Multiple organizations around the world have issued evidence-based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health-related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home-based or community-based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.
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In order to overcome cancer-related problems and to improve quality of life, an intensive multi-focus rehabilitation programme for cancer patients was developed. We hypothesised that this six-week intensive rehabilitation programme would result in physiological improvements and improvement in quality of life. Thirty-four patients with cancer-related physical and psychosocial problems were the subjects of a prospective observational study. A six-week intensive multi-focus rehabilitation programme consisted of four components: individual exercise, sports, psycho-education, and information. Measurements (symptom-limited bicycle ergometry performance, muscle force and quality of life [RAND-36, RSCL, MFI]) were performed before (T0) and after six weeks of rehabilitation (T1). After the intensive rehabilitation programme, statistically significant improvements were found in symptom-limited bicycle ergometry performance, muscle force, and several domains of the RAND-36, RSCL and MFI. The six-week intensive multi-focus rehabilitation programme had immediate beneficial effects on physiological variables, on quality of life and on fatigue.
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Hoe mooi zou het zijn als iedereen motorisch vaardig is, een positieve houding heeft ten opzichte van sport en bewegen, kennis heeft over het belang van sport en bewegen en in staat is om een krachtige beweegomgeving voor zichzelf en anderen te creëren. Zou het niet fantastisch zijn als deze grondhouding, kennis en motorische vaardigheden ertoe bijdragen dat alle mensen een leven lang deelnemen aan sport- en beweegsituaties? Dat is wat wij nastreven. Vanuit de gedachte: groot denken, maar klein beginnen, is in mei 2017 een enthousiaste groep mensen met uiteenlopende expertise - de ‘kwartiermakersgroep Physical Literacy’ – gestart met een verkenning naar de meerwaarde van het begrip ‘Physical Literacy’ voor de Nederlandse sport- en beweegpraktijk. In dit whitepaper schetsen we de noodzaak van een aangescherpte koers in het stimuleren van sport en bewegen en geven we aan hoe Physical Literacy kan bijdragen aan deze nieuwe koers.
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