Exercise For The Cancer Survivor ELISABETH TOMERE, PT, DPT, CLT SCCA PHYSICAL THERAPY

Transcription

1 Exercise For The Cancer Survivor ELISABETH TOMERE, PT, DPT, CLT SCCA PHYSICAL THERAPY

2 Presentation Topics Benefits of Exercise Guidelines and Recommendations for Exercise Strategies for Exercise Participation Community Resources Closing Comments and Questions

3 Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it. --Plato ( BC)

4 The Relevance Of The Holidays Expectations Time Constraints Environmental Barriers New Beginnings Life Long Commitment

5 Deep Breathing Exercise

6 Exercise? What Are The Benefits?

7 Prevention of cancer and recurrence Improved aerobic fitness and muscular strength Increased libido and quality of life Normal body weight/insulin regulation Increased BMD and decreased injuries Improved energy, reduced fatigue, better sleep Cognitive gains and elevated mood Improved balance and agility

8 ACSM Cancer Exercise Guidelines (2009) 1) Exercise training is safe during and after cancer treatments. 2) Improvements in physical functioning, quality of life, and cancer-related fatigue in several CA groups (breast, prostate, colon, blood, stem cell transplant, and gynecologic). 3) Survivors should follow the 2008 Physical Activity Guidelines for Americans and ACSM recommendations with specific individualized exercise prescription based on their disease and treatment related side effects. Courtesy of Lexi Harlow, PT, DPT, CLT

9 How Much And What Kind Of Exercise Do I Need?

10 US Dept Of Health And Human Services: 2008 Physical Activity Guidelines For Americans Adults: -2.5 hours/week of moderate intensity or 1.25 hours/week of vigorous intensity -Should increase to 5 hours/week of moderate intensity or 2.5 hours/week of vigorous intensity -2x/week of strengthening of major muscle groups Courtesy of Lexi Harlow, PT, DPT, CLT

11 Cardiorespiratory Exercise ACSM Guidelines Adults should get at least >/=150 minutes of moderateintensity exercise per week. Exercise recommendations can be met through minutes of moderate-intensity exercise (five days per week) or minutes of vigorous-intensity exercise (three days per week). One continuous session and multiple shorter sessions (of at least 10 minutes) are both to accumulate desired amount of daily exercise.

12 ACSM Guidelines Resistance Exercise Adults should train each major muscle group two or three days each week using a variety of exercises and equipment. Two to four sets of each exercise will help adults improve strength and power. For each exercise, 8-12 repetitions improve strength and power, repetitions improve strength in middle-age and older persons starting exercise, and repetitions improve muscular endurance.

13 Other Considerations For Exercise

14 Cardiovascular Warm-up/Cool-down Target HR Zone RPE (Rating of Perceived Exertion)

15 Rate of Perceived Exertion (RPE) The level of perceived exertion is often measured with a 15 category scale that was developed by the Swedish psychologist Gunnar Borg. Adapted from ACSM Current Comment. Written for the American College of Sports Medicine by Alan C. Utter, Ph.D., M.P.H., FACSM, Jie Kang, Ph.D., FACSM, Robert J. Robertson, Ph.D., FACSM

16 6 No exertion at all 7 Extremely light 8 9 Very light Light Somewhat hard Hard (heavy) Extremely hard 20 Maximal Exertion Gunnar Borg 1985

17 Strength training 2-3x/week For arms, abdominals, and legs Slow, steady progression 10 repetition maximum

18 Balance ACSM recommends 2-3 days per week Important to train with age Fall prevention

19 Stretching 2-3x/week Avoiding injury Importance of technique Yoga

20 Triangle Stretch

21 Safety Guidelines Gradual increase in exercise intensity, volume Heed warning signs of injury Proper attire, equipment in good working order Tape, braces, compression garments Protect against the elements, especially heat HYDRATE!

22 Precautions Physician Clearance Lymphedema Neuropathies Severe fatigue Heart conditions Metastases

23 What Else Can I Do To Improve My Fitness?

24 DON T SIT!!!

25 Cardiovascular disease Depression High blood pressure Worsening metabolic biomarkers

26 MINI SQUAT

27 Challenges Along the Way

28 Immediate and Late Effects of: Chemotherapy Radiation Surgery Hormonal Changes

29 Disease specific barriers Lack of time, enjoyment and social support Filling multiple roles; caretaking Medical appointments Change in physical appearance Concerns about safety

30 Solutions!

31 Increase your knowledge Join a team or group Get your spouse, best friend, children, or animals to join in Exercise journal or log Local classes or support groups Do something that you enjoy Set realistic goals Modifications to slide courtesy of Lexi Harlow, PT, DPT, CLT

32 Your daily life is your temple and your religion. Whenever you enter into it, take with you your all. --Kahlil Gibran

33 EXERCISE AND THRIVE PROGRAM YMCA, LIVESTRONG and Hutchinson Center collaboration 12-week, 2x/week, 90 min. strength and fitness program for survivors Training provided by Y, FHCRC and SCCA Assessment Pre and Post class Content foci: resistance exercise aerobic exercise support, nutrition Rajotte et al. J Cancer Survivorship, 2012

34 Seattle Area Exercise Programs Cancer Lifeline Team Survivor Northwest Gilda s Club YMCA Exercise and Thrive

35 Holiday Exercise Strategies Walk as much as possible Do extra laps at the mall Take stairs Park further away from doors Involve family, loved ones, and friends in fitness activity Suggest a walk or other physical activity after eating a meal Play with kids or grandkids While watching football games, get on floor and do some exercise or think of exercises to do while seated on the couch Courtesy of Lexi Harlow, PT, DPT, CLT

36 What s New For Cancer Survivors Low intensity exercise regimens may not be effective 150 minutes per week of walking is it enough? Not all exercise is equal

37 Special Topics: OSTEOPOROSIS

38 Recent Studies Evidence for decreased BMD loss in lumbar spine bone with resistance and impact exercises in patients on androgen deprivation therapy New evidence in general population studies for improved BMD with high impact exercise Jumping significantly increased BMD in premenopausal women

39 The Scientific 7-minute Work-out High-intensity circuit training (HICT) using body weight as resistance. Combines aerobic and resistance training into a single exercise bout lasting approximately 7 minutes. Participants can repeat the 7-minute bout 2 to 3 times, depending on the amount of time they have. As body weight provides the only form of resistance, the program can be done anywhere.

40 The 7-minute Work-out 1. Jumping jacks 2. Wall sit 3. Push-up 4. Abdominal crunch 5. Step-up onto chair 6. Squat 7. Triceps dip on chair 8. Plank 9. High knees 10. Lunge 11. Push-up and rotation 12. Side plank

41 EXERCISE! By exercising regularly, you are helping yourself to heal, potentially preventing new cancers from developing and preventing previous cancers from recurring, and at the same time lowering your risk of developing the most common life threatening medical condition heart disease. The benefits of exercise are enormous. -Dr. Julie K. Silver Courtesy of Lexi Harlow, PT, DPT, CLT

42 Knowledge IS Power! Best wishes for an amazing holiday season. Be well!

43 REFERENCES 1. Lamanne, D. Cassileth, B, Gubili, I. The Role of Physical Activity in Cancer Prevention, Treatment Recovery and Survivorship. CancerNetwork. Published July 18, Accessed October 10, Schmitz, KH, Courneya, KS, Matthews, C. American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Medicine & Science in Sports & Exercise. 2010; doi: /MSS. 0b013e3181e0c US Department of Health and Human Services Physical Activity Guidelines for Americans. Published October Accessed November 10, Garber, CE, Blissmer, B, Deschutes MR, et al. Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidelines for Prescribing Exercise. Medicine & Science in Sports & Exercise. 2011; 43: doi:10:1249/mss.0b013e318213fefb

44 REFERENCES CONT D 6. Mustian, K., Sprod, L, Janelsins, M, et al. Multicenter, Randomized Controlled Trial of Yoga for Sleep Quality Among Cancer Survivors. J of Clinc Oncol. 2012; 31: Owen, N, Healy GN, Howard, B, Dunstan, DW. Too Much Sitting: Health Risks of Sedentary Behavior and Opportunities for Change. President s Council on Fitness, Sports & Nutrition. 2012; 13: Pekmezi, D. Martin, M, Kvale, E, Meneses, K, Demark-Wahnefreid, W. Enhancing Exercise Adherence for the Breast Cancer Survivor. ACSMs Health Fitness Journal. 2013: 16; Klika, B, Jordan, L. High Intensity Circuit Training Using Body Weight: Maximum Results With Minimum Investment. ACSMs Health & Fitness Journal. 2013; doi: 10:1249/FIT.0b013e31828cble8 10. Silver, JK. After Cancer Treatment: Heal faster, Better, Stronger,. MD. Baltimore: John Hopkins University Press; 2006.

45 SUGGESTED RESOURCES American College of Sports Medicine. ACSM.org Dept of Health and Human Services. hhs.org CancerNetwork. cancernetwork.org President s Council on Fitness, Sports & Nutrition. fitness.gov