"My Body, My Rhythm, My Voice": a community dance pilot intervention engaging breast cancer survivors in physical activity in a middle-income country.

BACKGROUND: Interventions to promote physical activity among women breast cancer survivors (BCS) in low- to middle-income countries are limited. We assessed the acceptability and preliminary effectiveness of a theory-driven, group-based dance intervention for BCS delivered in Bogotá, Colombia. METHODS: We conducted a quasi-experimental study employing a mixed-methods approach to assess the 8-week, 3 times/week group dance intervention. The effect of the intervention on participants' physical activity levels (measured by accelerometry), motivation to engage in physical activity, and quality of life were evaluated using generalized estimating equation analysis. The qualitative method included semi-structured interviews thematically analyzed to evaluate program acceptability. RESULTS: Sixty-four BCS were allocated to the intervention (n = 31) or the control groups (n = 33). In the intervention arm, 84% attended ≥ 60% of sessions. We found increases on average minutes of moderate-to-vigorous physical activity per day (intervention: +8.99 vs control: -3.7 min), and in ratings of motivation (intervention change score = 0.45, vs. control change score= -0.05). BCS reported improvements in perceived behavioral capabilities to be active, captured through the interviews. CONCLUSIONS: The high attendance, behavioral changes, and successful delivery indicate the potential effectiveness, feasibility, and scalability of the intervention for BCS in Colombia. TRIAL REGISTRATION: ClinicalTrial.gov NCT05252780, registered on Dec 7th, 2021-retrospectively registered unique protocol ID: P20CA217199-9492018.

Innovative participatory evaluation methodologies to assess and sustain multilevel impacts of two community-based physical activity programs for women in Colombia.

BACKGROUND: Community-based physical activity (PA) programs are appealing to women in Latin America and show potential for improving women's health. This study aimed to engage healthy middle-aged women, breast cancer survivors and local stakeholders participating in two publicly funded community-based PA programs in Bogotá, Colombia (Recreovía and My Body) to assess and visually map the perceived barriers, facilitators, and outcomes to promote programs' improvement, scaling and sustainability. METHODS: We used two participatory action research methods, the 1) Our Voice citizen science method to capture data and drive local change in built and social environmental facilitators and barriers that influence women's engagement in community-based PA; and 2) Ripple Effects Mapping to visually map the intended and unintended outcomes of PA programs. We used thematic analysis to classify the results at the individual, social, and community levels. RESULTS: The stakeholders engaged in the participatory evaluation included cross-sector actors from the programs (N = 6) and program users (total N = 34) from the two programs (Recreovía N = 16; My Body N = 18). Program users were women with a mean age of 55.7 years (SD = 8.03), 65% lived in low-income neighborhoods. They identified infrastructure as the main feature affecting PA, having both positive (e.g., appropriate facilities) and negative (e.g., poorly built areas for PA) effects. Regarding program improvements, stakeholders advocated for parks' cleaning, safety, and appropriate use. The most highlighted outcomes were the expansion and strengthening of social bonds and the engagement in collective wellbeing, which leveraged some participants' leadership skills for PA promotion strategies in their community. The facilitated dialogue among program users and stakeholders fostered the sustainability and expansion of the community-based PA programs, even during the COVID-19 pandemic. CONCLUSIONS: The implementation of both participatory methodologies provided a multidimensional understanding of the programs' impacts and multisectoral dialogues that fostered efforts to sustain the community-based PA programs.

Application of physical exercise therapies in breast cancer survivors and their effects on the inflammatory profile: A narrative review.

BACKGROUND: One of the adverse effects of cancer treatments is the exacerbation of inflammation, which generates numerous limitations and contributes to the development of several comorbidities and the recurrence of cancer itself. Physical exercise (PE) has been proposed as an efficient complementary strategy to combat the inflammatory effects of oncological treatments and to prevent the development of comorbidities, but its adequate application in breast cancer survivors (BCS) requires the establishment of consensuses and practical recommendations. OBJECTIVE: This study aimed to review the randomized controlled trials that evaluated the influence of PE in the inflammatory profile of BCS. METHODS: The search for articles published between 1999 and 2020 was done in PsycINFO, PubMed, Cochrane, Science Direct, and Scopus databases. RESULTS: Current knowledge reveals the effectiveness of PE in the functional independence and health of BCS. Evidence of the capacity of PE to improve the inflammatory profile and the immune response in BCS has also been described. However, the heterogeneity of the studies regarding structural training variables, types of exercise, stages of intervention, and severity of the disease, still do not allow the establishment of precise guidelines for the prescription and progression of exercise to improve the inflammatory process in BCS. DISCUSSION: . This review suggests a possible strategy to be used in the assessment, training prescription, and rehabilitation of BCS, to support the development of new studies and the work of exercise professionals in the prescription and application of physical training to improve health and inflammatory status in BCS.

Improvements in muscle strength, power, and size and self-reported fatigue as mediators of the effect of resistance exercise on physical performance breast cancer survivor women: a randomized controlled trial.

PURPOSE: To gain more knowledge about the mechanism (i.e., mediators) of resistance exercise (RE)-induced improvements in physical performance (PP), we seek to investigate whether improvements in muscle strength (MS), muscle power (MP), and lean body mass (LBM) and (or) self-reported fatigue (SRF) are mediators of the effect of RE on PP in breast cancer survivor women (BCSW). METHODS: The volunteers were randomly divided into two groups: control group (CT; n = 9) and resistance exercise (RE; n = 11). The RE protocol consisted of three sets in each exercise (leg extension, leg curl, 45° leg press, and calf raise), between 8 and 12 repetitions per set, with an estimated load of 80% of one-repetition maximum (1RM), and three times a week on non-consecutive days for 12 weeks. The CT group performed only stretching exercises twice a week. SRF, maximal muscle power (Pmax), MP, LBM, and PP were assessed using the Brief Fatigue Inventory Questionnaire; 1RM test; isoinertial dynamometer; DXA; and walking speed, sit-to-stand (STS), and timed up and go (TUG) test, respectively. RESULTS: Following 12 weeks, the RE group reduced SRF and increased MP, Pmax, LBM, and performance in all tests (walking speed, STS, and TUG) when compared with the CT group. There were significant associations of the changes in LBM, MS, Pmax, and SRF with changes in physical performance tests only in the RE group. CONCLUSION: Our findings suggest that improvements in LBM, MS, MP, and self-reported fatigue mediate the effect of resistance exercise on physical performance in BCSW.

Predictive factors for persistent and late radiation complications in breast cancer survivors.

PURPOSE: With improved diagnostic techniques and treatments of breast cancer, overall survival times are longer, giving more opportunity for normal tissue complications of treatment to manifest. Radiation late effects (RLEs) could have profound long-term impacts on the quality of life of the survivors. The aim of this study was to identify predictive factors influencing timing and types of complications in patients referred to the Adult Radiation Late Effects Clinic (ARLEC). METHODS: In a period of 16 years, 296 breast cancer patients were referred to the ARLEC. The clinical records were retrospectively studied to collect epidemiologic, medical and treatment data. Associations were sought between candidate predictive factors and time to the first complication after radiation treatment (RT) completion (primary outcome), and pain or swelling (secondary outcomes) using univariable and multivariable linear and logistic regression analyses. All analyses were performed in SAS, version 9.4. RESULTS: All patients were female with a mean age of 56.3 years. The first treatment-related complication occurred after a median of 3 months. Patients were followed at ARLEC for a median of 18 months. Older age and delay from surgery to RT (S-RT delay) were associated with earlier onset of complications (both p < 0.001). The most common complications were breast pain (62.1%) and swelling (45.9%). Histology and RT boost were associated with pain (p = 0.035 and 0.013). RT boost and S-RT delay on the other hand were associated with swelling (p = 0.013 and 0.005). CONCLUSIONS: Clinical factors identified could help recognize the patients at high risk for developing RLEs and alert physicians to initiate earlier diagnostic and therapeutic measures.

Relationship between physical activity, disability, and physical fitness profile in sedentary Latina breast cancer survivors.

OBJECTIVE: To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. METHODS: Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m2; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. RESULTS: Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). CONCLUSION: Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.

Dietary Patterns in Puerto Rican and Mexican-American Breast Cancer Survivors: A Pilot Study.

Breast cancer is the leading cause of cancer death among Hispanic women. Certain dietary factors have been associated with the risk of breast cancer recurrence, but data in Hispanic survivors is scarce. OBJECTIVE: to examine dietary patterns and diet quality in two groups of Hispanic breast cancer survivors. METHODS: 23 Mexican-American (MA) and 22 Puerto Rican (PR) female breast cancer survivors completed a culturally adapted validated food frequency questionnaire. Intake was standardized per 1000 kcal and compared to US Dietary Guidelines and the DASH-style diet adherence score was calculated. RESULTS: Overweight/obese was 70 % in MA and 91 % in PR. PR consumed diets rich in fruit/100 % fruit juices and beans, while MA diets were high in vegetables, beans, and total grains. Both groups consumed high amounts of starchy vegetables, refined grains, animal protein and calories from solid fats and added sugars but low intakes of whole grains, dairy products and nuts and seeds. DASH scores were relatively low. CONCLUSION: MA and PR female breast cancer survivors have different dietary patterns but both groups had relatively low diet quality. These groups could benefit from culturally tailored interventions to improve diet quality, which could potentially reduce cancer recurrence. ClinicalTrials.gov Identifier NCT01504789.

Exercise training improves mean arterial pressure in breast cancer survivors / O exercício físico melhora a pressão arterial média em sobreviventes de câncer de mama / El ejercicio físico mejora la presión arterial media en los sobrevivientes de cáncer de mama

Currently, many breast cancer survivors worldwide live with treatment-related side effects, including cardiovascular health problems. This study examined effects of a 5-month exercise intervention on non-invasive markers of cardiovascular health in breast cancer survivors. Relationships between these markers and commonly used markers of overall health were also explored. Fifty-two survivors completed the exercise training at a rehabilitation center at the University of North Carolina at Chapel Hill between 2008-2011. A combined aerobic and resistance exercise intervention (3 times/week for 1h) at intensities progressing from low (40%) to moderate (65-70% of VO2max) for aerobic and 8-12 repetitions max for the resistance exercise were implemented. Significant reduction in mean arterial pressure (MAP) was observed from baseline to final assessment. A significant correlation was found between MAP and Body Mass Index (BMI). In conclusion, 5-months combined aerobic and resistance exercise intervention positively improved MAP which was, in part, attributed to changes in BMI...

"O exercício físico melhora a pressão arterial média em sobreviventes de câncer de mama."Atualmente, muitos sobreviventes de câncer de mama em todo o mundo vivem com os efeitos secundários relacionados com o tratamento, incluindo problemas de saúde cardiovascular. Este estudo examinou os efeitos de uma intervenção de exercício de 5 meses com marcadores não-invasivos de saúde cardiovascular em sobreviventes de câncer de mama. As relações entre esses marcadores e os marcadores mais utilizados de saúde em geral também foram exploradas. Cinquenta e duas sobreviventes completaram o treinamento em um centro de reabilitação da Universidade da Carolina do Norte em Chapel Hill entre 2008-2011. Foram implementadas intervenção combinando exercício aeróbio e resistido (3 vezes / semana durante 1h) em intensidades progredindo de baixo (40%) a moderada (65-70% do VO2max) para exercícios aeróbios, e 8-12 repetições máxima para o exercício de resistência. Redução significativa da pressão arterial média (PAM) foi observada a partir da linha de base para avaliação final. Foi encontrada uma correlação significativa entre o MAPA e Índice de Massa Corporal (IMC). Em conclusão, 5 meses de intervenção com exercícios combinados de resistência e aeróbio melhorou positivamente o MAP, que foi, em parte, atribuída a mudanças no IMC...

"El ejercicio físico mejora la presión arterial media en los sobrevivientes de cáncer de mama."Actualmente, muchos de los sobrevivientes de cáncer de mama en todo el mundo viven con los efectos secundarios relacionados con el tratamiento, incluyendo problemas de salud cardiovascular. Este estudio examinó los efectos de una intervención de ejercicio durante cinco meses con marcadores no invasivos de la salud cardiovascular en sobrevivientes de cáncer de seno. También se exploraron las relaciones entre estos marcadores y los marcadores más utilizados de la salud general. Cincuenta y dos sobrevivientes completaron la formación en un centro de rehabilitación en la Universidad de Carolina del Norte en Chapel Hill de 2008 a 2011. Intervención se implementara la combinación de ejercicio aeróbico y de resistencia (3 veces / semana durante 1 h) a intensidades que van de la baja (40%) o moderada (65-70% VO2max) para el ejercicio aeróbico, y 8-12 repeticiones máximas para el ejercicio de resistencia. Se observó una reducción significativa de la presión arterial media (MAP) desde el inicio hasta la evaluación final. Se encontró una correlación significativa entre el MAPA y el Índice de Masa Corporal (IMC). En conclusión, a cinco meses de intervención con ejercicio aeróbico y de resistencia combinado mejoraron positivamente el MAP, que se atribuye en parte a los cambios en el IMC...