Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). The effects of exercise on pain, fatigue, insomnia, and health perceptions in patients with operable advanced stage rectal cancer prior to surgery: a pilot trial The effect of resistance exercise on all-cause mortality in cancer survivors. Effects of exercise training on exercise capacity in patients with non-small cell lung cancer receiving targeted therapy Long-term follow-up after cancer rehabilitation using high-intensity resistance training: persistent improvement of physical performance and quality of life A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors Participation in and adherence to physical exercise after completion of primary cancer treatment The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial Randomized controlled trial of the effects of high intensity and low-to-moderate intensity exercise on physical fitness and fatigue in cancer survivors: results of the Resistance and Endurance exercise After ChemoTherapy (REACT) study Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: a randomised controlled trial High-intensity training following lung cancer surgery: a randomised controlled trial The influence of adjuvant therapy on cardiorespiratory fitness in early-stage breast cancer seven years after diagnosis: the Cooper Center Longitudinal Study Effects of aerobic or combined aerobic resistance exercise on body composition in overweight and obese adults: gender differences. A randomized intervention study. The influence of high-intensity compared with moderate-intensity exercise training on cardiorespiratory fitness and body composition in colorectal cancer survivors: a randomised controlled trial Interval versus continuous aerobic exercise training in breast cancer survivors—a pilot RCT Effects of resistance training combined with moderate-intensity endurance or low-volume high-intensity interval exercise on cardiovascular risk factors in patients with coronary artery disease. Reach out to ENhancE Wellness in Older Cancer Survivors (RENEW): design, methods and recruitment challenges of a home-based exercise and diet intervention to improve physical function among long-term survivors of breast, prostate, and colorectal cancer. Short‐Term Preoperative High‐Intensity Interval Training in Patients Awaiting Lung Cancer Surgery: A Randomized Controlled Trial Outcomes of Pulmonary Rehabilitation After Treatment for Non-Small Cell Lung Cancer Stages I to IIIa: AN OBSERVATIONAL STUDY
Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials Background Promoting quality of life ( QoL ) is a key priority in cancer care . We investigated the hypothesis that , in comparison to usual care , exercise post-neoadjuvant chemoradiation therapy/prior to surgical resection will reduce pain , fatigue , and insomnia , and will improve physical and mental health perceptions in patients with locally advanced stage rectal cancer . Methods In this non-r and omized controlled pilot trial , patients in the supervised exercise group ( EG ; Mage = 64 years ; 64 % male ) and in the control group ( CG ; Mage = 72 years ; 69 % male ) completed the European Organization for Research and Treatment of Cancer core Quality of Life question naire and the R AND 36-Item Health Survey three times : pre-neoadjuvant chemoradiation therapy ( Time 1 ; nEC = 24 ; nCG = 11 ) , post-neoadjuvant chemoradiation therapy/pre-exercise intervention ( Time 2 ; nEC = 23 ; nCG = 10 ) , and post-exercise intervention ( Time 3 ; nEC = 22 ; nCG = 10 ) . The 6-week exercise intervention was delivered in hospital and comprised of interval aerobic training . Patients trained in pairs three times per week for 30 to 40 min . Data were analyzed by Mann – Whitney tests and by Wilcoxon matched-pairs signed-rank tests . Results No significant between-group differences in changes were found for any of the outcomes . In both groups , fatigue levels decreased and physical health perceptions increased from pre- to post-exercise intervention . Pain levels also decreased from pre- to post-exercise intervention , albeit not significantly . Conclusions The findings from this study can be used to guide a more definitive trial as they provide preliminary evidence regarding the potential effects of pre-operative exercise on self-reported pain , fatigue , insomnia , and health perceptions in patients with locally advanced rectal cancer . Trial registration : This study has been registered with clinical trials.gov ( NCT01325909 ; March 29 , 2011 ) OBJECTIVE To examine the independent associations of leisure-time aerobic physical activity ( PA ) and resistance exercise ( RE ) on  all-cause mortality in cancer survivors . PATIENTS AND METHODS Patients included 2863 male and female cancer survivors , aged 18 to 81 years , who received a preventive medical examination between April 8 , 1987 , and December 27 , 2002 , while enrolled in the Aerobics Center Longitudinal Study in Dallas , Texas .  Physical activity and RE were assessed by self-report at the baseline medical examination . Cox proportional hazards regression analysis was performed to determine the independent associations of PA and RE with all-cause mortality in participants who had a history of cancer . RESULTS Physical activity in cancer survivors was not associated with a lower risk of all-cause mortality . In contrast , RE was associated with a 33 % lower risk of all-cause mortality ( 95 % CI , 0.45 - 0.99 ) after adjusting for potential confounders , including PA . CONCLUSION Individuals who participated in RE during cancer survival had a lower risk for all-cause mortality . The present findings provide preliminary evidence for benefits of RE during cancer survival . Future r and omized controlled trials examining RE and its effect on lean body mass , muscular strength , and all-cause mortality in cancer survivors are warranted Purpose Peak oxygen consumption ( VO2peak ) is an important predictive factor for long-term prognosis in patients with non-small cell lung cancer ( NSCLC ) . The purpose of this study was to investigate whether 8 weeks of exercise training improves exercise capacity , as assessed by VO2peak , and other related factors in patients with NSCLC receiving targeted therapy . Methods A total of 24 participants with adenocarcinoma were r and omly assigned to either the control group ( n = 11 ) or the exercise group ( n = 13 ) . Subjects in the exercise group participated in individualized , high-intensity aerobic interval training of exercise . The outcome measures assessed at baseline and after 8 weeks were as follows : VO2peak and the percentage of predicted VO2peak ( % predVO2peak ) , muscle strength and endurance of the right quadriceps , muscle oxygenation during exercise , insulin resistance as calculated by the homeostasis model , high-sensitivity C-reactive protein , and quality of life ( QoL ) question naire inventory . Results No exercise-related adverse events were reported . After exercise training , VO2peak and % predVO2peak increased by 1.6 mL kg−1 min−1 and 5.3 % ( p < 0.005 ) , respectively ; these changes were associated with improvements in circulatory , respiratory , and muscular functions at peak exercise ( all p = 0.001 ) . The exercise group also had less dyspnea ( p = 0.01 ) and favorably lower fatigue ( p = 0.05 ) than baseline . Conclusions Patients with NSCLC receiving targeted therapy have quite a low exercise capacity , even with a relatively high QoL. Exercise training appears to improve exercise capacity and alleviate some cancer-related symptoms The short-term beneficial effects of physical rehabilitation programmes after cancer treatment have been described . However , little is known regarding the long-term effects . The purpose of this study was to investigate the long-term effects of high-intensity resistance training compared with traditional recovery . A total of 68 cancer survivors who completed an 18-week resistance training programme were followed for 1 year . During the 1-year follow-up , 19 patients dropped out ( 14 due to recurrence of cancer ) . The remaining 49 patients of the intervention group were compared with a group of 22 patients treated with chemotherapy in the same period but not participating in any rehabilitation programme . Outcome measures were muscle strength , cardiopulmonary function , fatigue , and health-related quality of life . One year after completion of the rehabilitation programme , the outcome measures in the intervention group were still at the same level as immediately after rehabilitation . Muscle strength at 1 year was significantly higher in patients who completed the resistance training programme than in the comparison group . High-intensity resistance training has persistent effects on muscle strength , cardiopulmonary function , quality of life , and fatigue .  Rehabilitation programmes for patients treated with chemotherapy with a curative intention should include high-intensity resistance training in their programme Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life , functional capacity and cardiovascular disease risk factors in cancer survivors . Methods Cancer survivors within 24 months post-diagnosis were r and omly assigned into the low-volume high-intensity interval training group ( n = 8) or the continuous low to moderate intensity training group ( n = 8) group for 36 sessions ( 12 weeks ) of supervised exercise . The low-volume high-intensity interval training ( LVHIIT ) group performed 7 × 30 s intervals ( ≥85 % maximal heart rate ) and the continuous low to moderate intensity training ( CLMIT ) group performed continuous aerobic training for 20 min ( ≤55 % maximal heart rate ) on a stationary bike or treadmill . Results Significant improvements ( time ) were observed for 13 of the 23 dependent variables ( ES 0.05–0.61 , p ≤ 0.05 ) . An interaction effect was observed for six minute walk test ( 18.53 % [ 32.43–4.63 ] ES 0.50 , p ≤ 0.01 ) with the LVHIIT group demonstrating greater improvements . Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life , functional capacity and selected cardiovascular disease risk factors . The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness ( 6MWT ) ; it remains to be seen which intervention elicits the most clinical ly relevant outcomes for patients . A larger sample size with a control group is required to confirm the significance of these findings 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 Evidence suggests that exercise training improves CVD risk factors . However , it is unclear whether health benefits are limited to aerobic training or if other exercise modalities such as resistance training or a combination are as effective or more effective in the overweight and obese . The aim of this study is to investigate whether 12 weeks of moderate-intensity aerobic , resistance , or combined exercise training would induce and sustain improvements in cardiovascular risk profile , weight and fat loss in overweight and obese adults compared to no exercise . Methods Twelve-week r and omized parallel design examining the effects of different exercise regimes on fasting measures of lipids , glucose and insulin and changes in body weight , fat mass and dietary intake .  Participants were r and omized to either : Group 1 ( Control , n = 16 ) ; Group 2 ( Aerobic , n = 15 ) ; Group 3 ( Resistance , n = 16 ) ; Group 4 ( Combination , n = 17 ) . Data was analysed using General Linear Model to assess the effects of the groups after adjusting for baseline values . Within-group data was analyzed with the paired t-test and between-group effects using post hoc comparisons . Results Significant improvements in body weight ( −1.6 % , p = 0.044 ) for the Combination group compared to Control and Resistance groups and total body fat compared to Control ( −4.4 % , p = 0.003 ) and Resistance ( −3 % , p = 0.041 ) . Significant improvements in body fat percentage ( −2.6 % , p = 0.008 ) , abdominal fat percentage ( −2.8 % , p = 0.034 ) and cardio-respiratory fitness ( 13.3 % , p = 0.006 ) were seen in the Combination group compared to Control . Levels of ApoB48 were 32 % lower in the Resistance group compared to Control ( p = 0.04 ) . Conclusion A 12-week training program comprising of resistance or combination exercise , at moderate-intensity for 30 min , five days/week result ed in improvements in the cardiovascular risk profile in overweight and obese participants compared to no exercise . From our observations , combination exercise gave greater benefits for weight loss , fat loss and cardio-respiratory fitness than aerobic and resistance training modalities . Therefore , combination exercise training should be recommended for overweight and obese adults in National Physical Activity Guidelines .This clinical trial was registered with the Australian New Zeal and Clinical Trials Registry ( ANZCTR ) , registration number : ACTRN12609000684224 Objective To assess the effect of a multimodal group exercise intervention , as an adjunct to conventional care , on fatigue , physical capacity , general wellbeing , physical activity , and quality of life in patients with cancer who were undergoing adjuvant chemotherapy or treatment for advanced disease . Design R and omised controlled trial . Setting Two university hospitals in Copenhagen , Denmark . Participants 269 patients with cancer ; 73 men , 196 women , mean age 47 years ( range 20 - 65 ) representing 21 diagnoses . Main exclusion criteria were brain or bone metastases . 235 patients completed follow-up . Intervention Supervised exercise comprising high intensity cardiovascular and resistance training , relaxation and body awareness training , massage , nine hours weekly for six weeks in addition to conventional care , compared with conventional care . Main outcome measures European Organization for Research and Treatment of Cancer Quality of Life Question naire ( EORTC QLQ-C30 ) , Medical Outcomes Study Short Form ( MOS SF-36 ) , Leisure Time Physical Activity Question naire , muscular strength ( one repetition maximum ) , maximum oxygen consumption ( Vo2max ) . Statistical methods The general linear model was used for continuous outcome while analysis of associates between categorical outcomes was performed as analysis of marginal homogeneity in contingency tables . Results Adjusted for baseline score , disease , and demographic covariates , the intervention group showed an estimated improvement at six weeks for the primary outcome , fatigue , of −6.6 points ( 95 % confidence interval −12.3 to −0.9 , P=0.02 ; effect size=0.33 , 0.04 to 0.61 ) . Significant effects were seen on vitality ( effect size 0.55 , 95 % CI 0.27 to 0.82 ) , physical functioning ( 0.37 , 0.09 to 0.65 ) , role physical ( 0.37 , 0.10 to 0.64 ) , role emotional ( 0.32 , 0.05 to 0.59 ) , and mental health ( 0.28 , 0.02 to 0.56 ) scores . Improvement was noted in physical capacity : estimated mean difference between groups for maximum oxygen consumption was 0.16 l/min ( 95 % CI 0.1 to 0.2 , P<0.0001 ) and for muscular strength ( leg press ) was 29.7 kg ( 23.4 to 34.9 , P<0.0001 ) . No significant effect was seen on global health status/ quality of life . Conclusion A supervised multimodal exercise intervention including high and low intensity components was feasible and could safely be used in patients with various cancers who were receiving adjuvant chemotherapy or treatment for advanced disease . The intervention reduced fatigue and improved vitality , aerobic capacity , muscular strength , and physical and functional activity , and emotional wellbeing , but not quality of life . Trial registration Current Controlled trials IS RCT N05322922 Background International evidence -based guidelines recommend physical exercise to form part of st and ard care for all cancer survivors . However , at present , the optimum exercise intensity is unclear . Therefore , we aim ed to evaluate the effectiveness of a high intensity ( HI ) and low-to-moderate intensity ( LMI ) resistance and endurance exercise program compared with a wait list control ( WLC ) group on physical fitness and fatigue in a mixed group of cancer survivors who completed primary cancer treatment , including chemotherapy . Methods Overall , 277 cancer survivors were r and omized to 12 weeks of  HI exercise ( n = 91 ) , LMI exercise ( n = 95 ) , or WLC ( n = 91 ) . Both interventions were identical with respect to exercise type , duration and frequency , and only differed in intensity . Measurements were performed at baseline ( 4–6 weeks after primary treatment ) and post-intervention . The primary outcomes were cardiorespiratory fitness ( peakVO2 ) , muscle strength ( grip strength and 30-second chair-st and test ) , and self-reported fatigue ( Multidimensional Fatigue Inventory ; MFI ) . Secondary outcomes included health-related quality of life , physical activity , daily functioning , body composition , mood , and sleep disturbances . Multilevel linear regression analyses were performed to estimate intervention effects using an intention-to-treat principle . Results In the HI and LMI groups , 74 % and 70 % of the participants attended more than 80 % of the prescribed exercise sessions , respectively ( P = 0.53 ) . HI ( β = 2.2 ; 95 % CI , 1.2–3.1 ) and LMI ( β = 1.3 ; 95 % CI , 0.3–2.3 ) exercise showed significantly larger improvements in peakVO2 compared to WLC . Improvements in peakVO2 were larger for HI than LMI exercise ( β = 0.9 ; 95 % CI , −0.1 to 1.9 ) , but the difference was not statistically significant ( P = 0.08 ) . No intervention effects were found for grip strength and the 30-second chair-st and test . HI and LMI exercise significantly reduced general and physical fatigue and reduced activity ( MFI subscales ) compared to WLC , with no significant differences between both interventions . Finally , compared to WLC , we found benefits in global quality of life and anxiety after HI exercise , improved physical functioning after HI and LMI exercise , and less problems at work after LMI exercise . Conclusions Shortly after completion of cancer treatment , both HI and LMI exercise were safe and effective . There may be a dose – response relationship between exercise intensity and peakVO2 , favoring HI exercise . HI and LMI exercise were equally effective in reducing general and physical fatigue . Trial registration This study was registered at the Netherl and s Trial Register [ NTR2153 ] on the 5th of January 2010 Background Exercise is beneficial for breast cancer patients during chemotherapy but adherence to different types and doses of exercise is a challenge . The purpose of this study was to examine predictors of adherence to different types and doses of exercise during breast cancer chemotherapy in a multicenter r and omized controlled trial . Methods Breast cancer patients in Edmonton , Vancouver , and Ottawa , Canada receiving chemotherapy ( N = 301 ) were r and omized to a st and ard dose of 25–30 minutes of aerobic exercise ( STAN ) , a higher dose of 50–60 minutes of aerobic exercise ( HIGH ) , or a higher dose of 50–60 minutes of combined aerobic and resistance exercise ( COMB ) . Predictors included demographic , medical , fitness , and quality of life variables .  Exercise adherence  was measured as the percentage of supervised exercise sessions completed . Results Overall adherence to the supervised exercise sessions was 73 % ( SD = 24 % ) . In a multivariate regression model , six independent predictors explained 26.4 % ( p < 0.001 ) of the variance in exercise adherence . Higher exercise adherence  was achieved by breast cancer patients in Vancouver ( p < 0.001 ) , with fewer endocrine symptoms ( p = 0.009 ) , r and omized to STAN ( p = 0.009 ) , with fewer exercise limitations ( p = 0.009 ) , receiving shorter chemotherapy protocol s ( p = 0.015 ) , and with higher VO2peak ( p = 0.017 ) . Disease stage ( p for interaction = 0.015 ) and body mass index ( p for interaction = 0.030 ) interacted with group assignment to predict adherence . For disease stage , patients with stage I/IIa disease adhered equally well to all three exercise interventions whereas patients with stage IIb/III disease adhered better to the STAN intervention than the two higher dose exercise interventions . For body mass index , healthy weight patients adhered equally well to all three exercise interventions whereas overweight patients adhered best to STAN and worst to COMB ; and obese patients adhered best to STAN and worst to HIGH . Conclusions Determinants of  exercise adherence  in breast cancer patients receiving chemotherapy are multidisciplinary and may vary by the exercise prescription Purpose Resistance exercise has great potential to aid in the management of breast cancer-related lymphedema ( BCRL ) ; however , little is known regarding optimal exercise prescription . The pervasive view is that resistance exercise with heavy loads may be contraindicated , disregarding the dose – response relationship that exists between the load utilised in resistance exercise and the magnitude of structural and functional improvements . No previous research has examined various resistance exercise prescriptions for the management of BCRL . This study compared the effects of high load and low load resistance exercise on the extent of swelling , severity of symptoms , physical function and quality of life in women with BCRL . Methods Sixty-two women with a clinical diagnosis of BCRL ( > 5 % inter-limb discrepancy ) were r and omly assigned to a high-load resistance exercise ( n = 22 ) , low-load resistance exercise ( n = 21 ) or usual care ( n = 19 ) group . Participants in the experimental groups completed a 3-month moderate- to high-intensity resistance exercise program in which the load of the exercises was manipulated from 10–6 repetition maximum ( 75–85 % of one repetition maximum [ 1RM ] ) for the high-load group or from 20–15 repetition maximum ( 55–65 % 1RM ) for the low-load group . Outcome measures included the extent of swelling in the affected arm , symptom severity , physical function and quality of life . Results There were no differences between groups in the extent of affected arm swelling or severity of symptoms . The change in muscle strength , muscle endurance and quality of life – physical functioning was significantly greater in both high-load and low-load groups compared with the control group ( p < 0.040 ) . Change in quality of life – physical function was significantly associated with the change in symptom severity and muscle strength . No lymphedema exacerbations or other adverse events occurred during this trial . Conclusion Women with BCRL can safely lift heavy weights during upper body resistance exercise without fear of lymphedema exacerbation or increased symptom severity . Implication s for Cancer SurvivorsWomen with breast cancer-related lymphedema can be informed that appropriately prescribed and supervised upper body resistance exercise is safe and can aid in the management of lymphedema through improvements in physical function and quality of life Background Many patients with lung cancer are deconditioned with poor physical fitness . Lung resection reduces physical fitness further , impairing the patient 's ability to function in daily life . Methods We conducted a single-blind r and omised controlled trial of high-intensity endurance and strength training ( 60 min , three times a week , 20 weeks ) , starting 5–7 weeks after surgery . The control group received st and ard postoperative care . The primary outcome was the change in peak oxygen uptake measured directly during walking until exhaustion . Other outcomes included changes in pulmonary function , muscular strength by one-repetition maximum ( 1RM ) , total muscle mass measured by dual energy X-ray absorptiometry , daily physical functioning and quality of life ( QoL ) . Results The intention-to-treat analysis of the 61 r and omised patients showed that the exercise group had a greater increase in peak oxygen uptake ( 3.4 mL/kg/min between-group difference , p=0.002 ) , carbon monoxide transfer factor ( Tlco ) ( 5.2 % predicted , p=0.007 ) , 1RM leg press ( 29.5 kg , p<0.001 ) , chair st and ( 2.1 times p<0.001 ) , stair run ( 4.3 steps , p=0.002 ) and total muscle mass ( 1.36 kg , p=0.012 ) compared with the controls . The mean±SD QoL ( SF-36 ) physical component summary score was 51.8±5.5 and 43.3±11.3 ( p=0.006 ) , and the mental component summary score was 55.5±5.3 and 46.6±14.0 ( p=0.015 ) in the exercise and control groups , respectively . Conclusions In patients recently operated for lung cancer , high-intensity endurance and strength training was well tolerated and induced clinical ly significant improvements in peak oxygen uptake , Tlco , muscular strength , total muscle mass , functional fitness and QoL. This study may provide a basis for exercise therapy after lung cancer surgery . Trial registration number NCT01748981 We examined cardiorespiratory fitness ( CRF ) levels in early stage breast cancer patients and determined whether CRF differs as a function of adjuvant therapy regimen . A total of 180 early breast cancer patients representing three treatment groups ( surgery only , single- , and multi-modality adjuvant therapy ) in the Cooper Center Longitudinal Study ( CCLS ) were studied . A non-cancer control group ( n = 180 ) matched by sex , age , and date of the CCLS visit was included . All subjects underwent an incremental exercise tolerance test to symptom limitation to assess CRF ( i.e. , peak metabolic equivalents [ METs ] and time to exhaustion ) . The mean time from breast cancer diagnosis to exercise tolerance testing was 7.4 ± 6.2 years . In adjusted analyses , time to exhaustion and peak METs were incrementally impaired with the addition of surgery , single- , and multi-modality adjuvant therapy compared to those of matched controls ( p = 0.006 and 0.028 , respectively ) . CRF was lowest in the multi-modality group compared to all other groups ( all p ’s < 0.05 ) . Despite being 7 years post-diagnosis , asymptomatic early breast cancer survivors  have marked reductions in CRF . Patients treated with multi-modal adjuvant therapy have the greatest impairment in CRF BACKGROUND In the literature , it is not yet clear whether sex may affect the outcomes of exercise training in obese adults . AIM The aim of this study was to investigate gender difference in the effects of combined aerobic resistance exercise ( ARE ) versus aerobic exercise ( AE ) alone on body composition in overweight and obese adults . DESIGN R and omized clinical trial . SETTING University-based outpatient clinic . POPULATION Sixty-five healthy , untrained overweight and obese men and women METHODS They were r and omized into one of two intervention groups ; AE group ( N.=33 ) performed leg cycle exercises with increasing duration and frequency ; ARE group ( N.=32 ) performed additionally progressive weight-resistance exercises for the upper and lower parts of body . Both groups were asked not to change their diet . Body composition including percentage of fat ( PF ) , fat mass ( FM ) and fat free mass ( FFM ) in regional and whole body was determined by dual-energy X-ray absorptiometry ( DXA ) at baseline and week 12 . RESULTS ARE leads to more gains on regional and whole body FFM than AE . ARE was more effective in increasing the FFM of arms , trunk and whole body and decreasing PF of trunk in men and superior on reducing FM of legs in women when comparing with AE . CONCLUSION In order to reduce the trunk fat in men and leg fat in women , resistance exercise can be added into an aerobic training program . CLINICAL REHABILITATION IMPACT Dissimilar results of exercises on sex obtained in our study serves as a guide for prescribing exercises in overweight and obese men and women Purpose Following colorectal cancer diagnosis and anti-cancer therapy , declines in cardiorespiratory fitness and body composition lead to significant increases in morbidity and mortality . There is increasing interest within the field of exercise oncology surrounding potential strategies to remediate these adverse outcomes . This study compared 4 weeks of moderate-intensity exercise ( MIE ) and high-intensity exercise ( HIE ) training on peak oxygen consumption ( V̇O2peak ) and body composition in colorectal cancer survivors . Methods Forty seven post-treatment colorectal cancer survivors ( HIE = 27 months post-treatment ; MIE = 38 months post-treatment ) were r and omised to either HIE [ 85–95 % peak heart rate ( HRpeak ) ] or MIE ( 70 % HRpeak ) in equivalence with current physical activity guidelines and completed 12 training sessions over 4 weeks . Results HIE was superior to MIE in improving absolute ( p = 0.016 ) and relative ( p = 0.021 ) V̇O2peak . Absolute ( + 0.28 L.min−1 , p < 0.001 ) and relative ( + 3.5 ml.kg−1.min−1 , p < 0.001 ) V̇O2 peak were increased in the HIE group but not the MIE group following training . HIE led to significant increases in lean mass ( + 0.72 kg , p = 0.002 ) and decreases in fat mass ( −0.74 kg , p < 0.001 ) and fat percentage ( −1.0 % , p < 0.001 ) , whereas no changes were observed for the MIE group . There were no severe adverse events . Conclusions In response to short-term training , HIE is a safe , feasible and efficacious intervention that offers clinical ly meaningful improvements in cardiorespiratory fitness and body composition for colorectal cancer survivors . Implication s for Cancer SurvivorsHIE appears to offer superior improvements in cardiorespiratory fitness and body composition in comparison to current physical activity recommendations for colorectal cancer survivors and therefore may be an effective clinical utility following treatment Background Exercise therapy is being explored in a variety of cancer population s to counteract treatment-related deconditioning . Higher intensity interval protocol s are being prescribed to improve physical function and attenuate surrogates of comorbidity in non-cancer population s. The purpose of this study is to explore the safety of higher intensity exercise stimuli on cardiorespiratory fitness ( VO2peak ) in breast cancer survivors . Methods Postmenopausal breast cancer survivors were r and omized into three groups : supervised aerobic interval training ( AIT ) , supervised continuous moderate exercise training ( CMT ) , and an unsupervised control group ( CON ) . For 6 weeks , AIT exercised between 70 and 100 % VO2peak , while CMT exercised between 60 and 70 % VO2peak . Both groups followed a matched-work design . Results Thirty-three participants completed the study ( age , 57.2 ( 9 ) years ; weight , 67.6 ( 12 ) kg ) with no adverse advents . Between-group baseline values were non-significant . VO2peak at baseline ( 25.3 ( 5.4 ) mL·kg−1·min−1 ) was below population norms . Compared to CON , cardiorespiratory fitness improved in AIT and CMT by 12 % ( P < 0.001 ) with no significant difference between exercise groups . AIT had a greater influence on lower extremity strength ( P = 0.026 ) and body weight ( P = 0.031 ) . Conclusion This pilot study provides evidence that similar to CMT , AIT can safely increase VO2peak in a small group of breast cancer survivors . Further exploration of the benefits of implementing higher intensity training protocol s is warranted OBJECTIVES To determine the effects of resistance training combined with either moderate-intensity endurance or low-volume high-intensity interval training on cardiovascular risk profiles in patients with coronary artery disease . DESIGN Factorial repeated- measures study design . METHODS Nineteen patients were r and omized into moderate-intensity endurance ( n = 10 ) or high-intensity interval ( n = 9 ) groups , and attended 2 supervised exercise sessions a week for 6-months . The first 3-months involved exclusive moderate-intensity endurance or high-intensity interval exercise , after which progressive resistance training was added to both groups for the remaining 3-months . Fitness ( VO(2)peak ) , blood pressure and heart rate , lipid profiles and health related quality of life assessment s were performed at pretraining , 3 and 6-months training . RESULTS VO(2)peak increased from pretraining to 3-months in both groups ( moderate-intensity endurance : 19.8 ± 7.3 vs. 23.2 ± 7.4 ml kg(-1)min(-1 ) ; high-intensity interval : 21.1 ± 3.3 vs. 26.4 ± 5.2 ml kg(-1)min(-1 ) , p<0.001 ) with no further increase at 6-months . Self-evaluated health and high-density lipoprotein were increased following 6-months of moderate-intensity endurance exercise , while all remaining indices were unchanged . Low-volume high-intensity interval exercise did not elicit improvements in lipids or health related quality of life . Blood pressures and heart rates were unchanged with training in both groups . CONCLUSIONS Findings from our pilot study suggest improvements in fitness occur within the first few months of training in patients with coronary artery disease , after which the addition of resistance training to moderate-intensity endurance and high-intensity interval exercise elicited no further improvements . Given the importance of resistance training in cardiac rehabilitation , additional research is required to determine its effectiveness when combined with high-intensity interval exercise OBJECTIVE Cure rates for cancer are increasing , especially for breast , prostate , and colorectal cancer . Despite positive trends in survivorship , a cancer diagnosis can trigger accelerated functional decline that can threaten independence , reduce quality -of-life and increase healthcare costs , especially among the elderly who comprise the majority of survivors .  Lifestyle interventions may hold promise in reorienting functional decline in older cancer survivors , but few studies have been conducted . METHODS We describe the design and methods of a r and omized controlled trial , RENEW ( Reach out to ENhancE Wellness ) , that tests whether a home-based multi-behavior intervention focused on exercise , and including a low saturated fat , plant-based diet , would improve physical functioning among 641 older , long-term ( > or=5 years post-diagnosis ) survivors of breast , prostate , or colorectal cancer . Challenges to recruitment are examined . RESULTS Twenty thous and and fifteen cases were approached , and screened using a two-step screening process to assure eligibility . This population of long-term , elderly cancer survivors had lower rates of response ( approximately 11 % ) and higher rates of in eligibility ( approximately 70 % ) than our previous intervention studies conducted on adults with newly diagnosed cancer . Significantly higher response rates were noted among survivors who were White , younger , and more proximal to diagnosis and breast cancer survivors ( p-values<0.001 ) . CONCLUSION Older cancer survivors represent a vulnerable population for whom lifestyle interventions may hold promise . RENEW may provide guidance in allocating limited re sources in order to maximize recruitment efforts aim ed at this needy , but hard-to-reach population Introduction : Impairment in aerobic fitness is a potential modifiable risk factor for postoperative complications . In this r and omized controlled trial , we hypothesized that a high‐intensity interval training ( HIIT ) program enhances cardiorespiratory fitness before lung cancer surgery and therefore reduces the risk of postoperative complications . Methods : Patients with operable lung cancer were r and omly assigned to usual care ( UC ) ( n = 77 ) or preoperative rehabilitation based on HIIT ( Rehab ) ( n = 74 ) .  Maximal cardiopulmonary exercise testing and the 6‐minute walk test were performed twice before surgery . The primary outcome measure was a composite of death and in‐hospital postoperative complications . Results : The groups were well balanced in terms of patient characteristics . During the preoperative waiting period ( median 25 days ) , the peak oxygen consumption and the 6‐minute walking distance increased ( median + 15 % , interquartile range , 25th to 75 percentile [ IQR25%–75 % , % ] = + 9 % to + 22 % , p = 0.003 and + 15 % , IQR25%–75 % = + 8 % to + 28 % , p < 0.001 , respectively ) in the Rehab group , whereas peak oxygen consumption declined in the UC group ( median –8 % , IQR25%–75 % = –16 % to 0 % ] , p = 0.005 ) . The primary end point did not differ significantly between the two groups : at least one postoperative complication developed in 27 of the 74 patients ( 35.5 % ) in the Rehab group and 39 of 77 patients ( 50.6 % ) in the UC group ( p = 0.080 ) . Notably , the incidence of pulmonary complications was lower in the Rehab compared with in the UC group ( 23 % versus 44 % , p = 0.018 ) , owing to a significant reduction in atelectasis ( 12.2 % versus 36.4 % , p < 0.001 ) , and this decrease was accompanied by a shorter length of stay in the postanesthesia care unit ( median –7 hours , IQR25%–75 % = –4 to –10 ) . Conclusions : In this r and omized controlled trial , preoperative HIIT result ed in significant improvement in aerobic performances but failed to reduce early complications after lung cancer resection PURPOSE : Although rehabilitation after treatment for non-small cell lung cancer ( NSCLC ) was found to have a beneficial effect on exercise capacity in a number of studies , insight into its effect on quality of life ( QoL ) and fatigue is limited . The aim of this study was to examine the outcome of pulmonary rehabilitation ( PR ) regarding fatigue , QoL , and exercise capacity in adult patients curatively treated for NSCLC stages I to IIIa . METHODS : Study data were prospect ively and routinely gathered in daily practice in patients taking part in an outpatient PR program after treatment for NSCLC stages I to IIIa . PR consisted of 12 weeks of supervised exercises 3 times a week , supplemented with scheduled visits with members of a multidisciplinary team . Data were gathered at initial assessment and discharge . Outcomes included fatigue ( the Functional Assessment of Cancer Therapy-Fatigue and the fatigue domain of the Chronic Respiratory Disease Question naire ) ; QoL ( total CRQ score ) , Functional Assessment of Cancer Therapy-Lung , and the Short Form 36 ; and exercise capacity ( cardiopulmonary exercise testing ) . RESULTS : Fifty patients started the program out of the 70 patients referred to PR and 43 ( 86 % ) completed the program . Significant ( P ⩽ .01 ) and clinical ly relevant improvements were observed for all outcome measures . CONCLUSIONS : Rehabilitation after treatment for NSCLC stages I to IIIa showed promising improvements regarding patient fatigue , QoL , and exercise capacity . PR should be considered for patients after treatment for NSCLC stages I to IIIa
Purpose There is an increasing body of evidence underpinning high-intensity exercise as an effective and time-efficient intervention for improving health in cancer survivors .
The aim of this study was to , ( 1 ) evaluate the efficacy and ( 2 ) the safety of high-intensity exercise interventions in improving selected health outcomes in cancer survivors .