The effects of a home-based physical activity intervention on cardiorespiratory fitness in breast cancer survivors; a randomised controlled trial

The aim of this current randomised controlled trial was to evaluate the effects of a home-based physical activity (PA) intervention on cardiorespiratory fitness in breast cancer survivors. Thirty-two post-adjuvant therapy breast cancer survivors (age = 52 ± 10 years; BMI = 27.2 ± 4.4 kg∙m2) were randomised to a six-month home-based PA intervention with face-to-face and telephone PA counselling or usual care. Cardiorespiratory fitness and self-reported PA were assessed at baseline and at six-months. Participants had a mean relative V̇O2max of 25.3 ± 4.7 ml∙kg−1∙min−1, which is categorised as “poor” according to age and gender matched normative values. Magnitude-based inference analyses revealed likely at least small beneficial effects (effect sizes ≥.20) on absolute and relative V̇O2 max (d = .44 and .40, respectively), and total and moderate PA (d = .73 and .59, respectively) in the intervention compared to the usual care group. We found no likely beneficial improvements in any other outcome. Our home-based PA intervention led to likely beneficial, albeit modest, increases in cardiorespiratory fitness and self-reported PA in breast cancer survivors. This intervention has the potential for widespread implementation and adoption, which could considerably impact on post-treatment recovery in this population

The need to redefine age- and gender-specific overweight and obese body mass index (bmi) cut-off points

This is an accepted manuscript of an article published by Lippincott, Williams & Wilkins in Medicine and Science in Sports and Exercise in May 2016, available online: https://doi.org/10.1249/01.mss.0000486653.72857.0a The accepted version of the publication may differ from the final published version.For convenience, health practitioners and clinicians are inclined to classify people/patients as overweight or obese based on body mass index (BMI) cut-off points of 25 and 30 kg/m^2 respectively, irrespective of age and gender.Colin BorehamPublished versio

Osteogenic potential of external mechanical loading during walking in sedentary and non-sedentary adults

Sedentary behaviour is generally regarded as having deleterious effects on cardiometabolic health, although little is known about its specific association with bone health. Impact forces generated as the foot contacts the ground during activity have the potential to act as a stimulus for bone maintenance and development. Therefore, increased sedentary behaviour may reduce the time available to gain osteogenic benefits from impact-based activity. Peak ground reaction force is commonly used as an estimate of loading intensity when determining the osteogenic potential of activity [1]. Dynamic, high impact, high frequency activities have been shown to be most effective at applying an osteogenic stimulus [1], although low level impacts have been shown to beneficially modify bone geometry [2]. Therefore, differences in the characteristics of low impact activity have potential to influence bone health. As impact forces are attenuated as they travel up the body, exploration of mechanical loading at regions such as the spine, require further investigation. External force due to impact is related to acceleration; therefore an accelerometer attached to the spine can provide an estimation of the mechanical loading. The aim of this study, therefore, was to investigate associations between sedentary and nonsedentary behavior on the osteogenic potential of walking, and bone mineral density (BMD) of the lumbar spine

Stretch Intensity vs. Inflammation: A Dose-dependent Association?

The intensity of stretching is rarely reported in scientific literature. In this study, we examined the effects of stretching intensities at 30%, 60%, and 90% of maximum range of movement (mROM) on the inflammatory response of the right hamstring muscle. Methods: A randomised within-subject trial was conducted with 11 healthy recreationally active males over a three week period. Participants were strapped into an isokinetic dynamometer in the supine position, with the right knee fastened in a knee immobilizer. After randomising the ROM percentages, the hamstring muscle was moved to one of the three chosen ROM percentages for that week and held there for 5 x 60 seconds followed by a 10 second rest between repetitions. A 5ml blood sample was collected pre-, immediately post, and at 24 hours post intervention for high sensitivity C-reactive protein (hsCRP) assessments. Results: Significant increases in hsCRP levels were observed between 30% mROM and 90% mROM (p=0.004) and 60% mROM and 90% mROM (p=0.034), but not between 30% and 60% (p>0.05). Conclusions: Muscle stretching at submaximal levels does not elicit a significant systemic inflammatory responses

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

This is an accepted manuscript of an article published by Oxford Academic in Rheumatology on 07/04/2017, available online: https://doi.org/10.1093/rheumatology/kex053 The accepted version of the publication may differ from the final published version.RA is a chronic autoimmune disease characterized by high grade-inflammation, and associated with elevated cardiovascular risk, rheumatoid-cachexia and functional impairment. Sedentary behaviour (SB) is linked to heightened inflammation, and is highly pervasive in RA, likely as a result of compromised physical function and persistent fatigue. This high sedentarity may exacerbate the inflammatory process in RA, and hold relevance for disease-related outcomes. The aim of this narrative review is to provide an overview of the definition, measurement and health relevance of SB in the context of RA. Contradictions are highlighted with regard to the manner in which SB is operationalized, and the significance of SB for disease outcomes in RA is outlined. The advantages and disadvantages of SB measurement approaches are also discussed. Against this background, we summarize studies that have reported SB and its health correlates in RA, and propose directions for future research

Rheumatoid Cachexia: causes, significance and possible interventions

Rheumatoid arthritis is a chronic autoimmune disease characterised by joint pain and stiffness but also systemic mutli-organ involvement. Several features are due to excessive production of inflammatory cytokines, particularly tumour necrosis factor alpha, interleukin-1 and interleukin-6. These are implicated in both local synovial inflammation, which causes joint destruction, but also systemic inflammation, which can cause loss of body cell mass, amongst other phenomena. Body cell mass breakdown in rheumatoid arthritis leads to the classical, but largely ignored, metabolic abnormality known as rheumatoid cachexia. Cachexia is a very strong predictor of adverse functional outcome and death in many disease states. In this review we highlight the mechanisms linked with rheumatoid cachexia and discuss possible interventions that may limit this in patients with rheumatoid arthritis

Vascular Function and Inflammation in Rheumatoid Arthritis: the Role of Physical Activity

Inflammation disturbs biochemical pathways involved in homeostasis of the endothelium. Research has established clear links between inflammatory mediators, particularly C-reactive protein and tumour necrosis factor alpha, endothelial dysfunction, and atherosclerosis. Endothelial dysfunction and atherosclerosis may be subclinical at early stages, and thus the ability to detect them with non-invasive techniques is crucially important, particularly in populations at increased risk for cardiovascular disease, such as those with rheumatoid arthritis. This may allow the identification of interventions that may reverse these processes early on. One of the best non-pharmacological interventions that may achieve this is physical activity. This review explores the associations between inflammation, endothelial dysfunction, and atherosclerosis and discusses the role of exercise in blocking specific pathways in the inflammation, endothelial dysfunction - atherosclerosis network

The behavioural epidemiology of sedentary behaviour in inflammatory arthritis:where are we, and where do we need to go?

In the last decade, studies into sedentary behaviour in inflammatory arthritis have raised important questions regarding its role in this condition. Specifically, evidence is needed on whether sedentary behaviour might exacerbate adverse inflammatory arthritis outcomes, and whether reducing sedentary behaviour might offer an effective avenue for self-management in this population. Research exploring these important research questions is still very much in its infancy and lacks the direction and scientific rigour required to inform effective intervention design, delivery and evaluation. Behavioural epidemiology refers to research that aims explicitly to understand and influence health behaviour patterns to prevent disease and improve health. To this end, the Behavioural Epidemiology Framework specifies a focused approach to health behaviour research, which leads to the development of evidence-based interventions directed at specific populations. In this review, we introduce the Behavioural Epidemiology Framework in the context of research into sedentary behaviour in inflammatory arthritis and ask: where are we, and where do we need to go