Exercise Can Now Be Prescribed Like Medicine for Cancer Patients

It is well known that regular exercise can help prevent and treat many forms of heart disease, but less commonly known are the benefits of physical activity for cancer patients.

A new initiative called Moving Through Cancer — led by Dr. Kathryn Schmitz, professor of public health sciences at Penn State College of Medicine, and an international team of health practitioners and researchers — is hoping to change that.

According to the researchers, exercise is important for cancer prevention, as it can lower the risk of developing colon, breast, endometrial, kidney, bladder, esophagus and stomach cancers.

Exercise during and after cancer treatment can also help improve fatigue, anxiety, depression, physical function, and quality of life and can also help increase survival rates after a breast, colon or prostate cancer diagnosis.

In their new paper published in CA: A Cancer Journal for Clinicians, Schmitz and her team outline new exercise recommendations for people living with and beyond cancer.

“With more than 43 million cancer survivors worldwide, we have a growing need to address the unique health issues facing people living with and beyond cancer and better understand how exercise may help prevent and control cancer,” said Schmitz, who is also a member of the Penn State Cancer Institute.

“This esteemed, multidisciplinary group of leaders on the forefront of exercise oncology aimed to translate the latest scientific evidence into practical recommendations for clinicians and the public and to create global impact through a unified voice.”

Depending on each patient’s activity levels and abilities, the researchers generally recommend 30 minutes of moderately intense aerobic exercise three times a week and 20 to 30 minutes of resistance exercise twice a week.

But, Schmitz said health care professionals can also customize exercise prescriptions to individual patients.

“Through our research, we’ve reached a point where we can give specific FITT exercise prescriptions — which means frequency, intensity, time and type — for specific outcomes like quality of life, fatigue, pain and others,” Schmitz said.

“For example, if we’re seeing a head and neck cancer patient with a specific set of symptoms, we could give them an exercise prescription personalized to them.”

Schmitz said the recommendations will help with one of the premier goals of Moving Through Cancer: raising public awareness about the benefits of exercise for people living with and beyond cancer by 2029.

“Currently, an average person on the street will know that exercise is good for preventing and treating heart disease, but not for melanoma,” Schmitz said.  “We want to change that. When researchers in the 1950s built an evidence base for exercise and heart disease, there was a shift in public knowledge about that connection. It’s now time for the same thing to happen with exercise and cancer.”

Schmitz said the second piece of the initiative is resources and programs to help get cancer patients moving. The Moving Through Cancer website has an exercise program registry that can help patients, families, health care providers and others find programs near them.

The final piece is policy, Schmitz said, which could be used to increase the chances that health care professionals will talk to their patients about exercise and that patients will be adequately referred as they move through cancer.

“This is the center of my professional heart,” Schmitz said. “My mission for a decade now has been that I want exercise to be as ubiquitous in cancer care as it is in cardiac disease care, only better. The new recommendations and guidance are a tool that can help make that a reality.”

Source: Penn State

Physical Activity During Lessons Can Boost Learning

Students who take part in physical exercises like running in place during school lessons do better in tests than students who stick to sedentary learning.

A meta-analysis of 42 studies around the world conducted by researchers at the University College London, Leiden University, the National University of Singapore, and the University of Sydney, aimed to assess the benefits of incorporating physical activity in academic lessons. This approach has been adopted by schools that want to increase activity levels among students without reducing academic teaching time.

Typical activities include using movement to signify whether a fact is true or false, or jumping on the spot a certain number of times to answer a math question, the researchers explained.

The study concluded that incorporating physical activity had a large, significant effect on educational outcomes during the lesson, assessed through tests or by observing pupils’ attention to a given task. It also had a smaller effect on overall educational outcomes, as well as increasing the students’ overall levels of physical activity.

“Physical activity is good for children’s health, and the biggest contributor of sedentary time in children’s lives is the seven or eight hours a day they spend in classrooms,” said lead author Dr. Emma Norris of University College London. “Our study shows that physically active lessons are a useful addition to the curriculum. They can create a memorable learning experience, helping children to learn more effectively.”

“These improvements in physical activity levels and educational outcomes are the result of quite basic physical exercises,” added co-author Dr. Tommy van Steen of Leiden University in The Netherlands. “Teachers can easily incorporate these physical active lessons in the existing curriculum to improve the learning experience of students.”

For the study, researchers looked at data from 12,663 students between the ages of three and 14. Nearly half of the studies took place in the United States, with seven conducted in Australia, five in the UK, four in the Netherlands, and one in China, Croatia, Ireland, Israel, Portugal, and Sweden.

In one of the 42 studies analyzed, eight- and nine-year-olds simulated traveling the world by running in place in between answering questions relating to different countries.

The research team, also led by Norris at UCL, concluded that the children were more active and more focused on the task than peers in a control group, following teachers’ instructions more closely.

In another study in the Netherlands, primary school children who took part in physically active lessons three times a week over two years made significantly better progress in spelling and mathematics than their peers, equating to four months of extra learning gains, according to researchers.

The  study published in the British Journal of Sports Medicine.

Source: University College London

Chair Yoga May Improve Quality of Life in Dementia Patients

Chair yoga may help improve quality of life in older adults with moderate-to-severe dementia, according to a new study by Florida Atlantic University (FAU).

Chair yoga provides a safe environment for stretching, strengthening and flexibility while decreasing the risk of falls by using a chair. It also provides important breathing and relaxation techniques through stationary poses and guided relaxation of various muscle groups.

“We think that the physical poses we used in the chair yoga and chair-based exercise groups were an important factor in improving quality of life for the participants in our study,” said Juyoung Park, Ph.D., lead author and an associate professor in the Phyllis and Harvey Sandler School of Social Work within FAU’s College for Design and Social Inquiry.

“It is fascinating that, although some participants showed mild levels of agitation or wandering in the intervention room prior to the yoga session, they became calm and attentive when the yoga interventionist started demonstrating yoga poses.”

“Although they did not understand the interventionist’s verbal instructions due to their cognitive impairment associated with advanced dementia, they followed the instructor’s poses.”

For the study, published in the American Journal of Alzheimer’s Disease & Other Dementias, researchers from FAU compared chair yoga with two other types of non-pharmacological interventions: chair-based exercise and music intervention.

The study involved older adults (mean average age was 84 years old) with moderate-to-severe dementia, including Alzheimer’s disease (the largest diagnostic group), Lewy Body dementia and Parkinson disease dementia. The patients were unable to participate in regular exercise or standing yoga due to cognitive impairment, problems with balance, or fear of falling.

Participants in each of the three groups attended 45-minute sessions twice a week for 12 weeks. Researchers collected data at baseline, after six weeks and after completing the 12-week intervention.

Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions, and more than 97% of the participants fully engaged in each session.

The findings show that those in the chair yoga group improved significantly in quality-of-life scores compared to the music intervention group. Both the chair yoga and chair-exercise groups showed improvement over time, while the music intervention group declined.

In addition, both the chair yoga and chair-based exercise groups showed lower depression across all three time points when compared to the music intervention group.

The team did not find any differences in the three intervention groups on physical function, with the exception of handgrip strength, which was higher in the chair yoga group compared to the music intervention group. None of the three groups declined significantly in any of the investigated physical functional measures.

Researchers also did not find any significant between-group differences in anxiety at any time point. There were no significant between-group differences in change in depression and anxiety. The researchers also did not find significant differences among the three intervention groups for sleep quality at any of the three time points.

“We did see an increase in agitation in the chair yoga group even though this group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, ability to participate in meaningful activities, and final situations,” said Park.

“It’s important to note that quality of life is a more comprehensive approach to biopsychosocial and behavioral function than a mere measure of agitation. Meditation and the mind-body connection component of the chair yoga program may have increased quality of life for participants in this study. This finding is consistent with our earlier studies that showed a targeted approach was successful in increasing quality of life in patients with dementia.”

Source: Florida Atlantic University

Athletes’ Mild Brain Injuries Can Lead to ‘Leaky’ Blood-Brain Barrier

An international team of researchers has found that, even in mild traumatic brain injury (mTBI), teen and adult athletes may sustain damage to the blood-brain barrier (BBB), the brain’s semipermeable wall of protection from pathogens and toxins.

The findings are published in the Journal of Neurotrauma.

For the study, the research team from Ben-Gurion University (BGU) of the Negev, Stanford University and Trinity College in Dublin studied high-risk populations, specifically professional mixed martial arts (MMA) fighters and adolescent rugby players.

Their goal was to investigate whether the integrity of the blood-brain barrier is altered in mTBI and to develop a technique to better diagnose mild brain trauma.

“While the diagnosis of moderate and severe TBI is visible through magnetic resonance imaging [MRI] and computer-aided tomography scanning [CT], it is far more challenging to diagnose and treat mild traumatic brain injury, especially a concussion which doesn’t show up on a normal CT,” said Professor Alon Friedman, M.D., Ph.D., a neuroscientist and surgeon who established the Inter-Faculty Brain Sciences School at BGU.

The study shows that mild impact in professional MMA and adolescent rugby can still lead to a leaky BBB. If the results are confirmed in a larger study, the brain imaging techniques being developed could be used to monitor athletes to better determine safer guidelines for “return to play.”

In this study, MMA fighters were examined pre-fight for a baseline and again within 120 hours following competitive fight. The rugby players were examined pre-season and again post-season or post-match in a subset of cases.

Both groups were assessed using advanced MRI techniques developed at BGU, analysis of BBB biomarkers in the blood and a mouthguard developed at Stanford with sensors that track speed, acceleration and force at nearly 10,000 measurements per second.

The results show that 10 out of 19 adolescent rugby players showed signs of a leaky blood-brain barrier by the end of the season. Eight rugby players were scanned post-match and two had barrier disruptions.

The injuries detected were lower than the current threshold for mild head trauma. The team was also able to correlate the level of blood-brain barrier damage seen on an MRI with measurements from the mouthguard sensors.

“The current theory today is that it is the outer surface of the brain that is damaged in a concussion since, during an impact, the brain ricochets off of skull surfaces like Jell-O,” Friedman said.

“However, we can see now that the trauma’s effects are evident much deeper in the brain and that the current model of concussion is too simplistic.”

In the next phase of research, the team plans to conduct a larger study to determine whether BBB disruptions heal on their own and how long that takes.

“It is likely that kids are experiencing these injuries during the season but aren’t aware of them or are asymptomatic,” Friedman said. “We hope our research using MRI and other biomarkers can help better detect a significant brain injury that may occur after what seems to be a ‘mild TBI’ among amateur and professional athletes.”

Source: American Associates, Ben-Gurion University of the Negev

 

Want to Achieve Your Goals? Plan for Them

People who make concrete plans to meet their goals may engage in more physical activity, including visits to the gym, compared to those who don’t plan quite so far ahead, according to new research.

The study’s findings suggest that self-reported levels of a trait called “planfulness” may translate into real world differences in behavior.

Some people seem to be able to meet their goals more than others, but it remains unclear if personality traits that have been found to promote goal achievement in the lab similarly encourage individuals to achieve long-term goals in their day-to-day lives, according to lead researcher and doctoral student Rita M. Ludwig of the University of Oregon.

Conscientiousness, a measure of a person’s orderliness and dependability on the Big Five Inventory of personality, has long been tied with healthy behaviors, notes Ludwig.

Narrowing their focus to a single facet of this trait, planfulness, allowed researchers to zero in on the psychological processes, such as mental flexibility and a person’s ability to make short-term sacrifices in pursuit of future success, that contribute directly to achieving long-term goals.

“There indeed appears to be a certain way of thinking about goals that correlates with long-term progress,” Ludwig said. “What’s new in this study is that we used an objective measure of goal progress that could be recorded as participants naturally went about their lives: Their check-ins at a local gym.”

The research team examined this relationship by analyzing the gym attendance of 282 participants over a 20-week period. The researchers tracked the number of times each participant swiped into the campus recreation center after enrolling in the study at the start of the winter 2018 academic semester. They also retroactively collected data on gym attendance throughout the fall 2017 term.

The participants provided a written description of their exercise plans and completed measures of self-control and grit, in addition to the Big Five Inventory of personality and the research team’s 30-item Planfulness Scale.

While all participants experienced a similar decline in gym attendance over the course of each semester, individuals who rated themselves high on planfulness items, such as “developing a clear plan when I have a goal is important to me,” went to the gym more throughout both semesters compared to those who ranked themselves lower on planfulness.

The researchers discovered that a one point increase on the five-point Planfulness Scale corresponded with an additional 5.9 recreation center visits during the fall semester, and an additional 8.5 visits after enrolling in the study for the winter semester.

“This work is broadly informative for those who are curious about how people pursue health goals, including their own patterns of thought around goals,” Ludwig said. “Clinicians might find it helpful in understanding how their patients tend to think about goals and whether person-to-person differences in such thinking are related to outcomes.”

While there was a small, but significant, relationship between participant planfulness and the level of detail in their physical activity plans, descriptiveness was unexpectedly found to have no relationship with gym attendance, Ludwig and colleagues noted.

“It seems logical that people who are successful with their goals would be able to write in detail about their planning process,” Ludwig says. “We were surprised, then, to find no relationship between people’s goal pursuit behavior and how they wrote about their goals.”

Future psycholinguistic research might investigate alternative explanations for these findings, the researchers conclude.

The study was published in Psychological Science, a journal of the Association for Psychological Science.

Source: Association for Psychological Science

Working Out Too Much Can Also Tire Out Your Brain

A new study shows that excessive athletic training not only makes the body tired, but also the brain.

When researchers asked elite athletes to increase their training, the athletes showed a form of mental fatigue that included reduced activity in a portion of the brain important for making decisions. The athletes also acted more impulsively, opting for immediate rewards instead of bigger ones that would take longer to achieve, according to the researchers.

“The lateral prefrontal region that was affected by sport-training overload was exactly the same that had been shown vulnerable to excessive cognitive work in our previous studies,” said corresponding author Dr. Mathias Pessiglione of Hôpital de la Pitié-Salpêtrière in Paris. “This brain region therefore appeared as the weak spot of the brain network responsible for cognitive control.”

The studies suggest a connection between mental and physical effort — both require cognitive control, the researchers said. And maintaining physical effort to reach a distant goal requires cognitive control, the researchers noted.

“You need to control the automatic process that makes you stop when muscles or joints hurt,” Pessiglione said.

The researchers, including Pessiglione and first author Dr. Bastien Blain, said the initial idea for the study came from the National Institute of Sport, Expertise, and Performance (INSEP) in France, which trains athletes for the Olympic games. Some athletes suffered from “overtraining syndrome,” in which their performance plummeted as they experienced an overwhelming sense of fatigue. The question for the researchers was: Did this overtraining syndrome arise in part from neural fatigue in the brain — the same kind of fatigue that also can be caused by excessive intellectual work?

To find out, the researchers recruited 37 competitive male endurance athletes with an average age of 35. Participants were assigned to either continue their normal training or to increase that training by 40 percent per session over a three-week period. The researchers monitored their physical performance during cycling exercises performed on rest days and assessed their subjective experience of fatigue using questionnaires every two days. They also conducted behavioral testing and functional magnetic resonance imaging (fMRI) scanning experiments.

The study’s findings showed that physical training overload led the athletes to feel more fatigued. They also acted more impulsively in standard tests used to evaluate how they’d make economic choices. This tendency was shown as a bias in favoring immediate over delayed rewards when the athletes were offered $5 now or $50 later.

The brains of athletes who’d been overloaded physically also showed diminished activation of the lateral prefrontal cortex, a key region of the executive control system, as they made those economic choices, the researchers reported.

“Our findings draw attention to the fact that neural states matter: You don’t make the same decisions when your brain is in a fatigue state,” Pessiglione said.

The findings may be important not just for producing the best athletes, but also for economic choice theory, which typically ignores such fluctuations in the neural machinery responsible for decision-making, the researchers said. It suggests it may be important to monitor fatigue level to prevent bad decisions from being made in the political, judicial, or economic domains, they added.

In future studies, the researchers plan to explore why exerting control during sports training or intellectual work makes the cognitive control system harder to activate in subsequent tasks. Down the road, the hope is to find treatments or strategies that help to prevent such neural fatigue and its consequences, they concluded.

The study was published in the journal Current Biology.

Source: Cell Press