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While growing up in a small coastal town called Jeffreys Bay, I spent a lot of time with my grandfather who developed skin cancer in his old age. He was one of my favourite people and so the topic of cancer is one that is very dear to my heart.
There's a good chance that you either know somebody or have worked with somebody who has cancer, and so the following research paper may be one of the most important I have ever spoken about.
A 2022 paper by Dennett et al.:
This group of researchers and clinicians came together to develop a toolkit that could provide the education, resources and platform necessary to upskill practitioners on the key elements of prescribing exercise to patients with cancer.
They then tested the efficacy of this toolkit on 320 clinicians (87% of whom were physiotherapists) from 26 countries.
After a 3 month follow up, nearly all the respondents agreed that their ability and confidence to deliver Exercise Oncology Rehabilitation had improved.
Here are a 5 important pointers from the toolkit:
1) When prescribing strength exercise, it is important to do tests of repetition maximum instead of 1 rep max testing.
You can estimate one rep max using the following formula:
1RM = Weight ÷ ( 1.0278 – ( 0.0278 × Number of repetitions )
2) When prescribing aerobic exercise, it is important that you do not use the 220 - age formula.
Instead, use HR max= 208-(0.7 x age).
From there, it is optimal that exercise prescription should be made from Heart Rate Reserve.
3) When progressing exercise, it is important to firstly increase frequency, then time, then intensity.
4) When doing an objective assessment, one of the tests with the highest validity and reliability was a Timed Up and Go Test.
Patient starts by sitting on a chair. You then time how long it takes for them to stand up, walk 10 feet (3 metres), turn around and sit down again.
Completing this in under 20 seconds indicated a lower risk of falling. More than 20 seconds indicated a greater risk of falling.
5) When doing a subjective assessment, one of the big barriers to evaluate will be their level of fatigue.
To assess this, the patient can complete a Fatigue Symptom Inventory, which consist of 14 questions.
Total score = (General + Physical + Emotional + Mental) - Vigor
Higher scores indicate more fatigue.
To learn more, you can find the toolkit here: https://cancerexercisetoolkit.trekeducation.org/
References
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Written by Kyle van Heerden
Online Educator at Research Raconteur
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