ECSS Paris 2023: OP-MH41
INTRODUCTION: Exercise interventions during neoadjuvant chemotherapy treatment (NACT) for patients with BC have been studied extensively during last decade demonstrating beneficial effects related to reducing treatment-associated side effects. High intensity interval training (HIIT) interventions have demonstrated clinically meaningful benefits for physical health and quality of life in BC patients in a relatively short time during therapy, while long-term effects remain unclear (Mijwel et al., 2019). This study aimed to investigate the effects of remote aerobic HIIT intervention during neoadjuvant chemotherapy treatment (NACT) on physical health outcomes 18-24 months following end of intervention in breast cancer (BC) survivors METHODS: The HIIT intervention study was two arm randomized control trial (RCT) implementing remotely supervised 4x4 min HIIT at an intensity of 85-95% of peak heart rate for 6 months during NACT during 2022-2023 (Cancerbeat 1 study, Klavina et al., 2024). Incremental exercise test (VO2peak) and physical performance (6MWT and sit-to-stand test including 5 sec (5xSTS) 30 sec (30STS) assessment) was measured pre-post NACT and at 18-24 months follow-up (2024, Cancerbeat 2 study). The data were analyzed for 24 participants (HIIT= 13, CG = 11) who agreed to participate in follow-up study. RESULTS: HIIT demonstrated significant effects for 6MWT (ES = .27, p = .012), Sit-to-stand scores (5 x) sec (ES = .233, p = .023), VO2peak outcomes (ES = .186, p = .045) and time to exhaustion (TTE) (ES = .25, p = .012) compared to CG. Both groups, HIIT and CG, significantly improved in 6MWT at 18-24 months follow-up compared to pre- and post-NACT (p < .05). Significant positive correlations were found between TTE scores and 6MWT (r = .564, p = .045) and minute ventilation (VE) outcomes (r = .645, p = .017) in HIIT group at follow-up. In CG the TTE was significantly correlated with VO2peak (r =.966, p <.001). CONCLUSION: Participants in the HIIT group 18-24 months after intervention were demonstrating significant differences in aerobic endurance and leg muscle strength outcomes compared to CG. The CG presented physical health outcomes close to the pre-treatment follow-up. The remote 4x4 min HIIT intervention during the 6 months of NACT may lead to long-term benefits of physical health related outcomes. Future studies should emphasize the benefits of physical activity in long-term health maintenance by exploring individualized exercise prescriptions that align with the specific needs and post-treatment goals of each BC survivor. References: Klavina A, Ceseiko R, Campa M, et al. The effect of high-intensity interval training on quality of life and incidence of chemotherapy side effects in women with breast cancer. Integr Cancer Ther. 2024;23:15347354241297385. doi:10.1177/15347354241297385 Mijwel S, Jervaeus A, Bolam KA, et al. High-intensity exercise during chemotherapy induces beneficial effects 12 months into breast cancer survivorship. J Cancer Surviv. 2019;13(2):244-256. doi:
Read CV Aija KlavinaECSS Paris 2023: OP-MH41
INTRODUCTION: Fabry disease is a rare inherited metabolic disorder caused by a genetic fault in the alpha-galactosidase A enzyme. Breakdown of glycolipids in the lysosomes of cells is impaired, leading to excess storage of globotriaosylceramide that results in multi-organ disease (most notably affecting the brain, heart and kidneys). Mental health and quality of life is often severely impacted in Fabry disease, yet treatment is pharmacological and predominantly focuses on physical symptoms. Reducing sedentary behaviour and increasing physical activity are associated with improved mental health and quality of life in the general population. The aim of this study was to co-design a sedentary behaviour and physical activity intervention tailored for adults with Fabry disease. METHODS: Barriers and facilitators linked to sedentary behaviour and physical activity were identified through focus groups with adults with Fabry disease (N=13), family members (N=8), and staff of the Society for Mucopolysaccharide Diseases (N=6). This was in addition to semi-structured interviews with 10 healthcare professionals (physicians, clinical nurse specialists, and a physiotherapist). Participatory workshops were then undertaken (N=12 adults with Fabry disease), informed by focus group and interview data, to test concepts and define the intervention content. The design process and intervention components were further refined through patient and public involvement. Data analysis used the Framework Method with inductive and deductive coding. RESULTS: Barriers to reducing sedentary behaviour (e.g. habit, previous negative experiences, work environment) and increasing physical activity (e.g. comorbidities, perceived inability to be active, lack of understanding around Fabry disease in the community) were identified. Themes generated from the focus groups, interviews, and workshops led to a multi-component intervention, ‘ACTIVE-FAB’, that includes: (1) initial consultation with a physiotherapist to discuss sedentary behaviour, physical activity levels and set goals, (2) progress consultations with a physiotherapist focusing on intervention engagement and reviewing goals, (3) online education covering the importance of limiting sedentary behaviour and engaging in physical activity, and information to support engaging in adaptable physical activities, (4) a smartwatch that tracks sedentary behaviour and physical activity, and (5) online peer support. CONCLUSION: This study has led to the co-design of a multi-component intervention to reduce sedentary behaviour and increase physical activity in adults with Fabry disease. The feasibility, acceptability and potential effectiveness of ACTIVE-FAB is being evaluated in a randomised controlled feasibility trial. This intervention could provide an effective adjunct to pharmacological treatment and improve management of Fabry disease in the future.
Read CV Daniel BaileyECSS Paris 2023: OP-MH41
INTRODUCTION: Chronic kidney disease (CKD) is associated with several comorbidities, including uremic sarcopenia (US), which negatively influences patients’ health-related quality of life. Dietary-nutritional therapy (DNT) and adapted physical activity (APA) are effective nonpharmacological strategies to counteract the CKD progression and its complications. Among dietary approaches, low-protein diets (LPD) (0.6-0.8 g/kg body weight/day) with controlled intake of phosphorus, sodium, and potassium and adequate energy intake can help mitigate the metabolic imbalances that contribute to US. An alternative DNT, such as the plant-dominant LPD (PLADO), with ≥50% plant-based protein intake, may further slow the CKD progression through modulation of the gut microbiota and reduction of uremic toxins. However, the combined effects of PLADO and APA on the prevention of US remain unclear. This pilot study analyses the impact of a 12-week online APA protocol combined with PLADO or LPD on muscle mass, physical capacity and quality of life in CKD patients. METHODS: 15 CKD patients, aged 59.8±9.8 years, were randomized into 2 groups: A) Online APA protocol (3 sessions per week, lasting 1 hour each) combined with PLADO; B) Online APA protocol combined with LPD. Physical capacity (6-minute walking test), muscle strength (Handgrip), body composition (bioelectric impedance analysis), quadriceps femoris muscle thickness, and laboratory parameters were evaluated at baseline (T0) and after 12 weeks (T1). SF-36 was administered to assess patients’ general health. RESULTS: At T1 Group A and Group B increased the distance in the 6-minute walking test (p=.001; p=.034). Handgrip strength significantly improved in Group A for the left limb (p=.014), showing a positive trend in the right limb as well. In addition, there was a significant reduction in body mass index (BMI) in Group A (p=.022). While quadriceps femoris muscle thickness increased significantly in Group B (p=.050). No significant differences in free oxygen radical defense (FORD) and free oxygen radicals test (FORT) values were observed in both groups. Positive trend was reported in general health perception in both groups, and the item health change increased significantly in Group A (p=.050). CONCLUSION: Both PLADO and LPD, combined with APA, seems to positively affect muscle function and body composition of CKD patients. The results suggest that combining dietary interventions with structured exercise may improve health-related quality of life in CKD. Further investigations into long-term outcomes and larger sample are required.
Read CV Arianna MurriECSS Paris 2023: OP-MH41