Modality of exercise influences rate of decrease in depression for cancer survivors with elevated depressive symptomatology.

PURPOSE: This three-arm feasibility controlled trial examined whether different exercise modalities provide reductions in depression symptoms to cancer survivors with elevated depression. METHODS: Thirty-two participants (58.9 ± 9.4 years) were allocated to a 12-week supervised exercise group (EX; n = 10), a self-managed home-based exercise group (SMHB; n = 8), or a usual care control group (CONT; n = 14). EX performed two supervised resistance and aerobic sessions per week. SMHB were provided with printed material about benefits of exercise and encouraged to complete 150 min of exercise weekly. CONT received no exercise or printed material and were encouraged to maintain usual activity. RESULTS: A group × time interaction was found for the primary outcome of depression scores, measured using the Hospital Anxiety and Depression Scale (HADS-D; p = .008). SMHB (6.4 ± 5.3 to 2.2 ± 2.9, p = .006) and EX (6.9 ± 4.2 to 4.0 ± 2.4, p = .021) interventions both effectively reduced HADS-D scores compared to CONT (7.2 ± 2.5 to 7.7 ± 3.6). SMHB decreased depression to a greater extent, and this occurred more rapidly with greatest changes noted at 6 weeks (d = 0.50). Further favourable outcomes for exercise were also noted for several secondary outcome measures. CONCLUSION: The rate of exercise-related reduction in depression is influenced by the modality of exercise. However, increasing the duration of the programme appears to diminish the favourable short-term response to self-managed exercise with subsequent secondary outcomes of mental health favouring supervised exercise.

Effect of concurrent resistance and endurance training on physiologic and performance parameters of well-trained endurance cyclists.

The purpose of this study was to investigate the effect of concurrent resistance and endurance cycle training on physiologic and performance parameters of cyclists. Before and after a 6-week training intervention period, 14 well-trained male cyclists completed a maximal graded exercise test, a 30-km dynamic cycling test with 3 intermittent 250-m and 1-km sprints, and a 1 repetition maximum (1RM) squat test for the assessment of lower-limb strength. Subjects were allocated into 2 groups: a resistance training group (RT; n = 7) that completed a 6-week undulating, periodized resistance training program (3/wk) in conjunction with their regular cycle training and a control group (CON; n = 7) that maintained their usual cycle training. Upon completion of the training intervention, there was no change in graded exercise test parameters in either group, but the RT group showed a significantly greater increase in 1RM squat strength compared with CON (p < 0.05). Moreover, the change in 30-km time trial and sprinting performance did not differ between RT and CON, except for the final 1-km sprint where the percent change in 1-km final sprint performance was greater in CON (+11%) compared with RT (-5%). In conclusion, although concurrent resistance and endurance training in well-trained cyclists enhanced 1RM strength, it did not improve overall cycle time trial performance and in fact was shown to reduce 1-km final cycle sprint performance compared with a CON group performing their normal cycle training.

Effect of concurrent endurance and circuit resistance training sequence on muscular strength and power development.

The purpose of this study was to examine the influence of the sequence order of high-intensity endurance training and circuit training on changes in muscular strength and anaerobic power. Forty-eight physical education students (ages, 21.4 +/- 1.3 years) were assigned to 1 of 5 groups: no training controls (C, n = 9), endurance training (E, n = 10), circuit training (S, n = 9), endurance before circuit training in the same session, (E+S, n = 10), and circuit before endurance training in the same session (S+E, n = 10). Subjects performed 2 sessions per week for 12 weeks. Resistance-type circuit training targeted strength endurance (weeks 1-6) and explosive strength and power (weeks 7-12). Endurance training sessions included 5 repetitions run at the velocity associated with Vo2max (Vo2max) for a duration equal to 50% of the time to exhaustion at Vo2max; recovery was for an equal period at 60% Vo2max. Maximal strength in the half squat, strength endurance in the 1-leg half squat and hip extension, and explosive strength and power in a 5-jump test and countermovement jump were measured pre- and post-testing. No significant differences were shown following training between the S+E and E+S groups for all exercise tests. However, both S+E and E+S groups improved less than the S group in 1 repetition maximum (p < 0.01), right and left 1-leg half squat (p < 0.02), 5-jump test (p < 0.01), peak jumping force (p < 0.05), peak jumping power (p < 0.02), and peak jumping height (p < 0.05). The intrasession sequence did not influence the adaptive response of muscular strength and explosive strength and power. Circuit training alone induced strength and power improvements that were significantly greater than when resistance and endurance training were combined, irrespective of the intrasession sequencing.

Exercise Improves Physical Function and Mental Health of Brain Cancer Survivors: Two Exploratory Case Studies.

Background Malignant brain tumors are unpredictable and incurable, with 5-year survival rates less than 30%. The poor prognosis combined with intensive treatment necessitates the inclusion of complementary and supportive therapies that optimize quality of life and reduce treatment-related declines in health. Exercise therapy has been shown to be beneficial in other cancer populations, but no evidence is available for brain cancer survivors. Therefore, we report results from 2 preliminary cases. Methods Two female patients diagnosed with glioblastoma multiforme and oligodendroglioma participated in a structured and supervised 12-week exercise program. The program consisted of two 1-hour resistance and aerobic exercise sessions per week and additional self-managed aerobic sessions. Outcome measures of strength, cardiovascular fitness, and several psychological indicators (depression, anxiety, and quality of life) were recorded at baseline, after 6 weeks and at the conclusion of the intervention. Results Exercise was well tolerated; both participants completed all 24 sessions and the home-based component with no adverse effects. Objective outcome measures displayed positive responses relating to reduced morbidity. Similar positive responses were found for psychological outcomes. Scores on the Hospital Anxiety and Depression Scale showed clinically meaningful improvements in depression and total distress. Conclusion These findings provide initial evidence that, despite the difficulties associated with brain cancer treatment and survivorship, exercise may be safe and beneficial and should be considered in the overall management of patients with brain cancer.

Surveys of Cancer Patients and Cancer Health Care Providers Regarding Complementary Therapy Use, Communication, and Information Needs.

BACKGROUND: Complementary therapies (CTs) are increasingly utilized by cancer patients. Nonetheless, patients report insufficient support from health care practitioners (HCPs) and there is a general lack of patient-practitioner communication about CT use. Best care practices suggest that HCPs should address the needs of patients, including CT use. This study examined current practices of patients and HCPs as well as their interactions relating to CTs. METHODS: A total of 481 cancer outpatients and 100 HCPs completed questionnaires. Patient questions addressed CT use and information needs; HCP questions addressed knowledge, opinions and beliefs about complementary and alternative medicine. Patient-practitioner communication around CT was also examined. RESULTS: 47% of patients reported using CTs since diagnosis. Many commenced CT use to improve quality of life (65%) based on recommendations from family or friends. Patients acknowledged the need for trusted sources of information and would attend a hospital-based education program (72%). HCPs reported limited training about CTs but most (90%) expressed interested in receiving more training. The majority of HCPs (>80%) reported limited knowledge about the role of CTs in cancer care or evidence to support CT use. Questions about communication and interactions revealed that 80% of patients reported not having had an HCP speak to them about CTs. However, 63% of HCPs reported addressing CT use. CONCLUSION: Results demonstrate a need for improved CT education and training for patients and HCPs. increasing HCP knowledge and clinical skills will ensure patients' information needs about CTs are acknowledged and attended to, thereby providing safer and comprehensive cancer care.

Reliability of physiological attributes and their association with stochastic cycling performance.

PURPOSE: To assess the reliability of a 5-min-stage graded exercise test (GXT) and determine the association between physiological attributes and performance over stochastic cycling trials of varying distance. METHODS: Twenty-eight well-trained male cyclists performed 2 GXTs and either a 30-km (n = 17) or a 100-km stochastic cycling time trial (n = 9). Stochastic cycling trials included periods of high-intensity efforts for durations of 250 m, 1 km, or 4 km depending on the test being performing. RESULTS: Maximal physiological attributes were found to be extremely reliable (maximal oxygen uptake [VO2max]: coefficient of variation [CV] 3.0%, intraclass correlation coefficient [ICC] .911; peak power output [PPO]: CV 3.0%, ICC .913), but a greater variability was found in ventilatory thresholds and economy. All physiological variables measured during the GXT, except economy at 200 W, were correlated with 30-km cycling performance. Power output during the 250-m and 1-km efforts of the 30-km trial were correlated with VO2max, PPO, and the power output at the second ventilatory threshold (r = .58-.82). PPO was the only physiological attributed measured during the GXT to be correlated with performance during the 100-km cycling trial (r = .64). CONCLUSIONS: Many physiological variables from a reliable GXT were associated with performance over shorter (30-km) but not longer (100-km) stochastic cycling trials.

Effect of starting stance on initial sprint performance.

The effect of different starting stances from a standing position on short sprint times and the subsequent variability in times was investigated in this study. A dual-beam timing light system was used to measure 5- and 10-m times for 3 different standing starts commonly found in the sporting environment: parallel (feet parallel to the start line), split (lead left foot on start line, right leg back), and false (initial parallel start, right leg drops back to split start when movement initiated). The parallel start was found to be significantly (alpha < 0.05) slower than the other 2 stances for both the 5- ( approximately 8.3%) and the 10-m (approximately 5.9%) distances. Within the trial, variation of the different starting stances was equally consistent; however, there was less variability for the 10-m distance (CV = 1.16-1.67%) than the 5-m distance (CV = 1.43-2.15%) for each start for both men and women. The split and false start seem to offer the best option as a movement strategy for minimizing short-distance sprint times. However, the benefits of these 2 starts are less clear if total movement time is the variable of interest.