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Abstract BackgroundExercise can attenuate the deleterious combined effects of cancer treatment and aging among older adults with cancer, yet exercise participation is low. Telehealth exercise may improve exercise engagement by decreasing time and transportation barriers; however, the utility of telehealth exercise among older adults with cancer is not well established. ObjectiveWe aimed to evaluate the preliminary effectiveness of a one-on-one, supervised telehealth exercise program on physical function, muscular endurance, balance, and flexibility among older adults with cancer. MethodsIn this retrospective study, we analyzed electronic health record data collected from the Personal Optimism With Exercise Recovery clinical exercise program delivered via telehealth among older adults with cancer (≥65 y) who completed a virtual initial program telehealth assessment between March 2020 and December 2021. The virtual initial assessment included the following measures: 30-second chair stand test, 30-second maximum push-up test, 2-minute standing march, single leg stance, plank, chair sit and reach, shoulder range of motion, and the clock test. All baseline measures were repeated after 12-weeks of telehealth exercise. Change scores were calculated for all assessments and compared to minimal clinically important difference (MCID) values for assessments with published MCIDs. Paired samples t ResultsOlder adults with cancer who chose to participate in the telehealth exercise program (N=68) were 71.8 (SD 5.3) years of age on average (range 65‐92 y). The 3 most common cancer types in this sample were breast (n=13), prostate (n=13), and multiple myeloma (n=8). All cancer stages were represented in this sample with stage II (n=16, 23.5%) and III (n=18, 26.5%) being the most common. A follow-up telehealth assessment was completed by 29.4% (n=20) of older adults with cancer. Among those who completed a follow-up telehealth assessment, there were significant increases in the 30-second chair stand (n=19; mean change +2.00 repetitions, 95% CI 0.12 to 3.88) and 30-second maximum push-up scores (n=20; mean change +2.85 repetitions, 95% CI 1.60 to 4.11). There were no significant differences for the 2-minute standing march, plank, single leg stance, sit and reach, shoulder mobility, or clock test (P ConclusionsOur findings suggest a one-on-one, supervised telehealth exercise program may positively influence measures of physical function, muscular endurance, balance, and flexibility among older adults with cancer, but more adequately powered trials are needed to confirm these findings.

Introduction: Despite the traditional focus on assessment of athletes’ physical readiness to return to sport, mounting evidence suggests that consideration of psychological readiness is critically important in ensuring that individuals safely and effectively resume competitive activities. Objectives: The primary aims of this article are to: (1) evaluate existing measures assessing psychological readiness; among skiers and snowboarders (the focus of this special issue); (3) discuss biopsychosocial factors that facilitate or undermine psychological readiness; and (4) highlight implications of psychological readiness for return to sport outcomes and articulate future research directions. Methods: A literature search was performed in Scopus, PsycInfo, and PubMed using the keywords “psychological readiness,” “ski injuries,” “snowboard injuries,” “return to sport,” and “concussions.” Results: Existing measures of psychological readiness are limited by conceptual ambiguities and measurement shortcomings. Limited research with skiers and snowboarders suggests that cognitive, affective, and behavioral elements of psychological readiness outlined in past work is apparent among skiers. Physical (issue healing and body system recovery), psychological (personality, recovery motivation), and social (social support, trust in rehabilitation providers) factors can facilitate or undermine psychological readiness. Psychological readiness predicts salient postinjury outcomes, such as the likelihood of returning to sport, reinjury, as well as the quality of postinjury performance. Conclusions: Future research is needed to further delineate the nature of psychological readiness among skiers and snowboarders. Existing evidence, however, suggests a variety of biopsychosocial factors contribute to athletes’ psychological readiness which may be a key predictor of salient postinjury outcomes.

Objective: Despite the numerous benefits of regular exercise participation for cancer survivors, nearly 60% of survivors do not meet current guidelines. Hospital-based exercise oncology programs may be one strategy to promote exercise engagement as survivors have expressed a preference for exercise programs associated with a cancer hospital. However, follow-up rates in hospital-based exercise oncology programs can be low. Follow-up assessments are a critical component of exercise oncology programs as they determine survivor progress, allow for revision of exercise prescriptions, and demonstrate the effectiveness of the exercise program. Therefore, the purpose of this study was to identify clinical and demographic factors associated with not attending a 12-week follow-up assessment in a hospital-based exercise oncology program. Methods: We analyzed data collected from 2016 to 2019 (n = 849) from the Huntsman Cancer Institute’s hospital-based exercise oncology program, the Personal Optimism with Exercise Recovery (POWER) program. Cancer survivors completed an assessment at the start of POWER and were encouraged to attend a 12-week follow-up assessment. Factors associated with not attending a 12-week follow-up assessment were identified using logistic regression. Results: Multiple myeloma cancer survivors were more likely (OR 2.33; 95% CI 1.09, 4.98) to not attend a 12-week follow-up assessment, whereas endometrial cancer survivors were less likely (OR 0.39; 95% CI 0.18, 0.87). Greater travel time (OR 2.69; 95% CI: 1.83, 3.96) and distance (OR 2.37; 95% CI: 1.61, 3.49) were associated with not attending a 12-week follow-up assessment. Immunotherapy (OR 1.66; 95% CI 1.02, 2.72), waist circumference (OR 1.01; 95% CI 1.00, 1.02), overweight status per body mass index (OR 1.62; 95% CI 1.11, 2.38), and male sex (OR 1.70; 95% CI 1.23, 2.35) were associated with an increased likelihood of not attending a 12-week follow-up assessment. Survivors with a higher baseline quality of life (OR 0.96; 95% CI 0.93, 0.99) and peak oxygen consumption (OR 0.97; 95% CI 0.95, 0.99) were less likely not to attend a 12-week follow-up assessment. Conclusions: Both clinical and demographic factors were associated with not attending a 12-week follow-up assessment in a hospital-based exercise oncology program. Understanding factors related to follow-up assessment attendance in exercise oncology programs can inform the development of targeted interventions to improve follow-up rate thus maximizing exercise support for cancer survivors.

The psychological factors influencing a return to sport has gained increased research attention. In the current investigation, we explored professional basketball players’ perceptions of the psychosocial and behavioral factors facilitating a return to performance equal to or exceeding previous performance standards. We also sought to describe athletes’ experiences – both positive and negative – of returning to sport following injury recovery. Ten Italian professional male basketball players (age range 22–36 years), were retrospectively interviewed in relation to three time-periods: (1) from the commencement of rehabilitation to their first official competition, (2) the first official competition, and (3) the 6-months following the initial competition. Qualitative content analysis of the data revealed numerous themes across the three time periods. In regards to Period 1, participants indicated that social support, investment in rehabilitation and training programs, coping skills and motivation were fundamental in reaching pre-injury performance levels. During their first official game (i.e., Period 2), athletes reported that realistic performance expectations, focusing on the performance, positive emotions, motivation, arousal and social support facilitated their return to sport. Athletes, however, also described a predominance of factors that hindered their return to pre- injury levels (i.e., low confidence in personal abilities, decrements in skill execution and dysfunctional physical sensations). Moreover, participants typically described a substandard level of performance during their first competition back following injury. In recounting experiences during the 6 months following their first official game, basketballers reported improvements in skill execution and highlighted the importance of coping skills, motivation and social support. The process of restoring self-confidence in one’s ability to successfully perform was perceived as crucial in enabling participants to move beyond a mere return to sport to a return to high performance – that is, to reach a level of proficiency equal to or exceeding previous performance standards. Findings support the relevance of cognitive, emotional and behavioral responses highlighted in the Integrated Model and suggest the importance of addressing psychological factors throughout the return-to-sport process. Finally, results from the present study hold a number of practical implications for athletes’ aiming to achieve a return to pre-injury levels.