CONTEXT AND OBJECTIVE: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise. The purpose of this study was to determine whether exercise protocols that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment. DESIGN AND SETTING: Randomized controlled trial, at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado, and the North Colorado Medical Center. METHODS: Twenty inactive breast cancer patients were randomly assigned to a 21-week exercise group (n = 10) or a control group (n = 10). The exercise group trained at low to moderate intensity for 60 minutes on two days/week. The primary outcome measurements included body composition (skinfold method) and muscle strength (one repetition maximum). RESULTS: Significant differences in lean body mass, body fat and strength (p = 0.004, p = 0.004, p = 0.025, respectively) were observed between the groups at the end of the study. CONCLUSION: The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment.
The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake (TCI) of breast cancer patients undergoing treatment. A secondary purpose was to determine whether or not a relationship existed between changes in TCI, body fat composition (%BF), and fatigue during the study, which lasted 6 months. Twenty females recently diagnosed with breast cancer, scheduled to undergo chemotherapy or radiation, were assigned randomly to an experimental (N = 10) or control group (N = 10). Outcome measures included TCI (3-day food diary), %BF (skinfolds), and fatigue (revised Piper Fatigue Scale). Each exercise session was conducted as follows: initial cardiovascular activity (6-12 min), followed by stretching (5-10 min), resistance training (15-30 min), and a cool-down (approximately 8 min). Significant changes in TCI were observed among groups (F 1,18 = 8.582; P = 0.009), at treatments 2 and 3, and at the end of the study [experimental (1973 ± 419), control (1488 ± 418); experimental (1946 ± 437), control (1436 ± 429); experimental (2315 ± 455), control (1474 ± 294), respectively]. A significant negative correlation was found (Spearman rho (18) = -0.759; P < 0.001) between TCI and %BF and between TCI and fatigue levels (Spearman rho (18) = -0.541; P = 0.014) at the end of the study. In conclusion, the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects, including decreased TCI, increased fatigue, and negative changes in body composition.
The effects of generalized exercise programs to combat cancer and cancer treatment-related side effects have been extensively reported in the literature. The purpose of this study was to examine the effects of an individualized exercise program with emphasis on resistance exercise, changes in muscular strength and fatigue in breast cancer female patients under treatment. Twenty subjects were randomly divided in two groups: an experimental (57.5 ± 23.0 years) and a control (56.6 ± 16.0 years) group. A twenty-one week intervention involving pre-and post-functional assessments, prescriptive exercise, and three moments of fatigue measures was used. The experimental group exercised at a low to moderate-intensity for sixty minutes two days a week beginning after surgery. Significant differences in overall muscular strength were observed between groups post-intervention (p = 0.025). Fatigue was also significantly different between groups at treatment one (p = 0.001), treatment two (p = 0.005) and post-intervention (p = 0.001). The results of this study suggest that an emphasis on resistance training should be utilized to combat fatigue and to increase muscular strength in breast cancer patients undergoing treatment.
The objective was to determine whether serum creatine kinase (CK) and serum CK MB activity following exercise-induced muscle damage activity differs among females of varying menarchial status and to determine whether there is a relationship between serum estradiol (E2) concentration, CK, and CK MB activity. Fifteen menarchial (M), 15 premenarchial (P), and 10 postmenopausal (PM) females participated in the study. Exercise consisted of eccentric hamstring contractions. Estradiol concentrations were significantly higher in M women (p =.0001; M, 125.0 +/- 20.8 pg/mL, P, 54.6 +/- 38.6 pg/mL, PM, 46.2 +/- 34.6 pg/mL). Menarchial women had lower resting CK and CK MB activity and responded with a higher efflux of CK and CK MB post exercise (p =.0001). An inverse relationship was found between E2 concentration and baseline CK (p =.02) and CK MB activity (p =. 006). No relationship existed between post exercise efflux of CK and CK MB and E2 concentration. At rest, E2 influenced CK and CK MB activity across menarchial levels. However, E2 did not significantly reduce the level of CK and CK MB activity following this intense bout of eccentric exercise.
Recent advances in cancer detection and treatment have resulted in an increase in the survival rate of individuals diagnosed with cancer. The increased survival rate brings new challenges for increasing the quality of life for cancer survivors. Debilitating side effects can result from the cancer itself and the cancer treatment. The negative effects lead to decreased functional (work) capacity, increased fatigue, and debilitating muscular weakness. There have been very positive benefits seen from the use of individualized prescriptive exercise intervention in alleviating these cancer treatment related symptoms. The role of exercise intervention as a complementary therapy is just emerging. Studies have shown that exercise decreases the amount of fatigue, improves functional capacity, increases immune function, and leads to improved quality of life. The effects of cancer and cancer treatments require that an exercise intervention program be well based in sound scientific principles. The exercise intervention needs to be carefully structured and controlled. All patients should be assessed and reassessed to evaluate progress. A cancer exercise specialist should closely monitor the exercise regime. Exercise should involve a whole-body approach that emphasizes all areas of fitness. Exercise therapy for cancer patients is a new and exciting area that will continue to grow as medical professionals realize the necessity for post-cancer treatment intervention to improve quality of life.
Estrogen ingestion has been suggested as a protective mechanism of muscle membrane integrity against an exercise-induced muscle inflammatory response. Serum creatine kinase (CK) concentration and the heart muscle isoenzyme CK-MB have been used as diagnostic markers of muscle disruption following exercise. The purpose of this study was to determine the difference in serum CK, CK-MB, and perceived soreness following exercise-induced muscle disruption in females taking an oral contraceptive (OC) and those not. Subjects included sixteen females, eight in the experimental group and eight in the control group. Estrogen concentration, determined pre-exercise, was 181 ± 45 pg/ml for the OC group and 124 ± 25 pg/ml for the controls, respectively. Subjects participated in an eccentric hamstring exercise which consisted of six sets of ten repetitions at 110% of concentric 1RM. Serum CK, CK-MB concentration and perceived soreness were assessed pre-exercise and immediately, 24,48,72 and 96 hours post-exercise. Serum CK concentration increased significantly (p < .05) in the period post-exercise 17-fold in the OC group and 59-fold in the control group. Serum CK-MB concentration increased 3-fold in the OC group and 80-fold in the control group in the same period. Perceived soreness was significantly (p < .05) different between groups for hamstring soreness. The data indicate that a controlled concentration of serum estrogen supplied to the OC group may effectively reduce the degree of muscle membrane permeability or disruption as indicated by the reduced magnitude of the circulating concentration of the CK, CK-MB enzyme difference between the estrogen and non-estrogen groups, respectively, following exercise-induced muscle soreness.
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