1. CanLift Resistance Training Exercise Program for Post Treatment Cancer Survivors Miss Danielle Girard Chief Investigator Dr Jack Cannon & Dr Stephen Bird Research Supervisors

2. Presentation Overview  Introduction to the CanLift Exercise Program  Benefits of Exercise for Cancer Survivors  Post Cancer Fatigue (PCF)  Overview of the CanLift Training Program  Participant Selection Criteria  Contact Details

3. CanLift Training Program  Accredited Exercise Physiologists in the School of Human Movement Studies at Charles Sturt University as part of a PhD research project have developed a unique exercise program CanLift designed to serve post-treatment cancer survivors.  The purpose of CanLift is to provide post-treatment cancer survivors in the Bathurst Community the opportunity to partake in an individualized prescriptive resistance training exercise program designed to assist in the management of cancer treatment-related symptoms.  The exercise program will be offered free of charge and will start in September, 2012 and will run for a period of eight weeks.

4.  Persistent fatigue is a distressing symptom frequently experienced by disease-free post-treatment cancer survivors, which impacts negatively upon physical functioning and quality of life.  As such, clinicians and health care providers are increasingly recognising that Post Cancer Fatigue (PCF) is a significant health problem that warrants intervention.  The mechanisms associated with PCF are still under investigation; however, strong evidence exist suggesting that exercise is a beneficial treatment modality for managing PCF symptoms. Post Cancer Fatigue

5.  Exercise is considered safe following most types of cancer treatment.  Research has shown that exercise can:  Reduce cancer and treatments related side-effects such as fatigue symptoms  Increased health related quality of life in disease- free post-treatment cancer survivors and  Reduce the risk of cancer recurring in some disease-free post-treatment cancer survivors Exercise Related Health Benefits

6.  Previous studies have focused on the benefits of aerobic and/or mixed aerobic and resistance training modalities; few studies have exclusively examined the benefits of resistance based exercise on fatigue symptoms and health related quality of life.  Knowledge of whether resistance training exercise alone can improve fatigue symptoms in this population is currently limited. However, as post-cancer fatigue appears to be related to changes in motor drive and central nervous system function, it is reasonable to suggest that resistance training will help to reduce fatigue symptoms. Exercise Related Health Benefits

7.  Resistance Training (RT) in healthy populations has been shown to improve; lean body mass, muscle protein mass and contractile force, self- esteem, physical fitness and quality of life. RT influences metabolic and hormonal responses and elicits architectural and neural adaptations.  Skeletal muscle has been shown to be highly adaptable even in the presence of sever muscle loss and fatigue, provided an appropriate training stimuli is applied.  Based on this logic, it is hypothesised that an 8 week resistance training intervention will positively affect muscular strength, fatigue, functional status and quality of life in persons with PCF. Exercise Related Health Benefits

8.  Understanding if and how resistance training works to mitigate fatigue symptoms will assist in the development of exercise based strategies aimed at reducing symptoms in disease-free post treatment cancer survivors.  Hence, the aim of this research project is to: Aim Of The CanLift Training Program Examine the effect of resistance training on the symptoms of PCF in disease-free post- treatment cancer survivors with PCF and the neuromuscular adaptations to resistance training.

9. The CanLift Training Program

10. CanLift Training Program STUDY PARTICIPANTS  Research participants include: 1)Disease-free, post treatment cancer survivors with Post Cancer Fatigue (PCF) with various cancer diagnoses (e.g. prostate, colon, testicular, ovarian etc with the exception of lung and brain cancer types) 2)Healthy post-cancer survivors without PCF

11. CanLift Training Program PARTICIPANTS REQUIREMENTS  Healthy persons will be matched to the cancer survivor based on:  Age  Height  Body Composition  Sleeping Patterns And  Habitual Physical Activity Levels  All subjects will be  Aged Between 40-70 Years  Non-smokers  Participants must have no current musculoskeletal, metabolic, or cardiovascular conditions that may influence the results obtained in this study.  Cancer survivors will be disease-free and have ceased receiving cancer related treatments for a minimum period of 6 months.

12. CanLift Training Program RESEARCH GROUPS  Participants will be randomised into four groups: Two Resistance Training Groups 1)Disease-free, post-treatment cancer participants with PCF who will participate in a 8 week resistance training program 2)Healthy post-cancer survivors without PCF who will participate in a 8 wee k resistance training program Two Control Condition Groups 1)Disease-free, post-treatment cancer participants with PCF who will not participate in a 8 week resistance training program 2)Healthy post-cancer survivors without PCF who will participate in a 8 wee k resistance training program

13. CONTROL CONDITION  Participants not undertaking the resistance training program will be instructed to not undertake any structured exercise training, continue their normal physical activities and nutrition patterns for the duration of the 8 week intervention period.  Participants will be provided with dietary and physical activity journals to document dietary and physical activities over the 8 week period.  Following the completion of data collection, participants in the control group will be invited to commence an individually tailored resistance exercise training program at CSU. Following data collection, participants in the control group will be invited to complete the resistance exercise training program CanLift Training Program

14. RESISTANCE TRAINING GROUPS  The exercise program consists of structured resistance training sessions performed twice weekly.  A minimum of one (1) day rest will be provided between exercise sessions  The training intensity will be between 50-80% 1RM depending on pre-session fatigue questionnaire responses. Intensity will be reduced on days of heightened fatigue symptoms.  Each session will consist of a Warm-up, Conditioning and Cool- down  Session duration will be approximately 1 hours in duration Sessions will be conducted at Charles Sturt University, Bathurst campus in the Exercise Physiology and Functional Rehabilitation Clinic, building E1

15. CanLift Training Program ExerciseRepetitionsSetsTempoRest Intensity (% 1RM) Leg Press 8 - 12 32:1:2 2 min50-80% Leg Extension 8 - 12 32:1:22 min50-80% Cable Squat 8 - 12 32:1:22 min50-80% Lat Pulldown 8 - 12 32:1:22 min50-80% Chest Press 8 - 12 32:1:22 min50-80% Shoulder Press8- 1232:1:22 min50-80% Resistance Training Exercise Protocol Exercises to be performed during each resistance training session

16. Participant Benefits  Several meaningful health related benefits can be gained by participants, including:  Comprehensive health screening appraisal, providing information regarding risk of developing secondary health conditions (e.g. Heart disease, diabetes, obesity, etc)  Opportunity to participate in a fully supervised resistance based exercise intervention.  Exercise has demonstrated to be an effective non-pharmacological management strategy for reducing fatigue symptoms; thus an improvement in fatigue symptoms in persons with PCF can be anticipated.  Other potential health related benefits reported with participation in resistance training programs include increased bone mineral density and fat free mass, reduced fat mass and increased muscular strength. We invite you to participate in this exciting research project

17. Study Benefits  The primary benefit to Charles Sturt University is the collection of data for a PhD project, conducted by Ms Danielle Girard entitled: A Comparison Of The Physiological, Neuromuscular, Perceptual And Performance Adaptations During Different Exercise Fatigue Tasks And Following 12 weeks Between Disease-Free Breast Cancer Survivors With Post Cancer Fatigue And Healthy Matched Persons

18. Contact Details If you are interested in participating in this exercise program or would like more information please contact: Miss Danielle Girard Dip Fitness, B. Ex Sci (Hons), ESSAM, AEP School of Human Movement Studies Panorama Av, Bathurst NSW 2795 Tel: 02 63 38 6101 Email: dgirard@csu.edu.au If you are interested in participating in this exercise program or would like more information please contact: Miss Danielle Girard Dip Fitness, B. Ex Sci (Hons), ESSAM, AEP School of Human Movement Studies Panorama Av, Bathurst NSW 2795 Tel: 02 63 38 6101 Email: dgirard@csu.edu.au

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