Tag Archives: Movement

Balancing the benefits and harms of exercise for people living with and beyond cancer

The benefits of exercise for people living with and beyond a cancer diagnosis are well established. A wide range of types and intensities of exercise have been shown to improve quality of life, reduce anxiety and depression, reduce cancer-related fatigue, improve treatment tolerance, and potentially lead to extended life.

The compelling evidence demonstrating the benefits of exercise for cancer survivors led to both the Exercise and Sports Science Australia (ESSA) and the Clinical Oncology Society of Australia (COSA) to call for exercise therapy to be embedded as standardised care for people with cancer.

“Exercise is widely accepted as safe, even for people living with or beyond cancer,” said Dr Rosa Spence, Research Fellow and senior member of ihop.

“However, every healthcare intervention brings risk of harm alongside potential for benefit. Unlike benefits, the harms of exercise have been poorly reported in exercise oncology trials to date, with the majority of studies failing to report or under-reporting harms.

“The problem with this is that widespread uptake of exercise into standard cancer care will require evidence of both benefit and low risk of harm across all cancer and treatment types and at the moment there is an evidence gap.

“There has been growing recognition across clinical trial disciplines of the need to provide balanced reporting of benefits and harms.

“This is why we designed the Exercise Harms Reporting Method or ExHarM protocol,” she said.

“This protocol is specifically designed for harms assessment within exercise oncology trials but can also be applicable in other behaviour change settings.”

Dr Spence says she defines the harms of exercise as ‘all undesirable, physical, psychological, economic or social consequences that are related to an individual’s participation in exercise’.

“It’s important for clinicians, patients and exercise professionals to understand the potential harms of exercise to ensure exercise is recommended to the right patients, prescribed in the right way and that individuals can make informed decisions about the potential positives and negatives of exercise participation ,” she said.

“The ExHarm protocol was developed, trialled and refined by the ihop research group to guide comprehensive and reliable harms assessment and reporting in both research and in practice.

“The protocol involves four core steps to capture, classify, analyse and report all adverse outcomes relating to exercise therapy,” she said.

  • Step 1 – Monitor and Identify – the participant reports or exercise professional observes adverse outcome.
  • Step 2 – Assess and record – record details of adverse outcome, severity, causality, impact on intervention and type of adverse outcome.
  •  Step 3 – Harms panel review – harms panel reviews and revises causality of adverse outcomes.
  • Step 4 – Analyse and report – all-cause adverse outcomes and exercise-related adverse outcomes are analysed and reported.

Dr Spence says the four-step process provides a simple framework for the collection, classification, analysis and reporting of adverse outcomes.

“ExHarm was developed with the goal of improving the quality of harms assessment and reporting within exercise oncology research and practice,” she said.

“It has been successfully implemented in multiple exercise oncology trials, involving samples with different cancer types (breast, brain and gynaecological), different stages of disease at diagnosis (stage I-IV), primary and recurrent diagnoses, and inclusion of samples with multiple comorbidities.

“Our hope is to continue to refine the protocol and continue to work to improve harms reporting across exercise research, with the goal of improving the quality of life for people living with and beyond cancer.”

To read the full manuscript on ExHaRM visit
ExHaRM Manuscript (BMJ Open)

For more information about the ihop research group, visit improvinghealth.com.au

So what is motivation ?

Motivation is the determination to reach our personal goals or desires. It is influenced by how much we want to achieve that goal, what we might gain from the achievement and what we from expect from ourselves.
There is little doubt that when it comes to health and wellness, the ability to stay positively motivated and continue with good physical activity and nutrition habits can be a struggle. Often we start out strong and then ‘life’ gets in the way and we go back to our old, perhaps not so good, behaviours. So here are some quick tips to help you stay motivated. 

- Self-belief to stay motivated is important as it influences our thinking. Developing a positive and high self-belief can create successful changes in our behaviours especially during exercise and help us reach our goals. Use positive self-affirmations.

- Find your reason why you want to achieve this goal, write it up somewhere and keep your focus on it, this is often a good way to stay motivated if you feel you are faltering.

- Set realistic, rewarding goals and regularly review them. This is a key aspect of keeping yourself motivated to get the positive benefits. To start with, it is sometimes helpful to just set one achievable goal and work it into your daily routine, break it down into manageable parts.  For example if your goal is to exercise, start by doing a daily walk for 30 minutes. Have a timeframe for when you want to have achieved this a s regular activity and then build on it.

- Keep a good and regular routine – Use an app or a reminder system so you can’t let the day escape before you have achieved your daily goal – some people make this work by creating a daily appointment for themselves just as they would for any other appointment for example the hairdresser, doctor, dentist or a friend. Being busy’ or ‘being too tired’ often causes a break down in the routine that was
initially set.

- Use your family and friends as support – tell them about your goals and encourage them to help keep you motivated. Buddy up with someone so you can help and motivate each-other or get yourself a mentor to guide you. Check your goals and your progress frequently. Seeing good progress is a great motivator in itself, and can also improve your self-confidence.

- Keep goals fun and reward yourself when you have achieved them, make a plan for when and how you will do this. Put a note on your calendar for reward day so you keep progressing towards the goal.

Remember …..
If you lose motivation for a day or two, don’t let that deter you. Pick yourself up and carry back on again, see it as a challenge not a failure, setbacks are normal.

Moving through change

Things are changing and will continue to change over the next few months. We can easily let these uncertain times to our routines affect all aspects of our health.

This is the time that exercise becomes even more important than ever.

The sooner you create a new ‘new’ when it comes to exercise the better you will be coming out the other side of this pandemic.

Exercise can be one of the most positive strategies you can be using to manage both your mental and physical health at the moment. But you need to be proactive and intentional with your planning and create a new routine. The most important thing is don’t over think it and just move.

If you are self isolating at home or working remotely a weekly or daily plan can help you keep these important activities a regular part of your week. But it wont just happen unless you plan for it. We have too much going on in our heads at the moment to rely on our self motivation.

Create a weekly plan and put it somewhere you can see it. Ticking the box when completed is a simple strategy to keep you on track.

Example Weekly Exercise Plan
Monday: Walk with dog, 45 minutes
Tuesday: Beginners yoga you tube video
Wednesday: Walk 30 minutes and body weight strength circuit
Thursday: Pilates/Tai Chi you tube video
Friday: Walk 45 minutes
Saturday: Strength circuit with resistance bands
Sunday: Rest

In these uncertain times there are many things that we can’t control, but we can control our choices. Putting a simple plan in place can be a game changer in how you manage your health in this stage.

Guest blogger – Vicky Graham
Accredited Exercise Physiologist
True North Wellness