bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE PROTECT TRIAL - PREOPERATIVE EXERCISE THERAPY FOR PATIENTS WITH CANCER: A PILOT RANDOMISED-CONTROLLED TRIAL
Authors: Hennessy Dr Declan , Wallen Dr Matthew , Brown Dr Stephen , Wong-Shee A/Prof Anna , Rawstorn Dr Jonathan , Miller Dr Kyle , Oqueli Dr Ernesto , Aras Mr Drew , Grace Fergal 
Published: May 2024

INTRODUCTION & AIMS
Prehabilitation exercise is a promising strategy in oncology to optimise pre-operative cardiorespiratory fitness (CRF), which could reduce post-operative complications, mortality and enhance quality of life. This trial aimed to investigate the safety, feasibility, and effects of an aerobic prehabilitation exercise program in breast, colorectal, and prostate cancer patients. Primary outcomes were serious adverse events (SAE), adverse events (AE), participant adherence and compliance. Secondary outcomes were CRF variables and patient well-being.

METHODS
A CONSORT-compliant pilot randomised controlled trial (RCT) was conducted at a regional hospital in Ballarat, Australia. Prostate, breast, and colorectal cancer patients scheduled for surgery were randomised 1:1 into prehabilitation (PREHAB) or usual care (UCARE). PREHAB involved aerobic exercises informed by baseline cardio-pulmonary testing findings, with supervised sessions every two/three days for a minimum of 2-weeks. UCARE involved standard oncology treatment. Data on physical activity (actigraphy), resting vitals, and post-operative outcomes (Clavien-Dindo) were also collected.

RESULTS
Among 47 approached patients, 23 were randomised. Overall, 11 patients were analysed in the PREHAB and 9 in the UCARE groups. No SAEs were reported, and an exercise-related AE occurred every 756 minutes (total 3780). Participants attended 91.3% of PREHAB sessions. PREHAB participants attended 5.25 (SD = 2.16) sessions and had an average of 15 days from baseline testing to surgery. No significant time x group interactions were observed in V̇O2peak, ventilatory threshold (VT), or overall patient well-being (p = 0.90, 0.58, 0.82); PREHAB achieved small within-group increases in absolute V̇O2peak and VT (+4.9% and +1.8%, respectively).

CONCLUSIONS
The PROTECT trial demonstrated the safety and feasibility of delivering prehabilitation, revealing small clinically relevant increases in CRF fitness measures. Potentially due to the sample size, no significant improvements were observed in well-being or post-operative complications; future research should prioritise larger-scale RCTs further to explore the benefits of prehabilitation in this population.
EVALUATING FEASIBILITY OF A SECONDARY STROKE PREVENTION PROGRAM
Authors: Hunter Steph , Vogel Kimberley , O’Leary Shane , Blennerhassett Dr Jannette 
Published: May 2024

INTRODUCTION & AIMS
While 80% of strokes are preventable, stroke remains the second leading cause of disability and death worldwide. Recurrent stroke has an accumulative effect that increases the level of disability and demands on healthcare. Healthy lifestyles that include regular exercise can reduce stroke risk, but stroke survivors lack guidance to modify their lifestyle after hospital discharge. Models of community care may support secondary stroke prevention with guidelines recommending physical activity and cardiovascular exercise, and referrals to support behaviour change to address modifiable risk factors. Our aim was to evaluate the implementation of a secondary stroke prevention program provided within a community rehabilitation service to see if it was feasible to deliver and acceptable for participants.

METHOD
We evaluated the implementation of a secondary stroke prevention program involving supervised exercise, multidisciplinary education and health coaching to address modifiable risk factors. The group-based program involved face-to-face and telehealth sessions. The primary outcomes were feasibility, examined via service information (referrals, uptake, participant demographics, costs), and participant acceptability (satisfaction and attendance). Secondary outcomes examined self-reported change in lifestyle factors, and pre-post scores on standardised clinical tests, [e.g., waist-circumference, 6-Minute-Walk (6MWT)].

RESULTS
We ran seven programs in 12-months, and 37 people participated. Attendance for education sessions was 79%, and 30/37 participants completed the full program. No adverse events occurred. Participant satisfaction was high for ‘relevance’ (100%), ‘felt safe to exercise’ (96%) and ‘intend to continue’ (96%). Most participants (88%) changed (on average) 2.5 lifestyle factors (diet, exercise, smoking, alcohol). Changes in clinical outcomes seemed promising, with some being statistically significant, e.g. 6MWT (MD 59m, 95%CI 38m to 80159m, p&lt;0.001), and waist-circumference (MD –2.1cm, 95%CI -3.9cm to -1.4cm, p&lt;0.001).

CONCLUSION
The program was feasible to deliver, acceptable to participants and seemed beneficial for health. Access to similar programs may assist in secondary stroke prevention.
CHRONIC ADAPTATIONS TO BLOOD FLOW RESTRICTION AEROBIC OR BODYWEIGHT RESISTANCE TRAINING: A SYSTEMATIC REVIEW
Authors: Bommasamudram Mr Tulasiram , Morrell Ms. Zoe , Clarkson Dr Matthew , Nayak Prof. Kirtana Raghurama , K V Dr Rajagopal , Russell Prof. Aaron , Warmington Associate Professor Stuart 
Published: May 2024

INTRODUCTION
Blood flow restriction (BFR) training has garnered considerable attention in recent years as an innovative method for enhancing aerobic fitness, muscle strength, and muscular hypertrophy. However, the variation of intervention protocols has impeded consensus in the scientific literature. As a result, the primary objective of this study is to systematically investigate and review the available evidence concerning BFR in conjunction with aerobic and bodyweight resistance training.

METHODS
A thorough search of electronic databases, including PubMed (MEDLINE), Cinahl, SPORTDiscus® (via EBSCOhost), Embase, and Cochrane (Central), was conducted to identify relevant published studies. The inclusion criteria encompassed a healthy sample population aged 18 and above, original studies, chronic exercise sessions (minimum duration of 2 weeks of training) involving BFR in the context of aerobic or bodyweight resistance training, and comparisons with conventional non-BFR training.

RESULTS
The review identified 24 eligible studies that met the inclusion criteria. The findings demonstrated that chronic adaptations to BFR aerobic training were characterized by substantial improvements in VO2max (4-9%) and muscle strength (6-31%) compared to conventional aerobic training. Furthermore, BFR bodyweight resistance training yielded muscle hypertrophy (3-5%) and strength (4-11%) gains on par with those achieved through conventional resistance training.

CONCLUSION
This systematic review underscores the potential benefits of chronic adaptations stemming from blood flow restriction training in both aerobic and bodyweight resistance training. BFR aerobic training presents itself as a promising avenue for enhancing cardiovascular fitness, muscular strength, and hypertrophy. Meanwhile, BFR bodyweight resistance training shows promise in promoting muscle hypertrophy and strength gains, although it is worth noting that the available evidence is limited. Further research and a broader base of studies are required to validate and expand upon these findings.
UNDERSTANDING THE INDIVIDUALIZATION OF EXERCISE PRESCRIPTION FOR PEOPLE WITH CANCER: A SYSTEMATIC REVIEW
Authors: Cunningham Brent , Chong Jamie , Fariman Ciaran , Skinner Tina , Rose Grace 
Published: May 2024

PURPOSE
The importance of prescribing individualized exercise for people with cancer to minimize injury risk and optimize outcomes has been echoed internationally in position and consensus statements. However, it is unclear what individualization processes are employed in exercise oncology research and how exercise individualisation is implemented for people with cancer. This study aimed to systematically review the available evidence to elucidate the individualisation methods being employed in exercise oncology research.

METHODS
A systematic search of PubMed, EMBASE, CINAHL, and Web of Science was performed following the PRISMA guidelines. Eligible randomised controlled trials (RCT), controlled trials (CT), pre-post trials, and comparison trials included men and women aged ≥18 years with a histologically confirmed diagnosis of cancer; undertaking any structured exercise protocol that was ‘individualized’, with or without supervision; and that explored outcomes of intervention fidelity (e.g., recruitment, attendance, adherence, attrition), and/or patient health and wellbeing (i.e., quality of life, symptom improvement, medication use, physical activity). Study quality was assessed using the Delphi list tool.

RESULTS
Forty-nine studies were found to be eligible and subsequently included in the narrative synthesis. Study quality was on average 49% (range 14 to 100%). Individualization of the exercise prescription most occurred prior to intervention commencement (n=23, 47%), based on physiological results from baseline assessments (n=21, 43%). No study individualized exercise based on participant readiness to train. The exercise prescription was predominantly individualized via modulation of both the intensity and volume of exercise (11, 22%).

CONCLUSION
Exercise prescription individualization for people with cancer is highly prescriptive and predetermined. Seldom has exercise prescription been individualized based on participant readiness to train. Future exercise oncology studies should include greater detail on the reporting of exercise individualization methods and rationale to enhance our understanding of the relationship between individualization and exercise adherence and attrition in people with cancer.
STRUCTURED EXERCISE IMPROVES FATIGUE AND HEALTH-RELATED QUALITY OF LIFE IN METASTATIC BREAST CANCER PATIENTS: THE MULTINATIONAL RANDOMIZED CONTROLLED PREFERABLE-EFFECT STUDY
Authors: Zopf Dr Eva , Hiensch Dr Anouk E. , Depenbusch Dr Johanna , Schmidt Dr Martina E. , Monninkhof Dr Evelyn M. , Pelaez Mireia , Clauss Dr Dorothea , Zimmer Dr Philipp , Belloso Jon , Trevaskis Mark , Rundqvist Helene , Wiskemann Joachim , Mueller Jana , Fremd Carlo , Altena Renske , Kufel-Grabowska Joanna , Bijlsma Rhodé , van Leeuwen-Snoeks Lobke , ten Bokkel Huinink Daan , Sonke Gabe , Lahuerta Ainhara , Mann Bruce , Francis Prudence , Richardson Gary , Malter Wolfram , van der Wall Elsken , Aaronson Neil K. , Senkus Elzieta , Urruticoechea Ander , Bloch Wilhelm , Stuiver Martijn M. , Wengstrom Yvonne , Steindorf Karen , May Anne M. 
Published: May 2024

INTRODUCTION & AIMS
Exercise has been proven safe and effective for patients with breast cancer in the curative setting, however evidence in patients with metastatic breast cancer (mBC) is scarce. The aim of the PREFERABLE - EFFECT study (NCT04120298) was to evaluate the effects of a structured exercise program on fatigue, health-related quality of life (HRQoL), and other cancer- and treatment-related side effects in patients with mBC.

METHODS
The randomized controlled trial included patients with mBC from five European countries (Germany, Spain, Netherlands, Poland, Sweden) and Australia. Participants were randomly assigned to usual care (UC) or a 9-month supervised and individualized exercise program (EX) involving twice weekly aerobic, resistance, and balance exercises. The primary outcomes, physical fatigue (EORTC QLQ-FA12 subscale) and HRQoL (EORTC QLQ-C30 summary score) were assessed at baseline, 3, 6, and 9 months. Among other physical fitness outcomes, maximal short exercise capacity was assessed with the Steep Ramp Test. Changes from baseline to 3, 6 (primary endpoint) and 9 months were compared between groups using adjusted mixed models for repeated measures.

RESULTS
A total of 357 patients were randomized (EX=178, UC=179). On average, participants were 55.4 years of age (SD=11.1) and 73.9% had bone metastases. EX resulted in a significant reduction in physical fatigue (-5.3 [-10.0; -0.6], p=.027, ES=0.22) and improvement in HRQoL (+4.8 [2.2; 7.4], p=.0003, ES=0.33) compared to UC at 6 months (primary endpoint), as well as at 3 and 9 months. EX also improved physical fitness (+24.3 Watts, [15.5; 33.1], ES=0.42, at 6 months) and numerous relevant QLQ-C30 scales, including social functioning, pain, and dyspnoea.

CONCLUSION
This large multinational study demonstrates that supervised exercise improves fatigue, HRQoL, and other clinically relevant outcomes in patients with mBC. Based on these findings, supervised exercise should be recommended to patients with mBC.
PATIENT EXPERIENCES OF A VIRTUALLY SUPERVISED EXERCISE PROGRAM FOR ADULTS WITH ADVANCED CANCER AND CACHEXIA – A QUALITATIVE STUDY
Authors: Zopf Dr Eva , Ratcliffe Dr Madeleine , Krishnasamy Prof Meinir , Nandi Amruta , Parr Dr Evelyn , Martin Prof Peter , Cormie A/Prof Prue , van Loon Prof Luc J.C. , Bland Kelcey 
Published: May 2024

INTRODUCTION & AIMS
People with advanced cancer and cachexia experience significant body weight loss, impairing physical function and lowering quality of life (QOL). Effective, evidence-based treatments for cancer cachexia are lacking, leaving patients with unmet needs. Exercise holds promise to improve patient QOL. However, information on patients’ experiences of exercise, including their ability to cope with structured exercise, is limited. The aim of this qualitative study was to explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer.

METHODS
Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis.

RESULTS
Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included: 1) Deciding to exercise involves balancing concerns and expectations, 2) The exercise program is a positive experience, and 3) Moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased exercise convenience. Participants emphasized the need to extend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits.

CONCLUSION
Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.
PRESCRIBING BLOOD FLOW-RESTRICTED CYCLING USING RPE BALANCES THE PHYSIOLOGICAL AND PERCEPTUAL DEMANDS IN HEALTHY ADULTS
Authors: Smith Dr Nathan , Girard Dr Olivier , Scott Associate Professor Brendan , Peiffer Professor Jeremiah 
Published: May 2024

INTRODUCTION
Aerobic exercise is commonly prescribed using fixed heart rates or power/speed. These methods may not be suitable when incorporating blood flow restriction (BFR), as this technique can influence these measurements. Prescribing exercise via perception of exertion (RPE), which reflects overall psychophysiological stress, may present an alternative to overcome these issues. Aim: Describe physiological and perceptual responses during fixed-power and fixed-RPE cycling performed with blood flow restriction (BFR_{PWR} and BFR_{RPE}) and without (CON_{PWR} and CON_{RPE}).

METHODS
Following baseline testing, twelve active males cycled for ten minutes under four conditions. CON_{PWR} was performed first, then the remaining conditions in a randomised and counterbalanced order. BFR_{PWR} and CON_{PWR} were performed at the power equivalent to the first ventilatory threshold (161±38W). CON_{RPE} and BFR_{RPE} were prescribed at the RPE reported during CON_{PWR}. Continuous ventilatory and heart rate measurements were recorded as two-minute averages. Subjective RPE, effort, muscular discomfort, and cuff pain were recorded every two minutes. Blood lactate was measured pre-exercise, post-exercise, and two-minutes post-exercise.

RESULTS
BFR_{PWR} resulted in the greatest physiological and perceptual responses among all conditions. Power output was lower during BFR_{RPE} (119±48W) than CON_{RPE} (139±47W). Oxygen consumption during BFR_{RPE} (20.8±5.1mL·kg-1·min-1) was lower than CON_{PWR} (25.3±6.0mL·kg-1·min-1, p&lt;0.001) and CON_{RPE} (22.3±5.9mL·kg-1·min-1, p=0.007). Heart rate during CON_{PWR} (143±22beats·min-1) was greater than BFR_{RPE} (133±26beats·min-1, p&lt;0.001) and CON_{RPE} (131±25beats·min-1, p&lt;0.001). Muscular discomfort was not different between BFR_{RPE} (2.5±1.3au) and CON_{PWR}(2.3±1.5au), yet both were greater than CON_{RPE} (p&lt;0.001, 1.8±1.5au). Cuff pain was greater during BFR_{PWR} (3.3±1.7au) than BFR_{RPE} (2.2±1.1au, p&lt;0001). Blood lactate was greater during fixed-power (4.9±3.5mmol·L-1) compared to fixed-RPE trials (3.6±2.7mmol·L-1, p&lt;0.001).

CONCLUSIONS
BFR_{RPE} caused less discomfort and pain than BFR_{PWR} without compromising physiological stress compared to CON_{RPE}. BFR_{RPE} should be considered when high mechanical loads are contraindicated, or discomfort/pain is undesirable. These findings improve our understanding of aerobic BFR exercise prescription to healthy adults.
V̇O2PEAK PROVIDES A BETTER PREDICTOR OF ERGOMETER MEAN MAXIMAL POWER THAN MAXIMAL OXYGEN EXTRACTION IN TRAINED ROWERS
Authors: Lanigan Mr Bryce , Tinely Mr Zeke L , Binnie Dr Martyn J , Peeling Professor Peter , Scott Associate Professor Brendan R , Peiffer Professor Jeremiah J , Galna Dr Brook , Dennis Mr Myles C , Billaut Professor François , Goods Dr Paul SR 
Published: May 2024

INTRODUCTION & AIMS
Muscle oxygenation characteristics are suggested to better explain performance than peak oxygen uptake (V̇O2peak) in highly trained canoe-kayak athletes (Paquette et. al, 2018), but this has not been explored with rowers. Therefore, this investigation aimed to 1) determine whether maximal oxygen extraction improved prediction of rowing ergometer mean maximal power (MMP; W/kg) compared to V̇O2peak alone, and 2) assess differences in muscle oxygen extraction between anatomical sites during incremental rowing.

METHODS
Trained male (n=16) and female (n=6) rowers completed a 7x4min graded exercise test on a rowing ergometer to determine mean power output for each stage and V̇O2peak and MMP during the final stage. Change in muscle oxygen extraction (Δ[HHb]) during each stage was determined using near infrared spectroscopy (NIRS) at the vastus lateralis (VL), gastrocnemius medialis (GM), and biceps brachii (BB). The best predictor of MMP was determined using linear regression, and mixed-effects models were used to assess Δ[HHb] across sites and stage.

RESULTS
V̇O2peak was a significant predictor of MMP (R2=0.74); however, Δ[HHb] (at each site individually or combined) had no association with MMP (R2≤0.05). The strongest model included V̇O2peak and GM Δ[HHb] (R2=0.83); however, the improvement in model fit was modest (mean absolute error decreased from 0.211W.kg-1 to 0.193W.kg-1). A significant site x stage interaction was observed for Δ[HHb] at each site across all stages. Post-hoc analysis revealed VL Δ[HHb] was higher than GM Δ[HHb] for each stage; VL Δ[HHb] was lower than BB Δ[HHb] from stages 1-4, then higher from stages 5-7; and GM Δ[HHb] was lower than BB Δ[HHb] for stages 1-6, but higher in the final stage.

CONCLUSION
Maximal oxygen extraction alone cannot predict ergometer MMP in trained rowers. However, NIRS derived muscle oxygen extraction may provide additional useful information regarding relative muscle contributions at varying exercise intensities.
THE EFFECT OF DRY AND HUMID HEAT ACCLIMATION ON PERFORMANCE IN EACH ENVIRONMENT
Authors: McDonald Mr Peter , John Mr Kevin , Topham Dr Tom , Sawka Prof Mike , Clark Dr Brad , Périard Prof Julien 
Published: May 2024

BACKGROUND
Athletes adopt heat acclimation (HA) to partly restore heat-mediated decrements in performance. However, the influence of environmental characteristics during HA on performance in dry and humid conditions is unclear. Therefore, this study aimed to compare dry and humid HA on performance in each environment.

METHODS
In a counterbalanced crossover study, ten trained male cyclists (age 43 ± 9 y; body mass 80.8 ± 7.3 kg; maximal oxygen uptake; 59 ± 7 mL.kg-1.min-1) completed a 30-min time-trial in hot-dry (TT-DRY; 42°C, 25% RH) and warm-humid (TT-HUM; 33°C, 80% RH) conditions before and after 8 days of controlled heart rate (HR) HA in either dry (DRY-HA) or humid conditions (HUM-HA). A Bayesian multi-level model was used to determine posterior means, 90% credible intervals, and probability of direction (%).

RESULTS
The improvement in power output during TT-HUM was similar following DRY-HA (13 W [3, 22]; 99%) and HUMID-HA (11 W [3, 19]; 98%). In TT-DRY, the improvement in power output was 12 W ([1, 22]; 97%) higher following DRY-HA (19 W [10, 28]; &gt;99%) compared to HUM-HA (7 W [-2, 17]; 91%). During TT-HUM, mean rectal temperature changed following HUM-HA (0.03°C [-0.11, 0.17]; 63%) and DRY-HA (-0.14°C [-0.29, 0.02]; 92%), with a difference of 0.16°C ([-0.36, 0.03]; 92%). During TT-DRY, the difference was -0.20°C ([-0.40, 0.01]; 94%) between HUM-HA (-0.22°C [-0.38, -0.06]; 98%) and DRY-HA (-0.03°C [-0.19, 0.13]; 63%). Mean HR during TT-DRY (3 beats·min-1 [-2, 8]; 85%) and TT-HUM (-4 beats·min-1 [-10, 2]; 85%) was similar following DRY-HA and HUM-HA.

CONCLUSIONS
DRY-HA further improved mean power output during TT-DRY compared to HUM-HA. However, HUM-HA tended to lower rectal temperature more than DRY-HA during TT-DRY. HA condition did not influence HR during either TT. Our data indicate that performance is further improved in hot-dry conditions when acclimating to the same environment.