Physical Activity Prescription Research Articles

Activité Physique Adaptée et cancer métastatique : quels besoins et quelles attentes ?

Between October 2019 and March 2020, 60 medical oncologists and 305 patients with metastatic cancer were asked to fill in a self-completed questionnaire. The benefits of physical activity are recognised by most oncologists and patients. These benefits were perceived more by oncologists in prevention (78%) or in the early stage (72%) of the disease than in the metastatic stage (55%) (P=0.01). Patient's physical condition (45%) and age (37%) but also the lack of time during the consultation to explain supportive care (35%) are the main obstacles identified by the oncologist to the integration of physical activity into patient care. Furthermore, lack of knowledge of adapted programmes is the main reason given by the physicians who have never prescribed physical activity (51%). On the patient side, while 88% of them had heard of the benefits of physical activity, only 11% had received a prescription. Most oncologists and patients were very interested in receiving information on where and what types of activities to practice, as well as what to avoid. Efforts in terms of information for both oncologists and patients seem necessary to increase the level of physical activity prescription and practice for patients followed for metastatic cancer.

Clinical Relevance and Implementation Considerations of Physical Activity in Young Adult Cancer Survivorship: An Expert Consensus Study.

Significance: Elevated survival rates in young adult cancer survivors (YACS) are accompanied by high morbidity levels resulting in an array of unmet needs limiting full life potential. Physical activity (PA) improves physical, psychological, and social aspects of health after a cancer diagnosis. There are no standardized PA guidelines tailored to YACS. Therefore, there is a critical need to understand areas of clinical relevance/agreement on PA use and implementation in young adult (YA) survivorship care. Aim: To identify expert consensus areas on the assessment, prescription, and implementation of PA in YA survivorship care; identify areas of clinical relevance and endorsement of PA as a health optimization strategy in YA survivorship care. Methods: A four-round modified Delphi study of international multidisciplinary experts (Round I/II n = 18; Round III n = 57, Round IV n = 45) in exercise oncology, symptom management, survivorship care, youth cancer care was conducted. Qualitative content analysis, descriptive statistics (% agreement, standard deviation, mean), and inter-rater reliability (Kappa) were calculated. Results: Experts reached a consensus on clinical providers needed to assess, refer, and provide PA interventions, the need for guidelines, and essential care delivery system components to foster the integration of PA integration in YA survivorship care as a health optimization activity. Conclusions/Implications: Cancer care integration models should optimize the unique preferences, strengths, and developmental stage of YA affected by cancer. The study adds to the existing literature on multidisciplinary teams needed to provide clinical expertise and organizational support to foster PA integration into YA survivorship care.

Promoting Health and Behavior Change through Evidence-Based Landscape Interventions in Rural Communities: A Pilot Protocol.

Rural communities in the United States have many public health issues, including a high prevalence of physical inactivity, obesity, and higher risks for major non-communicable diseases. A lack of safe and convenient places to exercise could intensify healthy lifestyle disparities. Individually adapted physical activity prescriptions at the primary level of healthcare could play a role in behavior change for rural residents. Healthcare professionals and designers created the rural wellness hub concept, which integrates walking trails and therapeutic landscape features on the clinic site, to support patient physician-prescribed activities and treatments. This research protocol reports the design and implementation of the rural wellness hub at a clinic in Clay County, West Virginia. Following a participatory, evidence-based landscape intervention (EBLI) protocol, 58 user representatives (patient = 49; clinic employee = 9) participated in the four-phase protocol: (1) pre-design survey, (2) design and development, (3) post-design interview, and (4) post-occupancy evaluation. Survey and interview data from all phases were collected and analyzed. The preliminary results indicate that the redesigned clinic campus could promote several health programs among local communities, with the benefits of walking trails, in particular, highlighted. The rigorous EBLI protocol could serve as a template for rural communities that seek to develop similar healthcare intervention programs.

Influence of Ageism on Physical Activity Prescription for Prediabetes Management.

This study used a randomized online survey design to examine the potential influence of ageism on physical activity (PA) prescription for hypothetical patients with prediabetes of different chronological ages. Participants included 356 kinesiology students who were randomly assigned to one of four conditions. Each condition presented a clinical case study of a hypothetical patient with prediabetes referred to the participant as a qualified exercise professional for a PA intervention. Case studies were identical except for the reported patient's chronological age. Participants provided recommendations for PA support, frequency, duration, and intensity. Significant main effects were observed for PA duration, F(3, 352) = 8.62; p < .001, and intensity, F(3, 352) = 16.20; p < .001. The older patient was prescribed significantly lower PA duration and intensity compared to younger patients and no-age control. This study provides evidence for the presence and independent influence of ageism against older patients in PA prescription for prediabetes management.

Implementing Exercise = Medicine in routine clinical care; needs for an online tool and key decisions for implementation of Exercise = Medicine within two Dutch academic hospitals

BackgroundThere is much evidence to implement physical activity interventions for medical reasons in healthcare settings. However, the prescription of physical activity as a treatment, referring to as ‘Exercise is Medicine’ (E = M) is currently mostly absent in routine hospital care in The Netherlands. To support E = M prescription by clinicians in hospitals, this study aimed: (1) to develop an E = M-tool for physical activity advice and referrals to facilitate the E = M prescription in hospital settings; and (2) to provide an E = M decision guide on key decisions for implementation to prepare for E = M prescription in hospital care.MethodsA mixed method design was used employing a questionnaire and face-to-face interviews with clinicians, lifestyle coaches and hospital managers, a patient panel and stakeholders to assess the needs regarding an E = M-tool and key decisions for implementation of E = M. Based on the needs assessment, a digital E = M-tool was developed. The key decisions informed the development of an E = M decision guide.ResultsAn online supportive tool for E = M was developed for two academic hospitals. Based on the needs assessment, linked to the different patients’ electronic medical records and tailored to the two local settings (University Medical Center Groningen, Amsterdam University Medical Centers). The E = M-tool existed of a tool algorithm, including patient characteristics assessed with a digital questionnaire (age, gender, PA, BMI, medical diagnosis, motivation to change physical activity and preference to discuss physical activity with their doctor) set against norm values. The digital E = M-tool provided an individual E = M-prescription for patients and referral options to local PA interventions in- and outside the hospital. An E = M decision guide was developed to support the implementation of E = M prescription in hospital care.ConclusionsThis study provided insight into E = M-tool development and the E = M decision-making to support E = M prescription and facilitate tailoring towards local E = M treatment options, using strong stakeholder participation. Outcomes may serve as an example for other decision support guides and interventions aimed at E = M implementation.

Pilot Feasibility Assessment of a Tailored Physical Activity Prescription in Overweight and Obese People in a Public Hospital.

We aimed to evaluate the feasibility of a tailored physical activity (PA) prescription in overweight and obese people in a tertiary hospital in Lima, Peru. A feasibility pre–post-pilot study was conducted using mixed methods. Participants received a tailored prescription scheme for PA that lasted twelve weeks. It included two prescription sessions, three follow-up phone calls, and three evaluations. Primary feasibility outcomes were recruitment, visits, and phone call adherence. Primary intervention outcomes were self-reported PA levels and the 6 min walk test. Out of 228 people invited to participate, 30 were enrolled and received the first session of prescription, 11 went to the second session, and 21 went to the final evaluation; phone call participation decreased progressively during follow-up. There were no differences in the 6th week and the 12th week compared to the baseline for all the measures, except in the 6 min walk test. The participants considered the intervention was well designed, but they suggested complementing it with dietary instructions. The prescription of PA in overweight and obese people is feasible for promoting PA, but its implementation requires refinements to anticipate possible barriers to changing behavior.

P07-01 Prescription of adapted physical activity: knowledge and needs among general practitioners of Ile-de-France

BackgroundPhysical inactivity is the fourth leading cause of death in the world. In France, the concept of medical prescription of physical activity (PA) adapted now appears in a law which specifies the central role of the family physician since December 2016. The needs of the general practitioners (GP) about prescription of PA has not been studied.AimTo assess the knowledge and needs of GPs regarding the medical prescription of PA.MethodsThis is a transversal observational epidemiological study of GPs working in the departments of Hauts-de-Seine (92) and Val-de-Marne (94) near Paris. A questionnaire was sent by mail or email. A descriptive statistical analysis was conducted to describe the main variables of interest. Then, a multivariate statistical analysis by logistic regression was conducted to look for independent factors of the feeling of competence in the prescription of adapted PA.Results158 physicians were included. 72.2% of GPs rated their knowledge in PA as average to very poor. The initial training in PA is estimated as unsatisfactory by 84.2% of GPs. 81.6% haven't done a postgraduate additional training in PA. A specific skill in sports medicine, the individual practice of PA as well as the speaking about PA in more than 50% of consultations are significantly associated with a feeling of competence in PA prescription (p >0.01).Among the measures favoring the prescription of PA, GPs told that they need information brochures to give to the patient (60.8%), a website of help to the prescription of PA which can be used in consultation (60.1%), or the organization of a specific training on the medical prescription of AP (50,6%).ConclusionThe lack of training seems to be the major obstacle to the generalization of prescription of PA. The organization of training or the creation of specific tools for the attending physician seems to be promising solutions.

P07-13 Barriers and opportunities to improve collaboration between healthcare and physical activity professionals involved in prescribing physical activity for inactive people in the Netherlands

BackgroundHealthcare professionals play an important role in motivating inactive people with a chronic disease (e.g. diabetes, cancer, heart disease) for physical activity. They can initiate a discussion about physical activity with the patient and refer to a physical activity (PA)-professional for more detailed action-planning through ‘physical activity on prescription'. However, the collaboration between healthcare and PA-professionals to refer and guide patients to physical activities is in its infancy and can be improved. To enhance this collaboration the aim of our study was to evaluate how the collaboration is shaped and what barriers were experienced.MethodsWe conducted an exploratory study in which quantitative and qualitative research methods were used. Two online questionnaires were distributed among PA-professionals in the Netherlands (spring and autumn 2021). Questionnaires were returned by respectively 209 and 116 respondents. Questions on how the collaboration was shaped, how the collaboration worked and what barriers were experienced were asked. Besides that, two focus group discussions were held with PA-professionals (n = 8) focussing on barriers and opportunities to improve ‘Physical activity prescription'.ResultsMore than half of the Dutch PA-professionals indicate that they collaborate with healthcare professionals in primary care (56%) to guide patients to physical activities. Far fewer PA-professionals collaborate with healthcare professionals in secondary care (22%). Half of the respondents indicate that they experience the collaboration in physical activity prescription as insufficient (47%). Most important barriers are determined, for example healthcare and PA-professionals are unfamiliar with each other; there is uncertainty about roles and tasks of professionals involved; there is a lack of communication; PA-professionals sometimes do not have the skills to guide people with a chronic disease. Finally, a lack of time and budget limits the collaboration between professionals involved in physical activity on prescription.ConclusionsThe collaboration between professionals to refer and guide inactive people with a chronic disease from the healthcare setting to physical activities can be improved by responding to the barriers that are indicated by this study. This study contributes to improving health-enhancing physical activity in an inactive target group and decreasing the prevalence of physical inactivity.

P07-02 Prescription of adapted physical activity: expectations of patients consulting general practitioners in the department of Yvelines

BackgroundSince 2016, French law has allowed general practitioners to prescribe adapted physical activity (APA) to patients with long-term health conditions. Studies have demonstrated that physicians are interested in this practice but very few have surveyed patient expectations.ObjectiveThe objective of this work was to study patients' expectations regarding the prescription of APA.MethodsThis is a quantitative descriptive study treating data obtained from a survey carried out in general practice offices in the department of Yvelines between June and September 2019. The inclusion criteria for patients were: above 18 years old and present in the waiting room.Results252 patients were surveyed in 9 doctors' offices. We received 90% of responses. Prescription of APA is a good idea for 95.2% of patients, 80.2% were motivated to join an APA program and 67.4% thought that prescription of APA would increase their motivation. The main constraints to physical activity practice were lack of time (59.9%) and lack of motivation (31.7%). The main practices that would help patients to better adhere to an APA program were group sessions supervised by a professional (64.7%) pursued by a follow up with their doctor (41.7%). 53.2% of patients considered that it would be important to monitor their physical activity through a connected device. Factors independently associated with the motivation to participate in the APA program were a female gender (p > 0.01), a bachelor's degree (p = 0.01), a general opinion that prescription of physical activity is a good idea (p > 0.01).ConclusionOur results revealed an enthusiasm with patients for APA prescription, which is interesting for the promotion of PA in general medicine.

P07-09 Physical activity prescription for chronic disease in Belgium: results of a 6-month intervention led by physical educators

BackgroundPhysical activity (PA) prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease (Thornton et al., 2016). However, physicians report that they do not deliver PA counselling because of limitations in time, knowledge, confidence, and practical tools (Meriwether, Lee, Lafleur, & Wiseman, 2008). Physical educators have the required skills to address those issues in encouraging patients to adopt an active lifestyle that will reduce the incidence of their chronic conditions. In Belgium, physical activity prescription initiatives are emerging: this study aimed at monitoring one of these to ensure the development of evidence-based intervention relying on HEPA best practices.MethodsWith a PA prescription from their doctor, patients with chronic cardiac, neurological, metabolic, oncologic or spinal disease took part to a 6-month intervention supervised by physical educators in a Belgian municipality. The program was composed of weekly sessions of physical exercise focusing on the 4 dimensions of physical fitness according to international recommendations (ACSM, 2016). Monthly motivational sessions were also organized to promote active lifestyle. Monthly assessments included PA level (Ricci & Gagnon,2011), SF-36 (Ware & Sherbourne, 1992), and Senior Fitness Test (Rikli & Jones, 2001).ResultsPreliminary results after one month intervention on 19 patients (68.6 ± 10.8 years) with chronic cardiac (n = 11), neurological (n = 2), metabolic (n = 1), oncological (n = 4) or spinal (n = 1) disease exposed significant improvements of their lower (p = 0.03) and upper (p = 0.01) body strength, and aerobic endurance (p = 0.17). No significant changes were observed for physical activity level and SF-36 scores. Further results will provide information about the impact of motivational sessions on the adoption of an active lifestyle.ConclusionsPhysical activity prescription supervised by physical educators has the potential to bridge the missing link between hospital revalidation performed by health care professionals and autonomous physical activity. If outcomes are favourable, it could provide an advocacy to inspire key decision makers and policies to ameliorate chronic diseases care involving physical educators. Future local interventions should therefore rely on existing guidelines (Inserm, 2019) and support the development of this specific HEPA environment.

P06-13 Movida.Cronos – eHealth app at primary care to fight sedentary behavior

BackgroundHealth systems play a fundamental and recognized role in promoting physical activity, particularly in the context of primary health care. eHealth is a broad concept that incorporates any area that combines healthcare and technology. This concept is often associated with improvements in process efficiency and cost reduction. Still, high occurrence of physical inactivity demonstrate the importance of developing new eHealth approaches for a more effective actuation. The aim of this work was to develop a new methodology to increase physical activity level, at primary health care.MethodsA mobile application with web platform was developed to: physical activity prescription and monitoring; registration of biomedical variables, sending messages to users, managing physical activity events at the initiative of users (social network). The application was explained to the medical doctors and data from a case-study was accessed (56 years-old male, Caucasian, single, nuclear family, upper middle class). History of physical inactivity, obesity, hypertension, dyslipidemia and depressive disorder (sertraline 50mg and mexazolam 1mg therapy), body composition, physical and CRP fitness were assessed. International physical activity and Self-perceived quality of life assessment questionnaires were also used.ResultsIt was possible to understand that just by talking was not enough to engage the patient on a more active lifestyle. After several failed attempts on counseling for lifestyle changing, patient was referred for using the developed app. Physical exercise tailored plan was prescribed using the Movida.cronos. This tool opened the possibility of assessing patient performance and adherence to the prescribed program (>90%). It allowed a narrow informative channel between the patient and the medical doctor. In three months, the patient reduced form obesity to overweight (-3.4%), decrease his waist circumference (-6.3%), fat mass (-1.8%) and arterial mean pressure (-5.1%); with an associated increase on step test performance.ConclusionsThis case study demonstrate the potential use of eHealth technology, particularly in primary care. Movida.Cronos allowed the prescription and monitoring of performance and adherence levels to the prescribed exercise program. It brings novel perspectives on prescription and remote monitoring of physical exercise, leading to an increased adherence.

P07-04 A systematic review of key interventional elements in international exercise referral schemes

BackgroundWith the first initiatives dating back to the 1990s, the past two decades have seen a rapid increase in the use of exercise referral schemes (ERS) worldwide. Despite the accumulating evidence on their effectiveness, there are currently no international guidelines available to inform the design of such interventions. The key elements and processes employed vary both within and between countries. This systematic review aims to address this frequently overlooked topic by identifying elements that are predominant in international ERS.MethodsScientific databases (PubMed, Scopus) and grey literature sources were systematically searched. In order to collect the information relevant for understanding and visualizing all ERS models, a broad spectrum of document types was considered eligible for inclusion, i.e. randomized controlled or pragmatic trials, cohort studies, case-control studies, case series, case reports, qualitative studies, economic evaluations, mixed designs, policy documents, and official governmental reports. We extracted data on scheme components, contents, and main actors involved in scheme delivery. Cross-functional flowcharts were employed to facilitate comparison between different ERS designs: Firstly, the collected data were visualized in flowcharts indicating the pathway a patient follows from beginning to end of an individual ERS. Secondly, elements that appeared more frequently across all included ERS were identified.ResultsPreliminary results identified 18 models of ERS that were eligible for data analysis, including Green Prescription (New Zealand), Hreyfiseðill (Iceland), National Exercise Referral Scheme (Wales). Program designs ranged from short advice by a primary healthcare professional to physical activity prescription and/or further referral to affiliated health professionals. The prevailing actors involved in scheme delivery were physicians, nurses, physiotherapists, training experts, physical activity providers, and coordinators. Seven predominant elements emerged from the comparison between ERS designs: assessment, counselling, individualized physical activity recommendations, written prescription, behavior change techniques, support person, and follow-up.ConclusionsTo the best of our knowledge, this is the first study that takes a closer look at the design characteristics of ERS across the world. Our preliminary results indicate that there are seven key elements. The contribution of these elements on the effectiveness of ERS needs to be explored in future research.

P07-10 Nice acti'santé: Let’s move for health in Nice

IssueIn view of the multiple benefits, the integration of physical activity into the health care pathway of people with chronic diseases is a major issue. In Nice, nearly a third of the population is over 60 years old and more than 60,000 people are in long-term illness. In view of this, the City of Nice has decided to set up a physical activity prescription device named Nice Acti'Santé to support people in Nice with a chronic illness who want to make physical activity part of their life.Description of the problemThe main objective of the device is to encourage people with a chronic disease to engage in a physical activity appropriate to their health. A medico-active process has been implemented to meet this objective: (a) the doctor guides his patient toward the Nice Acti'Santé platform, (b) the platform team makes a free checkup of the patient and guides him toward a partner sports club, (c) the doctor validates the patient's orientation, prescribes the physical activity and signs the certificate, (d) the partner sports club takes charge of the patient and the plateform team sets up a follow-up, (e) after 4 months, the platform team makes a new checkup of the patient and guides him toward an autonomous practice and, (f) the doctor validates the new patient's orientation and signs the certificate.ResultsPreliminary results show that 1 out of 2 patients is registered in a partner sports club after being taken charge on the platform. Most patients are aware of the platform through media or communication supports, and few are oriented by their doctor.LessonsThe platform (a) acts in complementarity with the doctor who can count on a quality device with qualified staff to take charge of his patient, (b) guides the patient toward a physical activity adapted to health and taking account his capacities and needs and, (c) helps partner club sports to recruit participants.Main messagesNice Acti'Santé is an effective link between health and sport professionals/Nice Acti'Santé is an innovative and local device to serve the most vulnerable people in Nice.

Evaluating a web-based computer-tailored physical activity intervention for those living with and beyond lung cancer (ExerciseGuide UK): protocol for a single group feasibility and acceptability study

BackgroundLung cancer is the leading cause of cancer-related death globally. Physical activity and exercise provide unequivocal benefits to those living with and beyond lung cancer. However, few of those living with and beyond cancer meet the national physical activity guidelines. Various barriers exist for this population’s engagement in physical activity and exercise, such as the lack of knowledge and lack of tailored information, little access to exercise specialists, fatigue, and mobility challenges. Digitally delivered programmes have the potential to address several of these barriers, with techniques like “computer-tailoring” available to enable the delivery of tailored content at a time and place that is convenient. However, evaluation of such programmes is needed prior to implementation. This protocol describes a single group study that will examine the feasibility and acceptability of an online tool (ExerciseGuide UK) that provides those living with and beyond lung cancer web-based computer-tailored physical activity prescription and modules underpinned by behaviour change theories.MethodsThirty-five individuals diagnosed with lung cancer, or cancer affecting the lung (e.g. pleural mesothelioma), will be recruited into a single-intervention arm. The platform will provide tailored resources and a personalised physical activity programme using IF-THEN algorithms. Exercise prescription will be tailored on factors such as self-reported specific pain location, exercise history, and current physical fitness. In addition, modules grounded in behaviour change will supplement the physical activity programme and will focus on topics such as exercise benefits, safety, goal setting, and tracking. The primary outcome will be assessed using pre-established criteria on feasibility and mixed-methods approach for acceptability.Secondary outcomes will explore changes in the physical activity, quality of life, anxiety, and depression.DiscussionThis manuscript describes the protocol for a study examining the feasibility and acceptability of a web-based computer-tailored physical activity intervention for those living with and beyond lung cancer. The publication of this protocol aims to increase the transparency of the methods, report pre-determined criteria, and aid replication of the study and associated materials. If feasible and acceptable, this intervention will inform future studies of digital-based interventions.Trail registrationClinicalTrails.gov, NCT05121259. Registered on November 16, 2021.

Leisure-time physical activity and mortality risk in type 2 diabetes: A nationwide cohort study

AimPhysical activity improves insulin resistance, inhibits inflammation, and decreases the incidence of cardiovascular disease. These are major causes of death in patients with diabetes. MethodsThe Taiwan National Health Interview Survey collected baseline characteristics of socioeconomic level, education, marriage, and health behaviour, including leisure time physical activity in 2001, 2005, 2009, and 2013. The National Health Insurance research dataset 2000–2016 contained detailed information on medical conditions, including all comorbidities. All-cause and cardiovascular deaths were confirmed by the National Death Registry. ResultsA total of 4859 adults with type 2 diabetes were included in the analysis; 2389 (49 %) were men and the mean±SD age was 60±13 years. Kaplan-Meier curve of all-cause (log-rank P<0.001) and cardiovascular death (log-rank P=0.038) categorized by leisure-time physical activity showed a significant difference. The multivariable Cox regression model showed that those who had more leisure time physical activity had a significantly lower risk of all-cause death than those with no physical activity (physical activity of 1-800 MET-min/week HR = 0.66, 95% CI: 0.54–0.81, physical activity of >800 MET-min/week HR = 0.67, 95% CI: 0.56-0.81). A significant trend was also observed (P <0.001). Similar results were also observed for cardiovascular mortality (physical activity of 1-800 MET-min/week HR = 0.54, 95% CI: 0.36–0.84, physical activity of >800 MET-min/week HR = 0.78, 95% CI: 0.55–1.13). ConclusionFor those with diabetes, increased leisure-time physical activity significantly reduced risk of all-cause and cardiovascular death. Further research is warranted to determine the proper prescription for physical activity to prolong healthy life.

Understanding Barriers and Facilitators to Physical Activity Engagement to Inform a Precision Prescription Approach during Pregnancy.

Physical activity during pregnancy is an important health behavior. However, many pregnant individuals are provided with little-to-no guidance to adequately engage in physical activity. The purpose of this quantitative and quasi-qualitative study of currently or previously pregnant women was to examine physical activity behaviors in pregnancy and understand barriers and facilitators to achieving physical activity recommendations. Overall, 431 women (18+ years), White/Caucasian (84.5%), married (84.9%), and currently pregnant (66.6%), completed an online survey study. Most women (69.4%) reported engaging in cardio-based physical activity and willing to engage in physical activity to meet guidelines between 2 and 5days per week (77.4 -88.8%). The most frequently reported barriers were feeling too tired (72.8%) or uncomfortable (71.8%) and childcare needs (57.8%). Being able to choose time of day (96.0%), accessing home workouts (92.9%), and having a personalized prescription (95.6%) were the most reported facilitators. Open comment feedback resulted in additional barriers, such as ensuring proper energy intake, while motivation and support from other pregnant individuals were fundamental facilitators. Individualized physical activity prescription is lacking in routine prenatal care. To support pregnant individuals to achieve physical activity recommendations, developing a prescription with suitable modalities, at-home options, and consideration for physical activity timing are required.

Post-COVID era: Time to re-introduce "cardiorespiratory fitness" as a vital sign.

Post-COVID era: Time to re-introduce "cardiorespiratory fitness" as a vital sign.

Kinesiology Students' Perception Regarding Exercise Oncology: A Cross-Sectional Study.

Delivering physical activity in cancer care requires knowledge, competence, and specific skills to adapt the exercise program to the patients’ specific needs. Kinesiology students could be one of the main stakeholders involved in the promotion of physical activity. This study aims to investigate the knowledge, perception, and competence about exercise in patients with oncological disease in a sample of students attending the Sports Science University. A total of 854 students (13% response rate) from four Italian universities completed the online survey between May and June 2021. About half of the study participants identified the correct amount of aerobic (44%) and strength (54%) activities proposed by the American College of Sports Medicine for patients with cancer. Almost all the students recognized the importance of physical activity in cancer prevention (96%), in the management of cancer before surgery (96%), during anticancer treatments (84%), and after therapies completion (98%). On the contrary, they reported a lack of university courses dedicated to cancer diseases, psychological implications, and prescription of physical activity in all types of cancer prevention. Overall, few students felt qualified in delivered counseling about physical activity and individual or group-based exercise programs in patients with cancer. Logistic regression revealed that the students attending the Master’s Degree in Preventive and Adapted Physical Activity were more likely to have knowledge and competence than other students. The present study suggests that kinesiology universities should increase the classes and internships about exercise oncology to train experts with specific skills who are able to adequately support patients in their lifestyle modification.

Teaching Gender Differences at Medical School Could Improve the Safety and Efficacy of Personalized Physical Activity Prescription.

Teaching Gender Differences at Medical School Could Improve the Safety and Efficacy of Personalized Physical Activity Prescription.

Physical activity RX: development and implementation of physical activity counselling and prescription learning objectives for Canadian medical school curriculum.

Physical activity is an important component of health and well-being, and is effective in the prevention, management, and treatment of numerous non-communicable chronic diseases. Despite the known health benefits of physical activity in all populations, most Canadians do not meet physical activity recommendations. Physicians play a key role in assessing, counselling, and prescribing physical activity. Unfortunately, many barriers, including the lack of adequate education and training, prevent physicians from promoting this essential health behaviour. To support Canadian medical schools in physical activity curriculum development, a team of researchers, physicians, and exercise physiologists collaborated to develop a key set of learning objectives deemed essential to physician education in physical activity counselling and prescription. This commentary will review the newly developed Canadian Physical Activity Counselling Learning Objectives and give case examples of three Canadian medical schools that have implemented these learning objectives.