de Heer, HD, Kaufman, A, Repka, CP, Rojas, K, Charley, B, and Bounds, R. AlterG Anti-Gravity Treadmill accuracy of unloading is affected by support frame height. J Strength Cond Res 35(10): 2910–2914, 2021—The AlterG Anti-Gravity Treadmill uses air pressure to provide partial body-weight support (BWS), lowering impact forces and metabolic demand of walking and running. Users wear specialized shorts that zip onto a bag supported by a metal bar frame covering the treadmill. The frame is placed at hip height in positions numbered 1–9, adjusted up or down based on preference. Machine accuracy in providing BWS is important to achieve desired training effects, but it is unknown whether frame placement impacts accuracy. Twenty subjects (10 men/women) were weighed in 10% increments from 0 to 60% BWS with the frame at hip height (iliac crest), the “neutral” position, and reweighed with the frame placed up to 3 numbers above or below hip height. Although the machine displayed the same proportion BWS, placing the frame higher than the neutral position resulted in significantly more support, whereas placing the frame lower led to less support. At 10% BWS, placing the frame 3 positions higher resulted in 3% more support compared with the neutral position (13.1% BWS, p < 0.001) and 3 positions lower in 4.7% less support (5.3% BWS, p < 0.001). Deviances were greater with more BWS. At 60% BWS, 3 positions higher than neutral resulted in 71.2% BWS (11.2% more than expected, p < 0.001) and 3 below 48.1% BWS (12.9% below expected, p < 0.001), total 24.1% difference. These findings suggest that the position of the support frame significantly impacts the AlterG accuracy in providing BWS, with placement higher than hip height resulting in more support than displayed by the machine and lower placement resulting in less support.
Introduction/Purpose Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members. Methods Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms. Results There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05). Conclusions Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks.
Background Although exercise has been shown to improve cancer survivorship in other communities, cancer exercise studies among Native American communities are rare. We sought to adapt a Navajo-tailored cancer exercise pilot program to serve a broader Native American cancer community. Methods Tribal experts representing 10 different Tribal Nations were engaged in small focus groups (n=2–4) to assess program materials for cultural appropriateness and adaptation to expand tribal inclusiveness. Facilitated by a trained Native American interviewer, focus groups were provided a primer survey and then reviewed intervention materials (protocols, incentives, logo, flyers, etc.). Consensus was reached by the research team on all program adaptations. Results The program name, Restoring Balance, layout, graphics, and symbols were considered culturally appropriate overall. Program exercises and biomarker measurements were viewed as valuable to health improvements in the community. Important color, linguistic, and logistic program modifications were recommended to improve cultural alignment. The order of incentive items was revised to highlight restoration and the logo rotated to align with the four corners of the earth, an important cultural element. Linguistic modifications primarily related to prior traumatic research experiences in Native American communities where data had been taken without adequate community benefit or permission. Program emphasis should be on nurturing, added value and giving. Conclusion and Relevance The methodology used for cultural expert review was successful in eliciting adaptations to expand the tribal inclusiveness of Restoring Balance. Culture, as well as historically traumatic research experiences, among Native American populations must be considered when adapting health promotion programming.
Physical activity has been shown to improve quality of life, body composition, metabolic and physical function, and survival among cancer survivors. However, no studies have focused on Native American cancer survivors. Methods: Native cancer survivors and family members were enrolled in a 12-week multi-site, randomized supervised and home-based physical activity intervention (n = 63). The intervention includes 1d/wk supervised resistance, aerobic, flexibility, and balance and 2-3 days/wk of home-based exercise. National guidelines for survivorship exercise training were culturally tailored based focus groups and interviews, as well as cultural expert program review by representatives from 10 tribes. Preliminary descriptive statistics (mean, SD) and six and twelve week changes in weight (kg), fat mass (%), HbA1c (%), fitness by 6min walk test (meters), and quality of life by PROMIS10 questionnaire score have been assessed by paired t-test for survivors only (n = 30). Though currently under powered, data collection is ongoing and will be updated as participants complete the 12-week intervention. Results: Participants were 58.4 ± 12.2 years of age. Tumor types were breast (n = 7), colorectal (n = 7), stomach (n = 2), lung (n = 2), and other varied cancers. Reasons for loss to follow-up were: repeat surgeries or change in clinical care plan (n=3), loss of family members (n=1), and loss of contact (n=3). Comorbidities for cancer survivors included: diabetes (n=7), cardiovascular disease (N=13). Twenty-two Native cancer survivors have completed six weeks of intervention and 14 Native cancer survivors have completed twelve weeks of intervention thus far. Weight loss was significant at six weeks (-1.0 ± 2.2kg; p=0.04), but not twelve weeks. Fitness and quality of life were improved by twelve weeks, 31.9 ± 132m and 1.6±0.4, respectively, though not significant. Conclusions: Tailored exercise programs present opportunities to restore health and balance among Native cancer survivors. This ongoing trial will provide important information on the effects of physical activity in Native cancer survivorship, unaddressed to date. Citation Format: Jennifer W Bea, Hendrik de Heer, Taylor Lane, Brenda Charley, Etta Yazzie, Jennifer Hudson, Mishayla Mitchell, Betsy Wertheim, Anna Schwartz. Restoring Balance, a physical activity intervention for Native cancer survivors, preliminary analysis (NNR.14.192) [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B002.
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