NMES: a bridge to voluntary exercise in cancer care?
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Earlier detection and better treatment has led to an increase in long term cancer survivors. Treatment however can lower quality of life. CATCH ESR5 Dominic O'Connor
![NMES: a bridge to voluntary exercise in cancer
care?
Dominic O’Connor
ESR 5 – UCD
Prof Brian Caulfield
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the
Marie Sklodowska-Curie grant agreement number 722012
Introduction
• Earlier detection and better treatment has led to an increase in long
term cancer survivors [1].
• Treatment however can lower quality of life.
Challenges faced by survivors
• Cachexia affects approximately 50% of patients with cancer [2].
• Voluntary exercise difficult due to exercise limiting symptoms.
• NMES may be a pragmatic alternative to voluntary exercise.
Aims/Objectives
• Identify the rehabilitation needs of breast and prostate cancer survivors.
• Develop a targeted, home based NMES programme which can bridge the gap
between immobility and voluntary exercise
• Evaluate its use in cancer care pathways and how it may be integrated with nutritional
support and drug therapy for cachexia management.
Research Methodology
• Qualitative analysis of cancer specific rehabilitation needs.
• Development of a safe, effective and tolerable NMES programme through pilot trials.
• A period of home based, unsupervised NMES in the target cohort.
• Analysis of indices of physical function (Muscle strength, endurance capacity).
• Evaluation of the feasibility of NMES programmes within cancer care pathways.
References
1. Schmitz et al, 2010. American College of Sports
Medicine Roundtable on Exercise Guidelines for
Cancer Survivors. Medicine and Science in
Sports and Exercise. 42(7), pp.1409-1426.
2. Aoyagi et al, 2015. Cancer cachexia mechanism
and treatment. World Journal of Gastrointestinal
Oncology. 7(4), pp. 17-29.
3. Maffiuletti et al, 2010. Physiological and
methodological considerations for the use of
neuromuscular electrical stimulation. European
Journal of Applied Physiology. 110, pp. 223-234.
Cachexia
Weight loss
Loss of
strength
Loss of
physical
function
Inflammation
NMES: a bridge to voluntary exercise?
• Neuromuscular electrical stimulation involves controlled contraction and relation of skeletal muscle [3].
• Delivered via a portable pre-programmed unit and surface electrodes.
Figure 2. Symptoms associated with cachexia syndrome.
Contact:
Email: dominic.oconnor@insight-centre.org Twitter: @domdom2407 Linkedin: https://www.linkedin.com/in/dominicoconnorcatch/ Website: www.catchitn.eu
NMES
Portable
Inexpensive
Self Applied
Safe
Increased
strength
Increased
aerobic
capacity
Attenuated
loss of
muscle mass
Cancer
Fatigue
Reduced
muscle
strength
Loss of
muscle
mass
Low
aerobic
fitness
Improved
strength
Attenuated
muscle
mass loss
Improved
exercise
capacity
IMMOBILITY
VOLUNTARY
EXERCISE
PARTICPATION
NMES
Figure 1. Side effects associated with cancer treatment.
Figure 3. Potential benefits of NMES in cancer care. Figure 4. Bridging the gap between immobility and voluntary exercise](https://image.slidesharecdn.com/esr5-170720073248/85/NMES-a-bridge-to-voluntary-exercise-in-cancer-care-1-320.jpg)
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NMES: a bridge to voluntary exercise in cancer care?
- 1. NMES: a bridge to voluntary exercise in cancer care? Dominic O’Connor ESR 5 – UCD Prof Brian Caulfield This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement number 722012 Introduction • Earlier detection and better treatment has led to an increase in long term cancer survivors [1]. • Treatment however can lower quality of life. Challenges faced by survivors • Cachexia affects approximately 50% of patients with cancer [2]. • Voluntary exercise difficult due to exercise limiting symptoms. • NMES may be a pragmatic alternative to voluntary exercise. Aims/Objectives • Identify the rehabilitation needs of breast and prostate cancer survivors. • Develop a targeted, home based NMES programme which can bridge the gap between immobility and voluntary exercise • Evaluate its use in cancer care pathways and how it may be integrated with nutritional support and drug therapy for cachexia management. Research Methodology • Qualitative analysis of cancer specific rehabilitation needs. • Development of a safe, effective and tolerable NMES programme through pilot trials. • A period of home based, unsupervised NMES in the target cohort. • Analysis of indices of physical function (Muscle strength, endurance capacity). • Evaluation of the feasibility of NMES programmes within cancer care pathways. References 1. Schmitz et al, 2010. American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors. Medicine and Science in Sports and Exercise. 42(7), pp.1409-1426. 2. Aoyagi et al, 2015. Cancer cachexia mechanism and treatment. World Journal of Gastrointestinal Oncology. 7(4), pp. 17-29. 3. Maffiuletti et al, 2010. Physiological and methodological considerations for the use of neuromuscular electrical stimulation. European Journal of Applied Physiology. 110, pp. 223-234. Cachexia Weight loss Loss of strength Loss of physical function Inflammation NMES: a bridge to voluntary exercise? • Neuromuscular electrical stimulation involves controlled contraction and relation of skeletal muscle [3]. • Delivered via a portable pre-programmed unit and surface electrodes. Figure 2. Symptoms associated with cachexia syndrome. Contact: Email: dominic.oconnor@insight-centre.org Twitter: @domdom2407 Linkedin: https://www.linkedin.com/in/dominicoconnorcatch/ Website: www.catchitn.eu NMES Portable Inexpensive Self Applied Safe Increased strength Increased aerobic capacity Attenuated loss of muscle mass Cancer Fatigue Reduced muscle strength Loss of muscle mass Low aerobic fitness Improved strength Attenuated muscle mass loss Improved exercise capacity IMMOBILITY VOLUNTARY EXERCISE PARTICPATION NMES Figure 1. Side effects associated with cancer treatment. Figure 3. Potential benefits of NMES in cancer care. Figure 4. Bridging the gap between immobility and voluntary exercise