Function In Survivors Research Articles

Association of Psoas Muscle Mass at Intensive Care Unit Admission With Physical Function and Post-discharge Destination in Survivors of Critical Illness

Association of Psoas Muscle Mass at Intensive Care Unit Admission With Physical Function and Post-discharge Destination in Survivors of Critical Illness

Abstract PO1-11-07: Do factors other than type of surgery performed for breast cancer affect quality of life and sexual functioning in breast cancer survivors? An observational study from Northern India

Abstract INTRODUCTION There is an increasing focus of the treating clinicians on issues related to quality of life and sexual functioning in breast cancer survivors. This is even more important in developing countries like India as the incidence of breast cancer in young in also significant here. However, despite this, there is little data from India on the factors affecting quality of life and sexual functioning on breast cancer survivors. Hence, we decided to perform this study. METHODS Patients who had undergone surgery for breast cancer within the last 2-5 years were included. Patients having significant psychiatric illness were excluded and so were patients who developed metastasis or local recurrence during the follow up. Questions on demographics, clinical history, standard of living index, quality of life (SF-36 questionnaire) and sexual function (CSFQ questionnaire) were asked. Data was analyzed using SPSS v22. Normality of continuous data was tested by Kolmogorov–Smirnov and Shapiro–Wilk tests. As a test of significance, chi square was used for qualitative data and t-test, Mann-Whitney U, and Kruskal-Wallis were used (as applicable) for quantitative data. Bonferroni adjustment was made wherever significance was found, if more than 1 group were involved. Multiple linear regression was carried out for quantitative dependent variables where significant risk factors were found. Independent variables with significant collinearity were excluded from linear regression. RESULTS A total of 120 patients were enrolled. In QOL scores, both physical health (B = -13.76, p = 0.007) and emotional problems (B = -10.65, p = 0.035) were affected adversely by endocrine therapy. Patients who had received radiotherapy had worse emotional well-being scores (B = -14.61, p = < 0.001). Patients who received chemotherapy or were married had significantly better social functioning score (B = 15.27, p = 0.020, B = 17.38, p = 0.041 respectively), whereas it was worse in patients who received trastuzumab (B = -18.32, p = 0.024). Pain scores were higher in premenopausal patients (B = 11.95, p = 0.021) and lower in patients having co-morbidities (B = -10.95, p = 0.039). None of the factors affected physical functioning, energy/fatigue, general health or health change scores. In sexual functioning scores, pleasure score (B = 1.27, p = 0.011) frequency scores (B = 1.97, p = 0.012), orgasm score (B = 3.43, p = 0.019) and total score (B = 12.30, p = 0.006) were higher in married women. Pleasure score was found to be lower in patients with co-morbidities (B = -0.82, p = 0.003). None of the factors affected desire or arousal. CONCLUSION Even though sexual functioning depended a lot on having a long-term partner, most of the factors affecting quality of life scores were treatment related. Actively addressing these concerns may help in improving quality of life and in turn, may improve compliance to treatment and follow-up. Citation Format: SIDDHANT KHARE, Devesh Dhamor, R N NAGA SANTOSH IRRINKI, Bijaya Padhi. Do factors other than type of surgery performed for breast cancer affect quality of life and sexual functioning in breast cancer survivors? An observational study from Northern India [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-07.

Comparative effect of Tai Chi and aerobic exercise on cognitive function in advanced lung cancer survivors with perceived cognitive impairment: a three-arm randomized controlled trial with mediation analysis.

Cancer-related cognitive impairment is prevalent in metastatic lung cancer survivors. This study aimed to compare the effectiveness of aerobic exercise and Tai Chi on perceived cognitive function and the mediating role of psychoneurological symptoms with perceived cognitive impairment. In a subgroup of a parent randomized clinical trial, participants who reported cognitive impairment underwent a 16-week aerobic exercise (n = 49), Tai Chi (n = 48), and control (n = 54) groups. Measures included perceived cognitive function and psychoneurological symptoms (sleep disturbance, fatigue, anxiety, and depression) assessed at baseline (T0), 16-week (T1), and 1year (T2). Participants in Tai Chi showed significant improvements compared to aerobic exercise and control groups in perceived cognitive function at T1 (AE: between-group difference, 6.52; P < 0.001; CG: 8.34; P < 0.001) and T2 (AE: between-group difference, 3.55; P = 0.05; CG: 5.94; P < 0.001). Sleep disturbance, fatigue, anxiety, and depression at month 12 explained 24%, 31%, 32%, and 24% of the effect of the intervention on cognitive function at month 12, respectively. Only anxiety at month 4 explained 23% of the intervention effect at month 12. Tai Chi demonstrated beneficial effects on cognitive function in advanced lung cancer survivors with perceived cognitive impairment. Improvement in cognitive function was mediated by reducing sleep disturbance, fatigue, anxiety, and depression, highlighting the importance of addressing these symptoms in future interventions to improve cognitive function, with anxiety playing a significant role at an earlier stage. Tai Chi is a potentially safe complementary therapeutic option for managing cognitive impairment in this vulnerable population. ClinicalTrials.gov identifier: NCT04119778; retrospectively registered on 8 October 2019.

Evaluation the Effect of Anthracyclines on Cardiac Function in Children Lymphoma Survivors by Left Ventricular Myocardial Work.

Anthracycline chemotherapy is associated with the left ventricular (LV) dysfunction, but the conventional echocardiographic parameter is insensitive in detecting subclinical cardiac dysfunction, and the role of echocardiography in children cancer survivors (CCSs) has not been well established. Here, the myocardial work (MW) was employed to evaluate the early effect of the anthracyclines on LV function in children lymphoma survivors, as well as to explore the clinical application value of this modality. 51 children lymphoma survivors treated with anthracyclines were included. During the treatments, the echocardiography was performed at baseline (T0 phase), the 3rd (T1 phase) and 6th (T2 phase) chemotherapeutic cycle, respectively. After that, the conventional echocardiographic parameters, LV global longitudinal strain (GLS), and global myocardial work (GMW) parameters were obtained. Finally, these echocardiographic parameters were compared to distinguish the differences among three groups, and correlation analysis was used to identify relationship between GMW parameters and LV GLS. Compared with the baseline, we found that there are no significant differences for LVEF and other conventional echocardiographic parameters after chemotherapy, but the value of LV lateral E/E' increased at T1 and T2 group. The GLS, global work index, global constructed work, and global work efficiency were decreased, while the global wasted work was increased after chemotherapy (all P < 0.05). The correlation analysis showed that the GLS has significant correlation with GMW parameters (all P < 0.001). The MW, as a new noninvasive echocardiography modality, could be used to quantitatively evaluate the LV MW in children lymphoma survivors treated with anthracyclines, which providing a sensitive method to early detect the children's LV dysfunction after the chemotherapy.

Psychosocial Factors Associated with Cognitive Function in Prostate Cancer Survivors on Hormonal Treatments: A Systematic Review.

Hormonal treatments (HT) for prostate cancer (e.g., androgen deprivation therapy) yield clinical and survival benefits, yet adverse cognitive changes may be a side effect. Since psychosocial factors are largely modifiable, interventions targeting these factors may help mitigate these adverse cognitive effects. This systematic review aimed to identify a range of psychosocial factors associated with cognitive function in individuals with prostate cancer undergoing HT and to determine whether these factors mitigate or exacerbate this effect. Applying PRISMA guidelines, a comprehensive search of relevant databases conducted in September 2023 using terms related to prostate cancer, hormone therapy, and cognitive outcomes was undertaken. The search yielded 694 unique abstracts, with 11 studies included for analysis examining the relationship between cognitive function and the following psychosocial factors: psychological distress, fatigue, insomnia, and coping processes. Findings were mixed with only two studies reporting significant associations between cognitive performance with fatigue and depression. Three studies that included measures of perceived cognitive function identified associations with depression, anxiety, fatigue, insomnia, illness threat appraisals, and coping styles. However, no studies found evidence for an association between self-reported and objective measures of cognitive functioning. Evidence regarding the association of interpersonal factors is lacking. Moreover, whether these factors mitigate or exacerbate the effect of HT on cognitive function still needs to be determined. Overall, the research exploring the association between psychosocial factors and cognitive function in prostate cancer survivors undergoing HT is still in its infancy. Further research is required to optimize the implementation of neuropsychological interventions for prostate cancer survivors.

Associations between mitochondrial copy number, exercise capacity, physiologic cost of walking, and cardiac strain in young adult survivors of childhood cancer.

Childhood cancer survivors are at risk for cardiac dysfunction and impaired physical performance, though underlying cellular mechanisms are not well studied. In this cross-sectional study, we examined the association between peripheral blood mitochondrial DNA copy number (mtDNA-CN, a proxy for mitochondrial function) and markers of performance impairment and cardiac dysfunction. Whole-genome sequencing, validated by quantitative polymerase chain reaction, was used to estimate mtDNA-CN in 1720 adult survivors of childhood cancer (48.5% female; mean age = 30.7years, standard deviation (SD) = 9.0). Multivariable logistic regression was performed to evaluate the associations between mtDNA-CN and exercise intolerance, walking inefficiency, and abnormal global longitudinal strain (GLS), adjusting for treatment exposures, age, sex, and race and ethnicity. The prevalence of exercise intolerance, walking inefficiency, and abnormal GLS among survivors was 25.7%, 10.7%, and 31.7%, respectively. Each SD increase of mtDNA-CN was associated with decreased odds of abnormal GLS (adjusted odds ratio (OR) = 0.88, p = 0.04) but was not associated with exercise intolerance (OR = 1.02, p = 0.76) or walking inefficiency (OR = 1.06, p = 0.46). Alkylating agent exposure was associated with increased odds of exercise intolerance (OR = 2.25, p < 0.0001), walking inefficiency (OR = 2.37, p < 0.0001), and abnormal GLS (OR = 1.78, p = 0.0002). Increased mtDNA-CN is associated with decreased odds of abnormal cardiac function in childhood cancer survivors. These findings demonstrate a potential role for mtDNA-CN as a biomarker of early cardiac dysfunction in this population.

The association of chemotherapy-induced peripheral neuropathy with reduced executive function in chemotherapy-treated cancer survivors: A cross-sectional study

IntroductionChemotherapy-induced peripheral neuropathy (CIPN) is common and disabling among cancer survivors. Little is known about the association of CIPN with other measures of the nervous system's integrity, such as executive dysfunction. We compared measures of executive function in older chemotherapy-treated cancer survivors with and without CIPN. Materials and MethodsThis cross-sectional study enrolled 50 chemotherapy-treated cancer survivors (65.6 ± 11.5 years, 88% female) post-chemotherapy treatment who were previously referred for outpatient rehabilitation at the request of the cancer survivor or a medical provider. Twenty-two participants (44%) had CIPN defined by patient-reported distal paresthesia or numbness, which began with chemotherapy and continued to the time of cognitive testing. Measures of executive function included Trails-B, Stroop, and rapid reaction accuracy (RRA) and were evaluated between cancer survivors with and without CIPN using t-tests. Multivariable models were then used to determine whether CIPN was an independent determinant of the measures of executive function (Trails-B, Stroop Incongruent, and RRA). Models were adjusted for age, sex, history of anxiety, and benzodiazepine use due to their known associations with CIPN and executive function. ResultsCancer survivors with CIPN (CIPN+) had reduced executive function compared to survivors without CIPN (CIPN-) on Trails-B (CIPN+: 84.9 s ± 44.1 s, CIPN-: 59.1 s ± 22.5 s, p = 0.01), Stroop (CIPN+: 100.6 s ± 38.2 s, CIPN-: 82.1 s ± 17.3 s, p = 0.03), and RRA (CIPN+: 60.3% ± 12.9%, CIPN-: 70.6% ± 15.7%, p = 0.01). There were no differences in cancer stage severity or functional status by patient report or sit-to-stand function. The association between CIPN and reduced executive function was found in multivariable models after adjusting for age, sex, anxiety, and benzodiazepine use for Trails-B (ß:17.9, p = 0.046), Stroop (ß:16.9, p = 0.02), and RRA (ß:-0.072, p = 0.03). DiscussionIn this population, CIPN is associated with reduced executive function in older cancer survivors treated with chemotherapy. Future research is required to further understand this preliminary association, the causality, and the potential risk factors.

The role of peer support and patient navigation for empowerment in breast cancer survivors: implications for community cancer control

Abstract Background: Community-based organizations (CBO) offer support, including patient navigation (PN), to women at-risk for (eg, those with BRCA pathogenic variants) and surviving with breast cancer. However, the impacts of CBO efforts on survivors' empowerment (eg, control, self-confidence, knowledge/skills, coping) are largely unknown. Methods: As part of a quality improvement initiative (N = 2,247) focused on PN, care satisfaction, peer support, and quality of life (QoL), we conducted a secondary analysis of a CBO care delivery model on women's empowerment. Results: Under CBO led cancer control, empowerment was high: most survivors felt confident in (71.2%) and knowledgeable about (66.4%) managing their care. Perceived care quality was also high (91%): it was recommendable to others (93.9%), helpful (92.7%), informative (92.6%), timely (92.2%), reliable (91.5%), supportive (91.3%), and effective (88.7%). Regarding CBO care satisfaction, survivors felt supported by abundant resources (92.8%) and programs (91.2%), understood (92.0%), and helped (91.6%). Peer support (offered to &gt;25%) demonstrated high engagement (&gt;85%). Regarding QoL, 25.3% were in fair/poor health and 25.6% endorsed frequent mental distress (M = 7.2 physically unhealthy days, M = 7.8 mentally unhealthy days, and M = 6.4 activity-limited days within the past month). Disparities in empowerment were observed as a function of survivors' QoL: lowest among those with more frequent mental distress (t = −2.13, P &lt; .05), mentally unhealthy days (r = −0.083, P &lt; .05), and activity-limited days (r = −0.058, P &lt; .05)). These burdens may have influenced survivors' feelings of empowerment, especially among those without peer support (t = 3.77, P &lt; .001), who downgraded the quality of PN (t = 0.60, P &lt; .01), and were least satisfied with CBO cancer control (t = 0.57, P &lt; .01). In a multivariable model adjusting for mental distress, both perceived PN quality (B = 0.16, SE = 0.01, P &lt; .001) and peer support (B = 0.24, SE = 0.13, P = .05) were positively associated with empowerment: survivors who rated their PN higher, and offered peer support, felt more empowered. Conclusions: CBO cancer control can uplift most survivors: addressing socially determined disparities, through programs such as peer support, may enhance their effectiveness and particularly among those with poor mental health.

Brain-computer interface-based hand exoskeleton with bidirectional long short-term memory methods

It takes at least 3 months to restore hand and arm function to 70% of its original value. This condition certainly reduces the quality of life for stroke survivors. The effectiveness in restoring the motor function of stroke survivors can be improved through rehabilitation. Currently, rehabilitation methods for post-stroke patients focus on repetitive movements of the affected hand, but it is often stalled due to the lack of professional rehabilitation personnel. This research aims to design a brain-computer interface (BCI)-based exoskeleton hand motion control for rehabilitation devices. The Bidirectional long short-term memory (Bi-LSTM) method performs motion classification for the ESP32 microcontroller to control the movement of the DC motor on the exoskeleton hand in real-time. The statistical features, such as mean and standard deviation from the sliding windows process of electroencephalograph (EEG) signals, are used as the input for Bi-LSTM. The highest accuracy at the validation stage was obtained in the combination of mean and standard deviation features, with the highest accuracy of 91% at the offline testing stage and reaching an average of 90% in real-time (80%-100%). Overall, the control system design that has been made runs well to perform movements on the hand exoskeleton based on the classification of opening and grasping movements.

Reliability and validity of a graphical computerized adaptive test Longshi scale for rapid assessment of activities of daily living in stroke survivors

Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson’s correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach’s coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P < 0.05). The CAT-LS results obtained using the decision-tree scoring model were consistent with the scores for each BI item. A strong correlation was observed between CAT-LS and BI (Pearson’s r: 0.6–0.894, P < 0.001). The CAT-LS demonstrated good internal consistency (Cronbach’s α, 0.803–0.894) and interrater reliability (ICC, 0.928–0.979). CAT-LS is time-efficient and requires < 1 min to administer. The CAT-LS is a reliable and valid tool for assessing ADL function in stroke survivors and can provide rapid and accurate assessments that reduce the burden on healthcare professionals. Further validation of this tool in other populations and settings is necessary.Study registration number: No.: ChiCTR2000034067; http://www.chictr.org.cn/showproj.aspx?proj=54770.

Concurrent brain structural and functional alterations in the thalamus of adult survivors of childhood brain tumors: a multimodal MRI study

Adult survivors of childhood brain tumors often present with cognitive deficits that affect their quality of life. Studying brain structure and function in brain tumor survivors can help understand the underlying mechanisms of their cognitive deficits to improve long-term prognosis of these patients. This study analyzed voxel-based morphometry (VBM) derived from T1-weighted MRI and the amplitude of low-frequency fluctuation (ALFF) from resting-state functional magnetic resonance imaging (rs-fMRI) to examine the structural and functional alterations in 35 brain tumor survivors using 35 matching healthy individuals as controls. Compared with healthy controls, brain tumor survivors had decreased gray matter volumes (GMV) in the thalamus and increased GMV in the superior frontal gyrus. Functionally, brain tumor survivors had lower ALFF values in the inferior temporal gyrus and medial prefrontal area and higher ALFF values in the thalamus. Importantly, we found concurrent but negatively correlated structural and functional alterations in the thalamus based on observed significant differences in GMV and ALFF values. These findings on concurrent brain structural and functional alterations provide new insights towards a better understanding of the cognitive deficits in brain tumor survivors.

Mitral Annular Plane Systolic Excursion: An Early Marker of Subclinical Left Ventricular Function in COVID-19 Survivors

Introduction: The left ventricular (LV) function can be affected by COVID-19. Mitral annular plane systolic excursion (MAPSE) is a measurement that reflects the function of the LV. The association between MAPSE and LV function in COVID-19 survivors is not well understood, and this study aimed to explore that relationship. Material and methods: The retrospective cross-sectional study comprised 99 patients with a history of SARS-CoV-2 infection. These patients experienced symptoms lasting more than 2 months following the initial SARS-CoV-2 virus infection, including fatigue, shortness of breath, chest pain, and cough. The patients were categorized into two groups based on their MAPSE measurements: those with low MAPSE (&lt;12 mm) and those with non-low MAPSE (&gt;12 mm). MAPSE measurements were acquired using transthoracic echocardiography (TTE). Results: COVID-19 patients with low MAPSE, global longitudinal strain (GLS) (%) ([-17.61±0.95] - [-18.90±1.08], p &lt;0.001) and mitral E/A ratio ([0.83±0.39] - [0.97±0.23], p = 0.028) were statistically significant compared to the the group without low MAPSE. Left atrial volume index (LAVI) in mm/m2 ([37.24±2.11] - [35.34±2.50], p =0.001) was higher in the group of COVID-19 patients with lower MAPSE. High-sensitivity troponin T (Hs-TnT) (OR: 2.019, 95% CI: 1.043-3.712, p =0.028), intensive care unit (ICU) admission (OR: 1.432, 95% CI: 1.004-2.708, p =0 .037) and need for invasive mechanical ventilation (IMV) support (OR: 1.306, 95% CI: 1.128-2.630, p =0.004) were identified as independent predictors of reduced MAPSE. Conclusions: SARS-CoV-2 infection may lead to reduced or impaired MAPSE values, indicative of impaired LV function, in COVID-19 survivors. Additionally, our study revealed that elevated levels of (Hs-TnT), admission to the ICU, and the need for IMV support were predictive factors for low MAPSE values. These findings underscore the potential cardiac implications of COVID-19 and highlight the importance of monitoring cardiac function in patients with severe disease manifestations.

Effects of Screen Time on Emotional and Behavioral Functioning in Pediatric Cancer Survivors: The Potential Mediating Role of Sleep and Fatigue

Effects of Screen Time on Emotional and Behavioral Functioning in Pediatric Cancer Survivors: The Potential Mediating Role of Sleep and Fatigue

Abstract 7454: Cognitive function in older breast cancer survivors after chemotherapy

Abstract Background: In the United States, over 60% of breast cancer survivors are 65 years and older; however, little is known about patient-reported symptoms and the effect that cancer treatments could have on survivors years after their primary treatment and diagnosis. This study evaluated perceived cognitive function in older breast cancer survivors and whether prior chemotherapy was associated with cognitive outcomes. Methods: Breast cancer patients aged 65 years and older, diagnosed 2012-2013, with local and regional stage disease, were identified through the linked Texas Cancer Registry-Medicare dataset (TCR). Survivors were mailed a survey to assess their cognitive function through the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog V3) instrument (section G of the survey). The survey also collected demographic and clinical data and was collected between April 2018 and October 2019. Utilizing the data from the self-administered questionnaires, TCR, and Medicare claims, the cognitive function and quality of life among elderly patients were evaluated to assess whether prior chemotherapy and/or endocrine therapy impacts long-term health. A linear regression model was used to examine the significance of receiving chemotherapy to FACT-Cog V3 primary score while controlling for respondent sociodemographic and clinical variables. Results: Of 4,448 eligible patients, 1,954 (43.9% response rate) responded to section G. Of these, 1,065 respondents completed all 4 sections, 37 questions. Eighty of those 1065 respondents self-reported disease recurrence which excluded them from the analyses in order to avoid biases, leaving a total of 985 cases for this study. Median time from diagnosis to survey completion was 68 months (IQR 62-73). Receipt of chemotherapy was associated with a slightly lower FACT-Cog score. In total, those with chemotherapy scored, on average, 105.6 (SD 21.2) while those without scored 107.1 (SD 22.3). The largest difference in mean scores is attributed to the Perceived Cognitive Impairment subsection (scored from 0-72) where those with chemotherapy scored, on average, 57.2 (SD 13.8) and those without scored 58.7 (SD 14.0). Responsible Conduct Of Research: We need to ensure that the privacy of our patients will be protected when using their information from the surveys. Conclusion: Adjuvant chemotherapy was associated with more self-reported cognitive impairment in older breast cancer survivors, even 5-6 years after diagnosis. However, the difference between patients who received chemotherapy versus those who did not was modest, suggesting limited clinical significance. Further research is needed to determine the long-term impact of cancer treatments, particularly in older cancer survivors. Citation Format: Rachel Kim, Kai-Ping Liao, Susan Peterson, Daria Zorzi, Liang Li, Mariana Chavez MacGregor, Sharon Giordano. Cognitive function in older breast cancer survivors after chemotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7454.

Ankle-foot orthosis in stroke survivors: status of the issue

This paper presents an analysis of information regarding the peculiarity of ankle joint orthosis in cerebral stroke survivors. Gait research methods used to assess gait changes in patients who had suffered a cerebral stroke were briefly reviewed. The three most common patterns of gait impairment after a stroke, namely, stiff-knee gait, “dropped foot,” and gait with knee joint hyperextension, were described. A brief review of the main functional types of ankle joint orthoses, namely, static and dynamic, considering their strengths and weaknesses, was presented. Changes in temporal, spatial, and kinematic parameters of gait in cerebral stroke survivors using orthoses were reported. Changes in gait parameters when using ankle joint orthoses depending on the initial pattern of gait disturbance were assessed. The effect of orthotics on the angles of flexion in the ankle, knee, and hip joints at various gait phases as well as their effect on the speed, rhythm, and length of the step were described. Data on the effect of ankle orthosis on patient’s ability to maintain balance were also presented. The effects of orthosis on gait biomechanics and balance function in stroke survivors are debatable. Thus, our findings in this study allow us to raise the question regarding the optimal timing of the use of ankle joint orthoses during the recovery period of a stroke. Possible reasons for these ambiguous results were considered. The necessity for further research into the effectiveness of ankle–foot orthoses regarding various pathological gait patterns in stroke survivors is justified.

Abstract 6290: Effects of a circuit, interval-based exercise program on vascular function among cancer survivors

Abstract Background: Cancer survivors are at an increased risk of cardiovascular comorbidity, including atherosclerosis, hypertension, and heart failure, due to negative impacts of cancer treatments on vascular function. Exercise is recommended in recent cardio-oncology rehabilitation guidelines and has been shown to improve vascular function in clinical populations; however, its effects on vascular function are understudied in clinical oncology settings. Purpose: This pilot study examined whether a circuit, interval-based exercise intervention can improve vascular function, assessed by brachial artery flow-mediated dilation (baFMD) and carotid intima media thickness (cIMT) in breast, prostate, and colorectal cancer survivors. Methods: Overweight or obese (BMI&amp;gt;25.0 kg/m2), sedentary breast, prostate or colorectal cancer survivors were randomized to exercise (n=60) or usual care (n=30). Survivors in the 4-month exercise intervention trained three times/week, in a circuit, interval-based supervised moderate-vigorous aerobic (65-85% of VO2max) and resistance (65-85% of 1-repetition maximum) program. cIMT and baFMD were measured at baseline and post-intervention via an ultrasound. Paired t-tests and repeated-measures analysis of variance were run to assess within- and between-group differences. Results: The study sample included breast (n=38), prostate (n=24), colorectal (n=28) cancer survivors who were 63.2 ± 10.8 years old, completed chemotherapy and/or radiation (75%) and were obese (87%). Post-intervention, baFMD significantly increased in the exercise group compared to the control group (between-group mean difference: 6.3%; 95% CI: [1.9 to 9.3], p=0.001). There was also a significant reduction in cIMT in the exercise group compared to the control group (between-group mean difference: -0.039mm, 95% CI: [-0.080 to -0.009], p=0.002). Conclusions: Our findings in this pilot study support that a circuit, interval-based aerobic and resistance exercise intervention may improve vascular function in breast, prostate, and colorectal cancer survivors. Future studies are recommended to understand how exercise interventions can be utilized clinically to improve cardiovascular disease risk and co-morbidity among cancer survivors. Citation Format: Cami N. Christopher, Dong-Woo Kang, Paola Gonzalo-Encabo, Rebekah L. Wilson, Amber J. Normann, Mary K. Norris, Christina M. Dieli-Conwright. Effects of a circuit, interval-based exercise program on vascular function among cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6290.

Systemic Biological Mechanisms of Neurocognitive Dysfunction in Long-term Survivors of Childhood Hodgkin Lymphoma.

Hodgkin lymphoma (HL) survivors experience neurocognitive impairment despite receiving no central nervous system-directed therapy, though little is known about underlying mechanisms. HL survivors (n=197) and age-, sex- and race/ethnicity-frequency-matched community controls (n=199) underwent standardized neurocognitive testing, and serum collection. Luminex multiplex or ELISA assays measured markers of inflammation and oxidative stress. Linear regression models compared biomarker concentrations between survivors and controls and with neurocognitive outcomes, adjusting for age, sex, race, body mass index, anti-inflammatory medication, and recent infections. HL survivors (mean[SD] current age 36[8] years, 22[8] years post-diagnosis) demonstrated higher concentrations of interleukin-6 (IL-6), high-sensitivity c-reactive protein (hs-CRP), oxidized low-density lipoprotein, and glutathione peroxidase (GPx), compared to controls (p's<0.001). Among survivors, higher concentrations of IL-6 were associated with worse visuomotor processing speed (p=0.046). hs-CRP ≥3 mg/L was associated with worse attention, processing speed, memory, and executive function (p's<0.05). Higher concentrations of malondialdehyde were associated with worse focused attention and visual processing speed (p's<0.05). Homocysteine was associated with worse short-term recall (p=0.008). None of these associations were statistically significant among controls. Among survivors, hs-CRP partially mediated associations between cardiovascular or endocrine conditions and visual processing speed, while IL-6 partially mediated associations between pulmonary conditions and visuomotor processing speed. Neurocognitive function in long-term survivors of HL appears to be associated with inflammation and oxidative stress, both representing potential targets for future intervention trials.

Development and Internal Validation of a Multivariable Prediction Model for the Sexual Function of Cervical Cancer Survivors

Development and Internal Validation of a Multivariable Prediction Model for the Sexual Function of Cervical Cancer Survivors

Effects of vaginal dilation therapy on vaginal length, vaginal stenosis, vaginal elasticity and sexual function of cervical cancer survivors

Background Cervical cancer survivors can experience vaginal length shortening, vaginal stenosis, vaginal elasticity deterioration, sexual frequency reduction and sexual dysfunction. This prospective, uncontrolled, monocentric clinical interventional study aimed to evaluate the effect of vaginal dilation therapy on vaginal condition and sexual function of cervical cancer survivors who had not received timely vaginal dilation. Methods A total of 139 patients completed the study. They received 6 months of vaginal dilation therapy. We evaluated their vaginal elasticity, vaginal diameter, vaginal length and sexual function before and after vaginal dilation therapy. Their vaginal conditions were evaluated by customised vaginal moulds, and the sexual function was assessed by female sexual function index. The SPSS 25 software was used to analyse all the data. Results Age, vaginal diameter and sexual intercourse frequency before diagnosis were significantly associated with female sexual dysfunction of the patients after cancer treatment. Vaginal dilation therapy improved vaginal stenosis, vaginal length and sexual function in all the patients; however, the vaginal elasticity and incidence of sexual dysfunction did not improve significantly. Sexual intercourse frequency before diagnosis, vaginal elasticity, time interval from last treatment and treatment modalities were significantly associated with the change in female sexual function index score before and after vaginal dilation therapy. Patients with a time interval from the last treatment less than 24 months or those who had moderate or good vaginal elasticity, benefitted more from vaginal dilatation therapy. Conclusions Cervical cancer survivors who had not received timely vaginal dilation still benefitted from vaginal dilation therapy, irrespective of the treatment methods they received. Moreover, vaginal dilation therapy should be performed as early as possible after cervical cancer treatment.

A randomized comparison of online mindfulness-based group sex therapy vs supportive group sex education to address sexual dysfunction in breast cancer survivors.

Sexual difficulties and vaginal pain are common following treatment for breast cancer. The goal of this study was to evaluate an online mindfulness-based group sex therapy vs an online supportive sex education group therapy to address these sexual difficulties. Breast cancer survivors (n= 118) were randomized to 1 of the 2 arms; 116 provided informed consent and completed the time 1 assessment. Treatment included 8 weekly 2-hour online group sessions. Those randomized to the mindfulness group completed daily mindfulness exercises, and those in the comparison arm read and completed exercises pertaining to sex education. Assessments were repeated at posttreatment and 6 months after the completion of the group. There was a main effect of treatment on primary endpoints of sexual desire, sexual distress, and vaginal pain, with all outcomes showing significant improvements, with no differential impact by treatment arm. Secondary endpoints of interoceptive awareness, mindfulness, and rumination about sex also significantly improved with both treatments, with no group-by-time interaction. Both mindfulness-based sex therapy and supportive sex education delivered in group format online are effective for improving many facets of sexual function, vaginal pain, rumination, mindfulness, and interoceptive awareness in breast cancer survivors. We used a randomized methodology. Future studies should seek to diversify participants. These findings highlight the need to offer similar treatments to more breast cancer survivors immediately after and in the years following cancer treatment as a means of improving survivorship quality of life.