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Introduction: From the time of diagnosis, breast cancer survivors' physical activity (PA) tends to decline, which is accentuated during treatment because of side effects such as fatigue, depression, decreased muscle mass, and treatment toxicity. The My Active Health Retreat has been created to provide community-based support for breast cancer survivors to engage in a healthy lifestyle and educate about health matters. This qualitative study explores participants' perspectives and past, present, and future experiences regarding the workshops offered during the My Active Health retreat. Materials and Methods: My Active Health retreat has been designed to provide strategies to engage in a physically active lifestyle. Participants who consented to be part of this qualitative study filled out a questionnaire to provide their experiences and perspectives of the retreat. Themes were generated to help understand the participants' views about their experiences with the workshop's content in the retreat. Results: The participants were 21 women (mean age of 54.5 years) who filled out the post-retreat questionnaire. Workshops on yoga, meditation, exercise, and walking were highly praised for reducing stress and anxiety and promoting mindfulness. The importance of social contact in alleviating survivors' feelings of isolation was emphasized. The participants expressed their intention to incorporate the knowledge from the retreat into their daily lives. Conclusions: This study provides significant insights that can guide the development of content in health retreats focused on PA for breast cancer survivors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. Design: Single group implementation feasibility study using a pre–posttest design. Setting: Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). Participants: Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. Intervention: A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. Main Measure: Paired t -tests were used to assess pre–post changes and analyses of covariance were used to compare effects based on selected participant characteristics. Results: Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001). Conclusions: Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. Implications for Cancer Survivors: With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to apply the theory of planned behavior (TPB) to understand physical activity intentions and behaviors among Korean breast cancer survivors.Methods: A total of 286 Korean breast cancer survivors (Mage52.3 ± 8.3) completed a self-reported survey administered face to face by a trained interviewer. The survey assessed the physical activity frequency and intensity in a typical week after breast cancer diagnosis, demographic factors, and theory of planned behavior variables including attitude, subjective norm, perceived behavioral control (PBC), planning, and intentions to participate in physical activity. We used structural equation modeling to examine the direct and indirect effects of the TPB variables on physical activity intentions and behavior. Covariates included age, cancer stage, and clinical treatment.Results: Confirmatory factor analyses indicated a satisfactory model fit. We observed direct effects for instrumental attitude (ß = 0.34, p < 0.001), subjective norm (ß = 0.12, p < 0.05), and PBC (ß = 0.57, p < 0.001) on physical activity intentions. PBC (ß = .17, p < 0.01) and physical activity intentions (ß = 0.46, p < 0.01) had direct effects on planning. PBC (ß = 0.28, p < 0.01) and planning (ß = 0.22, p < 0.01) had direct effects on physical activity behavior.Conclusion: The TPB was a useful model for understanding Korean breast cancer survivors' physical activity intentions and behavior. Interventions that can enhance attitudes, subjective norm, PBC, intention, and planning may facilitate physical activity intentions and behaviors in this population. [ABSTRACT FROM AUTHOR]

Purpose: Almost all exercise guidelines recommend both aerobic and strength exercise, however, few studies have simultaneously examined the correlates of meeting both exercise guidelines. Here, we propose a new paradigm that calls on researchers to examine not only the correlates of meeting the various exercise guidelines versus no guideline but also the correlates of meeting the combined guidelines versus one guideline and meeting one guideline versus the other guideline.Methods: A random sample of 621 gynecologic cancer survivors located in Alberta, Canada, completed a mailed questionnaire.Results: A multivariate multinomial logistic regression analysis indicated that (a) meeting only the aerobic exercise guideline compared to neither guideline was associated with younger age, social drinking, healthy weight, better general health, and no comorbidities; (b) meeting only the strength exercise guideline compared to neither guideline was associated with social drinking and being healthy weight; (c) meeting the combined exercise guideline compared to neither guideline was associated with social drinking, being healthy weight, and better general health; (d) meeting the aerobic guideline only compared to the strength guideline only was associated with younger age and better general health; and (e) few correlates distinguished between meeting the combined guidelines compared to a single guideline.Conclusions: Demographic and health variables are associated with meeting the various exercise guidelines versus no guideline but they are not associated with meeting the combined exercise guidelines versus a single guideline or meeting one guideline versus the other guideline. Application of this new paradigm to cancer survivors is encouraged. [ABSTRACT FROM AUTHOR]

The article presents a study on the correlation between extreme sport/adventure activities (ESAA) participation and medical, demographic and behavioral variables in gynecologic cancer survivors. It discusses the ESAA benefits of self-discovery and personal challenge to overcome cancer-linked obstacles and adversity, findings indicating that cervical and ovarian cancer survivors are more likely to engage in ESAA and the themes of physical capability and financial resources in ESAA participation.

Background.Androgen deprivation therapy (ADT) increases survival rates in prostate cancer (PCa) patients with locally advanced disease, but is associated with side effects that may impair daily function. Strength training may counteract several side effects of ADT, such as changes in body composition and physical functioning, which in turn may affect health-related quality of life (HRQOL). However, additional randomised controlled trials are needed to expand this knowledge. Material and methods.Fifty-eight PCa patients on ADT were randomised to either 16 weeks of high-load strength training (n = 28) or usual care (n = 30). The primary outcome was change in total lean body mass (LBM) assessed by dual x-ray absorptiometry (DXA). Secondary outcomes were changes in regional LBM, fat mass, and areal bone mineral density (aBMD) measured by DXA; physical functioning assessed by 1-repetition maximum (1RM) tests, sit-to-stand test, stair climbing test and Shuttle walk test; and HRQOL as measured by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Results and Conclusion.No statistically significant effect of high-load strength training was demonstrated on total LBM (p = 0.16), but significant effects were found on LBM in the lower and upper extremities (0.49 kg, p < 0.01 and 0.15 kg, p < 0.05, respectively). Compared to usual care, high-load strength training showed no effect on fat mass, aBMD or HRQOL, but beneficial effects were observed in all 1RM tests, sit-to-stand test and stair climbing tests. Adherence to the training program was 88% for lower body exercises and 84% for upper body exercises. In summary, high-load strength training improved LBM in extremities and physical functioning, but had no effect on fat mass, aBMD, or HRQOL in PCa patients on ADT. [ABSTRACT FROM PUBLISHER]

Purpose: Shoulder pain and dysfunction may occur after surgery for head and neck cancer (HNC) as a result of damage to or resection of the spinal accessory nerve. Previous research found that 12 weeks of upper extremity progressive resistance exercise training (PRET) improved shoulder outcomes in survivors of HNC; the purpose of this study was to determine whether benefits persisted over the longer term. Methods: Survivors of HNC were assigned at random to PRET (n=27) or a standard therapeutic protocol (TP; n=25), with an opportunity for crossover in the TP group after 12 weeks. At 12-month follow-up, participants were mailed a questionnaire that assessed quality of life (QOL), shoulder outcomes, and exercise behaviour. Results: Of the 52 participants enrolled in the study, 44 were eligible at 12-month follow-up, and 37 (71%) completed the questionnaires. Overall, self-reported outcomes were largely sustained over the follow-up period. After 12 months, regardless of original group allocation, participants who continued resistance exercise training during the follow-up period reported better neck dissection-related functioning (p=0.021) and better QOL (p=0.011) than those who did not. Conclusions: Benefits of PRET were sustained at 12-month follow-up. Ongoing participation in resistance exercise training may prove valuable as a supportive care intervention for survivors of HNC. [ABSTRACT FROM AUTHOR]

Purpose: To explore the effects of targeted physical activity (PA) print material on PA and quality of life (QOL) in young adult cancer survivors (YACS) aged 18-39 either on or off treatment. Methods: YACS ( N=212) recruited from a cancer registry were randomly assigned to a Targeted Physical Activity Guidebook (TPAG) or the Canadian Physical Activity Guidelines (CPAG). An online or mailed survey assessed the primary outcome of self-reported PA minutes and secondary QOL outcomes. Assessments were conducted at baseline, 1 month, and 3 months for PA and at baseline and 3 months for QOL. Results: At 3 months, analyses of covariance showed no differences between the groups for the primary outcome of PA minutes/week (adjusted mean group difference=+8 minutes; 95% confidence interval [CI]: −60 to +77; p=0.81). The TPAG was superior to the CPAG for the mental component of QOL (adjusted mean group difference=+3.1; 95% CI: +0.1 to +7.3; p=0.043). In an exploratory analysis of YACS reporting ≤300 PA minutes/week at baseline ( N=108), the TPAG group was superior to the CPAG group at 3 months for PA minutes/week (adjusted mean group difference=+90; 95% CI: +10 to +170; p=0.028). Conclusion: Targeted PA print material did not increase PA compared to generic PA print material in a highly active sample of YACS. In YACS reporting ≤300 PA minutes/week at baseline-the group of interest from a PA behavior change perspective-the targeted PA print material was effective in increasing PA. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and correlates of meeting the public health strength exercise guidelines (?2 days/week) in colorectal cancer (CRC) survivors. Methods: A random sample of 600 CRC survivors in Alberta, Canada, completed a mailed questionnaire as­sessing medical, demographic, and be­havioral variables and participation in strength exercise. Results: About a quar­ter (25.5%) of CRC survivors were meet­ing strength exercise guidelines. In mul­tivariate analysis, meeting guidelines was associated with being male (p = .052), married (p = .079), a drinker (p = .006), in better health (p < .001), nonsmoking (p = .023), and nonobese (p = .010). Conclu­sions: Interventions to increase strength exercise participation in CRC survivors are needed. [ABSTRACT FROM AUTHOR]

Objectives: To examine the determinants of physical activity (PA) in young adult cancer survivors (YACS). Methods: A survey of 588 YACS in Alberta, Canada, assessed PA, medical and demographical factors, and theory of planned behavior variables. Results: Path analysis explained 38% (P<.001) of the variance in PA with significant contributions from intention, planning, affective attitude, education, and general health. In turn, 56% (P<.001) of the variance in intention was explained by perceived behavioral control, instrumental attitude, and affective attitude. Conclusion: PA interventions in YACS should focus on developing strong intentions by targeting perceived behavioral control, instrumental attitude, and affective attitude. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the effects supervised aerobic exercise had on the motivational outcomes and longer-term behavior of lymphoma patients. Researchers evaluated 60 patients. They found that supervised exercise has motivational effects in lymphoma patients and improves longer-term exercise behavior. They concluded that strategies to further enhance the motivational value of supervised exercise in lymphoma patients are warranted and should be developed.

Background: Over half of kidney cancer survivors (KCS) are completely inactive and only a quarter are meeting physical activity (PA) guidelines. This highlights the need to identify and understand the determinants of PA in this understudied population. The purpose of this study is to determine the social cognitive correlates of PA intention and behavior in KCS using the Theory of Planned Behavior (TPB). Methods: All 1,985 KCS diagnosed between 1996 and 2010 in Alberta, Canada were mailed a self-report survey that consisted of the Godin Leisure Time Exercise Questionnaire and standard TPB items for intention, planning, perceived behavioral control (PBC), affective and instrumental attitudes, and descriptive and injunctive norms. Standard demographic and medical variables were also collected. Results: Completed surveys were received from 703 of 1,654 (43%) eligible KCS. The TPB was tested using structural equation modelling and demonstrated an adequate-to-good fit to the data [χ2² = 256.88, p < .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.06, 90% CI = 0.05-0.06]. There were significant pathways to PA from PBC (β = 0.18, p = 0.02), planning (ß = 0.22, p < 0.01), and intention (β = 0.31, p < 0.01); and to planning from intention (β = 0.81, p < 0.01). In addition, there were significant model pathways to intention from instrumental attitude (β = 0.28, p = 0.03), descriptive norm (β = 0.09, p = 0.01), and PBC (β = 0.52, p < 0.01). Overall, the TPB accounted for 69%, 63%, and 42% of the variance in intention, planning and PA, respectively. Conclusion: The TPB appears to be a useful model for explaining PA in KCS. All TPB constructs except injunctive norm and affective attitude were useful for explaining intention with PBC emerging as the largest correlate. Developing PA interventions based on the TPB may be effective in promoting PA in KCS and may lead to important improvements in health. [ABSTRACT FROM AUTHOR]

The authors determined the validity and reliability of their Past Year Total Physical Activity Questionnaire (PYTPAQ), which assesses the frequency, duration, and intensity of occupational, household, and recreational activities performed over the past year. The PYTPAQ was completed twice at baseline, 9 weeks apart (on average), by 154 healthy Canadian men and women aged 35–65 years for assessment of reliability. The PYTPAQ was completed again 1 year later as a self-administered questionnaire. Four times during the year, participants wore an accelerometer for 7 days and completed 7-day physical activity logs. The authors assessed validity by comparing PYTPAQ summary values with 1-year averages of the physical activity logs and accelerometer data and with physical fitness and anthropometric data measured at baseline and 1 year. Spearman correlations for reliability (metabolic equivalent-hours/week) were 0.64 for total activity, 0.70 for occupational activity, 0.73 for recreational activity, and 0.65 for household activity. For total activity, the intraclass correlation coefficient for correlation between the PYTPAQ and the 7-day physical activity logs was 0.42 (95% confidence interval: 0.28, 0.54), and for the accelerometer data it was 0.18 (95% confidence interval: 0.03, 0.32). Spearman correlations between PYTPAQ hours/week of vigorous activity and maximal oxygen uptake were 0.37 and 0.32 at baseline and follow-up, respectively. In general, the PYTPAQ has acceptable reliability and validity for measurement of past-year physical activity that is comparable to that of similar questionnaires. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To examine the feasibility and preliminary efficacy of an eight-week supervised climbing intervention for gynecologic cancer survivors (GCSs). Design: A pilot randomized, controlled trial. Setting: The Wilson Climbing Center in Edmonton, Alberta, Canada. Sample: 35 GCSs who had completed cancer therapy. Methods: GCSs were randomized to an eight-week (16 session) supervised wall climbing intervention (WCI) (n = 24) or usual care (UC) (n = 11). Main Research Variables: Feasibility outcomes included recruitment rate, adherence rate, skill performance, and safety. Preliminary efficacy outcomes were objective health-related and functional fitness assessed before and after the eight-week intervention using the Senior Fitness Test. Findings: Median adherence to the WCI was 13.5 of 16 sessions. Most GCSs were proficient on 16 of 24 skill assessment items. No serious adverse events were reported. Based on intention-to-treat analyses, the WCI group was superior to the UC group for the 6-minute walk, 30-second chair stand, 30-second arm curls, sit and reach, 8-foot up-and-go, grip strength-right, and grip strength-left assessments. Conclusions: The Gynecologic Cancer Survivors Wall Climbing for Total Health (GROWTH) Trial demonstrated that an eight-week supervised WCI was safe, feasible, and improved functional fitness in GCSs. Phase II and III trials are warranted to further establish the safety, feasibility, and efficacy of WCIs in cancer survivors. Implications for Nursing: Oncology nurses may consider a climbing wall as an alternative type of physical activity for improving functional fitness in GCSs. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To assess the feasibility and safety of an aerobic exercise intervention in patients with rectal cancer during and after neoadjuvant chemoradiotherapy (NACRT). Design: A prospective, single-group design with assessments at pre-NACRT, post-NACRT, and presurgery. Setting: The Cross Cancer Institute and University of Alberta in Edmonton, Canada. Sample: 18 patients with rectal cancer scheduled to receive long-course NACRT followed by definitive surgery. Methods: Participants received a supervised moderate-intensity aerobic exercise program three days per week during six weeks of NACRT followed by an unsupervised aerobic exercise program for 150 minutes or more per week for 6-8 weeks prior to surgery. Main Research Variables: Eligibility rate, recruitment rate, follow-up rate, exercise adherence, serious adverse events, health-related fitness outcomes, and patient-reported outcomes. Findings: Follow-up rates post-NACRT were 83% for health-related fitness outcomes and 94% for patient-reported outcomes. Patients attended a median of 83% of their supervised exercise sessions and completed a mean of 222 minutes per week (SD = 155) of their unsupervised exercise. No serious adverse events were observed or reported. Most health-related fitness outcomes and patient-reported outcomes declined during NACRT and recovered after NACRT. Conclusions: Aerobic exercise is feasible and safe for patients with rectal cancer during and after NACRT. Implications for Nursing: Patients with rectal cancer are able to engage in moderateintensity aerobic exercise during NACRT. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To identify and compare the prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors. Design: Cross-sectional, descriptive survey. Setting: Nova Scotia, Canada. Sample: 741 breast, prostate, and colorectal cancer survivors. Methods: A stratified sample of 2,063 breast, prostate, and colorectal cancer survivors diagnosed from 2003-2011 were identified and mailed a questionnaire. Descriptive, chi-square, and logistic regression analyses were used to determine any correlations among the main research variables. Main Research Variables: Strength exercise behavior; medical, demographic, and motivational correlates using the Theory of Planned Behavior. Findings: Of 741 respondents, 23% were meeting the strength exercise guidelines of two or more days per week. Cancer survivors were more likely to meet guidelines if they were younger, more educated, had a higher income, better perceived general health, fewer than two comorbidities, and a healthy body weight. In addition, those meeting guidelines had significantly more favorable affective attitude, instrumental attitude, injunctive norm, perceived behavioral control, planning, and intention. The correlates of strength exercise did not differ by cancer site. Conclusions: The prevalence of strength exercise is low among breast, prostate, and colorectal cancer survivors in Nova Scotia and the correlates are consistent across those survivor groups. Implications for Nursing: Nurses should take an active role in promoting strength exercise among cancer survivors using the Theory of Planned Behavior, particularly among those survivors at higher risk of not performing strength exercise. [ABSTRACT FROM AUTHOR]

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response. Objectives: To examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS. Design: A provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables. Results: One third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = −0.10, p = 0.024). Discussion/conclusions: Sport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted. [ABSTRACT FROM AUTHOR]