The Impact of a Multimodal Sport Science-Based Prehabilitation Program on Clinical Outcomes in Abdominal Cancer Patients: A Cohort Study.

BACKGROUND: The potential for prehabilitation programs to impact clinical outcomes is uncertain in abdominal cancer patients due to the short window of time to intervene and the weakened state of the patients. To improve the effectiveness of prehabilitation intervention, a multimodal sports science approach was implemented. METHODS: Prior to cancer-related surgery, 21 patients participated in a 4-week exercise and nutrition prehabilitation program comprised of blood flow restriction exercise (BFR) and a sports nutrition supplement. Retrospective data of 71 abdominal cancer patients who underwent usual preoperative care was used as a comparator control group (CON). At 90 days post-surgery, clinical outcomes were quantified. RESULTS: Prehabilitation was associated with a shorter length of hospital stay (P = .02) with 5.5 fewer days (4.7 ± 2.1 vs 10.2 ± 1.2 days in CON) and decreased incidence of any complications (P = .03). Prehabilitation was not related to incidence of serious complications (P = .17) or readmission rate (P = .59). The prehabilitation group recorded 58% more steps on day 5 after surgery (P = .043). DISCUSSION: A 4-week home-based prehabilitation program composed of BFR training and sports nutrition supplementation was effective in reducing postoperative complications and length of hospital stay in older patients with abdominal cancer.ClinicalTrials.gov Identifier: NCT04073381.

A Mobile App With Multimodality Prehabilitation Programs for Patients Awaiting Elective Surgery: Development and Usability Study.

BACKGROUND: Complying with a prehabilitation program is difficult for patients who will undergo surgery, owing to transportation challenges and a limited intervention time window. Mobile health (mHealth) using smartphone apps has the potential to remove barriers and improve the effectiveness of prehabilitation. OBJECTIVE: This study aimed to develop a mobile app as a tool for facilitating a multidisciplinary prehabilitation protocol involving blood flow restriction training and sport nutrition supplementation. METHODS: The app was developed using "Appy Pie," a noncoding app development platform. The development process included three stages: (1) determination of principles and requirements of the app through prehabilitation research team meetings; (2) app prototype design using the Appy Pie platform; and (3) app evaluation by clinicians and exercise and fitness specialists, technical professionals from Appy Pie, and non-team-member users. RESULTS: We developed a prototype of the app with the core focus on a multidisciplinary prehabilitation program with accessory features to improve engagement and adherence to the mHealth intervention as well as research-focused features to evaluate the effects of the program on frailty status, health-related quality of life, and anxiety level among patients awaiting elective surgery. Evaluations by research members and random users (n=8) were consistently positive. CONCLUSIONS: This mobile app has great potential for improving and evaluating the effectiveness of the multidisciplinary prehabilitation intervention in the format of mHealth in future.

Prehabilitation program composed of blood flow restriction training and sports nutrition improves physical functions in abdominal cancer patients awaiting surgery.

INTRODUCTION: The impact of prehabilitation remains controversial due to a short presurgical waiting period and the diminished capacity of the patient population. A strategy to augment and optimize the effectiveness of prehabilitations for abdominal cancer patients may be found in the unlikely field of sport science. We investigated the use of blood flow restriction training and sport nutrition supplementation to augment functional capacity and increase muscle strength in twenty-four abdominal cancer patients awaiting surgery. MATERIALS AND METHODS: The sport science-based program was comprised of blood flow restriction exercise 5 to 6 times per week and a daily sports nutrition supplement containing l-citrulline, creatine monohydrate, and whey protein. RESULTS: After 4 weeks of prehabilitation, 6-min walk test, timed up and go, short physical performance battery, 5-chair stand test and physical component score of quality of life were significantly improved (all p < 0.05). Total body and appendicular lean mass as assessed by dual energy X-ray absorptiometry increased by 0.73 ± 1.04 kg (p = 0.004) and 0.42 ± 0.64 kg (p = 0.006), respectively. Total body fat mass and trunk fat mass decreased (p = 0.004 and p = 0.021). There were no significant changes in hand grip strength, fear of falling, the mental component summary of quality of life, or fasting serum concentrations of myostatin, follistatin, and growth hormone. CONCLUSION: A multimodal prehabilitation program, which encompasses blood flow restriction training and sports nutrition supplements, is both feasible and effective in improving lean mass and physical function in abdominal cancer patients prior to surgery.

Bone Mineral Content and Density Among Female NCAA Division I Athletes Across the Competitive Season and Over a Multi-Year Time Frame.

Stanforth, D, Lu, T, Stults-Kolehmainen, MA, Crim, BN, and Stanforth, PR. Bone mineral content and density among female NCAA Division I athletes across the competitive season and over a multi-year time frame. J Strength Cond Res 30(10): 2828-2838, 2016-Longitudinal and cross-sectional bone mineral content (BMC) and bone mineral density (BMD) comparisons were made among impact and nonimpact sports. Female collegiate athletes, 18-23 years of age, from basketball (BB; n = 38), soccer (SOC; n = 47), swimming (SW; n = 52), track sprinters and jumpers (TR; n = 49), and volleyball (VB; n = 26) had BMC/BMD measures preseason and postseason over 3 years. Control groups of 85 college females, 18-24 years of age, who completed 2 tests 1-3 years apart and of 170 college females, 18-20 years of age, were used for the longitudinal and cross-sectional analyses, respectively. A restricted maximum likelihood linear mixed model regression analysis with a compound symmetric heterogeneous variance-covariance matrix structure was used for all analyses (p ≤ 0.05). Increases from year-1 preseason to year-3 postseason included the following: total BMC (3.3%), total BMD (1.4%), and spine BMD (4.5%) for BB; total BMC (1.5%) and leg BMD (1.2%) for SOC; arm (1.8%), leg (1.9%), and total BMD (5.7%) for SW; total BMC (2.0%), arm (1.7%), leg (2.3%), pelvis (3.4%), spine (6.0%), and total BMD (2.3%) for TR; and arm (4.1%), leg (2.0%), pelvis (2.0%), spine (2.0%), and total BMD (2.7%) for VB. Comparisons among sports determined that BB had higher BMC and BMD values than all other sports for all variables except spine and total BMD; BB, SOC, TR, and VB had higher total BMC (11-29%), leg BMD (13-20%), and total BMD (9-15%) than SW and CON, and there were few differences among SOC, TR, and VB. In conclusion, small, significant increases in many BMC and BMD measures occur during female athlete's collegiate careers. The BMC and BMD differences between impact and nonimpact sports are large compared with smaller differences within impact sports.

Body composition changes among female NCAA division 1 athletes across the competitive season and over a multiyear time frame.

Body composition can affect athletic performance. Numerous studies have documented changes in body composition in female collegiate athletes from pre- to postseason; however, longitudinal studies examining changes across years are scarce. Therefore, the primary purpose of this study was to assess longitudinal body composition changes among female collegiate athletes across 3 years. Two hundred twelve female athletes from basketball (BB; n = 38), soccer (SOC; n = 47), swimming (SW; n = 52), track (sprinters and jumpers; TR; n = 49), and volleyball (VB; n = 26) with an initial mean age of 19.2 ± 1.2 years, height of 172.4 ± 8.9 cm, and total mass of 66.9 ± 9.0 kg had body composition assessments using dual-energy x-ray absorptiometry pre- and postseason over 3 years. A restricted maximum-likelihood linear mixed model regression analysis examined body composition differences by sport and year. Changes (p < 0.05) over 3 years included the following: Lean mass increased in VB from year 1 to 2 (0.7 kg), year 2 to 3 (1.1 kg), and year 1 to 3 (1.8 kg) and in SW from year 1 to 3 (0.6 kg); and percent body fat (%BF) increased in BB from year 1 to 3 (1.7%). There were no changes in SOC or TR. These results indicate that during their college careers, female collegiate athletes can be expected to maintain their %BF and athletes in sports like SW and VB can anticipate an increase in lean mass, but the increases may be less than many athletes, coaches, and trainers envision.

Undermining of nutrition and exercise decisions: experiencing negative social influence.

OBJECTIVE: The objective of this research was to assess social undermining (negative interpersonal influence) on health behaviors in a large sample of Internet users. DESIGN AND SAMPLE: This study used a cross-sectional descriptive design with an online survey that yielded quantitative and qualitative data. A total of 6,923 individuals received invitations and 1,270 participants completed the survey (18.3% response rate). Respondents completing at least 1 qualitative question were retained for analysis (n=1,158). The sample had more females (75.9%) than males (24.1%) and an average age of 42.9 years (SD±12.4). MEASURES: Participants described experiences and perceptions of undermining. Content analysis was used to identify themes, and responses were coded after establishing intercoder reliability (κ=.92). Coded responses were correlated with gender, body mass index, and satisfaction with weight. RESULTS: Many respondents reported that they were affected by undermining. The most common sources of undermining were family and significant others. Individuals satisfied with their current weight were more likely to resist undermining. Many suggested undermining might result from jealousy or others' guilt over their own decisions. CONCLUSIONS: Undermining of healthy behaviors is an important issue for public health researchers and practitioners as it pertains to patient counseling and the development of strategies for resisting undermining.

An investigation of exercise and the placebo effect.

OBJECTIVE: To replicate previous research that concluded exercise affects health via a placebo effect: simply telling workers with physically active jobs that their "work is exercise" improves health. METHOD: A convenience sample of university building service workers (n=53) learned "their work is exercise" or about job safety. RESULTS: Groups demonstrated similar outcomes at 4 and 8 weeks for weight, percent fat, waist circumference, and behavioral measures. Both groups increased self-perception as "regular exercisers"; blood pressure was reduced only in the intervention group. CONCLUSION: This research did not support the placebo effect. Although enticing, simply changing mind-set does not alter the relationship between exercise and health.