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How REACH Got Started

 

REACH stands for Research in Exercise And Cancer Health. After years of conducting research in exercise oncology and working with cancer survivors, I (Ciaran Fairman) realized there was a huge disconnect between how far the research has progressed in what we know is safe and effective, and what survivors are aware of. REACH exists to serve as a resource to patients, survivors and health professionals on how exercise can reduce cancer risk, complement traditional treatment, and improve survivorship.

Feel free to check out our podcast on ITunes, where you’ll hear from experts on nutrition, exercise and lifestyle behaviors, along with patients and survivors themselves, and what they go through.

Meet Ciaran

 
  Ciaran Fairman, PhD   CSCS, EP-C, CET, CISSN  Founder, Exercise Physiologist

Ciaran Fairman, PhD
CSCS, EP-C, CET, CISSN
Founder, Exercise Physiologist

Originally from Dublin Ireland, I came to the United States in 2008 to pursue my dream of becoming a professional soccer player. Seeing that you’re reading this and not seeing my name in lights with millions in my bank account, you may have realized (along with my coaches and teammates) that I wasn’t as good as I thought.

My mother got breast cancer during my sophomore year. Listening over the phone to her go through treatments and the struggles she faced, a switch flipped in me. I knew I wanted to find a way to combat this disease and all the side effects of its treatment. I went to a national conference that summer (2011), heard some folks at The University of Northern Colorado speak about their cancer rehabilitation center. I came away from that talk knowing what I wanted to do with my life and have been researching how exercise can help cancer patients and survivors ever since.

I am currently a Postdoctoral Research Fellow Exercise Medicine Research Institute (EMRI) situated within the School of Medical and Health Science (SMHS) at Edith Cowan University. Here, my research is focused on the physiological and psychosocial responses to physical activity lifestyle interventions in a variety of cancer populations.

Professional Qualifications

Degrees

Doctor of Philosophy (Ph.D.): Health and Exercise Science, Ohio State University, 2018

Master of Science (M.S.): Kinesiology, Georgia Southern University,  2014

Bachelor of Science (B.S.): Health Science, Kentucky Wesleyan College,  2012

 

Certifications

Certified Strength and Conditioning Specialist (CSCS) - National Strength and Conditioning Association

Certified Exercise Physiologist (EP-C) - American College of Sports Medicine

Certified Cancer Exercise Trainer (CET) - American College of Sports Medicine

Certified Sports Nutritionist (CISSN) - International Society of Sports Medicine

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Services

+ Speaking Engagements

From support groups to corporate events, or even private seminars, I love to talk about how exercise can reduce cancer risk, improve the response to treatment and restore fitness during recovery and beyond.

+ Seminars & Workshops

Tailored to gyms or small groups of trainers and fitness professionals, these seminars are focused on the intricacies of training the cancer population. These can be half-day, full-day, or weekend long events. Contact us for pricing.

Topics covered include:

  • Pathophysiology of the disease
  • Treatment related side effects
  • Evidence based information on exercise during and after treatment
  • Site specific training considerations
  • Developing relationships/referrals with local health providers

+ Private Consultations (in person/online)

Whether you’re in active treatment or a five year survivor, exercise is one of the most powerful tools to improve your health, physical function and quality of life. Contact us for options and pricing.

 

Upcoming Events

 
 

Dublin, Ireland - Dec 15th 2018

Exercise can be an extremely valuable tool to combat the side effects of treatment, improve survivorship, and reduce the risk of cancer recurrence. Ciaran will bring a wealth of clinical and research experience to deliver this workshop for personal trainers and health professionals interested in working with cancer patients and survivors.

You will learn:

- Common cancer treatments and their side effects.

- Exercise prescription for individuals with cancer before, during and after treatment.

- Site specific considerations and exercise modifications.

 

Register here: https://www.eventbrite.com/e/exercise-oncology-workshop-training-cancer-patients-and-survivors-tickets-42093539911?aff=es2

 

Antrim, Northern Ireland - Dec 19th 2018

Antrim Civic Centre, Antrim, Northern Ireland

9.00 am - 4.30 pm

Exercise Oncology Workshop

Module 1 - Overview of exercise oncology

Module 2 - Impact of cancer treatments on physical and mental Health

Module 3 - Patient/survivor Assessments

Module 4 - Exercise Prescription for individuals with cancer

Module 5 - Site-specific modifications of exercise

Module 6 - Cancer-Specific barriers to exercise and fostering behaviour change. 

 

Registration: Email kevin.campbell@northerntrust.hscni.net or ciaranfairman@gmail.com for registration form. 

 
 

Information by Cancer Type

The information and research differs slightly by cancer type. Click on the + signs for more information.

 

Breast Cancer

Breast cancer is the most common form of cancer among females. Fortunately, due to advancements in medical technology, earlier screening and detection, the survival rates are high and on the rise. Treatment typically involves surgery, radiation, chemotherapy, hormonal therapy or a combination of the above. While these techniques can be successful at removing cancerous cells and tumors, often times they lead to physical side effects that may affect your function and require some modifications to exercise.

+ Range of Motion

Pushing motions may be difficult, along with reaching with arms over the head. It's recommended that increasing flexibility and range of motion of the affected area be emphasized prior to performing upper body exercises. This gradual approach will serve to reduce the risk of injury, improve upper body functioning, and have greater long-term benefits.

+ Lymphedema

Lymphedema is most common among breast cancer survivors. Radiation and surgery can cause severe damage to lymph nodes, which results in a blockage of the vessels and subsequent build-up of fluid and swelling of the affected area.

While it was previously thought that exercise would exacerbate the symptoms of lymphedema, there has been a tremendous amount of research done in the last 10 years ago that suggest that not only is exercise safe for those with lymphedema, but it may even serve to improve symptoms. The process of muscle contraction can actually facilitate fluid flow back through the nodes and reduce swelling. Additionally, an increase in physicaly activity may reduce weight gain, which is a risk factor for developing lymphedema after breast cancer.

Survivors may consider wearing a compression sleeve, which may also help symptoms of lymphedema. It is recommended beginning with a gradual dose of exercise and progress according to symptom response. We strongly encourage resistance training, however it may be beneficial to begin under the supervision of a trained professional who can help to monitor lymphedema symptoms.

+ Low Bone Mineral Density

Another common side effect of treatment, survivors can experience a reduced bone mineral density, leading an increase risk of falls and fractures. Bone Mineral Density is usually evaluated by dual-energy x-ray absorptiometry or iDXA as it's often referred as. A lot of universities have an iDXA either in their medical center or kinesiology department. If you are interested in finding out your bone mineral density, these facilities offer testing to public at a relatively low cost. Having this information help with your exercise prescription.

Survivors with low bone mineral density may want to initially avoid high-impact, bounding exercises (jumping, bounding etc.). Fortunately, resistance training has been shown to be tremendously effective at improving bone mineral density, balance and overall physical functioning in breast cancer survivors.

+ Muscle Atrophy

Muscle atrophy is simply defined as the loss of muscle mass. We posit that muscle atrophy is more associated with a lack of physical activity as opposed to the treatment or cancer itself. Muscle atrophy, coupled with a low bone mineral density, can significantly increase risk of falls and fractures, and prevent you from performing your day to day tasks. Similarly, resistance training offers the most "bang for your buck" as not only can it increase bone mineral density, but it can increase muscle mass and overall strength, all of which will translate to a better functional ability and quality of life!


Prostate Cancer

Prostate cancer is one of the most common cancers among males. The survival rate has increased dramatically in recent years. Unfortunately, some of the treatments can leave survivors with decrements in physical and mental capability. There has been a wealth of research supporting the safety and efficacy of exercise, particularly resistance exercise in prostate survivors. More importantly, the physiological adaptations to a combination of resistance training and aerobic training can attenuate and almost reverse the decrements associated with treatment. Therefore it’s highly recommended for prostate survivors to emphasize a progressive resistance-training program. The addition of cardiovascular training will complement this with some aerobic adaptations and may aid in reducing blood pressure and improving body composition.

+ Androgen Deprivation Therapy (ADT)

One of the most common treatments for prostate survivors is androgen deprivation therapy (ADT) to reduce levels of male hormones, or androgens, which can often lead to cancer cell growth. Unfortunately, the side effects of this can be a reduction in testosterone levels, decreased bone mineral density, muscle atrophy, fatigue and insulin resistance. Recent literature has consistently shown the safety of resistance exercise in Prostate survivors undergoing ADT and that they can expect to see improvements in muscular strength, physical function, and quality of life. Progressive resistance exercise should be performed 2-3 days per week, focusing on larger, compound movements (squat, bench press, deadlift etc.)

+ Bone mineral Density

Prostate survivors can also experience decrements in bone mineral density, usually as a result of ADT coupled with physical inactivity. Low bone mineral density can dramatically increase one's risk of falls and fractures. Fortunately, progressive resistance training can serve to restore bone mineral density and reduce the aforementioned risks.

+ Atrophy

Muscle atrophy or loss of muscle mass, is extremely common among prostate survivors. Usually as a result of the coupling of ADT and physical inactivity. Survivors looking to improve their overall physical function should emphasize strength training to improve muscle mass, bone mineral density, strength, and overall functioning.


Colon Cancer

Screening for colon cancer, especially for those over the age of 50, is highly recommended. This can increase the treatability and curability of the disease when caught early enough. Primary treatment for colon cancer is surgery to remove the tumor and to evaluate the surrounding lymph nodes and connective tissue. Chemotherapy and/or radiation may also be considered depending on the severity of the tumor.

+ Body composition

When comparing those with the highest body mass index (BMI, a measure of fat based on height and weight) to those with the lowest BMI, the risk for developing colon cancer is almost doubled. A BMI greater than 35 has been shown to be associated wit more colon cancer deaths and recurrences. The importance for striving for a healthy body composition is paramount. More importantly, an emphasis should be put on making slow, gradual lifestyle changes that can translate to longer term, sustainable improvements.

+ Ostomy

At times when the disease has progressed far enough, removal of rectal and anal tissue may be required. If the remaining tissue can't be reconnected, then an ostomy is created in abdominal wall for waste to exit. A physician's clearance is recommended for those with ostomies prior to participation in certain types of exercise. Contact sports may increase the risk of injury (from a hit to the body), while resistance training may increase the risk of a hernia.

It may be advisable for those participating in resistance training to avoid intra-adominal pressures. Thus, the valsalva maneuver (exhaling against a closed glotits, should be avoided).

Resistance exercise should be started at a low resistance and gradually built up over time to reduce the risk of a hernia.


Lung Cancer

Lung Cancer is the leading cause of cancer related death among men and women in the United States. Recent statistics suggest that almost 30% of cancer mortality is related to lung and bronchus cancer.

Unsurprisingly, there is a strong dose-response relationship between smoking and lung cancer, with smoking accounting for almost 90% of cases.

Lung cancer is divided into two categories for diagnostic and prognostic purposes: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Those with SCLC often exhibit a more advanced stage of the disease. NSCLC accounts for approximately 80% of lung cancers and includes certain cell carcinomas and adenocarcinoma.

Treatment of the disease is dependent on the severity and progression of the disease. Treatment can include surgery, chemotherapy, radiation, or a combination of treatment.

+ Range of Motion

Breast Cancer will often involve surgery to the breast tissue or surrounding muscle to remove cancerous cells. Additionally, survivors may have a port-a-cath inserted into the chest for the admisitration of chemotherapy. These methods can leave a feeling of tightness around the chest and upper extremities, and may limit range of motion of the arms and chest.

Pushing motions may be difficult, along with reaching with arms over the head. It's recommended that increasing flexibilty and range of motion of the affected area should be emphasized prior to performing upper body exercises. This gradual approach will serve to reduce the risk of injury, improve upper body functioning, and have greater long term benefits.

+ Cardiovascular and pulmonary changes

Radiation to the chest wall may cause some cardiotoxicity, including damage to the heart and surrounding muscles. The hearts ability to expand can subsequently be damaged, along with an increased risk of cardiac ischemia or heart attacks.

Similarly, lung survivors, particularly those who have had surgery to remove parts of the lung, will experience difficulty breathing, along with a reduced aerobic capacity. In this case, long durations of aerobic exercise may not be appropriate. Smaller bursts of activity and lower exercise intensities may serve to attenuate symptoms while concurrently improving lung function. It's likely that those with a surgery or damage to the lung may never reach full lung capacity. Nevertheless, aerobic exercise can serve to drastically improve lung function, aerobic capacity, and overall health.

+ Range of Motion

Any surgery or radiation to the chest wall may cause tightness and restricted range of motion of the upper body. In this case, flexibility should be emphasized before entering a progressive resistance training program. Pressing exercises should as bench press or military press may cause pain and discomfort until a greater range of motion has been established.

Nevertheless, it remains that resistance training should be performed as soon as possible to improve upper body strength and physical function.

+ Muscle Atrophy

Muscle atrophy is simply defined as the loss of muscle mass. We posit that muscle atrophy is more associated with a lack of physical activity as opposed to the treatment or cancer itself. Muscle atrophy, coupled with a low bone mineral density, can significantly increase risk of falls and fractures, and prevent you from performing activities of daily living. Similarly, resistance training offers the most "bang for your buck" as not only can it increase bone mineral density, but it can increase muscle mass and overall strength, all of which will translate to a better functional ability and quality of life!


Other Cancers

The field of exercise oncology is in its infancy, and ever evolving. Researchers are constantly investigating different exercise modes on different cancer types, and those undergoing different treatments. Unfortunately, the most researched cancers are often those that are most common. For researchers to investigate a certain type of cancer, we must find a large enough number of survivors to participate to be able to provide us with sufficient evidence to draw conclusions about the effect. This means that we have a much clearer picture of the safety and efficacy of breast, prostate and colon cancer than other, less common.

Nevertheless, the success of research in other cancer types gives us confidence to suggest that exercise may be well tolerated in other types. In any case, survivors should consult a trained health professional before starting an exercise program. The survivor should perform exercises while monitoring symptom response and aim for most amount of physical activity possible.

+ Side effects

With localized cancer, the majority of side effects are going to be specific to that region (e.g. poor upper body range of motion for breast cancer survivors). There are some common side effects that can be acute, lasting days, or chronic, lasting weeks, months and even years post treatment. A survivor can experience pain, fatigue, neuropathy and impaired immune function. Ultimately, all survivors will respond differently to a diagnosis, the cancer itself and its treatment and knowledge of this can help individualize an exercise program to suit a survivors needs.

+ Physical Activity

Physical activity has been shown time and time again to be safe and effective in a broad range of cancers. Indeed, there is a great deal of research still to be conducted on more rare forms of cancer and investigating different modes of exercise, optimal dose-response etc. In the mean time, the general consensus from every governing body of cancer care is to avoid inactivity. Most likely, a survivor still receiving or recently completed treatment is not going to be able to hit the recommended levels of physical activity immediately. The key is so start with as much as you can handle and gradually build up. Ultimately this will serve to get your body accustomed to a new stimulus, and hopefully bring with it some lifestyle changes that will be long-term and help reduce the risk of recurrence and cancer-related mortality.

 

Research

There are so many brilliant researchers out there, doing incredible things now and in the future that will push this field forward towards establishing physical activity as a standard of care in cancer. I do my best to keep up with these people by producing some of my own research to help us along the way. Below are a select few of the projects I’ve worked on (I say select few, because I have many, many more. In fact, I have many leather-bound books and my apartment smells of rich mahogany).

 

Effects of a Group-Mediated Exercise and Dietary Intervention in the Treatment of Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: Results From the IDEA-P Trial.

Focht BC, Lucas AR, Grainger E, Simpson C, Fairman CM, Thomas-Ahner JM, Buell J, Monk JP, Mortazavi A, Clinton SK.

BACKGROUND:

Although androgen-deprivation therapy (ADT) is the foundation of treatment for prostate cancer, the physiological impacts of ADT result in functional decline and enhanced risk of chronic disease and metabolic syndrome.

PURPOSE:

The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is a single-blind, randomized, pilot trial comparing the effects of a group-mediated, cognitive-behavioral (GMCB) exercise and dietary intervention (EX+D) with those of a standard-of-care (SC) control during the treatment of prostate cancer patients undergoing ADT.

METHODS:

A total of 32 prostate cancer patients (M age = 66.28, SD = 7.79) undergoing ADT were randomly assigned to the 12-week EX+D intervention (n = 16) or control (n = 16). The primary outcome in IDEA-P was change in mobility performance with secondary outcomes including body composition and muscular strength. Blinded assessment of outcomes were obtained at baseline and at 2- and 3-month follow-ups.

RESULTS:

Favorable adherence and retention rates were observed, and no serious intervention-related adverse events were documented. Intent-to-treat ANCOVA controlling for baseline value and ADT duration demonstrated that EX+D resulted in significantly greater improvements in mobility performance (p < .02), muscular strength (p < .01), body fat percentage (p < .05), and fat mass (p < .03) at 3-month follow-up, relative to control.

CONCLUSION:

Findings from the IDEA-P trial suggest that a GMCB-based EX+D intervention resulted in significant, clinically meaningful improvements in mobility performance, muscular strength, and body composition, relative to controls. Collectively, these results suggest that the EX+D was a safe and well-tolerated intervention for prostate cancer patients on ADT. The utility of implementing this approach in the treatment of prostate cancer patients on ADT should be evaluated in future large-scale efficacy trials.

 

+ Abstract

BACKGROUND: Although androgen-deprivation therapy (ADT) is the foundation of treatment for prostate cancer, the physiological impacts of ADT result in functional decline and enhanced risk of chronic disease and metabolic syndrome.

PURPOSE:The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is a single-blind, randomized, pilot trial comparing the effects of a group-mediated, cognitive-behavioral (GMCB) exercise and dietary intervention (EX+D) with those of a standard-of-care (SC) control during the treatment of prostate cancer patients undergoing ADT.

METHODS:A total of 32 prostate cancer patients (M age = 66.28, SD = 7.79) undergoing ADT were randomly assigned to the 12-week EX+D intervention (n = 16) or control (n = 16). The primary outcome in IDEA-P was change in mobility performance with secondary outcomes including body composition and muscular strength. Blinded assessment of outcomes were obtained at baseline and at 2- and 3-month follow-ups.

RESULTS: Favorable adherence and retention rates were observed, and no serious intervention-related adverse events were documented. Intent-to-treat ANCOVA controlling for baseline value and ADT duration demonstrated that EX+D resulted in significantly greater improvements in mobility performance (p < .02), muscular strength (p < .01), body fat percentage (p < .05), and fat mass (p < .03) at 3-month follow-up, relative to control.

CONCLUSION: Findings from the IDEA-P trial suggest that a GMCB-based EX+D intervention resulted in significant, clinically meaningful improvements in mobility performance, muscular strength, and body composition, relative to controls. Collectively, these results suggest that the EX+D was a safe and well-tolerated intervention for prostate cancer patients on ADT. The utility of implementing this approach in the treatment of prostate cancer patients on ADT should be evaluated in future large-scale efficacy trials.

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A Scientific Rationale to Improve Resistance Training Prescription in Exercise Oncology

Ciaran M. Fairman, Michael C. Zourdos, Eric R. Helms, Brian C. Focht

+ Abstract

To date, the prevailing evidence in the field of exercise oncology supports the safety and efficacy of resistance training to attenuate many oncology treatment-related adverse effects, such as risk for cardiovascular disease, increased fatigue, and diminished physical functioning and quality of life. Moreover, findings in the extant literature supporting the benefits of exercise for survivors of and patients with cancer have resulted in the release of exercise guidelines from several international agencies. However, despite research progression and international recognition, current exercise oncology-based exercise prescriptions remain relatively basic and underdeveloped, particularly in regards to resistance training. Recent publications have called for a more precise manipulation of training variables such as volume, intensity, and frequency (i.e., periodization), given the large heterogeneity of a cancer population, to truly optimize clinically relevant patient-reported outcomes. Indeed, increased attention to integrating fundamental principles of exercise physiology into the exercise prescription process could optimize the safety and efficacy of resistance training during cancer care. The purpose of this article is to give an overview of the current state of resistance training prescription and discuss novel methods that can contribute to improving approaches to exercise prescription. We hope this article may facilitate further evaluation of best practice regarding resistance training prescription, monitoring, and modification to ultimately optimize the efficacy of integrating resistance training as a supportive care intervention for survivors or and patients with cancer.

Link to paper: https://link.springer.com/article/10.1007/s40279-017-0673-7


Resistance training interventions across the cancer control continuum: a systematic review of the implementation of resistance training principles

C M Fairman, P N Hyde, B C Focht

+ Abstract

Objectives: The primary purpose of this systematic review is to examine the extant resistance training (RT) cancer research to evaluate the proportion of RT interventions that: (1) implemented key RT training principles (specificity, progression, overload) and (2) explicitly reported relevant RT prescription components (frequency, intensity, sets, reps).

Design: A qualitative systematic review was performed by two reviewers (CMF and PNH) who inspected the titles and abstracts to determine eligibility for this systematic review. Identified papers were obtained in full and further reviewed. Data were extracted to evaluate the application of principles of training, along with specific RT components.

Data sources: Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, PEDro, PsychInfo, Cancer Lit, Sport Discus, AMED, Cochrane Central Register of Controlled Trials) and reference lists of included articles from inception to May 2016.

Results: 37 studies were included. The principle of specificity was used appropriately in all of the studies, progression in 65% and overload in 76% of the studies. The most common exercise prescription (∼50%) implemented in the studies included in this review were 2–3 days/week, focusing on large muscle groups, 60–70% 1 repetition maximum (RM), 1–3 sets of 8–12 repetitions.

Conclusions: Reporting of RT principles in an oncology setting varies greatly, with often vague or non-existent references to the principles of training and how the RT prescription was designed.

Link to paper: http://bjsm.bmj.com/content/51/8/677


 Photo Credit:&nbsp; jrmcnd.wordpress.com

Photo Credit: jrmcnd.wordpress.com

Utilization of an Anti-Gravity Treadmill in a Physical Activity Program with Female Breast Cancer Survivors: A Pilot Study

CM Fairman, KL Kendall, BS Harris, KJ Crandall J McMillan.

+ Abstract

Breast Cancer survivors can experience a myriad of physical and psychological benefits as a result of regular exercise. This study aimed to build on previous research using lower impact exercise programs by using an antigravity (Alter-G®) treadmill to administer cardiovascular training. The purpose of this study was to determine the effectiveness a physical activity program, including an Alter-G® treadmill, for improving physiological and psychosocial measures in female breast cancer survivors. A 14-week intervention using an AB-AB study design was employed. Six female breast cancer survivors were recruited to participate in the study. Participants attended three 60-minute sessions per week, consisting of a combination of muscular strength/endurance, and cardiovascular endurance exercises. Consistent with current literature and guidelines, exercise interventions were individualized and tailored to suit individuals. Data was collected and analyzed in 2013. Visual inspection of results found improvements in cardiovascular endurance and measures of body composition. Quality of life was maintained and in some cases, improved. Finally, no adverse effects were reported from the participants, and adherence to the program for those who completed the study was 97%. The results of this study suggest that the use of a physical activity program in combination with an Alter-G® treadmill may provide practical and meaningful improvements in measures of cardiovascular endurance and body composition.

Link to paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882471/


Effects of exercise interventions during different treatments in breast cancer.

Fairman CM, Focht BC, Lucas AR, Lustberg MB.

+ Abstract

Previous findings suggest that exercise is a safe and efficacious means of improving physiological and psychosocial outcomes in female breast cancer survivors. To date, most research has focused on post-treatment interventions. However, given that the type and severity of treatment-related adverse effects may be dependent on the type of treatment, and that the effects are substantially more pronounced during treatment, an assessment of the safety and efficacy of exercise during treatment is warranted. In this review, we present and evaluate the results of randomized controlled trials (RCTs) conducted during breast cancer treatment. We conducted literature searches to identify studies examining exercise interventions in breast cancer patients who were undergoing chemotherapy or radiation. Data were extracted on physiological and psychosocial outcomes. Cohen's d effect sizes were calculated for each outcome. A total of 17 studies involving 1,175 participants undergoing active cancer therapy met the inclusion criteria. Findings revealed that, on average, exercise interventions resulted in moderate to large improvements in muscular strength: resistance exercise (RE, 𝑑 = 0.86), aerobic exercise (AE, 𝑑 = 0.55), small to moderate improvements in cardiovascular functioning (RE, 𝑑 = 0.45; AE, 𝑑 = 0.17, combination exercise (COMB, 𝑑 = 0.31) and quality of life (QoL; RE, 𝑑 = 0.30; AE, 𝑑 = 0.50; COMB, 𝑑 = 0.63). The results of this review suggest that exercise is a safe, feasible, and efficacious intervention in breast cancer patients who are undergoing different types of treatment. Additional research addressing the different modes of exercise during each type of treatment is warranted to assess the comparable efficacy of the various exercise modes during established breast cancer treatments.

Link to Paper: https://www.ncbi.nlm.nih.gov/pubmed/27258052

 

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If you're looking for information on private consults, seminars or workshops, please fill out the information below or contact me at ciaranfairman@gmail.com

 

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