Physical exercise is a safe, cost-efficient, and effective intervention for cancer survivors. Regular exercise can reduce symptoms such as cancer-related fatigue, depression, prevent and reduce ...co-morbidities, attenuate toxicity related to cancer treatment, and reduce cancer-specific and all-cause mortality 1-4. Exercise is generally recommended for all cancer survivors and should be started as early as possible 5. However, there is limited evidence in head and neck cancer (HNC) 6, which has multiple challenges; patients typically present with substantial weight loss, inactivity and low cardiorespiratory fitness; treatments are gruelling with substantial short and long-term symptom burden; many live in areas of high deprivation, residing some distance from their treating centre and have low levels of health literacy; integrating interventions to this complex care pathway is challenging 7-13.
Objective: To investigate the feasibility of introducing a remotely delivered, personalised, collaborative, and flexible exercise programme into the HNC care pathway.
This prospective single arm feasibility and acceptability study aimed to recruit seventy HNC patients from two UK Centres, over 12 months. A conservative retention rate of 60% was predicted, to provide a minimum of 42 patients on study completion. The intervention was a personalised 8-week exercise programme delivered remotely by cancer exercise specialists, trained in behaviour change techniques. Patients were invited to participate any time between diagnosis and 8 weeks post-treatment, according to their preference. Intervention content was based on patient needs, preferences, and goals, guided by physical activity cancer guidelines. Primary outcomes included recruitment and retention. A qualitative sub-study included patient and healthcare professionals semi-structured interviews to evaluate intervention experiences and processes.
One hundred and eighteen patients were eligible for the study, 107 patients were approached, and 76 consented (71%). Recruitment uptake was different for each site 54% vs 82%. Reasons for non-participation were; too much to think about, additional paperwork, uninterested in exercise.
Participants M:F ratio 3:1; mean age 60.5 years (range 34-80). The majority had oropharyngeal (54%) or oral cancer (33%), 56% had T1/2 tumours. Fifteen patients (19%) had over the recommended alcohol intake (14 units/week), 8 (10.5%) were current smokers. Treatment included surgery alone (28.8%) surgery and adjuvant (chemo)radiotherapy (50.0%) or primary (chemo)radiotherapy (21.2%). The majority of patients consented to ACTIOHN pre-treatment (45%). Data collection finishes in February 2024. To date, 32 patients have completed ACTIOHN, 27 are on treatment and 17 have withdrawn. Key themes from on-going patient interviews (N=17) are; therapeutic alliances; understanding what the intervention involved; personalisation; treatment impact; programme impact; paperwork, and from eight healthcare professionals; describing the programme; personalisation; nutrition; treatment impact; buy-in.
This high uptake indicates that the ACTIOHN intervention was acceptable to HNC patients. Overall patients and HCPs were positive about the intervention. However, there were substantial system challenges, and despite many consenting to participate pre-treatment, a proportion of surgical patients were unable to start ACTIOHN until post-treatment. Patients appreciated a strong therapeutic bond and tailoring of the intervention to their needs and preferences. ACTIOHN requires further investigation to test effectiveness and fit with the pathway.
The effects of regular exercise on the health promotion of patients with type 2 diabetes mellitus (T2DM) have been well documented. The present study investigated the long-term effects of regular ...exercise training on biological indicators among these patients.
In this quasi-experimental trial with pretest-post-test design, 65 patients with T2DM aged 33-69 years (experiment (35), control (30)) participated. After 8 years of conducting the program, the data on 30 patients (experiment (15), control (15)) were entered into analysis. The training program included aerobic exercise three sessions per week, 90 min, 50%-80% VO
max. Before and after the intervention, the biological indicators (hemoglobin A1c (HbA1c), body mass index (BMI) and VO
max) were measured. Data were analyzed using multivariate analysis of covariance.
Our long-term exercise training program had a significant effect on HbA1C, BMI and Vo
max (P<0.05). Compared with patients in the control group, HbA1c was significantly reduced and BMI and VO
max were significantly improved among the experiment group.
Long-term regular physical activity training was found to be helpful in improving glycemic control, body composition and cardiovascular fitness among patients with T2DM. Long-term continuous physical activity offsets the deteriorations of biological indicators found in the control group. Further research, with a particular focus on practical and real-world programming, is needed to determine the responsive health outcomes of such long-term programs on the patients.
This study aims to explore the relationship between physical exercise (PE), self-control (SC), physical exercise atmosphere (PEA), and mobile phone addiction tendency (MPAT) among Chinese university ...students. Through the quota sampling, 1,433 students complied with the requirements were surveyed from 10 universities in China. PE, SC, PEA, and MPAT were assessed using standard scales. For data analysis, common method deviation test, mean number, standard deviation, correlation analysis and structural equation model analysis were carried out in turn. The results showed PE and MPAT were negatively related (
= -0.158,
< 0.05); PE significantly positively predicted SC (β = 0.082,
= 3.748,
< 0.01), and SC significantly negatively predicted MPAT (β = -0.743,
= -19.929,
< 0.01). Bootstrap method was used to test the mediating effect of SC. The results showed that 95% confidence interval did not include 0. After adding the mediating variable of SC, PE did not significantly negatively predict the tendency of MPAT (β = -0.027,
= -1.257,
> 0.05). The interaction item PEA and SC could significantly positively predict the tendency of MPAT (β = 0.165,
= 2.545,
< 0.05). In the high PEA group, SC had a significant negative predictive effect on the tendency of MPAT (β = -0.665,
= -14.408,
< 0.01); However, in the low PEA group, the negative predictive effect was stronger (β = -0.834,
= -15.015,
< 0.01). The present study shows that PE significantly negatively predicted the tendency of MPAT, and SC played a complete mediating role in the relationship between PE and MPAT; The second half of the indirect effect of PE and MPAT was regulated by the PEA. The PEA will enhance the influence of SC on MPAT, but the high PEA will increase the level of MPAT of individuals at a very high level of SC.
Chronic obstructive pulmonary disease (COPD) is characterized by a persistent respiratory disorder due to airflow limitation. COPD is considered a debilitating disease in which the symptomatology and ...muscle and functional damage affect the performance of physical activity and the quality of life of individuals. In these, periods of exacerbation of the disease can be frequent, with increased symptoms and even the need for hospitalization, which accentuates physical deconditioning, loss of strength and muscle mass. In this context, rehabilitation strategies should be designed and knowing the level of self-determination and symptomatology after COPD exacerbation can be useful for clinical decision.
The objective of the study was to evaluate the existence of a correlation between self-determination, self-efficacy for physical activity and symptomatology in patients hospitalized for COPD exacerbation.
This is a cross-sectional study. Nine individuals hospitalized for COPD exacerbation were evaluated. At the time of pre-hospital discharge, they were asked about self-determination (Behavioral Regulation in Exercise - Questionnaire 2 BREQ-2), self-efficacy (The COPD Self-Efficacy Scale) and symptomatology (COPD Assessment Test™ CAT and Medical Research Council mMRC dyspnoea). The BREQ-2 questionnaire was scored by domains (amotivation, introjected regulation, identified regulation, external regulation, and intrinsic motivation) and relative autonomic index, The COPD Self-Efficacy Scale was also scored by domains (negative effects, intense emotional arousal, physical exertion, time/environment, and behavioral risk factors).
The sample consisted of nine patients, 5 (55.6%) males and 4 (44.4%) females, aged 67±9 years old and hospital stay of 7.44±5 days. A positive correlation was found between the physical exertion domain of The COPD Self-Efficacy Scale and the relative autonomic index and introjected regulation of BREQ-2 (r= 0.83; p<0.01/ r= 0.86; p< 0.01, respectively). Furthermore, a negative correlation was found between the CAT and the BREQ-2 amotivation domain (r= -0.80; p<0.01) and a positive correlation between the mMRC and the BREQ-2 external regulation domain (r=0.64; p=0.05).
In patients hospitalized for COPD exacerbation, there is an association between the motivational level to perform physical activity and COPD symptomatology. The greater symptomatology was associated with greater external regulation for performing physical activity, as well as being more self-determined for the practice of physical activity and with more self-efficacy for managing dyspnea when performing physical exertion.
These results, even if determined by external reward, demonstrate susceptibility to changes in behavior related to the practice of physical activity.
Objective
The Videos of Physical Exercise and Sedentary Behaviours (VPESB) database is a novel database designed to experimentally investigate neural reactivity to physical exercise. The aim of this ...database is to provide a variety of dynamic images with a minimum of confounding factors.
Methods
A total of 196 healthy participants were recruited to evaluate 10 clips of sedentary activities and 10 clips of physical exercise. Each activity was performed by a male and female performer, resulting in a total of 40 video clips of 10 s each.
Results
The validation procedure confirmed the ability of these videoclips to accurately represent both sedentary and physical activity. In addition, video clips of physical activity were associated with higher effort ratings than sedentary activities (p < 0.01).
Conclusions
The VPESB is a versatile, rapid and easy‐to‐use tool that can be used to understand emotional and behavioural approaches to physical activity and to better disentangle some clinical conditions in which physical activity plays a central role.
Fibroblast growth factor 21 (FGF-21) is a protein that is involved in the regulation of glucose, lipids, and energy metabolism. To act on target tissues, endocrine FGF-21 binds preferably to FGF ...receptor 1 (FGFR1) in the presence of the coreceptor named β-klotho (KLB). Some of the effects of FGF-21 include increased fatty acid oxidation, glucose uptake, insulin sensitivity, and thermogenesis, which can regulate body weight and glycemia control. By exerting such metabolic effects, the therapeutic potential of FGF-21 for the treatment of obesity and diabetes has been investigated. Physical exercise has been widely used for the prevention and treatment of obesity. Several mechanisms mediate the effects of physical exercise, including the FGF-21 pathway. Studies have shown that physical exercise increases the concentration of circulating and tissue FGF-21 in animals, while contradictory results are still observed in humans. Considering the metabolic role of FGF-21 and the chance of physical exercise to induce FGF-21 secretion, in this review we explore the potential of physical exercise-induced FGF-21 modulation as a strategy for prevention and treatment of obesity.
Physical literacy (PL), given as a multidimensional construct, is considered a person's capacity and commitment to a physically active lifestyle. We investigated the effect of a holistic physical ...exercise training on PL among physically inactive adults.
A non-randomised controlled study was conducted. Thirty-one physically inactive adults in the intervention group (IG; 81% females, 44 ± 16 years) participated in a holistic physical exercise training intervention once weekly for 15 weeks. A matched, non-exercising control group (CG) consisted of 30 physically inactive adults (80% female, 45 ± 11 years). PL, compliance and sociodemographic parameters were measured. PL was evaluated by a questionnaire, covering five domains: physical activity behaviour, attitude towards a physically active lifestyle, exercise motivation, knowledge and self-confidence/self-efficacy. Data were analysed using ANCOVA models, adjusted for age, gender and BMI at baseline.
At post-training intervention, the IG showed significant improvements in PL (p = 0.001) and in the domains physical activity behaviour (p = 0.02) and exercise self-confidence/self-efficacy (p = 0.001), with no changes overserved for the CG regarding PL and those domains. No intervention effect were found for the other three domains, i.e. attitude, knowledge and motivation. Additionally, for the IG baseline BMI was identified to be positively correlated with physical exercise-induced improvements in PL (β = 0.51, p = 0.01).
The results from this study are very useful for further public health activities, which aim at helping physically inactive adults to adopt a physically active lifestyle as well as for the development of further PL intervention strategies. This pilot-study was a first attempt to measure PL in inactive adults. Yet, a validated measurement tool is still not available. Further research is necessary to determine the psychometric properties for this PL questionnaire.
German Clinical Trials Register (DRKS), DRKS00013991 , date of registration: 09.02.2018, retrospectively registered.
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