American College Of Sports Medicine Research Articles

Abstract SY08-01: Does exercise or fitness deter cancer progression after diagnosis

Abstract In the U.S., 42% of cancer cases and 45% of cancer deaths are estimated to be attributable to modifiable factors, including tobacco use. Among women, the combination of excess body weight, poor diet, low physical activity, and alcohol consumption contributed to 22.4% of cases, ahead of tobacco (14.8%), due to prevalence of lifestyle behavior-related cancers in women (e.g. breast). Among men, 24% were due to tobacco, and 13.9% due to obesity, diet, physical activity, and alcohol. Evidence increasingly supports a role of these factors for improving cancer progression and death outcomes among cancer survivors. For example, healthy (e.g. Mediterranean) or unhealthy (e.g. “Western”) dietary patterns are associated with cancer progression or death among individuals diagnosed with colorectal, breast and/or prostate cancers (Rock, CA J Clin, 2022). For example, among 1101 men and women with stage III colon cancer enrolled in the CALGB adjuvant chemotherapy trial, those with a high vs low “Western” dietary pattern (high in meat, fat, refined grains and dessert) had 3.25 times higher risk of recurrence and death (Meyerhardt, JAMA, 2007). Long-term follow up of the Women’s Health Initiative trial participants indicates persistent reduction in deaths after breast cancer, among women randomized to the low fat/high fruit, vegetables and grains intervention compared to usual diet control (Chlebowski, J Clin Onc, 2020). Studies similarly suggest that physical activity after diagnosis of cancer is associated with a reduced risk all cause and cancer death. Evidence has accumulated such that the 2018 Physical Activity Guidelines for Americans recommended that physical activity after diagnosis is beneficial to reduce cancer death among those with breast, colorectal, and prostate cancer (U.S. Dept. of Health & Human Services, 2018). More recently, in a pan-cancer study of more than 11,000 people with 18 different types of cancer, exercise consistent with guidelines was linked to a 25% reduced hazard of death (95% confidence interval (CI) 0.70-0.80) and a 21% reduced hazard of cancer death (95% CI, 0.72 to 0.88); exercise according to guidelines was defined as moderate-intensity exercise ≥4 days per week, with sessions averaging ≥30 minutes and/or strenuous-intensity exercise ≥2 days per week, with sessions averaging ≥20 minutes) (Lavery JA et al, JCO 2023). There is also accumulating evidence from studies that examined the combination of multiple lifestyle factors, which indicate the combined benefits of healthy diet, regular physical activity, and weight control in cancer survivors. For example, in the CALGB study, those with a higher American Cancer Society (ACS) cancer prevention guidelines score (based on body mass index, physical activity, and healthy dietary pattern), had a 42% lower risk of death (Van Blarigan, JAMA, 2018). Studies examining combined lifestyle factors scores among men with prostate cancer have observed similar, though not entirely consistent, results for the outcomes of cancer progression and death (Graff RE, Br J Ca 2023; Langlais CS, Br J Ca, 2023). Purported mechanisms for improved outcomes with healthy diet and physical activity include beneficial effects on insulin resistance, inflammation, oxidative stress, and sex hormone pathways. Evidence gaps exist for less common cancers, and more research is needed to understand the impacts of energy balance and body composition on cancer outcomes. The evidence generated supporting the benefits of physical activity and high diet quality for cancer survivors has resulted in guidelines from multiple national and international organizations, including the American Cancer Society, American College of Sports Medicine, American Institute of Cancer Research/World Cancer Research Foundation, and the American Society of Clinical Oncology. While the publications of these guidelines represent an important milestone, much works remains to see them implemented in practice. Most cancer survivors are not physically active at recommended levels or following dietary recommendations. Programming and services tailored for survivors are needed, but a major challenge is the lack of reimbursement for nutritional and exercise counseling and services in cancer care. While some care settings and community organizations offer exercise and/or nutritional programming and information to people with cancer, this largely relies on institutional funding or philanthropy. Often these programs have limited reach or capacity, and the availability of programs may be particularly limited for cancer patients treated in safety net care settings. In order to address these gaps, wider availability of programs and services as well as clinical workflows to facilitate referral to services by healthcare providers is needed. In conclusion, evidence is growing that diet and physical activity after a diagnosis of cancer deters cancer-specific and all cause death. Innovative solutions are needed to increase nutritional quality and exercise in cancer survivors, in particular among those who are historically under-served and/or of lower socioeconomic status. Reimbursement for nutrition and exercise counseling for cancer survivors is warranted. Citation Format: June M. Chan. Does exercise or fitness deter cancer progression after diagnosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr SY08-01.

Estimating metabolic rate from International Organization for Standardization heart rate method and two walking equations.

Assigning a value for metabolic rate is central to heat stress assessment. ISO 8996 describes a predictive method for walking based on the American College of Sports Medicine (ACSM) method and another generalized method based on average heart rate. In addition, the US Army uses the load carriage decision aid (LCDA) predictive equation to estimate metabolic rate. The purpose of this study was to assess the accuracy/bias and precision of the ISO heart rate method and the ACSM and LCDA equations. The laboratory database included metabolic rate, heart rate, treadmill speed, and grade during a progressive heat stress protocol. Treadmill speed and grade were set to represent one of three metabolic rates. Accuracy and precision were assessed with Bland-Altman plots. All three methods had good accuracy (low bias). For precision, the ISO heart rate method had a root mean square error (RMSE) of 34 W and 11% when adjusted for repeated measures. The RMSE for two equations was 20 W and 7%. Although the heart method had less accuracy, its application is more generalizable. The heart rate method should be used below the occupational exposure limit to avoid a bias toward higher predicted values due to heat strain.

Age-Related Declines in Health and Fitness among Law Enforcement Officers Compared to Population Norms.

Physical fitness is mandatory for public safety officers. Police officers experience elevated levels of cardiovascular disease and associated risks making fitness a peak concern. Officers often have more marked fitness level decreases with aging compared to the general population. This cross-sectional study investigated the cardiovascular health, muscular strength/endurance, and mobility of officers in a medium-sized police department (N = 83); (4 females, 79 males), age (36.82 ± 10 years), height (179.02 ± 7.7 cm), body mass (95.1 ± 16.29 kg) compared to American College of Sports Medicine (ACSM) guidelines. The findings revealed that police officers begin their careers with above average strength but demonstrate greater declines with age than the general population. Officers also demonstrated cardiovascular fitness below ACSM standards and significant decreases with aging compared to the general population. Body fat percentages (p = 0.003) and BMI (p = 0.028) surpassed recommendations, with higher than normal increases with age. Maximum vertical jump decreased as officers age (p = 0.004). These findings support the implementation of a targeted physical fitness regimen and the resources for a program designed to improve current health and fitness, reduce the greater than expected decreases with aging, and aim to optimize occupational performance and the safeguarding of the lifelong health and well-being of officers.

O101: Current guidelines on physical activity do not prevent skeletal muscle loss and physical decline prior to Oesophagogastric cancer surgery: a new benchmark for prehabilitation?

Abstract Prehabilitation is being widely adopted to optimise physical health prior to surgery. However, there remains a lack of consensus regarding exercise type and intensity with current guidance extrapolated from generic, non-cancer populations. The WHO and American College of Sports Medicine (ACSM) recommend 600-1200 Metabolic Equivalent minutes (MET-mins) per week of physical activity (PA) but the effectiveness of this recommendation in cancer populations is unknown. Patients undergoing treatment for Oesophagogastric cancer were prospectively recruited. International Physical Activity Questionnaire (IPAQ) quantified PA at baseline and throughout treatment. Two cohorts were defined (lowPA and highPA) based on ACSM cut-off of 1200 MET-mins/week. Outcome measures were physical function (1 minute sit-to-stand, 1mSTS), CT muscle mass, chemotoxicity, and failure to complete planned treatment. 38 patients completed all study assessments (highPA n=20, lowPA n=18) with no difference in baseline characteristics or disease stage between groups. LowPA group showed declines in 1mSTS performance following chemotherapy, whereas the highPA group improved (mean difference -4 versus +10, p=0.001). Whilst both saw a decline in skeletal muscle mass, the lowPA group lost significantly more (mean difference -5.1 versus -1.8, p=0.007). There were trends towards a lower incidence of severe chemotoxicity (30% vs 61%, p=0.054) and failure to complete planned treatment (15% versus 28%, p=.33) in the highPA group. Whilst further research is required to define the most effective prehabilitation strategy, this study is the first to suggest a new benchmark to preserve muscle mass and function is higher than current guidelines and should be considered when developing prehabilitation recommendations.

Impact of a 16‐week strength training program on physical performance, body composition and cardiac remodeling in previously untrained women and men

AbstractEven if more and more women are involved in strength‐training (ST) programs in fitness centers, studies on strength gain, body composition, and cardiac remodeling were mainly conducted in men and whether they are similar in women remains to be explored. In this context, the aim of our study was to assess the effect of a supervised ST program on strength gains, body composition, and cardiac remodeling in previously untrained women and men. 17 healthy and previously untrained young women and 17 young men participated in a supervised 16‐week ST program built according to the recommendation of the American College of Sports Medicine in terms of intensity, and strictly using similar volume and intensity in both groups. Strength performance, body composition, and cardiac remodeling were evaluated every 4 weeks. Cardiac adaptations were assessed using resting echocardiography, including regional 2D‐Strain analysis of the left atrium and ventricle (LA and LV, respectively). Despite lower values at baseline, women exhibited similar or even higher strength gains compared to men. ST induced a decrease of body and abdominal fat mass and an increase of lean body mass in both groups. Similar cardiac remodeling was observed in women, and women, including an early and progressive LV and LA enlargement throughout the ST program, without any alteration of LV diastolic and systolic functions. These findings underlie that ST programs are highly suitable for women to enhance their strength performance and their cardiovascular health.

The Positive Association between Grit and Mental Toughness, Enhanced by a Minimum of 75 Minutes of Moderate-to-Vigorous Physical Activity, among US Students

Drawing from the 2015 Gucciardi et al.’s mental toughness (MT) framework, this study examines the association between grit and MT in US college students, while considering the moderating role of at least 75 min of moderate-to-vigorous physical activity (MVPA) based on recommendations from the American College of Sports Medicine. We administered the Grit-S Scale and the Mental Toughness Index in two samples of a total of 340 US undergraduate student-athletes and graduate students. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was employed to ensure internal validity, while statistical procedures including principal component analysis and regression models were utilized to analyze the collected data. A weighted component combining grit and the interaction between MVPA and grit significantly predicted MT, explaining 23% of its variability. Drawing from a specific conceptual framework, this study provides novel insights into the relationship between grit, engagement in at least 75 min of MVPA per week, and MT among US collegiate students. The findings support a positive association between grit, MVPA, and both MT and a specific component of MT, highlighting the significance of these factors in enhancing performance and suggesting potential implications for future research and practical applications in the field.

A strategy to implement the American College of Sports Medicine's Exercise is Medicine® (EIM) initiative in a community oncology clinic.

Despite proven benefits, few cancer patients exercise during chemotherapy. The American College of Sports Medicine's Exercise is Medicine® (EIM) initiative describes a model to integrate exercise into oncology care, based upon assessing patients' ability to exercise safely, advising on exercise benefits, and referring patients to exercise. We developed and tested a strategy to implement EIM in a community-based oncology clinic, to assess-advise-refer 20 patients undergoing chemotherapy to a 3-month online exercise class, and measured implementation outcomes. Using a community-based provider participation in research (CBPPR) model, researchers and staff co-designed and tested a 4-level implementation strategy, with a goal of assessing-advising-referring 20 cancer patients to exercise. Surveys and interviews were conducted with 12 (100%) staff at baseline and post-implementation on acceptability/appropriateness/feasibility, perceptions of individual implementation roles, and organizational strengths/conditions. Data were analyzed using correlations, t-tests, and content analysis. The proposed strategy was revised in collaboration with staff who requested assistance for recruitment and data collection. EIM was successfully implemented with 41 (92%) patients assessed, 37 (90%) advised, and 22 (60%) referred to exercise classes. Barriers to implementation were staff shortages and time constraints; facilitators included research team supports. Staff's perceived organizational strengths were positively correlated with exercise promotion acceptability, appropriateness, and feasibility. There were no statistically significant changes in implementation outcomes (acceptability/appropriateness/feasibility) post-implementation. Using a collaborative model, EIM was successfully implemented in a community oncology clinic; however, the clinic required significant support from the research team. Adaptations to the EIM process may be required to improve implementation outcomes.

Association Between Subjective Cognitive Decline and Twice-Weekly Muscle-Strengthening Activities in Middle-Aged and Older US Adults: An Analysis of the 2019 Behavioral Risk Factor Surveillance System.

Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. 114164 respondents, representing approximately 59 million US adults aged ≥45. SCD was indicated if the respondent reported confusion or memory loss during the past 12months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.

The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine: Erratum

The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine: Erratum

A COMPARISON OF REPEATED WINGATE BASED OF HIGH INTENSITY INTERVAL TRAINING AND MODERATE INTENSITY CONTINUOUS TRAINING ON AEROBIC CAPACITY UNDER NORMOBARIC HYPOXIA

Aerobic capacity is very important for all people in terms of health and performance. Therefore, important organizations such as the World Health Organization (WHO) and the American College of Sports Medicine (ACSM) generally recommend that adults should perform physical activity maintain and improve their aerobic capacity. This study aimed to compare the effects of 8-week Repeated Wingate (RW) based of high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MICT) on the aerobic fitness in recreationally active young adults under hypoxic and normoxic conditions. Thirty-two recreationally active young adults (age:22,37±2,30 years) were randomly assigned to Hypoxia RW(n=8), Normoxia RW(n=8), Hypoxia MICT (n=8), Normoxia MICT (n=8) group training protocol. The HIIT groups consisted of 4-7×30-s Wingate “all-out” sprints with 4 min of passive rest. The MICT groups completed 25-40 minutes of continuous running. Before, 4-week and after the 8-week interventions the following tests were completed: maximum oxygen consumption (V̇O2max), anaerobic threshold oxygen consumption (AT VO2), time to exhaustion (TTE) be determined from the Bruce treadmill protocol and submaximal oxygen consumption (Submaximal VO2) be determined from the modified Astrand protocol. Statistical difference was found between the 4th and 8th weeks in the HIIT and MICT groups according to the pre-tests (p ≤ 0.05). However, no difference was found between the condition (Hypoxia - Normoxia) and training methods (HIIT-MICT) (p ≤ 0.05).

DO NEARBY PHYSICAL ACTIVITY DESTINATIONS ENCOURAGE PEOPLE TO BE F.I.T.T.?

Abstract Neighborhood amenities may reduce barriers to engaging in physical activity (PA). However, it is unclear whether proximity to these amenities will indeed promote increased PA. This study examined whether living near PA destinations was associated with greater self-reported PA. The sample included Cardiovascular Health Study participants (N=3,922; mean age=75.3 years) from visit 5 (1992-1993). Quantity of PA destinations (e.g., gyms) within a one-kilometer Euclidean buffer of each participant’s home address was provided by the National Establishment Time-Series database. PA over the previous two weeks was self-reported via the Minnesota Leisure Time Activity Questionnaire. The exposure was dichotomized into having at least one PA destination (vs. none) within one kilometer of participants’ homes. Outcomes were based on the FITT components of PA outlined by the American College of Sports Medicine: Frequency (activities per week), Intensity (MET-minutes per week), Time (minutes per day), and Type (number of different activities, i.e., variety). Outcomes were modeled separately as five-level ordinal variables considering PA guidelines. Using ordinal logistic regression models adjusting for age, sex, health status, smoking, and body mass index, we found that living within one kilometer of at least one PA destination was associated with significantly increased odds of engaging in higher levels of all four PA components (odds ratios: 1.17-1.20, all Ps &amp;lt; 0.01). After adjusting for social factors (race, education, income), associations were attenuated and no longer significant. When evaluating barriers to PA, social determinants of health should be considered, in addition to proximity of PA destinations.

Encuesta Nacional de Tendencias de Fitness en España para 2024 (National Survey of Fitness Trends in Spain for 2024)

Palabras clave: encuesta española fitness, tendencias fitness, industria fitness, encuesta ACSM Abstract. This is the eighth edition of the National Surveys of Fitness Trends in Spain, which replicate the methodology of international surveys on global fitness trends developed and promoted by the American College of Sports Medicine (ACSM). Every year since 2017, the objective of this study is to determine the main trends in the Spanish fitness sector based on the results obtained from the survey conducted for 2024, as well as compare these results with those reported in the 2023 national and international surveys. Additionally, the potential current impact of COVID-19 on the sector and the main trends identified by the respondents were also analyzed. The survey was sent to 7,055 professionals related to the fitness sector, resulting in a response rate of 7.2%, that to say 511 professionals (28.3 % women) answered the survey. The five most relevant trends for 2024 were, in descending order: "functional fitness training", "hiring certified professionals", "personal training in small groups", "personal training", and "exercise regulation of fitness professionals". As has been happening in recent editions, the trends in the top-20 in Spain for 2024 were consistent with those reported in 2023, both in the number of coincidences (18 common trends), positions occupied (within the top-10 there were 9 trends common to both surveys), as well as in the top-1 (functional fitness training). Similarly, there was a greater discrepancy between the 2024 Spanish survey and the 2023 international survey, with 6 coincident trends within the top-10, 13 common trends in the top-20 and a clear disparity in relation to the positions occupied. These results confirm, in line with previous editions, the consistency of trends in the Spanish fitness sector and the consequent divergence with international trends. Keywords: Spanish fitness survey, fitness trends, fitness industry, ACSM survey

Use of Dual-Task Timed-Up-and-Go Tests for Predicting Falls in Physically Active, Community-Dwelling Older Adults-A Prospective Study.

This prospective study aimed to determine which specific mobility tests were the most accurate for predicting falls in physically active older adults living in the community. Seventy-nine physically active older adults who met the American College of Sports Medicine physical activity guidelines volunteered. Participants were assessed and followed up for 12months. Mobility assessments included the 30-s sit-to-stand test, five times sit-to-stand test, single-task timed-up-and-go test (TUG), motor dual-task TUG (Mot-TUG), and cognitive dual-task TUG (Cog-TUG). Mot-TUG and Cog-TUG performances were moderately correlated with number of falls (r = .359, p < .01 and r = .372, p < .01, respectively). When Mot-TUG, Cog-TUG, or Age were included as fall predictors, discrimination scores represented by the area under the receiver operating characteristic curve (AUC) were AUC (Mot-TUG) = 0.843 (p < .01), AUC (Cog-TUG) = 0.856 (p < .01), and AUC (Age) = 0.734 (p < .05). The cutoff point for Cog-TUG was 10.98s, with test sensitivity of 1.00 and specificity of 0.66. Fall predictors for different populations may be based on different test methods. Here, the dual-task TUG test more accurately predicted falls in older adults who met American College of Sports Medicine's physical activity guidelines.

Exercise for Hypertension: New Recommendation Strategies for Blood Pressure Control

ABSTRACT Hypertension is a leading preventable risk factor for cardiovascular disease, stroke, and premature death worldwide. Due to its undeniable antihypertensive effects, exercise training is advised as an effective nonpharmacological method of preventing, treating, and controlling hypertension by the main professional and scientific societies, including the American College of Cardiology, American Heart Association, European Society of Hypertension, American College of Sports Medicine, and Exercise and Sport Science Australia. In this review, we aim to summarize the current recommendations of exercise training for hypertension and discuss the emerging research supporting the integration of new exercise strategies, such as neuromotor and isometric resistance exercise, for the prevention and management of hypertension.

Development of an interpretable machine learning-based intelligent system of exercise prescription for cardio-oncology preventive care: A study protocol.

Cardiovascular disease (CVD) and cancer are the first and second causes of death in over 130 countries across the world. They are also among the top three causes in almost 180 countries worldwide. Cardiovascular complications are often noticed in cancer patients, with nearly 20% exhibiting cardiovascular comorbidities. Physical exercise may be helpful for cancer survivors and people living with cancer (PLWC), as it prevents relapses, CVD, and cardiotoxicity. Therefore, it is beneficial to recommend exercise as part of cardio-oncology preventive care. With the progress of deep learning algorithms and the improvement of big data processing techniques, artificial intelligence (AI) has gradually become popular in the fields of medicine and healthcare. In the context of the shortage of medical resources in China, it is of great significance to adopt AI and machine learning methods for prescription recommendations. This study aims to develop an interpretable machine learning-based intelligent system of exercise prescription for cardio-oncology preventive care, and this paper presents the study protocol. This will be a retrospective machine learning modeling cohort study with interventional methods (i.e., exercise prescription). We will recruit PLWC participants at baseline (from 1 January 2025 to 31 December 2026) and follow up over several years (from 1 January 2027 to 31 December 2028). Specifically, participants will be eligible if they are (1) PLWC in Stage I or cancer survivors from Stage I; (2) aged between 18 and 55 years; (3) interested in physical exercise for rehabilitation; (4) willing to wear smart sensors/watches; (5) assessed by doctors as suitable for exercise interventions. At baseline, clinical exercise physiologist certificated by the joint training program (from 1 January 2023 to 31 December 2024) of American College of Sports Medicine and Chinese Association of Sports Medicine will recommend exercise prescription to each participant. During the follow-up, effective exercise prescription will be determined by assessing the CVD status of the participants. This study aims to develop not only an interpretable machine learning model to recommend exercise prescription but also an intelligent system of exercise prescription for precision cardio-oncology preventive care. This study is approved by Human Experimental Ethics Inspection of Guangzhou Sport University. http://www.chictr.org.cn, identifier ChiCTR2300077887.

Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors.

To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.

Comparison of VO2max Estimations for Maximal and Submaximal Exercise Tests in Apparently Healthy Adults.

Due to limited accessibility, direct measurement of VO2max is rarely performed in clinical settings or sports centers. As a result, regression equations have been developed and are currently used during exercise tests to provide an indirect estimation. The American College of Sports Medicine (ACSM) has recommended a regression equation for running to provide an indirect estimation of VO2. However, significant differences have been observed between these estimations and directly measured VO2max. Additionally, since submaximal assessments may be more convenient for both athletes and sedentary/diseased individuals, they were included in the analysis. This study aimed to evaluate the accuracy of VO2max estimations provided using the ACSM running equation when used during both maximal and submaximal exercise tests among adult runners. A total of 99 apparently healthy and active adults (age: 39.9 ± 12.2 years; VO2max: 47.4 ± 6.0 mL O2/kg∙min-1) participated in this study. Two types of submaximal estimations were performed to predict VO2max: one based on age-predicted maximal heart rate (HRmax) (ACSMsubmax,Fox), and the second using the actual HRmax measured during the exercise test (ACSMsubmax,measured). The measured VO2max was compared to these estimations obtained from a single exercise test. Both maximal and submaximal exercise tests significantly overestimated VO2max (ACSMmax: +9.8, p < 0.001; ACSMsubmax,Fox: +3.4, p < 0.001; ACSMsubmax,measured: +3.8 mL O2/kg∙min-1, p < 0.001). However, the submaximal estimations were closer to the measured VO2max (p < 0.001). This analysis demonstrated that the included methods overestimated the true VO2max. Nonetheless, the submaximal exercise tests provided a more accurate prediction of VO2max compared to the maximal exercise tests when using the ACSM running equation.

A Narrative Literature Review on the Role of Exercise Training in Managing Type 1 and Type 2 Diabetes Mellitus.

Diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia associated with impaired carbohydrate, lipid, and protein metabolism, with concomitant absence of insulin secretion or reduced sensitivity to its metabolic effects. Patients with diabetes mellitus have a 30% more risk of developing heart failure and cardiovascular disease compared to healthy people. Heart and cardiovascular problems are the first cause of death worldwide and the main complications which lead to high healthcare costs. Such complications can be delayed or avoided by taking prescribed medications in conjunction with a healthy lifestyle (i.e., diet and physical activity). The American College of Sports Medicine and the American Diabetes Association recommend that diabetic people reduce total sedentary time by incorporating physical activity into their weekly routine. This narrative literature review aims to summarize and present the main guidelines, pre-exercise cardiovascular screening recommendations, and considerations for patients with diabetes and comorbidities who are planning to participate in physical activity programs.

Physical activity levels in female breast cancer patients and survivors in Ekurhuleni, South Africa.

By using complementary therapies, such as exercise rehabilitation during and after cancer treatment, breast cancer patients and survivors can improve their quality of life and overall health while also negating the deleterious effects of breast cancer and its treatment. The aim of this study was to determine the physical activity levels of female breast cancer patients and survivors in Ekurhuleni, South Africa. The International Global Physical Activity Questionnaire (2002) determined participants' physical activity levels during work, travel and leisure. The questionnaire was disseminated to medical facilities in hard copy format and online via the Google Forms platform. Statistics were computed using the Statistical Package for Social Science (SPSS) with the level of significance set at 95% (p < 0.05). One hundred female breast cancer patients and survivors with a mean age of 55 years from Ekurhuleni, South Africa participated in this study. The findings reflected that most participants (59%) were meeting the American College of Sports Medicine's physical activity guidelines when considering activity done during work, travel and leisure. No significant difference was seen in physical activity participation between breast cancer patients and breast cancer survivors, or those attending private and public facilities. For the breast cancer patient, physical activity and exercise may be a promising and effective adjuvant treatment both during and after anticancer therapies, improving quality of life, playing a role in increasing treatment tolerance, mitigating a range of symptoms and side effects brought on by cancer diagnosis and treatments and enhancing outcomes.

Adverse Event Assessment and Reporting in Exercise Oncology: A Review

ABSTRACT Exercise oncology trials report few adverse events, but the extent to which these adverse events are assessed and reported has yet to be quantified. The aim of this review was to evaluate adverse events assessment and reporting in exercise oncology trials that informed the American College of Sports Medicine’s 2019 Exercise Guidelines for Cancer Survivors, the leading guidelines document in exercise oncology. All trials that inform the Exercise Guidelines for Cancer Survivors were sourced for evaluation. In total, 231 clinical trials were identified. Approximately one-in-two trials included no detail of adverse event assessment methods and did not report intervention-related harms. Trials that described an adverse event assessment protocol reported higher numbers of adverse events compared with trials that did not. Many trials reported that adverse events were related to exercise; however, the majority of the trials did not define how this relationship was determined. Although the benefit of exercise postcancer is well established, findings from this review highlight the inadequacies of adverse events reporting within the exercise oncology field. The development and evaluation of a standardized adverse events assessment and reporting protocol for use in exercise oncology trials is needed.