Effect of Exercise on Markers of Inflammation in Breast Cancer Survivors: The Yale Exercise and Survivorship Study Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. Predictors of adherence to exercise interventions during and after cancer treatment: A systematic review Analyzing Theoretical Mechanisms of Physical Activity Behavior Change in Breast Cancer Survivors: Results from the Activity Promotion (ACTION) Trial Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. Determinants of adherence to exercise in women treated for breast cancer. Effects of a self-managed home-based walking intervention on psychosocial health outcomes for breast cancer patients receiving chemotherapy: a randomised controlled trial Impact of a nutrition and physical activity intervention (ENRICH: Exercise and Nutrition Routine Improving Cancer Health) on health behaviors of cancer survivors and carers: a pragmatic randomized controlled trial A randomized pilot study with daily walking during adjuvant chemotherapy for patients with breast and colorectal cancer Effects of exercise intervention in breast cancer patients: is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Participation in and adherence to physical exercise after completion of primary cancer treatment Self-efficacy enhancing intervention increases light physical activity in people with chronic obstructive pulmonary disease Surviving and Thriving With Cancer Using a Web-Based Health Behavior Change Intervention: Randomized Controlled Trial The use of novel technology-based weight loss interventions for obese women with endometrial hyperplasia and cancer. Interactive Sensor-Based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial Pedometer-facilitated walking intervention shows promising effectiveness for reducing cancer fatigue: a pilot randomized trial Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial Novel physical activity interventions for older patients with prostate cancer on hormone therapy: A pilot randomized study.
Physical activity is associated with improved breast cancer survival , but the underlying mechanisms , possibly including modification of the inflammatory state , are not well understood . We analyzed changes in interleukin (IL)-6 , C-reactive protein ( CRP ) , and TNF-α in a r and omized controlled trial of exercise in postmenopausal breast cancer survivors . Seventy-five women , recruited through the Yale-New Haven Hospital Tumor Registry , were r and omized to either a six-month aerobic exercise intervention or usual care . Correlations were calculated between baseline cytokines , adiposity , and physical activity measures . Generalized linear models were used to assess the effect of exercise  on IL-6 , CRP , and TNF-α . At baseline , IL-6 and CRP were positively correlated with body fat and body mass index ( BMI ) and were inversely correlated with daily pedometer steps ( P < 0.001 ) . We found no significant effect of exercise  on changes in inflammatory marker concentrations between women r and omized to exercise versus usual care , though secondary analyses revealed a significant reduction in IL-6 among exercisers who reached 80 % of the intervention goal compared with those who did not . Future studies should examine the effect of different types and doses of exercise and weight loss on inflammatory markers in large-scale trials of women diagnosed with breast cancer . Cancer Prev Res ; 6(2 ) ; 109–18 . © 2012 AACR To evaluate the efficacy and economic efficiency of a multimedia , multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer . We conducted a r and omized trial with concurrent incremental cost-effectiveness analysis and blinded baseline , 3 , 6 and 12-month follow-up assessment s amongst women undergoing adjuvant therapy following surgery for breast cancer ( n = 89 ) . The intervention was a multimedia , multimodal exercise program comprising strength , balance and endurance training elements . The control was sham flexibility and relaxation program delivered using similar material s. The primary outcome was health-related quality of life ( EQ-5D & VAS , EORTC C30 , BR23 ) . Economic outcomes included direct health care costs and productivity gains and losses . Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [ mean ( sd ) EQ-5D VAS ( 0–100 ) baseline : 72.6 ( 15.6 ) , 3 month : 80.6 ( 11.6 ) ] when compared to control group participants [ baseline : 77.5 ( 13.5 ) , 3 month : 74.1 ( 20.6 ) , P = 0.006 ] and also improved more in terms of physical function [ mean ( sd ) EORTC C30 physical function scale intervention ( 0–100 ) baseline : 84.9 ( 14.8 ) , 3 month : 86.9 ( 10.7 ) , control baseline : 91.3 ( 9.6 ) , 3 month : 86.7 ( 14.9 ) , P = 0.02 ] . These improvements were not sustained beyond this point . Upper limb volumes were also lower amongst intervention group participants . However , there was low probability that the intervention would be both less costly and more effective than the control condition ( range probability = 0.05–50.02 % depending on approach ) . Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of question able economic efficiency PURPOSE To determine the effects of breast cancer-specific print material s and step pedometers on  physical activity ( PA ) and quality of life ( QoL ) in breast cancer survivors . PATIENTS AND METHODS Breast cancer survivors ( N = 377 ) were r and omly assigned to receive one of the following : a st and ard public health recommendation for PA , previously developed breast cancer-specific PA print material s , a step pedometer , or a combination of breast cancer-specific print material s and step pedometers . The primary outcome was self-reported moderate/vigorous PA minutes per week . Secondary outcomes were QoL ( Functional Assessment of Cancer Therapy-Breast ) , fatigue , self-reported brisk walking , and objective step counts . Assessment s were conducted at baseline and postintervention ( 12 weeks ) . RESULTS Attrition was 10.3 % ( 39 of 377 ) . On the basis of linear mixed-model analyses , PA increased by 30 minutes/week in the st and ard recommendation group compared with 70 minutes/week in the print material group ( mean difference , 39 minutes/week ; 95 % CI = -10 to 89 ; d = 0.25 ; P = .117 ) , 89 minutes/week in the pedometer group ( mean difference , 59 minutes/week ; 95 % CI , 11 to 108 ; d = 0.38 ; P = .017 ) , and 87 minutes/week in the combined group ( mean difference , 57 minutes/week ; 95 % CI , 8 to 106 ; d = 0.37 ; P = .022 ) . For brisk walking minutes/week , all three intervention groups reported significantly greater increases than the st and ard recommendation group . The combined group also reported significantly improved QoL ( mean difference , 5.8 ; 95 % CI , 2.0 to 9.6 ; d = 0.33 ; P = .003 ) and reduced fatigue ( mean difference , 2.3 ; 95 % CI , 0.0 to 4.7 ; d = 0.25 ; P = .052 ) compared with the st and ard recommendation group . CONCLUSION Breast cancer-specific PA print material s and pedometers may be effective strategies for increasing PA and QoL in breast cancer survivors . A combined approach appears to be optimal . CLINICAL TRIAL REGISTRATION Clinical Trials.gov Identifier Abstract Objective Exercise interventions benefit cancer patients . However , only low numbers of patients adhere to these interventions . This review aim ed to identify predictors of exercise intervention adherence in patients with cancer , during and after multimodality cancer treatment . Methods A literature search was performed using electronic data bases ( PubMed , Embase , and Cochrane ) to identify relevant papers published before February 1 , 2017 . Papers reporting r and omized controlled trials , conducted in adult cancer patients who participated in an exercise intervention during and /or after multimodality cancer treatment  , and providing outcome of factors predicting exercise adherence were included . Papers were assessed for method ological quality by using the Physiotherapy Evidence Data base scale . Results The search identified 720 potentially relevant papers , of which 15 fulfilled the eligibility criteria . In these 15 studies , 2279 patients were included and 1383 of these patients were r and omized to an exercise intervention .  During cancer treatment , the factors predicting exercise adherence were as follows : location of the rehabilitation center , extensive exercise history , high motivation for exercise , and fewer exercise limitations . After cancer treatment , factors that predicted adherence were as follows : less extensive surgery , low alcohol consumption , high previous exercise adherence , family support , feedback by trainers , and knowledge and skills of exercise . Method ological quality of the included papers was rated “ high ” . Conclusions The most prominent predictors of  adherence to exercise interventions were location of the rehabilitation center , extensive exercise history , high motivation for exercise , and fewer exercise limitations . To increase the number of cancer patients who will benefit , these results should be considered into the development and implementation of future exercise interventions Background We previously reported that a physical activity ( PA ) behavior change intervention based on the theory of planned behavior ( TPB ) increased PA and quality of life in breast cancer survivors . Purpose To examine the effects of our interventions on TPB variables and to determine if PA at 12 weeks follow-up was mediated by TPB variables at 4 weeks . Methods Breast cancer survivors ( N = 377 ) were r and omly assigned to receive either a st and ard public health recommendation for PA ( SR group ) , a step pedometer alone , or one of two TPB-based behavior change interventions consisting of print material s ( alone or combined with a step pedometer ) . For the purpose of this study , we compared the two TPB-based intervention groups ( INT group ) to the SR group . Results Compared to the SR group , the INT group reported more favorable changes in instrumental attitude ( mean difference = 0.13 ; 95 % CI = −0.01 to 0.23 ; d = 0.19 ; p = 0.077 ) , intention ( mean difference = 0.33 ; 95 % CI = 0.10 to 0.56 ; d = 0.33 ; p = 0.006 ) , and planning ( mean difference = 0.39 ; 95 % CI = 0.04 to 0.73 ; d = 0.26 ; p = 0.027 ) . Mediation analyses indicated that both planning and intention partially mediated the effects of the intervention on PA at 12 weeks . Conclusions Our TPB-based behavior change intervention result ed in small improvements in the TPB constructs that partially mediated the effects of our intervention on PA behavior . Additional research with the TPB is warranted AIMS AND OBJECTIVES To explore factors influencing exercise adherence  among women with breast cancer while following an exercise programme .  BACKGROUND Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge . Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer . DESIGN This was a qualitative study to explore patient 's perceptions of the challenges to exercise adherence during a r and omised , controlled trial . METHODS Twenty-seven women with early-stage breast cancer were purposively sample d for focus group interviews during 2011 - 2012 from their participation in the exercise intervention group during 2010 - 2012 . Five focus groups were performed , and data analysis was completed using the systematic text condensation method . RESULTS During the focus group study , five main themes were identified , which described factors participants perceived to influence their adherence to exercise during chemotherapy : ' side effects of breast cancer treatment as a barrier to exercise ' , ' restoring and maintaining normality in daily life motivates exercise ' , ' other valued activities compete with exercise ' , ' constructive support enhances exercise ' and ' positive beliefs about efficacy and outcomes motivate exercise ' . CONCLUSION Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing health behaviour . RELEVANCE TO CLINICAL PRACTICE Nurses should be aware that exercise adherence could be a challenge among women with breast cancer . They should help identify obstacles to exercise for women and ways to overcome them , as well as support them in their beliefs that they are capable of changing their health behaviour We describe adherence to a three group r and omised controlled trial that involved aerobic exercise therapy  ( N=34 ) and exercise-placebo intervention  ( N=36 ) or usual care  ( N=38 ) in women treated for breast cancer . We also investigated relationships between routes of trial recruitment , socio-economic characteristics , health behaviours , cancer treatment regimen(s ) and subsequent adherence to the interventions . Women who had completed breast cancer treatment 12 - 36 months previously were r and omised to one of the groups . The intervention groups attended an exercise facility three times per week for eight weeks . A total of 77 % of the aerobic exercise therapy and 88.9 % of the exercise-placebo groups attended at least 70 % of prescribed sessions . The percentage of women achieving 30min of aerobic exercise per session steadily increased during the intervention but many women were not able to achieve this goal . Routes of trial recruitment , socio-economic characteristics , health behaviours and cancer treatment regimen(s ) were not related to intervention . Exercise therapy participants were able to comply with the progressive nature of the aerobic exercise intervention , although some women were not able to achieve 30min of aerobic exercise per session by intervention completion . Research is still required to tease out all the potential determinants of exercise in this population Purpose This study evaluated the effectiveness of a self-managed home-based moderate intensity walking intervention on psychosocial health outcomes among breast cancer patients undergoing chemotherapy . Methods The r and omised controlled trial compared a self-managed , home-based walking intervention to usual care alone among breast cancer patients receiving chemotherapy . Outcome measures included changes in self-report measures of anxiety , depression , fatigue , self-esteem , mood and physical activity .  Fifty participants were r and omised to either the intervention group ( n = 25 ) , who received 12 weeks of moderate intensity walking , or the control group ( n = 25 ) mid-way through chemotherapy . Participants in the intervention group were provided with a pedometer and were asked to set goals and keep weekly diaries outlining the duration , intensity and exertion of their walking .  Levels of psychosocial functioning and physical activity were assessed pre- and post-intervention in both groups . Results The intervention had positive effects on fatigue ( F = 5.77 , p = 0.02 ) , self-esteem ( F = 8.93 , p ≤ 0.001 ) , mood ( F = 4.73 , p = 0.03 ) and levels of physical activity ( x2 = 17.15 , p = 0.0011 ) but not anxiety ( F = 0.90 , p = 0.35 ) and depression ( F = 0.26 , p = 0.60 ) as assessed using the HADS . We found an 80 % adherence rate to completing the 12-week intervention and recording weekly logs . Conclusion This self-managed , home-based intervention was beneficial for improving psychosocial well-being and levels of physical activity among breast cancer patients treated with chemotherapy . Trial registration Current Controlled Trials IS RCT N50709297 Background Physical activity and consuming a healthy diet have clear benefits to the physical and psychosocial health of cancer survivors , with guidelines recognising the importance of these behaviors for cancer survivors . Interventions to promote physical activity and improve dietary behaviors among cancer survivors and carers are needed . The aim of this study was to determine the effects of a group-based , face-to-face multiple health behavior change intervention on behavioral outcomes among cancer survivors of mixed diagnoses and carers . Methods The Exercise and Nutrition Routine Improving Cancer Health ( ENRICH ) intervention was evaluated using a two-group pragmatic r and omized controlled trial . Cancer survivors and carers ( n = 174 ) were r and omly allocated to the face-to-face , group-based intervention ( six , theory-based two-hour sessions delivered over 8 weeks targeting healthy eating and physical activity [ PA ] ) or wait-list control ( after completion of 20-week data collection ) . Assessment of the primary outcome ( pedometer-assessed mean daily step counts ) and secondary outcomes ( diet and alcohol intake [ Food Frequency Question naire ] , self-reported PA , weight , body mass index , and waist circumference ) were assessed at baseline , 8- and 20-weeks . Results There was a significant difference between the change over time in the intervention group and the control group . At 20 weeks , the intervention group had increased by 478 steps , and the control group had decreased by 1282 steps ; this represented an adjusted mean difference of 1761 steps ( 184 to 3337 ; P = 0.0028 ) . Significant intervention effects for secondary outcomes , included a half serving increase in vegetable intake ( difference 39 g/day ; 95 % CI : 12 to 67 ; P = 0.02 ) , weight loss ( kg ) ( difference -1.5 kg ; 95 % CI , -2.6 to -0.3 ; P = 0.014 ) and change in body mass index ( kg/m2 ) ( difference -0.55 kg/m2 ; 95 % CI , -0.97 to -0.13 ; P = 0.012 ) . No significant intervention effects were found for self-reported PA , total sitting time , waist circumference , fruit , energy , fibre , alcohol , meat , or fat consumption . Conclusions The ENRICH intervention was effective for improving PA , weight , body mass index , and vegetable consumption even with the inclusion of multiple cancer types and carers . As an example of successful research translation , the Cancer Council NSW has subsequently adopted ENRICH as a state-wide program . Trial registration Australian New Zeal and Clinical Trials Register identifier : ANZCTRN1260901086257 Abstract Background . Physical activity during chemotherapy has been shown in several studies to reduce fatigue , improve symptoms and impact positively on health-related quality of life ( HRQoL ) . Challenges associated with intervention studies on physical activity during cancer treatment relate to consistent adherence . The primary objective was to study feasibility and adherence of physical activity intervention among patients with cancer during adjuvant chemotherapy treatment . The secondary objective was to investigate the effects of physical activity on health aspects , including HRQoL , symptoms and surrogate markers for cardiovascular disease . Material and methods . This r and omized controlled trial included patients with breast cancer ( BRCA ) and colorectal cancer ( CRC ) during adjuvant chemotherapy .  The intervention continued for 10 weeks and included daily walks of 10 000 steps and a weekly supervised group walk . Adherence was assessed by a pedometer and the number of participants who reported step counts every week and percentage of participants who achieved the target steps every week . Results . Adherence average reached 91 % during the intervention period ; in total 74 % completed the exercise intervention . The majority of the participants achieved an average of 83 % of the target of 10 000 steps per day for 10 weeks . There was a significant increase in daily physical activity ( p = 0.016 ) in the intervention group . Significant differences were also found for some breast cancer-specific symptoms [ swelling , mobility and pain ( p = 0.045 ) ] . The study showed a relatively small weight gain an average of 0.9 kg in the intervention group and 1.3 kg in the control group . Conclusion . Physical activity in the form of walking is feasible during adjuvant chemotherapy treatment despite increasing symptoms . The physical activity increased in the intervention group during the study time and had a positive impact on breast symptoms and the weight gain was lower in comparison to previous studies Purpose To investigate and compare the effects of mobile health ( mHealth ) and pedometer with conventional exercise program using a brochure on physical function and quality of life ( QOL ) . Methods The study was a prospect i ve , quasi-r and omized multicenter trial where 356 patients whose cancer treatment had been terminated were enrolled . All patients were instructed to perform a 12-week regimen of aerobic and resistance exercise . The mHealth group received a pedometer and a newly developed smartphone application to provide information and monitor the prescribed exercises . Those in the conventional group received an exercise brochure . Physical measurements were conducted at baseline , 6 weeks , and 12 weeks . Self-reported physical activity ( international physical activity question naire-short form ) , general QOL ( European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 ) , and breast cancer-specific QOL ( Quality of Life Question naire Breast Cancer Module 23 ) were assessed at baseline and 12 weeks . A user satisfaction survey was assessed in the mHealth group . Results Basic characteristics were not different between the two groups except for age and previous radiotherapy . Physical function , physical activity , and QOL scores were significantly improved regardless of the intervention method , and changes were not significantly different between the two groups . Additionally , the mean Likert scale response for overall satisfaction with the service was 4.27/5 in the mHealth group . Conclusions Overall , both the mHealth coupled with pedometer and conventional exercise education using a brochure were effective in improving physical function , physical activity , and QOL . This study provides a basis of mHealth research in breast cancer patients for progressing further developing field , although superiority of the mHealth over the conventional program was not definitely evident Background ﻿The purpose of this study was to identify demographic , clinical , psychosocial , physical and environmental factors that are associated with participation in and adherence to a combined resistance and endurance exercise program among cancer survivors , shortly after completion of primary cancer treatment . Data from the r and omized controlled Resistance and Endurance exercise After ChemoTherapy ( REACT ) study were used for this study . Methods The participants of the REACT study were r and omly allocated to either a high intensity ( HI ) or low-to-moderate intensity ( LMI ) exercise program . Patients ’ participation rate was defined as the cancer survivors ’ decision to participate in the REACT study . Exercise adherence reflected participants ’ attendance to the scheduled exercise sessions and their compliance to the prescribed exercises . High session attendance rates were defined as attending at least 80 % of the sessions . High compliance rates were defined as performing at least of 90 % of the prescribed exercise across all sessions . Correlates of exercise adherence were studied separately for HI and LMI exercise . Demographic , clinical , and physical factors were assessed using self-reported question naires . Relevant clinical information was extracted from medical records . Multivariable logistic regression analyses were applied to identify correlates that were significantly associated with participation , high session attendance , high compliance with resistance and high compliance with endurance exercises . Results Participants were more likely to have higher education , be non-smokers , have lower psychological distress , higher outcome expectations  , and perceive more exercise barriers than non- participants . In HI exercise , higher self-efficacy was significantly associated with high session attendance and high compliance with endurance exercises , and lower psychological distress was significantly associated with high compliance with resistance exercises . In LMI exercise , being a non-smoker was significantly associated with high compliance with resistance exercises and higher BMI was significantly associated with high compliance with resistance and endurance exercises . Furthermore , breast cancer survivors were less likely to report high compliance with resistance and endurance exercises in LMI exercise compared to survivors of other types of cancer . The discriminative ability of the multivariable models ranged from 0.62 to 0.75 . ConclusionS everal demographic , clinical and psychosocial factors were associated with participation in and adherence to exercise among cancer survivors . Psychosocial factors were more strongly associated with adherence in HI than LMI exercise . Trial registration This study was registered at the Netherl and s Trial Register [ NTR2153 ] on the 5th of January 2010 Background People with chronic obstructive pulmonary disease lead sedentary lives and could benefit from increasing their physical activity . The purpose of this study was to determine if an exercise-specific self-efficacy enhancing intervention could increase physical activity and functional performance when delivered in the context of 4 months of upper body resistance training with a 12-month follow-up . Methods In this r and omized controlled trial , subjects were assigned to : exercise-specific self-efficacy enhancing intervention with upper body resistance training ( SE-UBR ) , health education with upper body resistance training ( ED-UBR ) , or health education with gentle chair exercises ( ED-Chair ) . Physical activity was measured with an accelerometer and functional performance was measured with the Functional Performance Inventory . Forty-nine people with moderate to severe chronic obstructive pulmonary disease completed 4 months of training and provided valid accelerometry data , and 34 also provided accelerometry data at 12 months of follow-up . The self-efficacy enhancing intervention emphasized meeting physical activity guidelines and increasing moderate-to-vigorous physical activity . Results Differences were observed in light physical activity ( LPA ) after 4 months of training , time by group interaction effect ( P=0.045 ) . The SE-UBR group increased time spent in LPA by + 20.68±29.30 minutes/day and the other groups decreased time spent in LPA by −22.43±47.88 minutes/day and -25.73±51.76 minutes/day . Changes in LPA were not sustained at 12-month follow-up . There were no significant changes in moderate-to-vigorous physical activity , sedentary time , or functional performance . Subjects spent most of their waking hours sedentary : 72%±9 % for SE-UBR , 68%±10 % for ED-UBR , and 74%±9 % for ED-Chair . Conclusion The self-efficacy enhancing intervention produced a modest short-term increase in LPA . Further work is needed to increase the magnitude and duration of effect , possibly by targeting LPA Background Given the substantial improvements in cancer screening and cancer treatment in the United States , millions of adult cancer survivors live for years following their initial cancer diagnosis and treatment . However , latent side effects can occur and some symptoms can be alleviated or managed effectively via changes in lifestyle behaviors . Objective The purpose of this study was to test the effectiveness of a six-week Web-based multiple health behavior change program for adult survivors . Methods Participants ( n=352 ) were recruited from oncology clinics , a tumor registry , as well as through online mechanisms , such as Facebook and the Association of Cancer Online Re sources ( ACOR ) . Cancer survivors were eligible if they had completed their primary cancer treatment from 4 weeks to 5 years before enrollment . Participants were r and omly assigned to the Web-based program or a delayed-treatment control condition . Results In total , 303 survivors completed the follow-up survey ( six months after completion of the baseline survey ) and participants in the Web-based intervention condition had significantly greater reductions in insomnia and greater increases in minutes per week of vigorous exercise and stretching compared to controls . There were no significant changes in fruit and vegetable consumption or other outcomes . Conclusions The Web-based intervention impacted insomnia and exercise ; however , a majority of the sample met or exceeded national recommendations for health behaviors and were not suffering from depression or fatigue at baseline . Thus , the survivors were very healthy and well-adjusted upon entry and their ability to make substantial health behavior changes may have been limited . Future work is discussed , with emphasis placed on ways in which Web-based interventions can be more specifically analyzed for benefit , such as in regard to social networking . Trial Registration Clinical trials.gov NCT00962494 ; http://www . clinical trials.gov/ct2/show/NCT00962494 ( Archived by WebCite at http://www.webcitation.org/6NIv8Dc6Q ) OBJECTIVE Obesity significantly increases the risk of the development of both endometrial hyperplasia and cancer . Our objective was to assess the feasibility of two technology-based weight loss interventions in this patient population . METHODS Women with obesity ( BMI ≥30kg/m(2 ) ) and endometrial hyperplasia or Type I endometrial cancer were r and omized 1:1 to a technology-based 6month lifestyle intervention via either telemedicine or text messaging . The telemedicine arm received weekly phone calls , with weights tracked online using Withings © Wi-Fi scales . The text arm received 3 - 5 personalized messages daily via Text4Diet ™ . Participants maintained a 1200 - 1800calorie/day diet , self-monitored food intake and received exercise goals . Biomarkers ( IGFBP-1 , adiponectin , VEGF , IL1-beta , IL2 , IL6 , and IL7 ) were assessed pre- and post-treatment . RESULTS Twenty women were r and omized ( Telemedicine : n=10 , Text4Diet : n=10 ) , and 90 % lost weight .  Many were early stage ( 70 % ) and grade ( 43.8 % ) disease with a median age of 60.5years . We observed a statistically greater weight loss in the Telemedicine arm [ median loss : 9.7 kg ( range : 1.6 - 22.9 kg ) ] versus 3.9 kg ( range : 0.3 - 11.4 kg ) in the Text4Diet arm ( p=0.0231 ) . Similarly , percent weight loss was greater in the Telemedicine ( 7.6 % ) as compared to the Text4Diet arm ( 4.1 % , p=0.014 ) . Mean serum levels of IL-2 were significantly ( 27.15pg/mL vs. 5.18pg/mL , p=0.0495 ) lower at intervention end as compared to baseline . CONCLUSIONS A technology-based weight loss intervention is feasible in women with Type I endometrial cancer/hyperplasia . Both interventions produced weight loss , although more person-to-person contact produced more significant outcomes . Reductions in expression of IL-2 were related to weight loss Background : Cancer patients with chemotherapy-induced peripheral neuropathy ( CIPN ) have deficits in sensory and motor skills leading to inappropriate proprioceptive feedback , impaired postural control , and fall risk . Balance training programs specifically developed for CIPN patients are lacking . Objective : This pilot study investigated the effect of an interactive motor adaptation balance training program based on wearable sensors for improving balance in older cancer patients with CIPN . Methods : Twenty-two patients ( age : 70.3 ± 8.7 years ) with objective ly confirmed CIPN [ vibration perception threshold ( VPT ) > 25 V ] were r and omized to either an intervention ( IG ) or a control ( CG ) group . The IG received interactive game-based balance training including repetitive weight shifting and virtual obstacle crossing tasks . Wearable sensors provided real-time visual/auditory feedback from the lower limb trajectory and allowed the perception of motor errors during each motor action . The CG received no exercise intervention and continued their normal activity . Outcome measures were changes in sway of ankle , hip , and center of mass ( CoM ) in both mediolateral and anteroposterior ( AP ) directions during 30-second balance tests with increasing task difficulty [ i.e. st and ing in feet-closed position with eyes open ( EO ) and eyes closed ( EC ) , and in semi-t and em position with EO ] at baseline and after the intervention . Additionally , gait performance ( speed , variability ) and fear of falling [ Falls Efficacy Scale-International ( FES-I ) ] were measured . Results : Training was safe despite the participants ' impaired health status , great severity of CIPN ( VPT 49.6 ± 26.7 V ) , and great fear of falling ( FES-I score 31.37 ± 11.20 ) . After the intervention , sway of hip , ankle , and CoM was significantly reduced in the IG compared to the CG while st and ing in feet-closed position with EO ( p = 0.010 - 0.022 , except AP CoM sway ) and in semi-t and em position ( p = 0.008 - 0.035 , except ankle sway ) . No significant effects were found for balance with EC , gait speed , and FES-I score ( p > 0.05 ) . Conclusions : This proof-of-concept study demonstrates that older cancer patients with CIPN can significantly improve their postural balance with specifically tailored , sensor-based exercise training . The training approach has potential as a therapy for improving CIPN-related postural control deficits . However , future studies comparing the proposed technology-based training with traditional balance training are required to evaluate the benefit of the interactive joint movement feedback Objective : Mechanisms for cancer related fatigue suggest that exercise but “ not too much and not too little ” could be effective . This study aim ed to investigate feasibility and estimate the potential effects of a walking exercise program in people with advanced cancer and fatigue . Design : A pilot r and omized trial . Setting : McGill University Health Centre ( MUHC ) , Montreal , Canada . Subjects : People with advanced cancer undergoing interdisciplinary assessment and rehabilitation with a fatigue level of 4 to 10 on a visual analogue scale . Interventions : An 8-week fatigue-adapted , walking intervention , facilitated using a pedometer ( STEPS ) , and offered at the same time as or after rehabilitation . Measures : Measures of fatigue , physical function and well-being were administered at entry , and 8 , 16 and 24 weeks . Generalized estimating equations ( GEE ) estimated the odds of response for people receiving the STEPS program in comparison to the odds of response in the controls ( odds ratio , OR ) . Results : Twenty-six persons were r and omized to three groups : during rehabilitation , after rehabilitation , and usual care . For the fatigue measures the OR for STEPS offered at any time using an intention-to-treat approach was 3.68 ( 95%CI : 1.05 - 12.88 ) ; for the physical function measures , the OR was 1.40 ( 95%CI : 0.41- 4.79 ) and 2.36 ( 95%CI : 0.66 - 8.51 ) for the well-being measures . Conclusion : Fifty percent of eligible people were able to participate . This small trial suggests that a personalized exercise program reduces fatigue and that 100 people are needed in a full strength trial Given observational findings that physical activity reduces breast cancer risk , improves survival , and improves quality of life in breast cancer survivors , a need has been identified for r and omized controlled trials that testthe efficacy of exercise on biological mechanisms associated with breast cancer survival . The primary aims of the Yale Exercise and Survivorship Study were to 1 ) determine the feasibility of recruiting breast cancer survivors into a r and omized controlled trial of the effects of exercise on biological markers and /or mechanisms associated with survival , 2 ) compare the effectiveness of various recruitment strategies on accrual rates and baseline characteristics , and 3 ) report adherence to the exercise trial BACKGROUND And rogen deprivation therapy ( ADT ) can decrease the physical performance ( PP ) of older men with prostate cancer ( PC ) . METHODS We conducted a three-arm r and omized pilot study ( n=19 ) comparing a home-based walking and resistance intervention ( EXCAP ) and a technology-mediated walking and resistance intervention using Wii-Fit to a usual-care arm  in men ≥70 years with PC receiving ADT . The intervention lasted for 6 weeks , with follow-up at 12 weeks . The primary pre-specified outcome was change in Short Physical Performance Battery ( SPPB ) score . Mixed effects regression models were used to assess change in outcomes over time . RESULTS Mean participant age was 70 years ( range : 67 - 93 ) . Eight patients were r and omized to the Wii-Fit arm , 6 to the EXCAP arm , and 5 to the usual-care arm . SPPB scores remained nearly constant in the usual-care arm ( β=-0.12 ; p=0.79 ) , while individuals in the EXCAP arm had on average a 1.2 point increase at each follow-up ( β=1.20 ; 95 % CI : 0.36 , 2.06 ) . The Wii-fit arm had a non-significant increase in SPPB score over time relative to usual-care ( β=0.32 ; 95 % CI -0.43 , 1.06 ; p=0.46 ) . Individuals in the EXCAP arm had an increase in steps per day over time compared to the usual-care arm ( p-value=0.006 ) ; the EXCAP arm had an increase of 2720 steps ( 95 % CI : 1313 , 4128 ) while the usual-care arm had an increase of 97 steps ( 95 % CI : -1140 , 1333 ) . Participants in the Wii-Fit arm had an increase of 1020 steps ( 95 % CI : -474 , 1238 , p=0.710 ) . Other outcomes ( i.e. , h and grip strength , lean muscle mass , and chest press repetitions ) were not statistically significant . CONCLUSIONS A home-based aerobic and resistance exercise program , EXCAP , shows promise for improving PP in older men with PC on ADT
Background : Exercise can ameliorate cancer- and treatment-related toxicities , but poor adherence to exercise regimens is a barrier .
Exercise interventions using digital activity trackers ( E-DATs ) may improve exercise adherence , but data are limited for patients with cancer .
We conducted a systematic review examining the feasibility of E-DATs in cancer survivors and effects on activity level , body composition , objective fitness outcomes , health-related quality of life ( HRQoL ) , self-reported symptoms , and biomarkers .