Physical activity and exercise training in cancer patients

Targeted Exercise Training for Cancer Patients: Moving beyond Generic Exercise Guidelines in Clinical Oncology Ciaran M Fairman1 and Jesper F Christensen()2,3 1Department of Exercise Science, University of South Carolina, USA 2Center for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark 3Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Denmark © The Authors Abstract The field of exercise oncology has rapidly evolved over the past 30 years. Initial investigations of safety and feasibility have progressed towards efficacy and effectiveness trials with a variety of health-related outcomes in mind. More recently, it has been recognized that interventions aimed at modifying physical activity behavior (i.e. behavioral interventions to increase participation in un/structured physical activity) are distinctly different from those aiming to target a clinically relevant outcome (using a specific exercise prescription). There is a strong rationale for the latter, where cancer/treatment toxicities can result in musculoskeletal, cardiopulmonary, and/or hematological declines with important prognostic implications. Treatment intolerance, unfavorable tumor response and heightened risk of mortality are all consequences of leaving these impairments unaddressed. Importantly, the control/reversal of the decline in these systems is more likely to occur through a targeted exercise prescription, specifically designed to target the impairment, rather than interventions trying to change behavior. This requires careful consideration in the study design in exercise oncology in relation to the selection of clinically relevant outcomes, decisions on methods of assessments and ensuring the exercise is targeted to the outcome. The objective of this review is to 1) conceptualize and provide a clinical rationale for targeted exercise interventions in exercise oncology, and 2) provide a framework for consideration in the design and execution in targeted exercise interventions in oncology. We hope that this framework can encourage research into targeted exercise interventions in oncology and that our framework can be used to inform the design of future trials.

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Cognitive dysfunction and multiple sclerosis: developing a rationale for considering the efficacy of exercise training

Multiple Sclerosis Journal ◽

10.1177/1352458511409612 ◽

2011 ◽

Vol 17 (9) ◽

pp. 1034-1040 ◽

Cited By ~ 49

Author(s):

Robert W Motl ◽

Brian M Sandroff ◽

Ralph HB Benedict

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Older Adults ◽

Cognitive Impairment ◽

Exercise Training ◽

Aerobic Fitness ◽

Controlled Trial ◽

Preliminary Evidence ◽

Cross Sectional ◽

Physical Activity And Exercise

Cognitive impairment is a prevalent, disabling, and poorly managed consequence of multiple sclerosis (MS). This underscores the importance of considering alternative approaches, such as exercise training, for managing cognitive impairment in persons with MS. The consideration of exercise training is warranted based on evidence summarized in literature reviews and meta-analyses that (1) aerobic fitness, physical activity, and exercise training are associated with better cognitive function in older adults; and (2) exercise training has comparable effects on mobility and quality of life outcomes in older adults and persons with MS. To date, research examining aerobic fitness, physical activity, and exercise training effects on cognition in MS is nascent and mostly includes cross-sectional designs that provide preliminary evidence for a well-designed randomized controlled trial (RCT). We believe that a future RCT should adopt research methodologies and practices from gerontology when examining exercise training and cognition in MS. This will maximize the potential for successfully generating a body of knowledge on exercise training and cognition with the potential for impacting the lives of persons with MS.

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