Thursday, December 27, 2012


    A 20% reduction in oxygen blood levels may be caused by the aging process and normal breathing habits. Poor breathing robs energy and negatively affects mental alertness. Unless breathing is exercised, aging affects the respiratory system as follows:  Stiffness: The rib cage and surrounding muscles get stiff causing inhalation to become more difficult. Less elasticity and weak muscles leave stale air in the tissues of the lungs and prevents fresh oxygen from reaching the blood stream.

    Rapid, Shallow Breathing: This type of breathing, often caused by poor posture and weak or stiff muscles, leads to poor oxygen supply, respiratory disease, sluggishness, or heart disease.

    The following exercises are simple ways to deepen breathing and to cleanse the lungs. These exercises will also increase energy and decrease tension.
      Lie flat on your back to get a proper sense of deep breathing. (Have some small pillows available to reduce strain by tucking them under the neck and knees. The natural course of breathing in that position will create a slight rise in the stomach upon inhaling and a slight fall upon exhaling.)  Place your hands palm down on your stomach at the base of the rib cage. (The lungs go that far down. What fills them deeper is the pushing down of the diaphragm. The diaphragm creates a suction which draws air into the lungs. the air is then expelled when the diaphragm pushes up. In this process, the life-giving oxygen fills the lungs and gets into the blood stream for distribution to the cells. Carbon dioxide is expelled from the blood into the about-to-be exhaled breath, thus cleansing the body and blood of waste products.)   Lay the palms of your hands on your stomach just below the rib cage, middle fingers barely touching each other, and take a slow deep breath.  (As the diaphragm pushes down, the stomach will slightly expand causing the fingertips to separate somewhat.

      This movement indicates full use of the lungs, resulting in a truly deep breath rather than the "puffed chest" breath experienced by many as the greatest lung capacity. Chest breathing fills the middle and upper parts of the lungs. Belly breathing is the most efficient method. Infants and small children use only this method until the chest matures. The yoga breath or roll breathing combines belly and chest breathing.


      1. Sit up straight. Exhale.2. Inhale and, at the same time, relax the belly muscles. Feel as though the belly is filling with air.
      3. After filling the belly, keep inhaling. Fill up the middle of your chest. Feel your chest and rib cage expand.
      4. Hold the breath in for a moment, then begin to exhale as slowly as possible.
      5.  As the air is slowly let out, relax your chest and rib cage. Begin to pull your belly in to force out the remaining breath.
      6. Close your eyes, and concentrate on your breathing.
      7.  Relax your face and mind.
      8.  Let everything go.
      9.  Practice about 5 minutes.

    Follow the instructions for inhaling the COMPLETE BREATH (Steps 1-3 above). Now, as you begin to slowly exhale, make a HUM sound. Keep making that humming sound as long as possible. Pull your stomach muscles in, squeezing out a few more seconds of humming. Then relax. Practice for 2 to 3 minutes.

    A very fine, short (though not shallow) breath exercise comes from the Chinese Tai Chi ChuanThree short inhales are done through the nose without exhaling. On the first inhale, the arms are lifted from the sides straight out in front at shoulder height. On the second, the arms are opened out straight to the sides while still at shoulder height. And on the third, the arms are lifted straight over the head. Then, on the exhale through the mouth, the arms are moved in an arc back down to the sides. Usually, ten or twelve breaths are sufficient and will not cause light headedness. If light headedness should occur, simply stop the exercise. This exercise also has the effect of really opening up people physically.  In subtle ways, this exercise uses the body in leading the mind and spirit to greater openness with each other and the environment.
    CAUTION !!  Especially for older people:  Never do panting or shallow breathing except while seated. Hyperventilation may occur. As long as one is seated, hyperventilation will not be a problem because, even if a brief blackout should occur, the body's automatic breathing apparatus will immediately take over.

The influences of exercise fulfillment on mental and physical functions of targeted older adults and the effect of a physical exercise intervention.

The influences of exercise fulfillment on mental and physical functions of targeted older adults and the effect of a physical exercise intervention.

Oct 2012 

[Article in Japanese]


Tokyo Metropolitan Institute of Gerontology.



To investigate the influence of the differences in exercise fulfillment on mental and physical functions and the effects of exercise intervention on community-dwelling older adults.


Participants in this study included 260 community-dwelling older adults (mean age +/- SD, 70.4 +/- 6.0 years) who participated in the exercise intervention study (intervention and control groups). Exercise fulfillment levels (low or high), physical activity levels (low or high), mental health (WHO-5 scores), health-related QOL (SF-8 score), and physical abilities of these adults were measured during a baseline health checkup. Based on the status of the 3 exercise fulfillment groups, multivariate analysis of variance (MANOVA), which was adjusted for age, sex, and physical activity levels, was performed to compare the results of the outcome measures among the 3 groups. The intervention group (n = 88, aged 70.3 +/- 6.2 years) was divided into 2 subgroups: the deterioration subgroup (participants with low-exercise fulfillment after the intervention) and the improvement subgroup (participants with high-exercise fulfillment after the intervention). Subsequently, the intervention effects were assessed by repeated measurements of the analysis of variance (ANOVA) between the 2 subgroups.


MANOVA analysis revealed that body mass index, grip strength, maximum walking speed, the WHO-5 score, and the SF-8 subscale (8 items) score differed significantly amongst the groups. The high-exercise fulfillment group demonstrated better results for these variables than the low-exercise fulfillment group. Similar results were obtained for each group with respect to the physical activity levels. The repeated-measures ANOVA revealed that time had an important effect on lower physical functions and the SF-8 subscale (1 item) score; it also revealed the important effects of body mass index, the WHO-5 score, the SF-8 subscale (6 items) score, and psychological independence on the group.


Older adults with higher exercise fulfillment demonstrated better mental and psychological health, regardless of their physical activity levels. Older adults with low-exercise fulfillment could potentially improve their physical abilities; however, their mental and psychological health significantly differed from that of older adults with medium- or high-exercisefulfillment after exercise intervention. These findings provide preliminary evidence, which indicates that exercise can provide sufficient fulfillment and contribute to the promotion and improvement of health in older adults. Moreover, performing adequate tests on exercise fulfillment may aid in assessing the effects of intervention programs in regional healthcare systems.

Leisure activities alleviate depressive symptoms in nursing home residents with very mild or mild dementia.

Leisure activities alleviate depressive symptoms in nursing home residents with very mild or mild dementia.

Oct 2012

**Editor's note: Exercise/leisure activities can help us with depression too, even depression associated with lymphedema.  It is nto only a vital part of our physical well being, but mental/emotional as well.The point being whatever your interest might be, take part in it as often as you can**


Department of Psychological Studies, Hong Kong Institute of Education, Kwai Chung Hospital, Hong Kong.



 To examine whether leisure activities can alleviate depressive symptoms among nursing home residents with very mild to mild dementia.


 A cluster-randomized open-label controlled design. Thirty-six residents with at least moderate depressive symptoms were randomized by home into three conditions-mahjong (a.k.a. mah-jongg), tai chi, and handicrafts (placebo). Activities were conducted three times weekly for 12 weeks. Outcome measure was Geriatric Depression Scale (GDS) administered at baseline, posttreatment, and at 6 months.


 Repeated-measures analysis of variance showed a group by time interaction on the GDS. Unlike control and tai chi participants whose scores remained relatively unchanged, the mahjong group reported a drop of 3.25 points (95% confidence interval: 1.00-5.50) on the GDS at posttreatment but gained back 2.83 points (95% confidence interval: 1.95-5.47) at 6 months. Activity discontinuation might be the reason for depression to return to baseline.


 Mahjong can lower depressive symptoms in those with mild dementia, but activity maintenance may be essential for long-term effects.

Saturday, December 22, 2012

A Warm Water Pool-Based Exercise Program Decreases Immediate Pain in Female Fibromyalgia Patients: Uncontrolled Clinical Trial.

A Warm Water Pool-Based Exercise Program Decreases Immediate Pain in Female Fibromyalgia Patients: Uncontrolled Clinical Trial.

**Editor's note: I am including this as a number of lymphedema patients also report having fibro myalgia - Pat**

Dec 2012


Department of Physical Education and Sports, School of Sport Sciences, University of Granada, Granada, Spain.


Fibromyalgia is characterized by chronic and extended musculoskeletal pain. The combination of exercise therapy with the warm water may be an appropriate treatment. However, studies focusing on the analysis of immediate pain during and after an exercise session are rare. This study aimed to determine the immediate changes of a warm water pool-basedexercise program (12 weeks) on pain (before vs. after session) in female fibromyalgia patients. 33 Spanish women with fibromyalgia were selected to participate in a 12 weeks (2 sessions/week) low-moderate intensity warm water pool-based program. We assessed pain by means of a Visual Analogue Scale before and after each single session (i. e., 24 sessions). We observed immediate benefits on pain with a mean decrease ~15% in all sessions, except in the fourth one. There was an association of pain difference (pre-post) session with pain pre session (p=0.005; β=0.097±0.034) and with age (p<0.001; β=0.032±0.008). There were no significant accumulative differences on pain, pre session, post session, and pre-post changes (all p>0.05). Therefore this study showed that a warm water pool-based exercise program for 12 weeks (2 times/week) led to a positive immediate decrease in level of pain in female patients with fibromyalgia. Improvements were higher in older women and in those with more intense pain.

Interrogating the Age-Old Wisdom of Exercise.

Interrogating the Age-Old Wisdom of Exercise.

Dec 2012


Framingham Heart Study, Framingham, MA; Brigham and Women's Hospital, Boston, MA.


We have long known that exercise is good for us. Hippocrates declared over 25 centuries ago that "if we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." There is now a wealth of evidence indicating that the benefits of physical activity extend across multiple organ systems and span the age spectrum.(1,2) Perhaps most compelling are data highlighting the potential of exerciseto prevent and attenuate chronic conditions related to insulin resistance and atherosclerosis.(3,4) Despite nationwide recommendations encouraging regular exercise for all adults, fewer than 1 in 3 Americans engage in routine physical activity.(5) Low adherence rates could relate in part to the fact that we still do not really understand how exercise works. For this reason, recommendations remain non-specific with respect to how frequent, how intense, how long, what type, and for whom exercise should be prescribed.(4).

Sunday, December 16, 2012

The Benefit of Aquatic Exercise for Lymphedema

The Benefit of Aquatic Exercise for Lymphedema


Today I would like to share with you an article on aquatic exercises written by Mary Essert, B.A., ATRIC for this blog.

Mary specializes in creation and delivery of water fitness and post rehab aquatic programs for individuals with disabilities and conditions such as Arthritis, Fibromyalgia, Breast Cancer, Lymphedema, post Polio Syndrome and chronic pain issues. More information on Mary Essert is available at the bottom of the article.
I would also like to inform you that all the exercises for the upper and lower extremities I covered in the last blog entry (Decongestive and Breathing Exercises for Lymphedema) may be performed in the water as well.
Here is Mary’s article:
Following Joe Zuther’s recent article on Resistive Exercises, this article would be a natural sequence and serve as an introduction to another non-invasive tool to use in management of Lymphedema symptoms.
In addition to a number of other benefits, aquatic exercises have a strengthening effect on the musculature.
Remainder of article:
**This is an excellent source of solid lymphedema information and I highly recommend it to anyone with an interest in this condition. Pat O'Connor**

Wednesday, December 5, 2012

Evidence based exercise - Clinical benefits of high intensity interval training.

Evidence based exercise - Clinical benefits of high intensity interval training.

Dec 2012


Obesity rates in Australia are among the highest in the world, with one in 4 adults being obese. Obesity increases the risk of coronary heart disease, type 2 diabetes mellitus (T2DM) and stroke, three of the top five causes of burden of disease and injury in Australia.2 Dietary modification is the mainstay of any weight loss program and has been shown to improve cardiovascular and metabolic risk factors including blood pressure, lipids, serum glucose, glycated haemoglobin (HbA1c) and insulin levels as well as reducing risk of acute coronary syndromes, stroke and all cause mortality. Exercise has been shown to be an important additional strategy to a weight loss program. However, in Australia, nearly 40% of males and 60% of females carry out insufficient daily physical activity.


Aerobic exercise has a marked impact on cardiovascular disease risk. Benefits include improved serum lipid profiles, blood pressure and inflammatory markers as well as reduced risk of stroke, acute coronary syndrome and overall cardiovascular mortality. Most exercise programs prescribed for fat reduction involve continuous, moderate aerobicexercise, as per Australian Heart Foundation clinical guidelines.


This article describes the benefits of exercise for patients with cardiovascular and metabolic disease and details the numerous benefits of high intensity interval training (HIIT) in particular.


Aerobic exercise has numerous benefits for high-risk populations and such benefits, especially weight loss, are amplified with HIIT. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery (either no or low intensity exercise). HIT is associated with increased patient compliance and improved cardiovascular and metabolic outcomes and is suitable for implementation in both healthy and 'at risk' populations. Importantly, as some types of exercise are contraindicated in certain patient populations and HIIT is a complex concept for those unfamiliar to exercise, some patients may require specific assessment or instruction before commencing a HIIT program.

Sunday, November 25, 2012

The role and efficacy of exercise in persons with cancer.

The role and efficacy of exercise in persons with cancer.

Nov 2012


Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin and Clement J. Zablocki VA Medical Center, Milwaukee, WI(⁎). Electronic address:


Improvements in cancer screening, diagnosis, and treatment have resulted in an increasing population of cancer survivors with impairments in physical function, cancer-related symptoms, and reduced quality of life. Exercise and physical activity have therapeutic value at multiple points along the cancer disease continuum, spanning disease prevention, treatment, survivorship, prognostic outcomes, and end-of-life issues. Molecular mechanisms for the influence of exercise in persons with cancer include altering tumor initiation pathways and affecting hormonal, inflammatory, immune, and insulin pathways. Physical activity has been found to play a role in the prevention of certain malignancies, including breast, colon, and other cancers. An increasing amount of evidence indicates that physical activity may affect prognostic outcomes in certain cancer diagnoses, especially breast cancer. Structured exercise and physical activity interventions can be helpful in addressing specific survivorship issues, including overall quality of life, cardio respiratory impairment, cancer-related fatigue, and lymphedemaExercise also may be helpful during the palliative care phase to alleviate symptoms and increase physical well-being. This article will familiarize physiatrists with the current state of evidence regarding the role and efficacy of exercise in persons with cancer.

**I have included this as so many of us (including myself) are either cancer patients or cancer survivors.**

Tuesday, November 13, 2012

Aerobic Exercises for Lymphedema

Aerobic Exercises for Lymphedema

This is the first part in a three-part series covering exercises for patients affected by lymphedema. Part two will cover resistive exercises; part three will discuss decongestive and breathing exercises – so stay tuned.
Lymphedema patients can and should be active, and those who never exercised before should consider starting that daily walk, wim or spending twenty minutes on a stationary bicycle. The right type of physical activity helps to reduce the swelling by improving the flow of lymph, and presents a vital tool for patients to stay in shape and continue with normal activities of daily living.
So what is the right type of exercise for lymphedema?
Many patients ask if they can continue their pre-lymphedema activities, or if the should adjust, or replace them. The answer to that question really depends on the kind of activity. Tennis or golf for example does not rank very high on the list of beneficial activities for individuals with upper extremity lymphedema. For patients with lymphedema of the leg, kick-boxing and step-aerobics are activities that bear a great risk of injury and therefore should be avoided.
But the reality is that for some individuals exercise plays such a vital role in their daily routine, and is so engrained in their personality, that giving up these so called “high-risk activities” would have a serious impact on their well-being.
Complete Article:  Lymphedema Blog
Editor's Note:  I have spoken of this blog in many of my own sites and if you have not yet "toured" it, you are missing out on some top quality information for your lymphedema.  

Wednesday, November 7, 2012

Tips for Getting Exercise Into Your Life

Tips for Getting Exercise Into Your Life

1. Get off a stop or 2 earlier during your bus or subway commute; walk the rest of the way. 
2. Purposefully park you car a little further from the mall or store. It may not seem like much, but over weeks and months, these minutes of exercise add up. 
3. Use the stairs instead of elevators and escalators whenever possible. 
4. Consider buying a piece of cardiovascular equipment for your home (e.g. treadmill, bike, elliptical machine). Home models can be more reasonable than you think and you can't beat the convenience. 
5. When you get busy, try to combine your cardiovascular exercise with something that you do already. Hop on that piece of home equipment while watching TV, reading the newspaper or returning phone calls. 
6. Make it fun! Try a new sport like tennis or rollerblading. The more that you enjoy exercise the more likely you are to stick to it. 
7. Make it social. Walk with a friend, your spouse, or your family in the morning or evening. 
8. Keep an exercise log. It will help to make you more accountable. 9. Take a walk for 20 minutes of your lunch hour. 10. Hire a personal trainer for a session or 2 to help you with your weight training and flexibility training.
Then you'll have the confidence to branch out on your own.
Time for an Average 150 lb Adult to Burn 150 Calories:
Intensity Activity METs* Duration in minutes Moderate Volleyball, noncompetitive 3.0 43 Moderate Walking, moderate pace (3 mph, 20 min/mile) 3.5 37 Moderate Walking, brisk pace (4 mph, 15 min/mile) 4.0 32 Moderate Table tennis 4.0 32 Moderate Raking leaves 4.5 32 Moderate Social dancing 4.5 29 Moderate Lawn mowing (powered push mower) 4.5 29 Hard Jogging (5 mph, 12 min/mile) 7.0 18 Hard Field hockey 8.0 16 Very hard Running (6 mph, 10 min/mile) 10.0 13
* MET indicates metabolic equivalent. One MET is the amount of energy used when sitting quietly. Source: Physical Activity and Health: A report of the Surgeon General (1) 
Harvard EDU - page no longer available

Nurse-assisted education and exercise decrease the prevalence and morbidity of lymphedema following breast cancer surgery.

Nurse-assisted education and exercise decrease the prevalence and morbidity of lymphedema following breast cancer surgery.

JulSep 2012


Department of Nursing, Cukurova University Medical Faculty, Balcali, Adana, Turkey.



To evaluate an educational and exercise program for the prevention and progression of post-mastectomy lymphedema of the arm and shoulder.


Fifty-five patients who had undergone mastectomy and axillary lymph node dissection between June 2009 and January 2010 were included in this study. The patients were informed by a trainer nurse about the precautions they should take to prevent the development of lymphedema. The patients were also trained for the appropriate exercises and were given written educational material prepared by the investigators.


Among the participants, 96.4% underwent modified radical mastectomy (MRM) and 3.6% breast-conserving (BCS) surgery. The mean postoperative follow-up period was 9.87 ± 17.55 months. The degree of lymphedema was found lower, even within 6 months, in the patients that exercised as compared to the patients that did no .


The results indicate that the risk of development and progression of mastectomy-related lymphedema was reduced with education and exercise provided by trained nurses at an early stage.

Thursday, November 1, 2012

Decongestive and Breathing Exercises for Lymphedema

Decongestive and Breathing Exercises for Lymphedema


In this last part of the three-part series about exercises, I would like to address decongestive- and breathing exercises, which are an integral part in the treatment and management of lymphedema.
Unlike the heart in the blood circulatory system, the lymphatic system does not have an active pump to propel lymphatic fluid back to the bloodstream. Effective lymph flow depends on sufficient muscle and joint activity, especially if the functionality of the lymphatic system is compromised. Decongestive exercises are most effective if performed while the patient wears compression garments or bandages, which are also essential components in lymphedema management. Ideally, decongestive exercise protocols are performed two to three times daily for about 10-15 minutes, and the patient should rest with the affected limb elevated for at least 10 minutes following the exercises.
These active, non-resistive and repetitive exercise protocols should be customized by the lymphedema therapist and/or physician to meet individual goals for patients affected by lymphedema. The stage and type of lymphedema, specific restrictions and limitations of joint and muscle activity, as well as additional medical conditions need to be considered.
Breathing Exercises
The downward and upward movement of the diaphragm in deep abdominal breathing is an essential component for the sufficient return of lymphatic fluid back to the bloodstream. Patients affected by lymphedema of the leg benefit greatly from an exercise program including diaphragmatic breathing exercises. The movement of the diaphragm, combined with the outward and inward movements of the abdomen, ribcage, and lower back, also promotes general well-being, peristalsis and return of venous blood back to the heart.
Following are sample decongestive exercise protocols, combined with breathing exercises for the upper and lower extremity, which are published in the book Lymphedema Management. This book also contains self-MLD and self-bandaging protocols for patients affected by lymphedema. The exercise protocols below serve as guidelines and the movements outlined must not cause discomfort, pain, or soreness.
Before you engage in any exercise program, especially if you have additional medical conditions, please make sure to get your physicians approval.
Continuation of Article and additional exercise articles:
Editor's Note:  I am including this article not only because of the quality of the information, but as an introduction to one of the best lymphedema information sites available.  The blog was founded and is maintained by Joachm Zuther of the Academy of Lymphatic Studies.    You really need to include this blog in your list of reading sites.  Pat O'Connor

Friday, October 19, 2012

Exercise - Position Statement of the National Lymphedema Network

Exercise - Position Statement of the  National Lymphedema Network


Fitness and Exercise: 
It is very important for individuals with lymphedema to be physically fit and maintain a healthy weight. A safe form of exercise is an essential part of a fitness program for people with lymphedema. Fitness and exercise are not the same. Exercise includes many different types of physical movement. The three main types of exercise are: aerobic, strength, and flexibility. These three types of exercise, along with Lymphedema Remedial Exercises, are addressed in this paper. There are many other types of exercise that have health benefits such as Pilates, yoga, Tai Chi, Qigong, aquatic exercise,1 trampoline rebounding, breathing exercises,2 and relaxation exercise that have not been adequately studied in people with lymphedema. However, the person with lymphedema can use the benefits of any system of exercise if he/she follows the general safety principles of exercise with lymphedema, seeks medical guidance, and uses caution in starting any new exercise program. 

Exercise and types of lymphedema: 
Lymphedema has many causes. The type of exercise that is best for an individual depends upon the severity and cause of lymphedema and other co-existing medical conditions (e.g. heart disease, diabetes, arthritis, etc). Exercise for breast cancer-related lymphedema is the most studied lymphedema condition. Many conclusions about exercise and lymphedema are based on studies of breast cancer survivors that may or may not apply to other forms of lymphedema. 

Lymphedema Remedial Exercise:

Lymphedema Remedial Exercise is a part of treatment for lymphedema when reduction of size of a limb is necessary. Lymphedema Remedial Exercise involves active, repetitive, non-resistive motion of the involved body part. Exercise in Phase I and Phase II Complete Decongestive Therapy (CDT) (see Position Paper “Diagnosis and Treatment of Lymphedema” is performed with compression as an essential part of the total (complete) reductive phase of lymphedema therapy.3-5 Lymphedema exercises, used with compression, help the body’s natural muscle pump to increase venous and lymphatic fluid return to the circulatory system and out of the swollen areas. 

Remedial Exercises for lymphedema are similar to some movements of low impact Tai Chi and Qigong, but are different in that lymphedema Remedial Exercise is used with Phase I treatment of lymphedema to reduce size of the body part. Lymphedema Remedial Exercise has been studied and shown to reduce limb swelling.3-5 It is unknown whether Lymphedema Remedial Exercise alone can prevent lymphedema in at-risk individuals, or whether they can maintain reduction of swelling without compression. 

Flexibility or Stretching Exercises: 

Flexibility exercises include a wide range of activities that stretch muscle and connective tissues to increase and/or preserve range of motion. Flexibility exercises can minimize skin scarring and joint contractures that may lessen lymph flow. Flexibility exercises should be performed slowly and progressed gradually. Flexibility exercises are not a treatment for lymphedema, but are a part of optimal lifestyle management for reducing the complications of lymphedema. Lymphedema has a tendency to restrict motion of muscles and joints. Optimal lymphatic function requires full mobility of muscles and joints. Lymphedema from cancer treatment can be associated with tight muscles and connective tissues due to fibrous adhesions from surgery or radiation. Tight muscles and scars from surgery or radiation may require Physical or Occupational Therapy to treat before attempting to do self-stretching. 

Specific stretching exercises for cancer treatment-related scars and joint restrictions in an area at risk of lymphedema should be prescribed by a provider familiar with the management of lymphedema. A specialized form of stretching exercise may be required for Axillary Web Syndrome (AWS) or axillary cording, a condition that can occur in cancer survivors who have had axillary (armpit) lymph nodes removed.6 AWS may benefit from treatment by a certified lymphedema therapist and specific home stretches taught by a therapist.7

**Important - Please read the full text on the National Lymphedema Network website:


Wednesday, August 29, 2012

Community-based exercise program effectiveness and safety for cancer survivors

Community-based exercise program effectiveness and safety for cancer survivors

Jan. 2012
Rajotte EJ, Yi JC, Baker KS, Gregerson L, Leiserowitz A, Syrjala KL.
Source Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, D5-220, P.O. Box 19024, Seattle, WA, 98109, USA.
Keywords: Cancer survivors – Exercise – Physical activity – Community – YMCA
PURPOSE: Clinical trials have demonstrated the benefits of exercise for cancer survivors. This investigation determined the effectiveness and safety of a disseminated community-based exercise program for cancer survivors who had completed treatment.
METHODS: Personal trainers from regional YMCAs received training in cancer rehabilitation and supervised twice-a-week, 12-week group exercise sessions for survivors. At baseline and post-program, validated measures assessed patient-reported outcomes (PRO) and physiologic measurements.
RESULTS: Data were collected from 221 survivors from 13 YMCA sites and 36 separate classes. All participants had data available at one time point, while matched baseline and post-program PRO and physiologic data were available for 85% (N = 187). Participants with matched data were largely female (82%), with mean age of 58 (range, 28-91 years). Time since diagnosis ranged from 1 to 48 (mean, 5.6 years), and mean time since last treatment was 3.0 (range, 1-33 years). Physiological improvements were significant in systolic (P < 0.001) and diastolic (P = 0.035) blood pressure, upper and lower body strength, the 6-min walk test (P = 0.004), and flexibility (P < 0.001). Participants reported improvements in overall health-related quality of life (P < 0.001), social support (P = 0.019), body pain (P = 0.016), fatigue (P < 0.001), insomnia (P < 0.001), and overall musculoskeletal symptoms (P = <0.001). Few injuries or lymphedema events occurred during classes.
CONCLUSIONS: Community-based exercise groups for cancer survivors of mixed diagnoses and ages, who have completed active treatment, have physiologic and psychosocial benefits, and are safe. 
IMPLICATIONS FOR CANCER SURVIVORS: Survivors may expect significant benefit from participating in a community-based exercise program tailored to meet their individual needs as a survivor.