Home-Based Physical Activity in Patients With Breast Cancer: During and/or After Chemotherapy? Impact on Cardiorespiratory Fitness. A 3-Arm Randomized Controlled Trial (APAC).

OBJECTIVES: Physical activity (PA) programs are recommended for breast cancer care. However, their modalities remain to be discussed. This study determined the best time to begin a personalized or adapted program based on cardiopulmonary exercise test function. This randomized controlled trial evaluated the effect of home-based adapted PA (APA) performed during or after treatment on cardiorespiratory fitness (CRF) at 12 months. METHOD: The primary endpoint was the peak oxygen consumption (VO2peak) at 12 months (group A vs C and B vs C). Secondary endpoints included the 6-minute walking test, assessment of muscle strength, fatigue, quality of life, anxiety, and depression, and a questionnaire on PA levels. All tests were evaluated at baseline and at 6 and 12 months. A total of 94 patients with breast cancer were randomized to 3 different groups: group A, performing 6 months of APA during adjuvant care; group B, 6 months of APA after adjuvant care; and group C, 12 months of APA during and after specific care. The program combined 1 resistance session and 2 aerobic sessions per week. Analysis of variance was used for repeated measures, Student's t-test or the Mann-Whitney U-test for continuous variables, and χ2 test for binary or categorical variables. RESULTS: The study assessed 81 participants at 6 months and 73 at 12 months. The majority of patients completed more than 85% of the exercise sessions. The baseline for VO2peak and secondary outcomes did not differ among the groups. VO2peak increased during the exercise period and decreased during the chemotherapy period without APA, but at 12 months no significant difference was observed. The same variation was observed in the 6-minute walking test, with significance at 6 months between A+C versus B (P = .04), but no difference among the groups at 12 months. In the 3 groups, no decreases in other studied parameters were noted, except at 6 months in group B without APA. CONCLUSION: Home-based APA in breast cancer patients has a positive effect on CRF and physical functions, with no differences based on the timing of this program based on specific cancer treatment. TRIAL REGISTRATION: ClinicalTrials.gouv.fr (NCT01795612). Registered 20 February 2013.

Effects of a Multicomponent Exercise Program on Spatiotemporal Gait Parameters, Risk of Falling and Physical Activity in Dementia Patients.

BACKGROUND: Exercise programs are presumed to rehabilitate gait disorders and to reduce the risk of falling in dementia patients. This study aimed to analyze the specific effects of multicomponent exercise on gait disorders and to determine the association between gait impairments and the risk of falling in dementia patients before and after intervention. METHODS: We conducted an 8-week multicomponent exercise program in 16 dementia patients (age 86.7 ± 5.4 years). All participants were assessed several times for gait analysis (Locométrix®), Tinetti score and physical activity (Body Media SenseWear® Pro armband). RESULTS: After 8 weeks of the exercise program, the mean gait speed was 0.12 m/s faster than before the intervention (0.55 ± 0.17 vs. 0.67 ± 0.14 m/s). The multicomponent exercise program improved gait performance and Tinetti score (p < 0.05). Gait performance (gait speed, stride length) was correlated with the Tinetti score (p < 0.05). CONCLUSION: Analysis of spatiotemporal gait parameters using an accelerometer method provided a quick and easy tool to estimate the benefits of an exercise program and the risk of falling.

Longitudinal follow-up of biochemical markers of fatigue throughout a sporting season in young elite rugby players.

The aims of this study were to evaluate links between biochemical markers and competition and training conditions, overtraining questionnaire scores, and anthropometric characteristics of young elite rugby players and to identify evolving profiles of fatigue during the sports season. Twelve elite rugby players were included in the study. The tests were carried out every 15 days over the course of one sporting season from July until March, including the interseason. Changes in body composition parameters, blood biochemistry, and scores on various questionnaires were examined. The majority of the biochemical parameters and subjective variables showed significant variations over time. There were significant positive correlations between overtraining scores and alanine amino transferase (ALAT; r = 0.24, p < 0.05) and creatine phosphokinase (CK; r = 0.3, p < 0.01) levels. In addition, game time was significantly correlated with changes in CK (r = 0.46, p < 0.01), whereas difficult training sessions were significantly correlated with changes in both CK (r = 0.27, p < 0.05) and ALAT (r = 0.33, p < 0.01). We suggest that regular monitoring of these biochemical parameters may provide important information for the coach on the fatigue of rugby players and their perceived difficulty of training.

Relationships between physiological and psychological stress and salivary immunoglobulin A among young female gymnasts.

We investigated whether psychological and physical stress induced by training or competition influence the secretory immune system among 12 highly trained young female gymnasts. Salivary levels of secretory IgA and cortisol responses to gymnastic training session or competition were assessed a total of 10 times, immediately before and after two training sessions which had different intensities and just before and after a major competition. These parameters were also measured on two non-training days. The Brunel Mood Scale was also used to assess the gymnasts's overall mood on each test day. IgA:Protein ratio was calculated. Significant decreases in this ratio were found after each exercise session, related to the physiological and psychological stress induced by exercise. Over the 5-mo. training period the presession IgA:Protein ratios were unchanged. Gymnasts registered any episodes of upper respiratory tract infection. Bouts of exercise induce transitory effects on the immune system in relation to the workload and the stress induced by the exercise without any relation to increased susceptibility to illness in children.