Adapted Physical Activity Protocol for Lower Limb Functional and Strength Recovery in a Young Athlete with Cutaneous Melanoma: Feasibility and Efficacy during COVID-19 Pandemic

Abstract

Adapted physical activity (APA) can improve psychophysical wellbeing and quality of life (QoL) in cancer survivors, a vulnerable population requiring a global management, especially during the recent pandemic. On this basis, we investigated for the first time the impact of a tailored APA intervention on a melanoma-affected 18-year-old female athlete to counteract treatment sequelae and promote lower limb functional and strength recovery. Patient was evaluated at baseline and post-protocol by a test battery focusing on mobility, muscle strength measured by dynamometry, and lower limb girths assessed at specific anatomical points. Moreover, health-related QoL, depression/anxiety, psychological distress and pain intensity were evaluated by Functional Assessment of Cancer Therapy–Melanoma (FACT-M), Hospital Anxiety and Depression Scale (HADS), distress thermometer, and numerical rating scale (NRS) questionnaires, respectively. An almost doubled up increase in lower limb strength, along with hip mobility improvement, and post-surgical edema and pain reduction were observed following the protocol. Concerning the QoL assessment, a moderate post-intervention improvement in physical and emotional wellbeing was detected, while depression state worsened though remaining within the normality range. Our findings show that a specialist-supervised structured APA protocol based on a patient-centered multidisciplinary approach may represent an effective strategy to recover functional and psychophysical efficiency, thus promoting a quick return to daily life activities and offering a concrete chance of resuming competitive sport practice.

Biofeedback-Based Proprioceptive Training to Improve Functional Prerequisites of Dragon Boating in Breast Cancer Survivors

“…Even though leisure and sport activities specifically addressing this vulnerable target population are more oriented to overall psychophysical well-being recovery than to performance [108], in the case of stabilized outcomes, sport-specific athletic training and mixed strength-resistance exercise benefits have been demonstrated over time [33,[109][110][111]. Supervised progressive exercise plays a crucial role in correcting/mitigating treatment-related postural alterations and muscle recruitment imbalance, hence helping to prevent injuries and upper body morbidity exacerbation [40,81]. Particularly, proprioceptive exercises targeted to this anatomofunctional region can effectively re-educate sensorimotor patterns and postural awareness by enhancing muscle flexibility, joint stability, and neuromuscular coordination [91,112,113].…”

“…In fact, the literature has widely demonstrated that the recent pandemic and the consequent anti-contagion restrictions led to a drastic change in lifestyle behaviors, thus causing a massive physical fitness decline in all ages of the global population [121,122]. Several studies highlighted that these confinement-related detraining issues have been even worse and hard to counteract when referred to a vulnerable target such as oncological individuals [81,123]. Though gradually resumed, dragon boat training might simply have evidenced this phenomenon particularly referred to the anatomical regions most involved in paddling-specific motor gestures.…”

“…The last section of our survey assessed the perceived pain intensity in specific body regions and the psychological distress level through validated visual tools such as the Numerical Rating Scale (NRS) [40,79] and distress thermometer [80], respectively. Both these tools consist of a 0-10 graphic scale with higher values corresponding to worse perceived pain and psychological distress levels, respectively [81]. Finally, the perceived quality of life was measured through the mental and physical indexes extrapolated from the 12-item Short-Form (SF-12) questionnaire, a qualitative assessment tool frequently used not only in healthy populations but also in the oncological field [82,83].…”