Physical impairments and quality of life of colorectal cancer survivors: a case-control study.

The aim of the study is to determine the physical performance, quality of life and fatigue in colorectal cancer survivors compared with healthy controls. Twenty-three colorectal cancer survivors and 22 matched controls were recruited for this case-control study. Fitness level (muscle trunk flexor endurance test, 6-min walk test, chair sit and reach test and flamingo test) was assessed in both groups. Participants completed the European Organization of Research and Treatment of Cancer, the Quality of Life Questionnaire (QLQ-C30), the Piper Fatigue Scale (PFS) and the International Fitness Scale (IFIS). Significant differences between groups were found for all fitness parameters (P < 0.05). In addition, the anova revealed significant differences in all of the IFIS scores (P < 0.001), PFS (P < 0.01) and functioning scores of the QLQ-C30 (P < 0.05) between colorectal cancer survivors and the control group. The Mann-Whitney U-test showed a significant increase in symptom scores such as fatigue, dyspnoea and diarrhoea in the cancer survivors (P < 0.05). This study shows the existence of perceived and objective deterioration of health-related fitness level, presence of moderate cancer fatigue and reduced perceived quality of life in colorectal cancer survivors compared with healthy controls.

Agreement between telerehabilitation involving caregivers and face-to-face clinical assessment of lymphedema in breast cancer survivors.

Lymphedema is a lifetime complication of breast cancer survivors that can limit their participation in recreational or strenuous daily activities. Follow-up of lymphedema using an Internet application could help patients to determine the influence on their condition of these activities and adapt them accordingly. We aimed to determine the level of agreement between lymphedema assessment by telerehabilitation and by the traditional face-to-face method. Thirty breast cancer survivors participated in a descriptive study of repeated measures using a crossover design. Patients attended a session for clinical face-to-face and real-time online telerehabilitation assessments of lymphedema. There was a 120-min interval between these two sessions. The order of sessions was randomly selected for each patient. A caregiver (relative or friend) conducted the telerehabilitation assessment using a system that includes a specific tool based on an arm diagram for measuring the participant's arm circumferences via a telehealth application. All outcome measures showed reliability estimates (α) ≥ 0.90; the lowest reliability was obtained for the total volume on the non-affected side (α = 0.90). The diagnosis of lymphedema by the two methods also showed good inter-rater reliability (Rho = 0.89). These preliminary findings support the use of an Internet-based system to assess lymphedema in breast cancer survivors, offering carers a useful role in helping patients to follow up this lifetime health problem.

Influence of physical inactivity in psychophysiological state of breast cancer survivors.

Physical inactivity has been postulated as mediator of the relationship between cancer-related symptoms and psychoneurobiological alterations. The aim of the study was to evaluate the influence of physical inactivity level on mood state, fitness level as well as on salivary markers of the hypothalamic-pituitary-adrenal axis (cortisol) and the SNS (α-amylase) in breast cancer survivors. One hundred and eight breast cancer survivors (stages I-IIIa) participated in this cross-sectional study. Data were gathered on the following: Minnesota Leisure Time Physical Activity Questionnaire, profile of mood state, 6-min walk test, force handgrip, blood pressure, salivary cortisol concentration and salivary α-amylase activity. For our analysis, two groups were formed based on physical activity level measured as energy expenditure during diary leisure activities of the participants at the moment of the study, a physical inactivity level group (<3 METs × h/week) and an adequate physical activity level group (>3 METs × h/week). Fitness level was significantly higher in the active than the inactive group, while anger, fatigue, depression, confusion, mood disturbance, diastolic blood pressure and salivary α-amylase activity were significantly greater in the inactive than the active group. These results suggest that physical inactivity induces a worse psychoneurobiological state in inactive than in active breast cancer survivors.

Aquatic exercise in a chest-high pool for hormone therapy-induced arthralgia in breast cancer survivors: a pragmatic controlled trial.

OBJECTIVE: To investigate the impact of aquatic exercise on pressure pain threshold in breast cancer survivors with hormone therapy-associated arthralgia. DESIGN: Single-blind, controlled trial. SETTING: Two major metropolitan hospitals and a Sport and Spa Club in Granada, Spain. SUBJECTS: Forty women aged 29-71 years with stage I-III breast cancer who reported arthralgia. INTERVENTION: Patients were allocated alternately to either aquatic exercise in a chest-high pool or usual care while on the waiting list; control patients received treatment later. The two-month hydrotherapy intervention consisted of 24 sessions 3 days per week. Each session included 5 minutes of warm-up, 15-20 minutes of aerobic exercise, 15 minutes of mobility exercise and 20 minutes of recovery techniques. MAIN MEASURES: Pressure pain threshold at neck, shoulder, hand and leg were evaluated as primary outcomes. Cancer-related fatigue, as measured by the Piper Fatigue Scale, body mass index and waist circumference were secondary outcomes. A 2 × 2 repeated-measure ANCOVA was used in this study. RESULTS: No adverse events or development of worsening of pain was observed. Almost all the participants in the intervention group (89%) adhered to the hydrotherapy programme. Participants experienced a decrease in pressure pain threshold measured in neck, hand, shoulder and leg, as measured by algometry pressure, and waist circumference; all P < 0.05. Cancer-related fatigue (P = 0.06) and body mass index (P = 0.42) did not show significant improvement. CONCLUSIONS: These data suggest that hydrotherapy in a chest-high pool may reduce the pain threshold and waist circumference in breast cancer survivors with hormone therapy-associated arthralgia.