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Exercise Training Beyond Breast Cancer (EXPINKT™)

expinkt lynnette jones student and client

Introduction

expinkt logo small colourOne in nine New Zealand women will be diagnosed with breast cancer in their lifetime (NZ Cancer Society). While 85% survive, many women experience late and long-tem side effects of their treatment.  Side effects include limited shoulder and arm movement on the involved side, fatigue, pain, depression, anxiety, fear of recurrence, lower cardiorespiratory fitness, loss of strength, weight gain, adverse changes in body composition, overall quality of life and an increased risk for the development of heart disease and diabetes.

Eexpinkt gym session exercyclesxercise has been shown to be effective in attenuating these side effects and also to playing a supportive role during treatment. Women who exercise during treatment tend to complete their treatment and perceive themselves as better able to cope with side effects that arise. To date exercise benefits include maintenance of weight and body composition, improved fitness, strength, exercise self-confidence, improved quality of life, and lower levels of fatigue, pain and depressive symptoms.

This clinic provides a unique opportunity for senior undergraduate students to work with cancer survivors. Cancer diagnosis and treatments affect the normal physical and physiological functions of the body. Imposing an exercise stress on already stressed body systems, for example the heart and lungs, can make exercise challenging and even risky in certain individuals.  Cancer patients and survivors are potentially the most complex group to manage in an exercise setting, due to the treatment effects.  By studying the development of cancer and the effects of cancer and its treatments on the body, students are better equipped to work safely and effectively with cancer survivors. The course that sits alongside this clinic programme is PHSE 408/508 Exercise and Cancer Recovery.

Aims

  • To significantly improve the physical health and quality of life for cancer survivors and patients with the provision of prescribed and monitored exercise programmes in a safe and supervised environment.
  • To educate and prepare exercise trainers who have specialist knowledge of cancer in the exercise setting.

Objectives

expinkt student and client calf raiseTo improve cardiovascular fitness, muscle strength and physical function in women diagnosed with primary breast cancer, by:

1. Providing prescribed exercise prescription programmes for women in active treatment for breast cancer or those who have completed treatment, leading to:

  • Improved shoulder and arm function
  • Increased caloric expenditure with an additional aim to maintain or reduce body weight
  • Increased functional strength and endurance
  • Increased exercise capacity 
  • Improved confidence for undertaking exercise and pursuing sporting and recreational pursuits
  • Reduced fatigue
  • Enhanced well-being
  • Early return to the work force

2. To introduce students to cancer and provide the specialist knowledge required when undertaking exercise following cancer diagnosis by:

  • Introducing the aetiology, biology, epidemiology, and diagnosis of cancer
  • Linking exercise science with cancer and cancer treatment
  • Understanding the importance around exercise screening, testing and programming in cancer survivors
  • Providing experiential learning opportunities in the EXPINKT™ clinic

Of note, the core elements of the EXPINKT™ programme have been used and adapted successfully for individuals presenting with other cancers including prostate, lymphoma, thyroid, neuroendocrine, and lung cancers, and one individual with an astrocytoma.

Research

Since the clinic programme began in September 2009, several research projects focused on the health and well-being of cancer survivors have been undertaken by students.

2016 MPhEd.  Rebekah Wilson. “Case-controlled, cross-sectional study of vascular health in prostate cancer survivors and non-cancer controls”.
2015 MPhEd. Zara Taylor (Distinction). “Effects of circuit resistance training on vascular health in breast cancer survivors: a randomised controlled trial”.
2014 MPhEd. (Distinction). Katy Atkinson. “Work experiences of breast cancer survivors in New Zealand”.
2014 MPhEd. (Distinction). Casey Brown. “Determinants of cardiovascular health based on physical activity states in breast cancer survivors”.
2012 MPhEd (Distinction). Saskia van den Ende. “Weight gain and resting metabolic rate during chemotherapy for primary breast cancer”.
2012 MPhEd (Distinction). Amy Fastier. “Circuit resistance training for strength and fitness improvements in survivors of breast cancer”.
2016 PGDipPE Marguerite Larvin. “The lived experiences and exercise programming preferences of breast cancer survivors”
2014 PGDipPE (Credit). Susie Ferkins. “Exercise and cardiovascular preconditioning prior to treatment for breast cancer: A narrative review”.
2013 PGDipPE (Distinction) – Rebekah Wilson. “Vascular health in prostate cancer survivors”.
2012 PGDipPE (Distinction) – Katy Atkinson. “Factors constraining successful return to work following cancer diagnosis and treatment”.
2016 BPhEd (Hons). Katie Morris. Enrolled 2016.  “Qualitative evaluation of the EXPINKT™ programme”.
2015 BPhEd (Hons First Class). Nicole O’Loughlin. “Circuit resistance exercise and cardiovascular health in breast cancer survivors”
2015 BPhEd (Hons First Class). Claudia Stothart. “High density lipoprotein cholesterol and cancer: cause or effect: A systematic review”
2014 BPhEd (Hons First Class). Tasha Chinnery. “Strength and fitness changes in response to combined resistance and aerobic exercise in prostate cancer survivors”.
2013 BPhEd (Hons First Class). Zara Taylor. “EXPINKT™: Exercise training beyond breast cancer. Strength and fitness changes in response to combined resistance and aerobic exercise in survivors of primary breast cancer”.
2012 BPhEd (Hons First Class). Anna Coulthard. “Submaximal exercise testing in women diagnosed with breast cancer: what is the most reliable test?”
2011 BPhEd (Hons First Class). Megan Haines. “Does 10 weeks of moderate intensity circuit resistance training improve strength in women previously diagnosed with primary breast cancer?”
2010 BPhEd (Hons First Class). Adiella White. “Evaluation of the beyond pink exercise programme”.