ECSS Paris 2023: OP-MH25
INTRODUCTION: Recreational football (RF) has demonstrated potential in improving health outcomes and attenuating treatment-related adverse effects among prostate cancer (PCa) patients. However, the physiological demands of RF can exceed the functional capacity or exercise tolerance of inactive PCa survivors. Therefore, walking football (WF) may serve as a lower-intensity precursor within an RF-based rehabilitation framework, by facilitating a safer transition to RF. METHODS: Twelve inactive male PCa patients (age=73±3 years; stature=165±6 cm; body mass=73.2±10.0 kg; fat mass=27.8±4.5%; SBP=137±18 mmHg, DBP=79±11 mmHg) participated in this intervention study consisting of a 3-month WF phase followed by a 4-month RF phase. Each phase consisted of three weekly 60-minute training sessions comprising a warm-up, strength and balance exercises, followed by small-sided games of either WF or RF. Heart rate (HR) was continuously monitored to determine mean and peak values, as well as time spent across six HR zones (<50%, 61-70%, 71-80%, >80%, 81-90%, and 91-100% HRmax). Training sessions’ rating of perceived exertion (RPE) was assessed for respiratory, muscular, and global domains, along with fun levels. Falls and injuries were recorded during all training sessions and expressed as number per 1000 training hours. RESULTS: RF elicited significantly higher mean HR (73±10%HRmax) and peak HR (82±10%HRmax) compared to WF (mean: 71±12%HRmax, p=0.024, d=0.98, 95%CI: 0.27-1.65; peak: 78±12% HRmax, p=0.006, d=0.75, 95%CI: 0.10-1.40). Time spent across all HR zones showed no significant differences (p>0.05). Global RPE was significantly higher during RF (5.0±1.7 AU) vs. WF (4.2±2.1 AU, p=0.046, d=0.65, 95%CI: 0.01-1.27), as well as muscular RPE (RF: 5.0±2.1 AU vs. WF: 4.0±1.9 AU, p=0.027, d=0.73, 95%CI: 0.08-1.36), whereas respiratory RPE was similar (p>0.05). Fun levels were consistently high and not significantly different between WF and RF (WF: 7.7±1.6 AU; RF: 8.1±1.3 AU, p=0.056, d=0.62, 95%CI: 0.02-1.23). However, RF showed a significantly higher fall incidence compared to WF (RF: 114±83 vs. WF: 62±58 falls/1000h; p=0.03, d=0.76, 95%CI: 0.09-1.40), although injury rates due to falls did not differ significantly (RF: 1.5±5.1 vs. WF: 0.0±0.0 injuries/1000h; p>0.05). CONCLUSION: RF showed higher cardiovascular stimulus than WF, although both elicited sufficient time in target HR zones to provide marked health benefits for the PCa patients. Both modalities showed high fun levels, supporting long-term adherence. The fall incidence was 2-fold higher in RF compared to WF, albeit this did not result in major injuries. These findings support WF as a suitable precursor for inactive PCa patients within a RF framework, facilitating a safe progression to RF while preserving cardiovascular load. This work was supported by National Funds by FCT - Foundation for Science and Technology, under the project UID/04045/2025 (https://doi.org/10.54499/UID/04045/2025).
Read CV Susana PóvoasECSS Paris 2023: OP-MH25
INTRODUCTION: Sarcopenia is a condition defined as concurrent lack of strength and muscle mass [1] which has prognostic value among prostate cancer survivors (PCa). Black PCa who are prescribed androgen deprivation therapy (ADT) can experience adverse body composition alterations more than non-Black PCa. However, lack of strength for determining sarcopenia is usually assessed through handgrip strength (HGS) which may not capture overall body strength. Additionally, evidence of sarcopenia incidence with gold standard measurements of strength is scarce among Black PCa. Therefore, the aim of this observational analysis is to report incidence of sarcopenia and compare maximum relative strength levels between sarcopenic (SA) and non-sarcopenic (NS) Black PCa who are prescribed ADT. METHODS: Black PCa who are prescribed ADT were recruited within a larger ongoing exercise trial (NCT05327465). Population-specific cut-offs were used to determine sarcopenia: HGS <35.5kg and Appendicular Skeletal Muscle Mass Index (ASMI) <7.26kg/m^2. [2] HGS was tested with a handheld dynamometer and ASMI was assessed with a whole body DEXA scan. Two 10-repetition maximum (RM) strength tests were also performed on a Leg Press (LP) and a Chest Press (CP). The 1-RM values were estimated using the Brzycki formula. Estimated 1-RM was normalized to participants’ weight to determine relative strength. Differences between SA and NS were explored using unpaired t-tests. RESULTS: A total of 48 Black PCa were included in this analysis with mean age and BMI of 68.8±9.0 years and 29.7±5.09 kg/m^2, respectively. Overall, HGS was 33.9±8.07 kg and ASMI 8.2±1.13 kg/m^2. Nine (19%) participants were sarcopenic with HGS of 27.9±4.83 kg and ASMI of 6.6±0.45 kg/m^2. Among NS (n=39), significantly higher HGS (Mean diff 7.3, 95%CI 1.64–12.97, p=0.013) and ASMI (1.9, 1.28–2.55, p<0.001) were observed compared to SA. Relative CP 1-RM was significantly higher among NS compared to SA (0.5±0.16 vs 0.4±0.12; Mean diff 0.1, 95%CI 0.01–0.24, p=0.033), while relative LP 1-RM was not (1.1±0.30 vs 0.9±0.24; Mean diff 0.2, 95%CI -0.01–0.43, p=0.062). CONCLUSION: Black PCa who underwent ADT may present with sarcopenia, yet only 19% of our sample were sarcopenic. Nevertheless, maximal relative strength of the upper body was significantly lower among those presenting with sarcopenia. This population might benefit from specialized, prescriptive resistance exercise to mitigate ADT side effects on strength and muscle mass. In addition, large scale observational studies are needed to assess sarcopenia among Black PCa. References 1 Kirk, B. et al. The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age and Ageing 53 (2024). https://doi.org/10.1093/ageing/afae052 2 Cawthon, P. M. et al. Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis. J Am Geriatr Soc 68, 1429–1437 (2020). https://doi.org/10.1111/jgs.16517
Read CV Salvatore FicarraECSS Paris 2023: OP-MH25
INTRODUCTION: Exercise interventions are increasingly recognized as safe and beneficial in pediatric oncology. However, their integration into routine care remains inconsistent across centers due to organizational (e.g., lack of structures/staff), cultural, and resource-related barriers, limiting scalability. This study explored the organizational factors that enabled the implementation of a long-standing structured exercise project in a pediatric oncology setting, whose goal was to integrate exercise within the broader concept of care. METHODS: We conducted a qualitative exploratory study at the Fondazione IRCCS Istituto Nazionale dei Tumori (Milan, Italy), where a sport/exercise program has been implemented in the pediatric department since 2013. Nineteen healthcare professionals from diverse roles (oncologists, physiotherapists, exercise physiologists, nurses, psychologists, educators/schoolteachers, and a social worker) were purposively recruited and interviewed using a semi-structured guide. Semi-structured interviews (30-45 minutes) allowed flexibility to explore participants' lived experiences while ensuring coverage of key domains (e.g., program facilitators, barriers, and integration into care pathways); open-ended questions encouraged detailed narratives, with probes for clarification and depth, enabling inductive theme generation reflective of organizational realities. RESULTS: Participants described pediatric oncology care as a multidimensional process encompassing clinical treatment as well as relational, emotional, educational, and social components. The exercise program was consistently framed as meaningful and increasingly integral to routine care. Its implementation was supported by institutional endorsement, strong clinical leadership, dedicated exercise professionals, and established multidisciplinary communication routines. Key facilitators included daily coordination with the referring pediatric oncologist, clear role definition, stable staffing, and structured scheduling to minimize conflicts with other clinical and educational activities. Ongoing challenges were primarily organizational and cultural, including limited recognition of exercise as a standard publicly funded component of care and constraints in physical space and resources, which restricted scalability and transferability CONCLUSION: In a well-supported multidisciplinary environment, structured exercise can be embedded in pediatric oncology as a routine supportive care practice. Our findings identified actionable organizational conditions—leadership, dedicated personnel, communication structures, exercise physiologist involved and sustainable funding mechanisms—that may guide implementation of exercise programs in other pediatric oncology centers. In this context, the “exercise as medicine” paradigm is operationalized through the contribution of exercise physiologist, and exercise is perceived as a valued component of the pediatric cancer care pathway rather than a barrier.
Read CV William ZardoECSS Paris 2023: OP-MH25