Exercise medicine for prostate cancer

Since initial reports in the mid-1980s, there has been increasing interest in the application of exercise as medicine for the prevention and management of cancer. A large number of high-quality, randomised, controlled trials with cancer survivors have confirmed both aerobic and resistance exercise to be highly beneficial for improving body composition, quality of life, mental health functional capacity and reducing risk of cancer recurrence and development of other chronic diseases. Such benefits have ultimately been realised in reduced cancer mortality between 30 and 60 % in large cohort retrospective studies. Treatments for prostate cancer are increasingly effective with quite high 5- and 10-year survival rates; however, side effects of endocrine treatments in particular impact on quality of life and increased co-morbidities for the survivor. Testosterone deprivation while highly effective for controlling prostate cancer growth results in loss of muscle and bone, increased fat mass, increased incidence of metabolic syndrome, cardiovascular disease and sudden death. Exercise has been demonstrated to be a very effective medicine for counteracting all of these treatment toxicities as well as improving mental health and quality of life. Exercise has been demonstrated to be safe and well tolerated by cancer patients. Current recommendation is to complete at least 150 min of aerobic exercise and two or more sessions of resistance training per week. More specific exercise prescription is required to address particular treatment toxicities such as bone loss or obesity. This paper is a review of key research from our group into exercise medicine for prostate cancer

Testosterone replacement for male military personnel - A potential countermeasure to reduce injury and improve performance under extreme conditions

Tactical operators, inclusive of soldiers in the military, are reliant upon their physiological and psychological state in often volatile and extreme life or death situations that require correct decisions and precise actions to ensure operational success with minimal collateral damage. Accordingly, the development of physical and mental resilience are hallmarks of prophylactic and remedial programs designed to ensure military personnel are combat ready, thus optimising their capacity to perform at expert levels, while reducing their risk of injury or the severity of injury sustained..

PEAK POWER OUTPUT IN THE IPOWER CLEAN -THE INFLUENCE OF RELATIVE STRENGTH

The aim of this study was to determine whether athletes of higher relative strength maximise their power output at higher percentages of their 1RM in the power clean. Twenty-nine male athletes (power clean 1 RM = 99.2 ± 18.9 kg) performed two power cleans at 10% increments from 50% to 100% of 1 RM. Bar displacement was collected by a Ballistic Measurement System (BMS) and power output was calculated using system mass (SM) and bar mass (BM) methods. Optimal loads were 50% and' 90% for the SM and BM methods respectively. However, a limitation of the stUdy was that loads below 50% of 1RM were not examined. Relative strength was not related to percentage of 1 RM at which maximal power output was achieved

Keeping patients with cancer exercising in the age of COVID-19

The novel 2019 coronavirus disease (COVID-19) pandemic is a global public health emergency. To date, physical distancing and good personal hygiene have been the only effective measures to limit spread. The pandemic has altered routine cancer care, including allied health and supportive care interventions. Clinicians must adapt and find ways to continue to deliver optimal patient care at this time. The prescription of exercise to people with cancer has been demonstrated to have meaningful benefits for both physical and mental health and quality of life, and may even enhance survival. Such exercise interventions provide the largest benefit to patients when delivered in a supervised, group, clinic-based setting. In the age of COVID-19, group-based exercise in communal facilities presents risks for both aerosol and surface transmission of the virus among people exercising, necessitating a pivot from the usual methods of exercise delivery to home-based exercise programs. In this article, we discuss the challenges that need to be overcome in moving to a home-based program for patients with cancer while maintaining the benefits of targeted and high-fidelity exercise medicine. We provide practical recommendations for how home-based exercise can be supported and nurtured by qualified exercise professionals who treat people living with cancer, as well as pointing to resources that are available online to assist practitioners. Despite the challenges faced during this pandemic, we believe that it is important for people to continue to benefit from exercise in a safe environment with the support of exercise specialists

Kinetics and kinematics of the squat and step-up in well-trained rugby players

The purpose of this study was to compare and contrast the kinetics and kinematics of squat and step-up performance in well-trained athletes. Triaxial ground reaction force (GRF) and 3D kinematic data were collected in 4 maximal effort repetitions each at 70, 80, and 90% of 1 repetition maximum (1RM) of squat and step-up. The difference in concentric phase kinetics and kinematics between the squat and step-up was compared using effect sizes (ES ± 90% confidence limits [CLs]) classified as: less than 0.2 as trivial; 0.2-0.6 as small; 0.6-1.2 as moderate; and 1.2-2.0 as large. Where the 90% CL crossed negative and positive 0.2 values, the effect was considered unclear.n Ground reaction force was higher for the step-up than squat at all relative intensities per leg (peak GRF ES: 2.56 ± 0.19 to 2.70 ± 0.37; average GRF ES: 1.45 ± 0.27 to 1.48 ± 0.29). Per leg, the difference in concentric impulse favored the step-up compared with squat at 70% 1RM (ES = 0.71 ± 0.40) and 80% 1RM (ES = 0.30 ± 0.41) but was unclear at 90% 1RM (ES = -0.25 ± 0.47). The squat peak velocity was greater compared with step-up at all intensities (ES = -1.74 ± 0.48 to -1.33 ± 0.48). Despite a lower external load and a single base of support, per leg, the step-up produced comparable GRF because the squat suggesting overload provided by the step-up is sufficient for maximal strength development. Future research may investigate the efficacy of the step-up in a training intervention for the development of lower-body strength

Specificity and transfer of lower-body strength: influence of bilateral or unilateral lower-body resistance training

Appleby, BB, Cormack, SJ, and Newton, RU. Specificity and transfer of lower-body strength: Influence of bilateral or unilateral lower-body resistance training. J Strength Cond Res 33(2): 318-326, 2019-To examine the development of lower-body strength using either bilateral or unilateral resistance training. Developmental rugby players (n = 33; mean training age = 5.4 ± 2.9 years; 1 repetition maximum [1RM] 90° squat = 178 ± 27 kg) completed an 18-week randomized controlled training design (bilateral group [BIL], n = 13; unilateral group [UNI], n = 10; comparison, n = 10). The 8-week training phase involved 2 lower-body, volume-load matched resistance sessions per week (6-8 sets × 4-8 reps at 45-88% 1RM), differing only in the prescription of a bilateral (back squat) or unilateral (step-up) resistance exercise. Maximum strength was assessed by a randomized order of 1RM back squat and step-up testing and analyzed for within- and between-group differences using effect sizes (ES ± 90% confidence limits [CL]). Both training groups showed practically important improvements in their trained exercise (ES ± 90% CL: BIL = 0.67 ± 0.48; UNI = 0.74 ± 0.38) with transfer to their nontrained resistance exercise (BIL step-up = 0.27 ± 0.39: UNI squat = 0.42 ± 0.39). The difference between groups in adaptation of squat strength was unclear (BIL ES = -0.34 ± 0.55), while the UNI group showed an advantage in step-up training (ES = 0.41 ± 0.36). The results demonstrate that practically important increases in lower-body strength can be achieved using bilateral or unilateral resistance training and development of that strength may be expressed in the movement not trained, supporting the transfer of strength training between exercises of similar joint movements and muscles. Coaches may choose to incorporate unilateral strength training where the prescription of bilateral training may be inhibited

Reliability of squat kinetics in well-trained rugby players: Implications for monitoring training

The aim of this study was to determine the within-session reliability in kinetic variables of the squat in well-trained athletes during a typical resistance training protocol. Fifteen subjects completed 2 testing sessions. Session 1 was establishment of 1 repetition maximum (1RM) squat, and session 2 involved 2 sets of 2 maximal effort repetitions of the squat at 70, 80, and 90% of 1RM with 3D motion analysis and ground reaction force (GRF) measurement using 2 in-ground triaxial force plates. Reliability was calculated using typical error ± 90% confidence limits, expressed as the coefficient of variation and intraclass correlation coefficient. The smallest worthwhile change (SWC%), calculated as 0.2 × between-subject SD, was used to determine the smallest important change in performance. Peak GRF and average GRF were found to have acceptable measures of reliability with the combined left and right leg average GRF capable of detecting the SWC. Independent limb contributions were reliable (left and right, or dominant and nondominant). Reliable kinetics can be obtained in back squat performance typical of a resistance training session in well-trained athletes. This suggests that coaches integrating force plate technology within training sessions may effectively capture between 1 and 6 training sets among several athletes, facilitating analysis and intervention on larger data sets

Unilateral and bilateral lower-body resistance training does not transfer equally to sprint and change of direction performance

Given maximal strength can be developed using bilateral or unilateral resistance training, the purpose of this study was to determine the magnitude of transfer of unilateral or bilateral resistance training to sprint and change of direction (COD) performance. Thirty-three trained participants (average training age = 5.4 ± 2.9 years and 1 repetition maximum [1RM] 90° squat = 177.6 ± 26.7 kg) completed either a bilateral group (BIL, n = 13), unilateral (UNI, n = 10), or comparison (COM, n = 10) 18-week randomized controlled training design. Training involved 2 lower-body, volume-load-matched resistance sessions per week (6-8 sets × 4-8 reps at 45-88% 1RM), differing only in the prescription of a bilateral (squat) or unilateral (step-up) resistance exercise. Strength was assessed through 1RM squat and step-up, in addition to 20-m sprint and a customized 50° COD test. The effect size statistic ± 90% confidence limit (ES ± CL) was calculated to examine the magnitude of difference within and between groups at each time point. BIL and UNI groups improved their trained and nontrained strength exercise with an unclear difference in adaptation of squat strength (ES = -0.34 + 0.55). Both groups improved 20-m sprint (ES: BIL = -0.38 ± 0.49 and UNI = -0.31 ± 0.31); however, the difference between the groups was unclear (ES = 0.07 ± 0.58). Although both groups had meaningful improvements in COD performance, bilateral resistance training had a greater transfer to COD performance than unilateral resistance training (between-groups ES = 0.59 ± 0.64). Both bilateral and unilateral training improved maximal lower-body strength and sprint acceleration. However, the BIL group demonstrated superior improvements in COD performance. This finding potentially highlights the importance of targeting the underlying physiological stimulus that drives adaptation and not exercise selection based on movement specificity of the target performance

Likeability and perceived effectiveness of messages designed to encourage physical activity participation among older adults

Issue addressed: Older adults are significantly less likely than their younger counterparts to engage in physical activity. Comprehensive policies to support healthy ageing thus need to include components encouraging greater participation in physical activity in later life. This study tested potential messages for use in health communication campaigns aimed at increasing physical activity among older adults. Methods: Twelve written messages designed to encourage older adults to increase their levels of physical activity were rated by Australians aged 60-92 years (n = 369; 54 % female) on the variables of likeability and perceived effectiveness. Results: Ratings for all the tested messages were high across both outcome variables. The message Move more, live longer scored most favourably, with large majorities of participants liking this message (87 %) and considering it effective (81 %). Messages featuring rhyming or alliteration were rated significantly higher on both outcomes than messages without these attributes (all Ps \u3c .001). Conclusions: Results provide insights into the types of messages that are likely to be accepted by older adults. Statements that use the phonological patterns of rhyming or alliteration are likely to be especially well received. So What?: Increasing participation in physical activity among older adults is critical to promoting the sustainability of health care systems and enhancing quality of life. The specific messaging attributes identified in the present study as being effective could be used by public health practitioners to inform their approach to physical activity messaging to older adults and incorporated into future health communication campaigns to increase their potential effectiveness with this target group

Characterizing the metabolic intensity and cardiovascular demands of walking football in Southeast Asian women

Given that the recent rise in obesity rates throughout Southeast Asia is disproportionately driven by women, part of the regional solution may be to encourage more habitual physical activity within this population. Taking advantage of the regional popularity of walking football, this study sought to characterize the cardiovascular demands and metabolic intensity of Southeast Asian women competing in walking football matches to determine the sports’ suitability for promoting physical health. It was hypothesized that both cardiovascular and metabolic intensity measures (≥65% HR% and ≥3.0 METs, respectively) would meet or exceed established thresholds for improving fitness and health. Methods: Women’s teams from Singapore (Mean±SD: 42±11 yrs age; 29.2±7.0 kg/m2 BMI; n=14) and Malaysia (40±10 yrs age; 32.9±5.7 kg/m2 BMI; n=8) competed in two successive matches within a single day during which measures of heart rate (HR) and GPS (from portable handheld device) were recorded for each player, while relative HR was computed as a percent of each player’s age-predicted maximal HR (HR%, %). The GPS data were later converted to walking distance and metabolic intensity (i.e., metabolic equivalents, or METs). One-sample t-tests at the 0.05 alpha level were used to compare variables to their respective thresholds. Results: Both Malaysian and Singaporean teams had mean relative HRs (91-95% of HRMAX [P=0.008] versus 77-80% of HRMAX [