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1.
Crit Rev Oncol Hematol ; : 103543, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34808374

RESUMO

Overweight and obese men with prostate cancer are at an increased risk of disease recurrence, exacerbated treatment-related adverse effects, development of obesity-related comorbidities, earlier progression and development of metastatic disease, and higher all-cause and prostate cancer-specific mortality. The physiological mechanisms associating obesity with poor prostate cancer outcomes remain largely unknown; however, an increased inflammatory environment and metabolic irregularities associated with excess fat mass are commonly postulated. Although research is limited, fat loss strategies using exercise and nutrition programmes may slow down prostate cancer progression and improve a patient's prognosis. This review is an overview of: 1) the association between obesity and poor prostate cancer prognosis; 2) potential physiological mechanisms linking obesity and prostate cancer progression; 3) the effect of obesity on treatments for prostate cancer; and 4) the potential for weight loss strategies to improve outcomes in patients with prostate cancer.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34740223

RESUMO

OBJECTIVE: To compare training and match loads for CP football athletes in a state-level development program to assess the specificity of training for competition in the para sport. DESIGN: Time-motion analysis and heart-rate monitoring were applied during 20 training sessions of the Western Australia CP football 2017 training season, and seven competition matches of the 2017 Australian National Championships. The study employed an observational study design with between-subjects and within-subjects comparisons of training and match loads. RESULTS: There were no significant differences between training and match loads in players' measurements of speed components and heart-rates, with two exceptions: higher match distance covered in very-high-speed (g = 0.33) and time in heart rate zone 1 (<75% HRmax,g = 0.45), and less time in HR Zone 2 (g = 0.42). CONCLUSION: Our results indicate that the athletes were conditioned to perform at similar intensities implemented during training, as demonstrated by the consistency between competition and training data in total distance, relative speed zones and relative heart rate zones. Coaches should apply this knowledge in the programming of training volume and intensities to obtain peak match fitness and specifically prepare athletes for competition in CP football.

3.
Front Oncol ; 11: 746040, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34595123

RESUMO

Physical exercise is increasingly recognized as a valuable treatment strategy in managing prostate cancer, not only enhancing supportive care but potentially influencing disease outcomes. However, there are limited studies investigating mechanisms of the tumor-suppressive effect of exercise. Recently, extracellular vesicles (EVs) have been recognized as a therapeutic target for cancer as tumor-derived EVs have the potential to promote metastatic capacity by transferring oncogenic proteins, integrins, and microRNAs to other cells and EVs are also involved in developing drug resistance. Skeletal muscle has been identified as an endocrine organ, releasing EVs into the circulation, and levels of EV-containing factors have been shown to increase in response to exercise. Moreover, preclinical studies have demonstrated the tumor-suppressive effect of protein and microRNA contents in skeletal muscle-derived EVs in various cancers, including prostate cancer. Here we review current knowledge of the tumor-derived EVs in prostate cancer progression and metastasis, the role of exercise in skeletal muscle-derived EVs circulating levels and the alteration of their contents, and the potential tumor-suppressive effect of skeletal muscle-derived EV contents in prostate cancer. In addition, we review the proposed mechanism of exercise in the uptake of skeletal muscle-derived EVs in prostate cancer.

4.
Artigo em Inglês | MEDLINE | ID: mdl-34648225

RESUMO

OBJECTIVE: Little is known about how to effectively encourage higher levels of activity among older people. This study tested the effectiveness of a public service advertisement designed according to recommendations for communicating with older audiences and featuring five types of moderate-to-vigorous physical activity: tennis, line dancing, cycling, swimming and jogging. METHODS: A survey administered to 1,200 Australians aged 50+ years assessed effects of the public service advertisement on: motivation (intrinsic and extrinsic); perceived believability, relevance, and effectiveness; and feelings elicited (e.g. interest, hope, guilt). Open-ended questions enabled respondents to describe aspects of the ad they considered to be most and least effective. RESULTS: Moderate to high scores were obtained on the motivation measures and the ad evaluation criteria of perceived effectiveness, likeability, believability and personal relevance. Mean scores for the feelings measures were generally low, with the exception of the positive feelings of being interested, inspired, hopeful and determined. CONCLUSIONS: The results suggest physical activity promotion ads can be motivating across age and socioeconomic subgroups of older people. Implications for public health: Ads aiming to encourage older people to be more physically active may be accepted and effective if they depict everyday older people enjoying a range of relevant activities.

5.
Sci Rep ; 11(1): 21085, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702909

RESUMO

To systematically review and analyse the effects of exercise on morphological and neuromuscular muscle quality (MQ) outcomes in older adults and assess a range of possible moderators that may affect the impact of exercise on MQ outcomes. Using PRISMA guidelines, randomised controlled trials were searched in CINAHL, EMBASE, LILACS, PubMed, SciELO, Web of Science, MedNar, OpenGrey and OpenThesis databases. Eligible trials examined the effects of exercise interventions on morphological and neuromuscular MQ in older adults (≥ 60 years). Twenty-one trials (n = 973 participants) were included. Exercise significantly improved morphological MQ (effect size (ES) = 0.32, 95% CI 0.13-0.51, P < 0.001) with significant results maintained for studies assessing muscle density and intermuscular adipose tissue (ES = 0.45-0.52, P < 0.05). For neuromuscular MQ, exercise provided significant positive effects (ES = 0.49, 95% CI 0.29-0.69, P < 0.001) but only maintained for physically healthy participants (ES = 0.43, P < 0.001), resistance exercise interventions (ES = 0.64, P < 0.001), or studies assessing 1-RM or knee extensor isokinetic muscle strength relative to leg lean mass (ES = 0.48-0.62, P = 0.001). Associations between exercise duration and changes in MQ measures were not observed (P > 0.05). Supervised exercise interventions significantly improved different measures of MQ regardless of exercise duration, although these effects were small-to-moderate and not supported across all population-, exercise-, and methods-related features.

6.
Cancer Med ; 10(22): 8058-8070, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34636156

RESUMO

BACKGROUND: Exercise may improve clinical and quality of life outcomes for men with prostate cancer. No randomized controlled trials (RCTs) have examined the feasibility, safety, and acceptability of remote exercise training in men with metastatic castrate-resistant prostate cancer (mCRPC). METHODS: We conducted a pilot RCT (1:1:1 aerobic or resistance exercise 3x/week or usual care) to determine the feasibility, safety, and acceptability of remotely monitored exercise over 12 weeks in 25 men with mCRPC. A prescribed exercise program was based on baseline testing including high- and moderate-intensity aerobic exercise or resistance exercise completed at a local exercise facility. Feasibility was based on attendance, adherence, and tolerance; safety on adverse events; and acceptability on participant interviews. RESULTS: Between March 2016 and March 2020, 25 patients were randomized (8 aerobic, 7 resistance, and 10 control). Twenty-three men (82%) completed the 12-week study. Men who completed the remote intervention attempted 90% and 96% of prescribed aerobic and resistance training sessions, respectively, and 86% and 88% of attempted sessions were completed as or more than prescribed. We observed changes in performance tests that corresponded with the exercise prescription. No safety concerns were identified. Ninety percent of participants interviewed were satisfied with the program and would recommend it to others. CONCLUSIONS: Remotely monitored exercise training is feasible, safe, and acceptable in men with mCRPC; there was no difference in these outcomes by mode of exercise. Through this research, we provide direction and rationale for future studies of exercise and clinical outcomes in patients with metastatic prostate cancer.

7.
J Cancer Surviv ; 2021 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-34510366

RESUMO

PURPOSE: While calls have been made for exercise to become standard practice in oncology, barriers to implementation in real-world settings are not well described. This systematic scoping review aimed to comprehensively describe barriers impeding integration of exercise into routine oncology care within healthcare systems. METHODS: A systematic literature search was conducted across six electronic databases (since 2010) to identify barriers to implementing exercise into real-world settings. An ecological framework was used to classify barriers according to their respective level within the healthcare system. RESULTS: A total of 1,376 results were retrieved; 50 articles describing implementation barriers in real-world exercise oncology settings were reviewed. Two hundred and forty-three barriers were identified across all levels of the healthcare system. Nearly 40% of barriers existed at the organizational level (n = 93). Lack of structures to support exercise integration and absence of staff/resources to facilitate its delivery were the most common issues reported. Despite the frequency of barriers at the organizational level, organizational stakeholders were largely absent from the research. CONCLUSIONS: Implementing exercise into routine cancer care is hindered by a web of interrelated barriers across all levels of the healthcare system. Organizational barriers are central to most issues. Future work should take an interdisciplinary approach to explore best practices for overcoming implementation barriers, with organizations as a central focus. IMPLICATIONS FOR CANCER SURVIVORS: This blueprint of implementation barriers highlights critical issues that need to be overcome to ensure people with cancer have access to the therapeutic benefits of exercise during treatment and beyond.

8.
Disabil Rehabil ; : 1-12, 2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34550846

RESUMO

BACKGROUND: Urinary incontinence is one of the most clinically relevant side effects in the treatment of prostate cancer patients. The aim of this systematic review and meta-analysis was to analyze the specific exercise effects of supervised versus unsupervised pelvic floor muscle exercise (PFME) and exercise volume on urinary incontinence status after radical prostatectomy. METHODS: A systematic data search was performed for studies published from January 2000 to December 2020 using the following databases: PubMed, Embase, SciSearch, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews and Effects. The review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A random-effects meta-analysis of urinary incontinence remission was performed. The relation between time since surgery and urinary incontinence remission was analyzed using a non-linear dose-response meta-analysis. RESULTS: The meta-analysis included 20 randomized controlled trials involving 2188 men (n = 1105 in intervention groups; n = 1083 in control groups). PFME versus no PFME had a beneficial effect on urinary incontinence remission at 3 months, 3-6 months, and more than 6 months post-surgery, with risk differences ranging from 12 to 25%. These effects were particularly evident for higher volume, supervised PFME in the first 6 months post-surgery. Additional biofeedback therapy appeared to be beneficial but only during the first 3 months post-surgery. CONCLUSIONS: There is good evidence that the supervised PFME causes a decrease in short-term urinary incontinence rates. Unsupervised PFME has similar effects as no PFME in postoperative urinary incontinence. PFME programs should be implemented as an early rehabilitative measure to improve postoperative short-term urinary incontinence in patients with prostate cancer.IMPLICATIONS FOR REHABILITATIONProstate cancer, surgery, and urinary incontinenceThe surgical treatment of prostate cancer often leads to urinary incontinence.Pelvic floor training leads to a significant improvement of this situation.Exercise therapy support is very important in this context and is even more effective than unsupported training.

9.
J Strength Cond Res ; 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34537802

RESUMO

ABSTRACT: Songsupap, T, Newton, RU, and Lawsirirat, C. Balancing injury risk and power development by weighted jump squat through controlling eccentric loading. J Strength Cond Res XX(X): 000-000, 2021-Weighted jump squat (WJS) training is highly effective for increasing neuromuscular power but entails higher injury risk than traditional resistance training because of the impact of landing. Braking mechanisms can be used to control the landing impact; however, the optimal eccentric loading condition that balances injury risks and power output is still unclear. The purpose of this study was to assess different eccentric braking conditions. Twenty-two male varsity basketball players aged 20.8 ± 1.1 years and a 1 repetition maximum (1RM) of back squat-to-body mass ratio of 2.0 ± 0.2 participated in the study. The subjects performed 2 sets of WJS of 6 repetitions with additional 30% of 1RM load under 4 randomly assigned conditions: (a) traditional load, no braking (B0), (b) 25% braking load reduction during landing (B25), (c) 50% braking load reduction during landing (B50), and (d) 100% braking load reduction during landing with release at touchdown (B100R). A repeated measures analysis of variance was used to determine differences of dependent variables: peak power output, peak force, peak velocity, and impulse. B100R resulted in statistically lower eccentric peak force and impulse for the first 50 milliseconds than the other 3 conditions (p < 0.05), but the largest concentric peak power. Furthermore, B0 resulted in statistically lower concentric peak power and peak velocity than the other 3 conditions (p < 0.05). We suggest that B100R was a more favorable loading condition that balanced injury risk and power production in WJS.

10.
Med Sci Sports Exerc ; 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34559721

RESUMO

PURPOSE: Although several mechanisms have been proposed for the tumor-suppressive effect of exercise, little attention has been given to myokines even though skeletal muscle is heavily recruited during exercise resulting in myokine surges. We measured resting serum myokine levels before and after an exercise-based intervention and the effect of this serum on prostate cancer cell growth. METHODS: Ten prostate cancer patients undertaking androgen deprivation therapy (ADT) (age 73.3 ± 5.6 yrs) undertook a 12-week exercise-based intervention including supervised resistance training, self-directed aerobic exercise, and protein supplementation. Body composition was assessed by dual-energy x-ray absorptiometry (DXA) and muscle strength by the one-repetition maximum (1RM) method. Fasting blood was collected at baseline and post-intervention, and serum levels of myokines: SPARC, OSM, decorin, IGF-1, and IGFBP-3 were measured. The growth of the prostate cancer cell line DU145 with baseline and post-intervention serum was measured. RESULTS: Bodyweight (p = 0.011), fat mass (p = 0.012), and percent body fat (p = 0.033) were reduced, while percent lean mass (p = 0.001) increased as did strength (leg press, p = 0.006; chest press, p = 0.020) across the intervention. Serum OSM levels (p = 0.020) and relative serum OSM levels (p = 0.020) increased compared to baseline. A significant reduction in DU145 Cell Index (p = 0.012) and growth rate (p = 0.012) was observed after applying post-intervention serum compared to baseline serum. CONCLUSION: This study provides evidence for enhanced myokine expression and tumor-suppressive effects of serum from chronically exercise-trained prostate cancer patients on ADT.

11.
Phys Ther Sport ; 52: 69-80, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34418589

RESUMO

OBJECTIVE: This review aims to provide a succinct and critical analysis of the current physical and mechanical demands of elite Australian football while examining lower-limb injury and the associated physical and kinanthropometric risk factors. METHODS: MEDLINE, PubMed, Web of Science and SPORTSDiscus electronic databases were searched for studies that investigated the playing demands, injury trends, and physical and kinanthropometric injury risk factors of elite Australian football. Articles from similar team sports including soccer and rugby (union and league) were also included. RESULTS: While the physical demands of elite AF have steadied over the past decade, injury rates continue to rise with more than two-thirds of all injuries affecting the lower-limbs. Body composition and musculoskeletal morphological assessments are regularly adopted in many sporting settings with current research suggesting high and low body mass are both associated with heightened injury risk. However, more extensive investigations are required to determine whether the proportions of muscle and fat are linked. Repeated assessment of musculoskeletal morphology may also provide further insight into stress fracture rates. CONCLUSIONS: While kinanthropometric and physical attributes are highly valued within elite sporting environments, establishing a deeper connection with injury may provide practitioners with more insight into current injury trends.


Assuntos
Traumatismos em Atletas , Futebol Americano , Traumatismos da Perna , Futebol , Traumatismos em Atletas/epidemiologia , Austrália/epidemiologia , Humanos , Incidência , Traumatismos da Perna/epidemiologia , Fatores de Risco
12.
BMC Public Health ; 21(1): 1539, 2021 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380465

RESUMO

BACKGROUND AND OBJECTIVE: Chronic medical conditions accumulate within individuals with age. However, knowledge concerning the trends, patterns and determinants of multimorbidity remains limited. This study assessed the prevalence and patterns of multimorbidity using extensive individual phenotyping in a general population of Australian middle-aged adults. METHODS: Participants (n = 5029, 55% female), born between 1946 and 1964 and attending the cross-sectional phase of the Busselton Healthy Ageing Study (BHAS) between 2010 and 2015, were studied. Prevalence of 21 chronic conditions was estimated using clinical measurement, validated instrument scores and/or self-reported doctor-diagnosis. Non-random patterns of multimorbidity were explored using observed/expected (O/E) prevalence ratios and latent class analysis (LCA). Variables associated with numbers of conditions and class of multimorbidity were investigated. RESULTS: The individual prevalence of 21 chronic conditions ranged from 2 to 54% and multimorbidity was common with 73% of the cohort having 2 or more chronic conditions. (mean ± SD 2.75 ± 1.84, median = 2.00, range 0-13). The prevalence of multimorbidity increased with age, obesity, physical inactivity, tobacco smoking and family history of asthma, diabetes, myocardial infarct or cancer. There were 13 pairs and 27 triplets of conditions identified with a prevalence > 1.5% and O/E > 1.5. Of the triplets, arthritis (> 50%), bowel disease (> 33%) and depression-anxiety (> 33%) were observed most commonly. LCA modelling identified 4 statistically and clinically distinct classes of multimorbidity labelled as: 1) "Healthy" (70%) with average of 1.95 conditions; 2) "Respiratory and Atopy" (11%, 3.65 conditions); 3) "Non-cardiometabolic" (14%, 4.77 conditions), and 4) "Cardiometabolic" (5%, 6.32 conditions). Predictors of multimorbidity class membership differed between classes and differed from predictors of number of co-occurring conditions. CONCLUSION: Multimorbidity is common among middle-aged adults from a general population. Some conditions associated with ageing such as arthritis, bowel disease and depression-anxiety co-occur in clinically distinct patterns and at higher prevalence than expected by chance. These findings may inform further studies into shared biological and environmental causes of co-occurring conditions of ageing. Recognition of distinct patterns of multimorbidity may aid in a holistic approach to care management in individuals presenting with multiple chronic conditions, while also guiding health resource allocation in ageing populations.


Assuntos
Envelhecimento Saudável , Multimorbidade , Adulto , Austrália/epidemiologia , Doença Crônica , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
13.
Artigo em Inglês | MEDLINE | ID: mdl-34420038

RESUMO

BACKGROUND: To systematically review and analyse the associations between fat and muscle mass measures with overall survival in men with prostate cancer. METHODS: A systematic search was conducted in CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science databases from inception to December 2020, while abstracts from the American Society of Clinical Oncology (ASCO), Clinical Oncology Society of Australia (COSA), and the American College of Sports Medicine (ACSM) conferences were searched from 2014 to 2020. Eligible articles examined the association of body composition measures, such as fat mass (e.g., fat mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT) and muscle mass measures, with overall survival in prostate cancer patients at any treatment stage. The primary endpoint was overall survival. Random-effect meta-analysis was conducted for studies reporting multivariable or univariable analysis assessing the associations of fat mass measures (i.e., fat mass, VAT, SAT, VAT/SAT) and muscle mass measures with overall survival. RESULTS: Sixteen cohort studies that comprised 4807 men with prostate cancer were included. Total adiposity (hazard ratio (HR) 0.98, 95% CI: 0.75-1.28, p = 0.888) and VAT (HR 1.03, 95% CI: 0.74-1.43, p = 0.873) were not significantly associated with overall survival, while higher subcutaneous adipose tissue levels were associated with higher survival (HR 0.68, 95% CI: 0.54-0.84, p = 0.001). Greater mortality risk was found in patients with localised (HR 1.91, 95% CI: 1.40-2.62, p < 0.001) and advanced disease (HR 1.43, 95% CI: 1.07-1.92, p = 0.020) presenting with low levels of muscle mass compared to those presenting with high levels. DISCUSSION: These results indicate that although overall adiposity should be cautiously interpreted in regards to survival, high muscle mass and SAT, and low VAT/SAT ratio values are associated with overall survival in men with prostate cancer.

14.
Integr Cancer Ther ; 20: 15347354211040757, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34412527

RESUMO

PURPOSE: Although exercise medicine is recommended to counter treatment-related side-effects and improve health-related outcomes of patients affected by different cancers, no specific recommendations exist for patients with melanoma. As a result, we systematically examined the current evidence regarding the effects of physical activity and exercise on objectively-measured and patient-reported outcomes among patients with melanoma. METHODS: Searches were conducted in PubMed, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases. This review included published data involving physical activity or exercise and objectively-measured or patient-reported outcomes of patients with cutaneous melanoma. The quality of included studies was assessed using the McMaster University Critical Appraisal Tool for Quantitative Studies. RESULTS: Six studies including 882 patients with melanoma were included. Studies presented heterogeneity of design with 2 cross-sectional surveys, 2 retrospective analyses, and 2 non-randomized intervention trials. No statistically significant change in quality of life, fatigue, physical function, cardiorespiratory fitness, body composition, psychological distress, cognitive function, or treatment-related side-effects were attributable to physical activity or exercise. Importantly, physical activity or exercise during melanoma treatment or into survivorship did not adversely impact patients/survivors. CONCLUSION: In summary, physical activity or exercise did not adversely impact quality of life, objectively-measured or patient-reported outcomes in patients with melanoma. In addition, there is a paucity of quality studies examining the effects of physical activity or exercise on patients with melanoma throughout the cancer care continuum.


Assuntos
Melanoma , Neoplasias Cutâneas , Estudos Transversais , Exercício Físico , Humanos , Melanoma/terapia , Qualidade de Vida , Estudos Retrospectivos , Neoplasias Cutâneas/terapia
15.
Br Med Bull ; 139(1): 100-119, 2021 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-34426823

RESUMO

INTRODUCTION: Exercise is one of several factors known to lower the risk of developing cancer, as well as improve outcomes in patients already diagnosed. People who exercise after cancer have lower rates of cancer complications, treatment toxicities, relapse and improved survival. This review highlights the supportive data and biochemical processes, which explain these potential benefits. SOURCES OF DATA: PubMed, Embase, Medline and Cochrane libraries were searched for papers which addressed the effects of exercise and physical activity on cancer for this review. The search terms used were physical activity, exercise and cancer up to February 2021. We also referred to the background research required for international exercise intervention study involving men with prostate cancer (INTERVAL-GAP4) and scrutinized references within the robust papers published on this subject to ensure we did not miss any clinically studies. One hundred and eighty eight papers were included. AREAS OF AGREEMENT: Exercise programmes mitigate many of the complications and risks associated with cancer, particularly thromboembolism, fatigue, weight gain, arthralgia, cognitive impairment and depression. AREAS OF CONTROVERSY: Molecular and biomarker changes, resulting from exercise, suggest that exercise elicits beneficial changes in insulin-related pathways, down-regulates inflammation and serum oestrogen levels, and enhances oxidative, immune and cellular repair pathways. Nonetheless, the evidence remains preliminary. GROWING POINTS: The timing, intensity and challenges of prehabilitation, adjunct and rehabilitation exercise programmes are being increasingly understood but their implementation remains sporadic. AREAS FOR DEVELOPING RESEARCH: More robust clinical trial data are needed to substantiate a causal effect of exercise on overall and cancer-specific survival. These studies are ongoing. Research evaluating the most cost-efficient ways of incorporating prehabilitation, adjunct and rehabilitation programmes into routine practice would be helpful to funding bodies and health care strategists.


Assuntos
Recidiva Local de Neoplasia , Qualidade de Vida , Atenção à Saúde , Exercício Físico , Terapia por Exercício , Humanos , Masculino , Comportamento de Redução do Risco
16.
Pilot Feasibility Stud ; 7(1): 151, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344482

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a disorder linked with a multitude of extra pulmonary manifestations (also known as treatable traits), including low bone mineral density (BMD). To date, no specific guidelines exist for the management of BMD in this population. Impact loading exercise has been identified as an intervention that improves or maintains BMD in other populations. However, the feasibility of and tolerance to impact loading exercise has not been tested in people with COPD. The aim of the proposed study will be to investigate the feasibility and tolerance of adding impact loading exercise to a standard pulmonary rehabilitation programme (PRP) in people with COPD and report its effects on bone health, balance and falls risk. METHODS: This is a protocol for a pilot feasibility and tolerance randomised controlled trial (RCT). Fifty-eight people with COPD will be randomly allocated, on a 1:1 ratio, to either the experimental or control group. Initially, participants in both groups will complete a standard 8-week (twice-weekly) PRP followed by a 32-week period of maintenance exercises. Over the initial 8-week period, participants allocated to the experimental group will also undertake targeted lower limb resistance exercises and commence a programme of impact loading exercises (e.g. bounding and drop jumps). On completion of the initial 8-week PRP, in addition to the standard maintenance exercises, participants in the experimental group will continue with home-based impact loading exercises, four times a week, for the extra 32 weeks. The primary outcome of this study is feasibility of and tolerance to impact loading exercises. Feasibility will be measured using data collected pertaining to recruitment, withdrawal and completion. Adherence to the exercises will be collected using exercise logs. Tolerance to the exercises will be determined using outcomes to assess pain, recording any adverse effects such as a fall and feedback from the participants in semi-structured interviews on completing of the trial. The effects of the 40-week experimental intervention on bone health, balance and falls risk will be reported. DISCUSSION: This pilot RCT will test the feasibility and tolerance of an intervention that has never been trialed in people with COPD. It will also provide initial information regarding the size of the effect this intervention has on outcomes such as BMD, balance and falls risk. These data will be critical when designing a definitive RCT to advance this area of research. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ANZCTR): 12620001085965 (20/10/2020).

17.
J Sports Sci Med ; 20(3): 391-397, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34267577

RESUMO

The purpose of the present study was to examine the influence of an acute bout of high-intensity resistance exercise on measures of cognitive function. Ten men (Mean ± SD: age = 24.4 ± 3.2 yrs; body mass = 85.7 ± 11.8 kg; height = 1.78 ± 0.08 m; 1 repetition maximum (1RM) = 139.0 ± 24.1 kg) gave informed consent and performed a high-intensity 6 sets of 10 repetitions of barbell back squat exercise at 80% 1RM with 2 minutes rest between sets. The Automated Neuropsychological Assessment Metrics (ANAM) was completed to assess various cognitive domains during the familiarization period, immediately before, and immediately after the high-intensity resistance exercise bout. The repeated measures ANOVAs for throughput scores (r·m-1) demonstrated significant mean differences for the Mathematical Processing task (MTH; p < 0.001, η2 p = 0.625) where post hoc pairwise comparisons demonstrated that the post-fatigue throughput (32.0 ± 8.8 r·m-1) was significantly greater than the pre-fatigue (23.8 ± 7.4 r·m-1, p = 0.003, d = 1.01) and the familiarization throughput (26.4 ± 5.3 r·m-1, p = 0.024, d = 0.77). The Coded Substitution-Delay task also demonstrated significant mean differences (CDD; p = 0.027, η2 p = 0.394) with post hoc pairwise comparisons demonstrating that the post-fatigue throughput (49.3 ± 14.4 r·m-1) was significantly less than the pre-fatigue throughput (63.2 ± 9.6 r·m-1, p = 0.011, d = 1.14). The repeated measures ANOVAs for reaction time (ms) demonstrated significant mean differences for MTH (p < 0.001, η2 p = 0.624) where post hoc pairwise comparisons demonstrated that the post-fatigue reaction time (1885.2 ± 582.8 ms) was significantly less than the pre-fatigue (2518.2 ± 884.8 ms, p = 0.005, d = 0.85) and familiarization (2253.7 ± 567.6 ms, p = 0.009, d = 0.64) reaction times. The Go/No-Go task demonstrated significant mean differences (GNG; p = 0.031, η2 p = 0.320) with post hoc pairwise comparisons demonstrating that the post-fatigue (285.9 ± 16.3 ms) was significantly less than the pre-fatigue (298.5 ± 12.1 ms, p = 0.006, d = 0.88) reaction times. High-intensity resistance exercise may elicit domain-specific influences on cognitive function, characterized by the facilitation of simple cognitive tasks and impairments of complex cognitive tasks.


Assuntos
Cognição/fisiologia , Treinamento de Força/métodos , Adulto , Atenção , Frequência Cardíaca , Humanos , Ácido Láctico/sangue , Masculino , Memória , Rememoração Mental , Fadiga Muscular/fisiologia , Força Muscular , Tempo de Reação , Adulto Jovem
18.
Int J Radiat Oncol Biol Phys ; 111(3): 716-731, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34246737

RESUMO

PURPOSE: Radiation therapy is a commonly used treatment for prostate cancer; however, the side effects may negatively affect quality of life and cause patients to be less physically active. Although exercise has been shown to mitigate radiation therapy-related fatigue in men with prostate cancer during radiation therapy, other adverse effects of treatment such as physical deconditioning, urinary symptoms, or sexual dysfunction have not been systematically reviewed in this patient population. Thus, the purpose of this review was to investigate the effect of exercise on physical function and treatment-related side effects in men with prostate cancer undergoing radiation therapy. METHODS: A systematic literature search was conducted in the PubMed, Embase, CINAHL Plus, SPORTDiscus, and Web of Science databases in December 2020. Included studies were randomized controlled trials examining the effects of aerobic and/or resistance exercise interventions on measures of physical function and treatment-related side effects in prostate cancer patients undergoing radiation therapy. Meta-analysis was performed on outcomes that were reported in 2 or more studies. RESULTS: Seven publications from 6 randomized controlled trials involving 391 prostate cancer patients were included. Patients had stage I to IV cancer with a Gleason score of ≤6 to 10. Exercise resulted in consistent significant benefits for physical function in terms of cardiovascular fitness (standardized mean difference [SMD], 0.83; 95% confidence interval [CI], 0.31-1.36; P < .01) and muscle function (SMD, 1.30; 95% CI, 0.53-2.07; P < .01). Furthermore, there was a significant positive effect of exercise on urinary toxicity (SMD, -0.71; 95% CI, -1.25 to -0.18; P < .01), but not on intestinal (P = .21) or hormonal toxicity (P = .41), depression (P = .45), or sleep symptoms (P = .88). CONCLUSION: Based on the current evidence, exercise in men with prostate cancer undergoing radiation therapy improves physical function and mitigates urinary toxicity. The effect of exercise on other treatment-related side effects are less clear and require further investigation.

19.
Cancers (Basel) ; 13(14)2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34298627

RESUMO

Supervised exercise and nutrition programs can mitigate or reverse androgen deprivation therapy (ADT) induced fat mass (FM) gain, lean mass (LM) loss, and impaired physical function. It is unclear whether these benefits are retained following transition to self-management. This study examined the effect of a home-based weight maintenance program on body composition and physical function in obese men with prostate cancer (PCa) on ADT following a 12-week supervised weight loss intervention. Eleven obese PCa patients (74 ± 5 years, 40.0 ± 4.9% body fat) on ADT (>6 months) completed a 12-week self-managed home-based weight maintenance program consisting of 150 min/week of aerobic and resistance training while maintaining a healthy balanced diet. Body composition (DXA), muscle strength (1RM), and cardiorespiratory fitness (400 m walk) were assessed. Significant reductions in weight (-2.8 ± 3.2 kg) and FM (-2.8 ± 2.6 kg), preservation of LM (-0.05 ± 1.6 kg), and improvements in muscle strength and VO2max were achieved across the supervised intervention. Across the home-based program, no significant changes were observed in weight (-0.6 ± 2.8 kg, p = 0.508), FM (0.2 ± 1.4 kg, p = 0.619), LM (-0.8 ± 1.6 kg, p = 0.146), muscle strength (-0.2 to 4.1%, p = 0.086-0.745), or estimated VO2max (0.3 ± 2.1 mL/min/kg, p = 0.649). Self-managed, home-based exercise and nutrition programs are a viable strategy to promote maintenance of body composition and physical function following a supervised intervention in obese PCa patients on ADT.

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