Aerobic capacity and upper extremity strength in women diagnosed with breast cancer are generally lower than population norms. Assessment of values for lower extremity strength is less conclusive. As more research is published, expected values for sub-groups by age, treatment, and co-morbidities should be developed. [Neil-Sztramko SE, Kirkham AA, Hung SH, Niksirat N, Nishikawa K Campbell KL (2014) Aerobic capacity and upper limb strength are reduced in women diagnosed with breast cancer: a systematic review.Journal of Physiotherapy60: 189-200].

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Our results suggest that PSTP is feasible among women with breast cancer for early identification of arm morbidity. A larger study is needed to determine the cost and effectiveness benefits.

We describe the design of our federated task processing system. Originally, the system was created to support two specific federated tasks: evaluation and tuning of on-device ML systems, primarily for the purpose of personalizing these systems. In recent years, support for an additional federated task has been added: federated learning (FL) of deep neural networks. To our knowledge, only one other system has been described in literature that supports FL at scale. We include comparisons to that system to help discuss design decisions and attached trade-offs. Finally, we describe two specific large scale personalization use cases in detail to showcase the applicability of federated tuning to on-device personalization and to highlight application specific solutions.

Background Admission stroke severity is an important clinical predictor of stroke outcomes. Pre-stroke physical activity (PA) contributes to stroke prevention and may also be associated with reduced stroke severity. Summarising the evidence to-date will inform strategies to reduce burden after stroke. Aims To summarise the published evidence for the relationship between pre-stroke physical activity (PA) and admission stroke severity and to provide recommendations for future research. Summary of Review MEDLINE, Embase, Emcare, CENTRAL and gray literature databases were searched on February 14, 2020 using search terms related to stroke and pre-stroke PA. We screened 8,152 references and assessed 172 full-text references for eligibility. The final review included seven studies (n=41,800 stroke patients). All studies were observational, assessed pre-stroke PA using self-reported questionnaires, and assessed admission stroke severity using the National Institute of Health Stroke Scale. Pre-stroke PA was associated with milder stroke severity (4/7 studies). Greater pre-stroke PA duration (1/7 studies), intensity (1/7 studies), or amount (3/7 studies) were independently associated with milder stroke severity. Studies ranged between moderate to critical risk of bias, primarily due to confounding factors. Pre-stroke PA was associated with reduced risk factors for severe stroke, distal occlusion, smaller infarcts, and treatment delays. Conclusion Pre-stroke PA may be associated with reduced admission stroke severity. Lack of randomised controlled trials limited causality conclusions. Further investigation is needed to understand the effect of pre-stroke PA on admission stroke severity.  

Objectives The burden and costs of abdominal surgery for chronic conditions are on the rise, but could be reduced through self-management support. However, structured support to prepare for colorectal surgery is not routinely offered to patients in Canada. This study aimed to describe experiences and explore preferences for multimodal prehabilitation among colorectal surgery patients. Methods A qualitative descriptive study using three focus groups (FG) was held with 19 patients who had a surgical date for abdominal surgery (April 2017-April 2018) and lived close (≤ 50 km radius) to a tertiary hospital in Western Canada (including a Surgical Lead for the British Columbia Enhanced Recovery After Surgery (ERAS) Collaborative). FGs were audio-taped and verbatim transcribed with coding and pile-and-sort methods performed by two independent reviewers, confirmed by a third reviewer, in NVivo v9 software; followed by thematic analysis and narrative synthesis. Results Four themes emerged: support, informed decision-making, personalization of care, and mental/emotional health, which patients felt was particularly important but rarely addressed. Patient preferences for prehabilitation programming emphasised regular support from a single professional source, simple health messages, convenient access, and flexibility. Conclusions There is an unmet need for structured preoperative support to better prepare patients for colorectal surgery. Future multimodal prehabilitation should be flexible and presented with non-medical information so patients can make informed decisions about their preoperative care and surgical outcomes. Healthcare providers have an important role in encouraging healthy lifestyle changes before colorectal surgery, though clearer communication and accurate advice on self-care, particularly mental health, are needed for improving patient outcomes.

Increased lateral trunk lean walking on a treadmill resulted in significantly higher levels of steady-state energy expenditure, HR, and perceived exertion, but no difference in knee pain. While increased lateral trunk lean has been shown to reduce biomechanical measures of joint loading relevant to OA progression, it should be prescribed with caution given the potential increase in energy expenditure experienced when it is employed.

Favorable cerebral collateral circulation contributes to hindering penumbral tissue from progressing to infarction and is associated with positive clinical outcomes after stroke. Given its clinical importance, improving cerebral collateral circulation is considered a therapeutic target to reduce burden after stroke. We provide a hypothesis-generating discussion on the potential association between pre-stroke physical activity and cerebral collateral circulation in ischemic stroke. The recruitment of cerebral collaterals in acute ischemic stroke may depend on anatomical variations, capacity of collateral vessels to vasodilate, and individual risk factors. Physical activity is associated with improved cerebral endothelial and vascular function related to vasodilation and angiogenic adaptations, and risk reduction in individual risk factors. More research is needed to understand association between cerebral collateral circulation and physical activity. A presentation of different methodological considerations for measuring cerebral collateral circulation and pre-stroke physical activity in the context of acute ischemic stroke is included. Opportunities for future research into cerebral collateral circulation, physical activity, and stroke recovery is presented.