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Supplemental digital content is available in the text. Purpose: While general guidelines (such as CONSORT or Consensus on Exercise Reporting Template) exist to enhance the reporting of exercise interventions in the field of exercise science, there is inadequate detail facilitating the standardized reporting of resistance training adherence in the oncology setting. The purpose of this study was to apply a novel method to report resistance training dose, adherence, and tolerance in patients with cancer. Methods: A total of 47 prostate cancer patients (70.1 ± 8.9 yr, body mass index, 28.6 ± 4.0) with bone metastatic disease completed an exercise program for 12 wk. We assessed traditional metrics of adherence (attendance and loss to follow-up), in addition to novel proposed metrics (exercise-relative dose intensity, dose modification, and exercise interruption). Total training volume in kilograms (repetitions × sets × training load (weight)) was calculated for each patient. Results: Attendance assessed from traditional metrics was 79.5% ± 17.0% and four patients (9%) were lost to follow-up. The prescribed and actual cumulative total dose of resistance training was 139,886 ± 69,150 kg and 112,835 ± 83,499 kg, respectively, with a mean exercise-relative dose intensity of 77.4% ± 16.6% (range: 19.4% –99.4%). Resistance training was missed (1–2 consecutive sessions) or interrupted (missed ≥3 consecutive sessions) in 41 (87%) and 24 (51%) participants, respectively. Training dose was modified (reduction in sets, repetitions, or weight) in 40 (85%) of patients. Importantly, using attendance as a traditional metric of adherence, these sessions would have all counted as adherence to the protocol. Conclusions: Traditional reporting metrics of resistance training in exercise oncology may overestimate exercise adherence. Our proposed metrics to capture resistance training dose, adherence, and tolerance may have important applications for future studies and clinical practice. [ABSTRACT FROM AUTHOR]

Exercise has been shown to be safe and effective for patients with prostate cancer (PrCa). The monitoring of resistance exercise (RE) intensity is an emerging area of interest in RE prescription. Rating of perceived exertion (RPE) is one of the most commonly used methods but has not yet been validated in this population. Thus, the purpose of this study was to examine the relationship between RPE and RE intensity in PrCa. Data for this study were abstracted from baseline upper- and lower-body strength assessments from 2 previous trials (Individual Diet and Exercise Adherence Pilot Trial; Livestrong, Austin, TX, USA) in our laboratory investigating functional outcomes in patients with PrCa undergoing androgen deprivation therapy (ADT). A total of 75 participants from both trials were included in this study. Ratings of perceived exertion corresponding to 50, 70, and 90% 1 repetition maximum (1RM) were extracted from the results of participants' upper- and lower-body 1RM strength tests. The changes in RPE across increasing intensities were assessed using separate univariate analysis of variance (ANOVA). For each ANOVA, RPE was used as the dependent variable and intensity (50, 70, and 90%) used as the fixed factor. A univariate ANOVA revealed a significant difference (p ≤ 0.05) among the RPE values for each intensity for both upper- and lower-body lifts. The results of our analyses suggest that RPE values rise linearly in response to increases in exercise intensity. Our study supports the concept that RPE may be a practical training tool to accurately estimate RE intensity in PrCa survivors undergoing ADT. Practitioners may consider using RPE to monitor and adjust RE intensity in this population. [ABSTRACT FROM AUTHOR]

Post-treatment weight gain places breast cancer (BCa) survivors at heightened risk for cardiovascular disease, metabolic syndrome, and functional decline. Lifestyle weight management (LWM) interventions combining exercise and dietary weight loss represent an effective approach to mitigating the adverse cardiometabolic and functional effects frequently observed in BCa survivors. Unfortunately, community access to cost-effective, sustainable, LWM interventions among BCa survivors remains limited and this lack of easily accessible programming undermines efforts to integrate behavioral weight management in the supportive care of BCa survivors. PURPOSE: The purpose of this pilot trial is to determine the feasibility and preliminary efficacy of a 6-month community-based LWM intervention implementing a group-mediated cognitive behavioral approach in BCa survivors. In the current study, we evaluated the effects of the LWM intervention on select body composition, physical function, and social cognitive outcomes of the first wave of participants enrolled in the trial. METHODS: A total of 11 BCa survivors (M age = 54 years) participated in the LWM intervention. Assessments of body composition assessed (Dual-energy X-ray Absorptiometry), physical function (400m walk test), and select social cognitive outcomes (satisfaction with function and appearance and perceived competence with exercise and diet intake) were obtained at baseline and 3-months. RESULTS: Analysis of change from baseline in the outcomes using Cohen's d effect sizes revealed clinically meaningful improvements in fat mass (d= -0.46), percent lean mass (d= 0.33), lean mass (d= -0.45), physical function (d= -0.59), satisfaction with function (d= 1.89) and appearance (d= 1.16) and perceived competence for exercise (d= 0.42) and dietary intake (d= 0.47). CONCLUSION: Findings from this study demonstrate the preliminary efficacy of implementing a GMCB-based LWM intervention among overweight or obese BCa survivors. Given the meaningful impact that successful weight management has on reducing risk for chronic diseases, these results highlight the ut ility of implementing a LWM intervention in the community for BCa survivors in an effort to extend the access and reach of supportive care approaches during BCa survivorship. [ABSTRACT FROM AUTHOR]

Despite growing recognition of the importance of lifestyle weight management (LWM) in cancer survivorship, over 65% of breast cancer (BCa) survivors are overweight or obese. Successfully promoting maintenance of lifestyle behavior change and limited community access to cost-effective, sustainable LWM interventions are critical barriers that undermine the utility of integrating LWM approaches in the supportive care of BCa survivors. PURPOSE: The purpose of this pilot trial is to determine the feasibility and preliminary efficacy of a 6-month community-based LWM intervention implementing a group-mediated cognitive behavioral (GMCB) approach in BCa survivors. In the current study, we evaluated select indicants of the feasibility and acceptability of the LWM intervention. METHODS: The 6-month, community-based pilot trial promotes behavioral weight management through an evidence-based exercise and dietary lifestyle intervention program. Feasibility and acceptability were tracked prospectively during the trial and assessed using retention and adherence rates and self-reported indices of intervention satisfaction and acceptability. RESULTS: Retention at 3 month and 6 months was 72.7%, however, only 45% completion of select functional and strength battery components at 6-month. Adherence to the intensive intervention sessions was 66% at 3M and 42.4% at 6M. Average satisfaction of the exercise, dietary, and group based behavioral sessions were 9.5, 8.75, and 8.63 out of 10, respectively. There was strong interest for participation in a longer trial, (M = 9.12, SD = 1.25), along with interest for technology supported delivery (M = 9.12, SD = 1.8). Overall, there was highly favorable patient reported satisfaction with program content, program structure, and perceived benefits reported at both 3 months and 6 months. CONCLUSIONS: The present findings provide support for the initial feasibility and acceptability of implementing a GMCB community-based LWM intervention among overweight or obese BCa survivors. Consequently, further evaluation of the efficacy and impact of a integrating the community-based LWM intervention in the supportive care of BCa survivors is warranted. [ABSTRACT FROM AUTHOR]

Addressing skeletal muscle mass loss is an important focus in oncology research to improve clinical outcomes, including cancer treatment tolerability and survival. Exercise is likely a necessary component of muscle-mass-preserving interventions for people with cancer. However, randomized controlled trials with exercise that include people with cancer with increased susceptibility to more rapid and severe muscle mass loss are limited. The aim of the current review is to highlight features of cancer-related skeletal muscle mass loss, discuss the impact in patients most at risk, and describe the possible role of exercise as a management strategy. We present current gaps within the exercise oncology literature and offer several recommendations for future studies to support research translation, including (1) utilizing accurate and reliable body composition techniques to assess changes in skeletal muscle mass, (2) incorporating comprehensive assessments of patient health status to allow personalized exercise prescription, (3) coupling exercise with robust nutritional recommendations to maximize the impact on skeletal muscle outcomes, and (4) considering key exercise intervention features that may improve exercise efficacy and adherence. Ultimately, the driving forces behind skeletal muscle mass loss are complex and may impede exercise tolerability and efficacy. Our recommendations are intended to foster the design of high-quality patient-centred research studies to determine whether exercise can counteract muscle mass loss in people with cancer and, as such, improve knowledge on this topic. [ABSTRACT FROM AUTHOR]

Changes in body composition during multimodal treatment for cancer patients are characterised by decreases in lean muscle mass and increases in fat mass. These changes, in particular loss of lean muscle mass, have been linked with poorer treatment outcomes and increased morbidity and mortality in some cancer populations. While the effect of resistance training (RT) on body composition in healthy and elite athlete populations is well characterised, the capacity for RT to modify body composition in cancer cohorts is less clear. PURPOSE: This study aimed to determine the effect of RT on body composition (fat mass and lean mass) in patients with cancer undergoing treatment and survivors of cancer. METHODS: We conducted a systematic review and meta-analysis conforming to PRISMA guidelines. MEDLINE, Embase, SportDiscus, CINAHL and Cochrane Library were searched up to June 2020. Randomized controlled trials that compared RT to a non-exercise control arm in adults with a diagnosis of cancer (undergoing or completed cancer treatment) were included. Article screening and data extraction was performed independently by two reviewers and study quality was assessed using the TESTEX scale. Separate pairwise random-effects meta-analyses were performed for 'on treatment' and 'survivorship' studies. RESULTS: When RT was performed during survivorship, significant differences between the RT and control groups were found for changes in muscle size (0.38 kg [95% CI 0.06, 0.71], p = 0.02; I² = 50.7%, p = 0.01) and fat mass (-0.55 kg [95% CI -0.97, -0.13], p = 0.01; I² = 71.3%, p = <0.001). When RT was performed during treatment, there was a significant difference between RT and control groups for changes in muscle size (0.86 kg [95% CI 0.25, 1.47], p = 0.005; I² = 0.0%, p = 0.63), however there was no difference between groups for changes in fat mass (-0.00 kg [95% CI -0.82, 0.81], p = 0.99; I² = 0.0%, p = 0.62). CONCLUSION: Modest improvements in body composition were observed following RT in cancer survivors on treatment and throughout survivorship. These changes are smaller than those observed following similar programs in the general population. The reason for these differences warrants further investigation. [ABSTRACT FROM AUTHOR]

Breast cancer survivors (BCS) commonly exhibit post-treatment declines in muscular strength and physical function. These adverse effects place BCS at heightened risk for chronic disease and functional decline. Theory-based exercise and dietary (EX+D) lifestyle interventions, promoting both regular resistance training and mastery of EX+D self-regulatory strategies, consistently yield meaningful improvements in clinically-relevant outcomes. However, little is known regarding the feasibility or utility of integrating these approaches in community settings among BCS. PURPOSE: The purpose of the Healthy New Albany Breast Cancer (HNABC) pilot study was to determine the feasibility and preliminary efficacy of a community-based group-mediated cognitive behavioral (GMCB) lifestyle intervention in the supportive care of BCS. METHODS: The pilot trial was a 6-month, single-group feasibility study examining the effects of a novel GMCB intervention on EX+D behavior delivered to a cohort of BCS (n = 11; M age = 54 years). Objectively determined chest press (CP) and leg extension (LE) one-repetition maximum (1RM; kg) was assessed using a standardized protocol. Self-reported resistance training volume (RTV; kg) and ratings of perceived exertion (RPE; 0-10 scale) were extracted individual training logs and averaged across the cohort for the CP and leg press (LP) exercises, respectively. Balance was assessed in the medial-lateral direction via root mean square excursion (RMSE; mm) using a balance plate. Baseline to 3-month mean change was calculated and effect size was estimated using Hedge's g. RESULTS: Modest improvement in average 1RM was observed for both CP (3.12 kg; g = 0.54) and LE (4.21 kg; g = 0.44). Self-reported average RTV also increased for both CP (429.37 kg; g = 1.09) and LP (1807.93 kg; g = 0.98). Notably, both CP and LP RPE remained stable with modest average changes despite large increases in RTV (< 0.61). No differences were observed for RMSE. CONCLUSION: Improvements in strength and training volume together with stability of average RPE indicate successful self-management of training variables. Findings from this pilot study support the feasibility and preliminary efficacy of implementing a community-based GMCB EX+D intervention in the supportive care of BCS. [ABSTRACT FROM AUTHOR]