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      Effects of a Multicomponent Exercise Program in Older Adults with Non-Small-Cell Lung Cancer during Adjuvant/Palliative Treatment: An Intervention Study

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          Abstract

          Clinical intervention studies support the efficacy and safety of exercise programs as a treatment modality for non-small-cell lung cancer (NSCLC) during adjuvant/palliative treatment, but the effectiveness of real-world oncogeriatric services is yet to be established. We aimed to examine the effects of a 10-week structured and individualized multicomponent exercise program on physical/cognitive functioning and mental wellness in elderly patients with NSCLC under adjuvant therapy or palliative treatment. A non-randomized, opportunistic control, longitudinal-design trial was conducted on 26 patients with NSCLC stage I–IV. Of 34 eligible participants, 21 were allocated into two groups: (i) control group ( n = 7) received usual medical care; and (ii) intervention group ( n =19) received multicomponent program sessions, including endurance, strength, balance, coordination and stretching exercises. Tests included the Short Physical Performance Battery (SPPB), 5-m habitual Gait Velocity Test (GVT), Timed Up & Go Test (TUG), 6-Min Walk Test (6MWT), independence of activities in daily living (IADL), muscular performance, cognitive function, and quality of life, which were measured at baseline and after 10 weeks of the program. Results revealed a significant group×time interaction for SPPB ( p = 0.004), 5-m GVT ( p = 0.036), TUG ( p = 0.007), and muscular performance (chest and leg power; p < 0.001). Similarly, significant changes were observed between groups for cognitive functioning ( p = 0.021) and quality of life for EUROQoL 5D ( p = 0.006). Our findings confirm that a multicomponent exercise program improves measures of physical/cognitive functioning and quality of life in the elderly with NSCLC under adjuvant therapy or palliative treatment. This is an interesting and important study that adds to our current body of knowledge on the safety of exercise interventions, especially in the elderly with solid tumors.

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          Most cited references38

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          Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.

          Functional assessment is an important part of the evaluation of elderly persons. We conducted this study to determine whether objective measures of physical function can predict subsequent disability in older persons. This prospective cohort study included men and women 71 years of age or older who were living in the community, who reported no disability in the activities of daily living, and who reported that they were able to walk one-half mile (0.8 km) and climb stairs without assistance. The subjects completed a short battery of physical-performance tests and participated in a follow-up interview four years later. The tests included an assessment of standing balance, a timed 8-ft (2.4-m) walk at a normal pace, and a timed test of five repetitions of rising from a chair and sitting down. Among the 1122 subjects who were not disabled at base line and who participated in the four-year follow-up, lower scores on the base-line performance tests were associated with a statistically significant, graduated increase in the frequency of disability in the activities of daily living and mobility-related disability at follow-up. After adjustment for age, sex, and the presence of chronic disease, those with the lowest scores on the performance tests were 4.2 to 4.9 times as likely to have disability at four years as those with the highest performance scores, and those with intermediate performance scores were 1.6 to 1.8 times as likely to have disability. Among nondisabled older persons living in the community, objective measures of lower-extremity function were highly predictive of subsequent disability. Measures of physical performance may identify older persons with a preclinical stage of disability who may benefit from interventions to prevent the development of frank disability.
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            Exercise Guidelines for Cancer Survivors

            The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue.
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              Assessment of Activities of Daily Living, Self-Care, and Independence.

              Activities of daily living (ADL) comprise the basic actions that involve caring for one's self and body, including personal care, mobility, and eating. In this review article, we (1) review useful clinical tools including a discussion on ways to approach ADL assessment across settings, (2) highlight relevant literature evaluating the relationship between cognitive functioning and ADLs, (3) discuss other biopsychosocial factors affecting ADL performance, (4) provide clinical recommendations for enhancing ADL capacity with an emphasis on self-care tasks (eating, grooming, dressing, bathing and toileting), and (5) identify interventions that treatment providers can implement to reduce the burden of ADL care.
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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                21 March 2020
                March 2020
                : 9
                : 3
                : 862
                Affiliations
                [1 ]Department of Health Sciences, Public University of Navarra, Navarrabiomed-Biomedical Research Centre, IDISNA-Navarra’s Health Research Institute. C/irunlarrea 3, Complejo Hospitalario de Navarra, 31008 Pamplona, Navarra 31008, Spain; ilemdayana@ 123456gmail.com (I.D.R.); robin640@ 123456hotmail.com (R.R.-V.); nicolas.martinez.velilla@ 123456navarra.es (N.M.-V.); ba.cedeno.veloz@ 123456navarra.es (B.A.C.-V.); idoiamorilla@ 123456gmail.com (I.M.)
                [2 ]Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, 28029 Madrid, Spain
                Author notes
                [* ]Correspondence: mikel.izquierdo@ 123456gmail.com or mikel.izquierdo@ 123456unavarra.es ; Tel.: +34-948-417876
                Author information
                https://orcid.org/0000-0003-3075-6960
                https://orcid.org/0000-0001-9576-9960
                https://orcid.org/0000-0002-0190-4402
                https://orcid.org/0000-0002-1506-4272
                Article
                jcm-09-00862
                10.3390/jcm9030862
                7141539
                32245169
                0d4eb7ee-d3b7-451f-a7fc-9d42f5ef598f
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 10 February 2020
                : 20 March 2020
                Categories
                Article

                exercise therapy,physical function,strength,functional capacity,lung cancer,elderly

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