Vigorous physical activities (VPA) and walking time decreased by 16.8% (p < 0.001) and 58.2% (p < 0.001), respectively, whereas ST increased by 23.8% (p < 0.001). The percent of people fulfilling the 75 min/week of VPA recommendation decreased by 10.7% (p < 0.001) while the percent of people who reached 150 min/week of moderate activity barely changed (1.4%). The group that performed the most VPA before confinement showed the greatest decrease (30.5%, p < 0.001). Men reduced time in VPA more than women (21% vs 9%, respectively) who even increased time in moderate PA by 11% (p < 0.05) and reported less increase in ST than men (35% vs 25.3%, respectively). Conclusion: The Spanish adult population, especially young people, students and very active men, decreased daily self-reported PA and increased ST during COVID-19 confinement.

The Effect of Different Cadence on Paddling Gross Efficiency and Economy in Stand-Up Paddle Boarding.

Background: Due to the importance of energy efficiency and economy in endurance performance, it is important to know the influence of different paddling cadences on these variables in the stand-up paddleboarding (SUP). The purpose of this study was to determine the effect of paddling at different cadences on the energy efficiency, economy, and physiological variables of international SUP race competitors. Methods: Ten male paddlers (age 28.8 ± 11.0 years; height 175.4 ± 5.1 m; body mass 74.2 ± 9.4 kg) participating in international tests carried out two test sessions. In the first one, an incremental exercise test was conducted to assess maximal oxygen uptake and peak power output (PPO). On the second day, they underwent 3 trials of 8 min each at 75% of PPO reached in the first test session. Three cadences were carried out in different trials randomly assigned between 45-55 and 65 strokes-min-1 (spm). Heart rate (HR), blood lactate, perceived sense of exertion (RPE), gross efficiency, economy, and oxygen uptake (VO2) were measured in the middle (4-min) and the end (8-min) of each trial. Results: Economy (45.3 ± 5.7 KJ·l-1 at 45 spm vs. 38.1 ± 5.3 KJ·l-1 at 65 spm; p = 0.010) and gross efficiency (13.4 ± 2.3% at 45 spm vs. 11.0 ± 1.6% at 65 spm; p = 0.012) was higher during de 45 spm condition than 65 spm in the 8-min. Respiratory exchange ratio (RER) presented a lower value at 4-min than at 8-min in 55 spm (4-min, 0.950 ± 0.065 vs. 8-min, 0.964 ± 0.053) and 65 spm cadences (4-min, 0.951 ± 0.030 vs. 8-min, 0.992 ± 0.047; p < 0.05). VO2, HR, lactate, and RPE were lower (p < 0.05) at 45 spm (VO2, 34.4 ± 6.0 mL·kg-1·min-1; HR, 161.2 ± 16.4 beats·min-1; lactate, 3.5 ± 1.0 mmol·l-1; RPE, 6.0 ± 2.1) than at 55 spm (VO2, 38.6 ± 5.2 mL·kg-1·min-1; HR, 168.1 ± 15.1 beats·min-1; lactate, 4.2 ± 1.2 mmol·l-1; RPE, 6.9 ± 1.4) and 65 spm (VO2, 38.7 ± 5.9 mL·kg-1·min-1; HR, 170.7 ± 13.0 beats·min-1; 5.3 ± 1.8 mmol·l-1; RPE, 7.6 ± 1.4) at 8-min. Moreover, lactate and RPE at 65 spm was greater than 55 spm (p < 0.05) at 8-min. Conclusion: International male SUP paddlers were most efficient and economical when paddling at 45 spm vs. 55 or 65 spm, confirmed by lower RPE values, which may likely translate to faster paddling speed and greater endurance.