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.

Abstract

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.

Springerlink

When at Lymphedema Risk After Breast Cancer

When at Lymphedema Risk After Breast Cancer

Editor's note:  This article is from one of my personal favorite sites for breast cancer.

EXERCISE

When at Lymphedema Risk After Breast Cancer


By Naomi Aaronson MA OTR/L CHT 


StepUoSpeakOut.org

Low Back Exercises

Low Back Exercises

Relieve Low Back Pain

Take an anti-inflammatory medication (these help to decrease the swelling and inflammation in the spine). 
Apply ice or heat to your back. 
Stop all strenuous activities. 
Relieve the pressure on the sciatic nerve with correct postures. 
Use proper back supports. 
Do low back exercises. 
See your doctor if the pain persists or goes into the leg.

Low Back Exercises

Unless instructed otherwise, do each exercise 1 to 5 times, twice each day. Gradually increase your workout to 10 repetitions twice a day. Use slow, smooth actions as you exercise. 

If you feel any discomfort while doing the exercises, stop immediately and contact your physician. Stop any exercise that increases back pain or causes tingling, numbness, or weakness in your legs.

Double knee-to-chest stretch

a. Lie down on back.

b. Pull both knees in to chest until you feel a comfortable stretch in lower back.

c. Keep the back relaxed.

d. Hold for 45 to 60 seconds.

Pelvic tilt exercise

a. Lie on back with knees bent, feet flat on floor, and arms at sides (a)

b. Flatten small of back against floor. (Hips will tilt upward.) (b)

c. Hold for 10 to 15 seconds and release. Gradually increase your holding time to 60 seconds.Lower trunk rotation stretch

a. Lie on back.

b. Keeping back flat and feet together, rotate knees to one side.

c. Hold for 45 to 60 seconds.Curl-up exercise

a. Lie on the floor on back.

b. Keeping arms folded across chest, tilt pelvis to flatten back. Tuck chin into chest.

c. Tighten abdominal muscles while raising head and shoulders from floor.

d. Hold for 10 seconds and release.

e. Repeat 10 to 15 times. Gradually increase your repetitions.Trunk flexion stretch

a. On hands and knees, tuck in chin and arch back.

b. Slowly sit back on heels, letting shoulders drop toward floor.

c. Hold for 45 to 60 seconds.Alternate arm-leg extension exercise

a. Face floor on hands and knees.

b. Raise left arm and right leg. Do not arch neck.

c. Hold for 10 seconds and release.

d. Raise right arm and left leg. Do not arch neck.

e. Hold for 10 seconds and release.Prone Lumbar Extension
Purpose: To extend your lower back.

1. Lie on your stomach and place your hands on the floor near the sides of your head.

2. Slowly push your upper body off the floor by straightening your arms, but keep your hips on the floor. Hold for 10 seconds, then relax your arms, moving back to the floor.Alternate leg extension
Lie on your stomach with your arms folded under your chin. Slowly lift one leg -- not too high -- without bending it, while keeping your pelvis flat on the floor. Slowly lower your leg and repeat with the other leg.
Hamstring stretch while standing

a. Stand on right leg with left leg on table/chair.

b. Stretch hamstring by slowly bending right knee.

c. Hold for 30-45 sec.

d. Repeat with other leg.

Whole Fitness

Exercise in patients with lymphedema: a systematic review of the contemporary literature

Exercise in patients with lymphedema: a systematic review of the contemporary literature

Dec. 2011

Kwan ML, Cohn JC, Armer JM, Stewart BR, Cormier JN.

Source

Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA, Marilyn.L.Kwan@kp.org.

Abstract

BACKGROUND: Controversy exists regarding the role of exercise in cancer patients with or at risk for lymphedema, particularly breast. We conducted a systematic review of the contemporary literature to distill the weight of the evidence and provide recommendations for exercise and lymphedema care in breast cancer survivors.

METHODS: Publications were retrieved from 11 major medical indices for articles published from 2004 to 2010 using search terms for exercise and lymphedema; 1,303 potential articles were selected, of which 659 articles were reviewed by clinical lymphedema experts for inclusion, yielding 35 articles. After applying exclusion criteria, 19 articles were selected for final review. Information on study design/objectives, participants, outcomes, intervention, results, and study strengths and weaknesses was extracted. Study evidence was also rated according to the Oncology Nursing Society Putting Evidence Into Practice® Weight-of-Evidence Classification.

RESULTS: Seven studies were identified addressing resistance exercise, seven studies on aerobic and resistance exercise, and five studies on other exercise modalities. Studies concluded that slowly progressive exercise of varying modalities is not associated with the development or exacerbation of breast cancer-related lymphedema and can be safely pursued with proper supervision. Combined aerobic and resistance exercise appear safe, but confirmation requires larger and more rigorous studies.

CONCLUSIONS: Strong evidence is now available on the safety of resistance exercise without an increase in risk of lymphedema for breast cancer patients. Comparable studies are needed for other cancer patients at risk for lymphedema. IMPLICATIONS FOR CANCER SURVIVORS: With reasonable precautions, it is safe for breast cancer survivors to exercise throughout the trajectory of their cancer experience, including during treatment.

Springerlink

A Sample Progressive Exercise Program

A Sample Progressive Exercise Program

This exercise program has been devised to increase your strength and endurance. The program, which takes you from your bed to being up and around in three stages, can be started as soon as your physician says its ok. You can refer to the healthlibrary.stanford.edu/resources/videos.html website for videotapes of appropriate exercises.

Stage I is on one tape and Stages II and III are together on another tape. The demonstrations include warm-up and full-exercise programs with relaxation sessions at the end.

Stage I exercises are simple and help you to maintain and increase your range of motion. They require little exertion and can be done in bed.

Stage II exercises use a small added weight to increase resistance and can be done when you are spending part of the day out of bed. Once you have gotten back to your normal activities, you will need to establish an exercise routine that includes exercises like these to build up your body's reserves so that temporary bouts with bed rest will not deplete your energy stores.

Stage III exercises provide you with a strengthening and maintenance program for when you are able to spend the whole day out of bed. This series of exercises is a progressive and comprehensive physical rehabilitation program for people with acute or chronic illness. With your doctor's permission, you can begin these exercises even while you are recovering from surgery or undergoing cancer therapy.

Cancer Supportive Care Programs

Cancer Supportive Care Programs