Cáncer de mama y ejercicio físico: Estudio piloto

El cáncer de mama (CM) es el más común entre las mujeres occidentales, con un alto porcentaje de supervivencia, la cual no está exenta de numerosos efectos secundarios tanto por los tratamientos como por la enfermedad, afectando a la calidad de vida de estas mujeres. El objetivo de este proyecto es conocer el efecto de un programa de ejercicio físico conducido en la calidad de vida de mujeres afectadas por cáncer de mama. Método. El programa de ejercicio físico consistió en 24 sesiones (doce semanas) y se desarrolló íntegramente en la Facultad de Ciencias de la Actividad Física y del Deporte-INEF (UPM), donde se estudió a 31 mujeres afectadas. Resultados. Se muestra una mejora en la calidad de vida (p= 0,034), así como en diferentes aspectos de autoestima y depresión (p = 0,029 y p = 0,003 para el primero y p = 0,018 y p = 0,015 para el segundo). También se observó una mejora en el índice de fuerza general (p = 0,009) y en la capacidad funcional (p = 0,005). Conclusiones. Estos resultados permiten asociar un programa de ejercicio físico regular con posibles mejoras en la calidad de vida de las mujeres afectadas por cáncer de mama

Case studies in physiology: Training adaptation in an elite athlete after breast cancer diagnosis.

The aim of this study was to evaluate the capacity to return to competition of a 28-yr-old female 400-m hurdle elite athlete after a diagnosis of breast cancer. The study lasted 14 mo after diagnosis. She was tested four times (T1–T4) to measure body mass (BM), body mass index (BMI), percentage of total fat mass (TFM%), total fat-free mass (TFFM%), bone mineral density (BMD), one-repetition maximum (1RM), and maximal power (MP) in bench press and half squat, maximum oxygen uptake, and 400-m dash and hurdles. T0 (baseline time) was established with values before diagnosis. BM and BMI increased from T0 to T1 (5.3% and 5.2%) and remained stable. BMD experienced no change. TFM% values decreased from T1 to T4 (3.5%). TFFM% values increased from T1 to T3 (0.9%). During T1–T2, the athlete presented a global decline from T0 in 1RMSquat, 1RMBench, MPSquat, and MPBench (32.6%, 27.2%, 37.5%, and 27.6%, respectively). Results during T3–T4 were also lower for these parameters from T0 (23.3%, 20.6%, 23.4%, and 11%). During T1–T2, the V̇o2max declined compared with T0 (1.8% and 6.4%), showing a small increase at T3 (+1%) and reaching the lowest level at T4 (9%). During T1–T2, the time record of 400-m dash (8.3%) and hurdles (7.4%) increased. However, a slight improvement was found at T3 (1.3% and 0.6%, respectively). The results of this case study reflect that exercise training improved body composition, maintained BMD and TFFM, but could not completely reverse the worsening of the cardiorespiratory, muscle strength and power, and running performance levels.pre-print325 K

Effects of Acute Vitamin C plus Vitamin E Supplementation on Exercise-Induced Muscle Damage in Runners: A Double-Blind Randomized Controlled Trial

Considering the existing controversy over the possible role of acute antioxidant vitamins in reducing exercise-induced muscle damage (EIMD), this doubled-blind, randomized and controlled trial aimed to determine whether supplementation with vitamins C and E could mitigate the EIMD in endurance-trained runners (n = 18). The exercise protocol involved a warm-up followed by 6 to 8 bouts of 1 km running at 75% maximum heart rate (HRmax). Two hours before the exercise protocol, participants took the supplementation with vitamins or placebo, and immediately afterwards, blood lactate, rate of perceived exertion and performance were assessed. At 24 h post-exercise, CK, delayed onset muscle soreness and performance were determined (countermovement jump, squat jump and stiffness test). The elastic index and vertical stiffness were calculated using a stiffness test. Immediately after the exercise protocol, all participants showed improved maximum countermovement jump, which only persisted after 24 h in the vitamin group (p 0.05). Vitamin C and E supplementation does not seem to help with EIMD in endurance-trained individual

Influencia de un programa de ejercicio aeróbico en la calidad de vida de pacientes afectadas por cáncer de mama = Influence of an aerobic exercise program on breast cancer patients’ quality of life

INTRODUCCIÓN Actualmente las supervivientes de cáncer de mama viven durante más tiempo. Sin embargo, los tratamientos utilizados presentan importantes efectos secundarios que afectan y marcan su calidad de vida. Numerosos estudios han mostrado que el ejercicio es una herramienta apta, segura y efectiva reduciendo algunos de estos efectos secundarios y, en suma, mejorando la calidad de vida de estas pacientes, aspecto que presenta al ejercicio físico como una intervención integral para ellas. Por el contrario, se ha observado que las supervivientes de cáncer de mama reducen la cantidad de ejercicio que realizan después de dichos tratamientos. Por ello, el objetivo de este proyecto es examinar los efectos de un programa integral de ejercicio en la calidad de vida y la cantidad de ejercicio físico que realizan las pacientes con cáncer de mama en su tiempo, tras finalizar sus tratamientos. MATERIAL Y MÉTODOS Se diseñó un Ensayo Clínico Aleatorizado. Noventa pacientes diagnosticadas de cáncer de mama en estadios tempranos que habían terminado sus tratamientos de radioterapia y quimioterapia recientemente, fueron reclutadas por la Universidad Politécnica de Madrid, desde enero de 2013 hasta junio de 2014. Las pacientes fueron aleatorizadas tras las mediciones iniciales al grupo control (tratamientos habituales) o grupo intervención, durante tres meses. La intervención consistió en 24 clases de ejercicio combinando práctica aeróbica y de fuerza con el fin de reducir los efectos secundarios de dichos tratamientos. La calidad de vida, la cantidad de ejercicio físico realizado en tiempo de ocio, VO2max, la fuerza, la movilidad articular del hombro, la fatiga, la depresión y la ansiedad fueron medidos al inicio y después de los tres meses en todos los pacientes. RESULTADOS Un total de 89 pacientes con una media de 49.06±8.75 de edad fueron finalmente analizadas. El grupo intervención (n=44) mostraron significativamente mejores resultados en calidad de vida (p=0.0001; d=0.85), cantidad de ejercicio en tiempo de ocio (p=0.0001; d=2.77), en variables de la composición corporal, en variables físicas y en variables psicológicas comparado con el grupo control (n=45). Además, se observó una correlación significativa entre la calidad de vida y el ejercicio realizado en tiempo de ocio en el grupo intervención (r= 0.58; p=0.001), que no fue patente en el grupo control. Se observaron cambios significativos en el grupo de intervención relativos a la composición corporal, con aumento de la masa muscular (p=0.001) y reducción de la masa grasa (p=0.0001). Tanto las variables físicas como psicológicas también mostraron diferencias significativas a favor al grupo de intervención en las comparaciones entre grupos. CONCLUSIONES Según estos resultados, un programa de ejercicio físico específico es una intervención integral que mejora los hábitos y la calidad de vida de las supervivientes de cáncer de mama, lo que reduce determinados efectos secundarios de los tratamientos y aumenta la salud física y psicológica general de estas mujeres. Este tipo de intervenciones pude ser una herramienta barata y efectiva para ofrecer a los pacientes, integrada en los tratamientos habituales. ABSTRACT INTRODUCTION It is well known that breast cancer survivors are living longer. However, breast cancer treatments present serious side effects, which could affect breast cancer survivors’ (BCS) health and quality of life (QoL). Exercise has been presented as a feasible, safe and effective tool in reducing some of these side effects and to improve survivors’ QoL, acting as an integrative treatment for them, although it has been observed that BCS reduce their leisure time exercise (LTE) levels. Therefore, the aim of this study was to examine the effects of an integrative exercise program in QoL and LTE in BCS after the completion of their adjuvant treatment. MATERIAL AND METHODS A randomized controlled trial (RCT) was designed. Ninety patients diagnosed with an early stage of breast cancer and who recently finished chemotherapy and radiotherapy treatments were recruited by the Technical University of Madrid from January 2013 to June 2014. Patients were randomized after baseline assessments to the intervention group (IG) or to the control group (CG) (usual care) for three months. The Intervention consisted in 24 supervised exercise classes, combining aerobic and resistance exercises in order to reduce the most common side effects of the treatments. QoL, LTE, body composition, VO2max, strength, shoulder range of motion, fatigue, depression and self-esteem were measured in all the patients at baseline and after three months. RESULTS A total of 89 patients aged 49.06±8.75 years were finally assessed. IG (n=44) showed significant better results in QoL (p=0.0001; d=0.85), LTE (p=0.0001; d=2.77), in body composition, in the physical variable and in psychological outcomes, compared with the CG (n=45). In addition, a correlation between QoL and LTE (r= 0.58; p=0.001) was found in the IG, while CG did not show this correlation. Significant changes in body composition were observed in the group comparisons, especially in lean mass (p=0.001) and body fat mass (p= 0.0001). Positive changes were also observed in the physical and psychological variables in comparisons between groups. CONCLUSIONS These results suggest that this exercise program may be an integrative intervention, which is able to improve QoL and LTE levels in breast cancer survivors, reducing breast cancer side effects of treatments and improving their physical and psychological general health. Exercise may be an effective and inexpensive strategy to be included in patients integrative care

Exercise oncology. From theory to the practice

Exercise-Oncology is an emerging area with a lot of questions for physical activity professionals focused on health. This review collects the general side effects and exercise implication and benefits, such as body composition changes, cardiovascular limitations or functional impairments as lymphedema; exercise relevance in cancer biomarkers related to cancer prognosis; as well as the exercise cautions related to some specific side effects. In addition, exercise recommendations to specialists are explained, including practice suggestions about how to personalize exercise prescription collecting a clinical history in order to control patient’s development; how to control exercise intensity with different devices; and, finally, types of exercise and how they should be developed in terms of intensity and volume.El ejercicio físico oncológico es un área muy novedosa en nuestro país que, actualmente, genera muchas dudas a los profesionales del ejercicio físico y la salud. Esta revisión, trata de aportar información general sobre los tipos de efectos secundarios que los pacientes pueden presentar y qué tipo de ejercicio puede ser útil en cada caso. También se introduce la importancia del ejercicio en el cambio de determinados biomarcadores relativos al pronóstico del cáncer, así como algunas cuestiones de seguridad que deben tenerse en cuenta en relación con el ejercicio, si los pacientes presentan determinados efectos secundarios. Por último, se hace un repaso práctico de cómo se debe aplicar las bases de la planificación de un programa de ejercicio a estos pacientes, teniendo en cuenta la importancia de la individualización, el seguimiento de la intensidad o la evolución del programa en los pacientes

Running away from side effects: physical exercise as a complementary intervention for breast cancer patients

The number of breast cancer survivors increases every year, thanks to the development of new treatments and screening techniques. However, patients present with numerous side effects that may affect their quality of life. Exercise has been demostrated to reduce some of these side effects, but in spite of this, few breast cancer patientes know and follow the exercise recommendations needed to remain healthy. In this review, we describe the differente breast cancer treatments and the related side effects and implications of exercise in relation to these. We propose that exercise could be and integrative complementary intervention to improve physiological, physical and psychological factors that affect survival and quality of life of these patients. For that reason, the main objective of this review is to provide a general overview of exercise benefits in breast cancer patients and recommendations of how to design exercise interventions in patients with different side effects

Effects of a Clinical Exercise Program on Health-Related Fitness and Quality of Life in Spanish Cancer Patients Receiving Adjuvant Therapy

Objective: To report the feasibility and effectiveness of a newly developed clinical exercise program for improving maximal cardiorespiratory fitness in Spanish cancer patients receiving adjuvant chemotherapy or radiation. We also examined the effectiveness of the exercise program for improving maximal muscular strength, body composition, fatigue, and quality of life, and explored if the effectiveness varied based on selected patient characteristics. Design: The study was a single group implementation feasibility study using a pre-posttest design. Methods: Participants performed a 12-week, twice-weekly, supervised, multi-component exercise program during adjuvant therapy. Paired t-tests were used to assess pre-post changes, and analyses of covariance were used to compare effectiveness based on selected patient characteristics. Results: We had 100 cancer patients referred to the clinical exercise program of which 85 (85%) initiated the exercise program and 76 (89%) completed the post-intervention fitness assessment. Exercise significantly improved VO2max by 4.8 mL/kg/minutes (P < .001, d = 0.74). Exercise also significantly improved chest strength (P < .001, d = 0.82), leg strength (P < .001, d = 1.27), lean body mass (P < .001, d = 0.11), skeletal muscle mass (P < .001; d = 0.09), fat mass (P < .001; d = 0.10), % body fat (P < .001; d = 0.17), quality of life (P = .0017; d = 0.41), and fatigue (P = .007; d = 0.46). Treatment modality, cancer type, and age affected some exercise responses, especially related to body composition changes. Conclusions: A 12-week, supervised, multi-component exercise program was effective for improving health-related fitness and quality of life in Spanish cancer patients receiving adjuvant therapy. Our results show the benefits of incorporating clinical exercise programming into the supportive care of cancer patients receiving treatments.S

Estimating fat-free mass in recreationally resistance-trained young men: Longitudinal and cross-sectional validation of different methods

Several techniques exist to measure fat-free mass (FFM). Accordingly, this study is based on data from our recent trial comparing the sensitivity of the main field methods available with that of dual-energy X-ray absorptiometry (DXA) as reference and analyzing the cross-sectional accuracy of these field methods in recreationally resistance-trained males. We hypothesized that the use of these techniques would lead to varying estimates of FFM compared with DXA. Participants (N = 23; 21.4 ± 3.3 years) completed a 10-week resistance training plus diet intervention designed to optimize hypertrophy. FFM was determined by bioelectrical impedance analysis (BIA), 23 anthropometric equations, and DXA. After the intervention, FFM increased significantly according to BIA and most anthropometric estimates, but this increase was not detected by 2 anthropometric equations or by DXA. Only 1 of these 2 equations showed significant correlation with DXA and no standardized or significant differences to this reference method, although it did display significant heteroscedasticity. In our cross-sectional analysis, only 1 anthropometric equation gave rise to good accuracy as confirmed by DXA. Our findings indicate that the use of different techniques to assess FFM gains in response to a hypertrophic intervention yields different results. BIA with general embedded equations should not be used to monitor a young male adult's body composition. To monitor FFM over time, we would recommend the Dunne et al. equation (2) as the most sensitive field method, and to assess FFM cross-sectionally, equation (1) of these authors is the most accurate field method.Sin financiación4.5 Q2 JCR 20220.773 Q2 SJR 2022No data IDR 2021UE

Impact of the COVID-19 Lockdown on Physical Activity Levels and Health Parameters in Young Adults with Cancer

The lockdown of the COVID-19 pandemic impacted physical activity (PA) levels around the world, affecting health parameters in young adults with cancer (YAC). To our knowledge, there is no evidence of the impact of the lockdown on the Spanish YAC. To analyse the changes in PA levels before, during, and after the lockdown of the YAC and its impact on health metrics in Spain, in this study, we utilized a self-reported web survey. PA levels decreased during the lockdown, and a significant increase in PA was observed after the lockdown. Moderate PA had the largest reduction (49%). Significant increases in moderate PA were noted after the lockdown (85.2%). Participants self-reported more than 9 h of sitting per day. HQoL and fatigue levels were significantly worse during the lockdown. The impact of the COVID-19 pandemic in this cohort of Spanish YAC showed a decrease in PA levels during the lockdown, affecting sedentarism, fatigue and HQoL. After lockdown, PA levels partially recovered, while HQoL and fatigue levels remained altered. This may have long-term physical effects such as cardiovascular comorbidities associated with sedentarism and psychosocial effects. It is necessary to implement strategies such as cardio-oncology rehabilitation (CORE), an intervention that can be delivered online, potentially improving participants’ health behaviours and outcomes

Impact of the COVID-19 Lockdown on Physical Activity Levels and Health Parameters in Young Adults with Cancer

The lockdown of the COVID-19 pandemic impacted physical activity (PA) levels around the world, affecting health parameters in young adults with cancer (YAC). To our knowledge, there is no evidence of the impact of the lockdown on the Spanish YAC. To analyse the changes in PA levels before, during, and after the lockdown of the YAC and its impact on health metrics in Spain, in this study, we utilized a self-reported web survey. PA levels decreased during the lockdown, and a significant increase in PA was observed after the lockdown. Moderate PA had the largest reduction (49%). Significant increases in moderate PA were noted after the lockdown (85.2%). Participants self-reported more than 9 h of sitting per day. HQoL and fatigue levels were significantly worse during the lockdown. The impact of the COVID-19 pandemic in this cohort of Spanish YAC showed a decrease in PA levels during the lockdown, affecting sedentarism, fatigue and HQoL. After lockdown, PA levels partially recovered, while HQoL and fatigue levels remained altered. This may have long-term physical effects such as cardiovascular comorbidities associated with sedentarism and psychosocial effects. It is necessary to implement strategies such as cardio-oncology rehabilitation (CORE), an intervention that can be delivered online, potentially improving participants’ health behaviours and outcomes.Depto. de MedicinaFac. de MedicinaTRUEpubDescuento UC