Paulette M. Yamada

Was not provided for this article.

Purpose: Survivors of childhood cancer have unique needs, requiring tailored psychosocial support. To ascertain the effectiveness of a community-based survivorship group’s services on changes in emotional and social self-efficacy, perceived purpose and meaning in life, loneliness, and post-traumatic growth from pre- to postretreat among minority adolescent and young adult (AYA) survivors over a 2-year period. Methods: Two annual residential retreats were attended by 15 and 13 AYA survivors, respectively. Experiential learning activities that fostered connection, self-reflection, and resilience were provided. Inventories assessing meaning/purpose (Patient-Reported Outcomes Measures Information Systems [PROMIS]), social (SSE) and emotional self-efficacy (ESE), loneliness, and Post-Traumatic Growth Inventory (PTGI) were administered at four timepoints (pre-/post-2024 and 2025 retreat). Quantitative data were analyzed with orthogonal polynomial contrasts and the MIXED procedure method. Qualitative survivor feedback was collected after the retreats. Counselor journals, participant quotes, and exit interviews were used to contextualize survivor-reported data. Results: PROMIS, SSE, and ESE improved immediately following the retreats, with continual improvement after the second retreat. PTGI did not change. After each retreat, AYAs scored the improvement in loneliness (7.3 ± 1.3 and 7.5 ± 1.9, respectively, with 10 representing maximal benefit), indicating that each retreat impacted their loneliness to the same degree. Qualitative data indicate that AYAs appreciated the opportunity to face difficult topics in a safe space and could benefit from attending consecutive retreats. Conclusion: The intervention benefited participants who were in different stages of their cancer and life journey and reached an underserved minority population. Implementation of these types of support groups could reduce loneliness and improve self-efficacy, thereby having broader impacts on quality of life.

Background: While exercise is critical for breast cancer survivors, identifying prescriptions that promote long-term adherence is a challenge. This study evaluated whether survivors could maintain fitness gains during a 6-month self-managed phase following two distinct 12-week supervised programs. Specifically, we compared whether transitioning from one-on-one training to either individualized (Ind) or group-based (Gr) sessions influenced a participant’s ability to sustain improvements in strength, range of motion (ROM), and cardiorespiratory endurance (VO₂peak). Methods: Thirty breast cancer patients from diverse backgrounds completed an initial 12-week supervised individual training program. They were then randomized into either Ind (n = 13) or Gr (n = 17) supervised sessions for a second 12-week phase. Fitness assessments were conducted at baseline, 3 months (post-initial training), and 1 year (after the 6-month self-managed phase). Data were analyzed using generalized estimating equations to evaluate the effects of time and training format. Results: Significant improvements were observed across all fitness categories over time. Muscular strength (bench press, plank, and squats) and VO₂peak increased significantly by 3 months and were successfully maintained at the 1-year follow-up mark. Shoulder ROM also showed significant improvement at 1 year. Notably, the training format (group vs. individual) had no significant impact on these outcomes, with the exception of one ROM metric. Conclusions: Initial supervised exercise leads to significant fitness gains that breast cancer survivors can successfully maintain for at least six months through self-management. These gains are sustained regardless of whether the preceding supervised training was delivered in a group or individual format, suggesting flexibility in clinical exercise prescriptions.

Background: Any cancer experience can adversely affect the psychosocial health of adolescent and young adults (AYAs) diagnosed with cancer. This can lead to social withdrawal, educational/employment issues, depression, anxiety, and risky behavior. There is an unmet need for comprehensive AYA cancer survivorship care that uses a tailored approach rather than a one-size-fits-all approach. Community-based survivorship groups that focus on psychosocial needs of patients could enhance survivorship care. These groups have the ability to use an observation-based approach to provide long-term surveillance, reach underserved populations, and could contribute to evidence-based research. Method: This article describes an existing, community-based program that uses a tailored approach. Ho‘oulu Me Ke Ikaika is a community-based organization that provides an open, safe, and nurturing environment that encourages positive transformative growth of AYA patients with cancer into confident, independent, and resilient survivors. Ikaika uses a flexible mindset to adapt to survivors’ evolving needs. Ikaika's retreat staff often share life experiences with AYA participants either because they were diagnosed with childhood cancer themselves or they are oncological healthcare providers. Results: This article provides insight for other AYA support groups. There is abundant knowledge that can be learned from community organizations that could maximize the impact of AYA survivorship care and research. Discussion: Collaborative efforts among scholars, healthcare professionals, and survivorship groups could help streamline long-term health surveillance, provide valuable insight for research, and assist in recruiting and retaining of research participants. This article stimulates a dialog that could change the trajectory of AYA survivorship research.

International Journal of Exercise Science 17(4): 405-417, 2024. Phase Angle (PhA), derived from bioelectrical impedance analysis, is a measurement of cellular resistance to electrical current and a non-invasive tool to monitor neuromuscular performance. The relationship between PhA and components of athletic performance is not fully understood. The purpose of this study was to determine if maximal running speed, critical speed (CS), and/or D prime (D’) derived from a 3-minute all-out-test (3MAOT) correlates to PhA, reactance (Xc), or resistance (R). Sixty-one (male n=35, female n=26) healthy young adults (23.4±3.9 years) completed bioelectrical impedance analysis (Inbody770) and a 3MAOT. The correlations between PhA, Xc, and R and 3MAOT results were evaluated using correlations. Simple and multiple linear-regressions were used to test if results from the 3MAOT (maximum running speed, CS, D’) could predict PhA. Linear regression analysis indicated that maximum running speed and CS alone explained 32% and 9% of the variance in PhA, respectively (R2=0.32, p<0.05; R2=0.09, p<0.05). Multiple linear regression indicated that maximum running speed, CS, and D’ explained 35% of the variance in PhA (R2=0.35; p<0.05). Only maximum running speed remained a significant predictor of PhA after controlling for age (β=0.45; p0.05). Since maximum running speed was a stronger predictor of PhA compared to CS (proxy for endurance performance), practitioners should use discernment when using PhA as a readiness tool to monitor endurance performance.

International Journal of Exercise Science 17(4): 115-128, 2024. The addition of wearable technology during a 3-minute all-out overground running test (3MAOT) could provide additional insights to guide training and coaching strategies. The purpose of this study was to explore the relationships between critical speed (CS) and biomechanical parameters (cadence, stride length, vertical oscillation, stance time, form power, leg spring stiffness, and impact loading rate), and changes in biomechanical parameters throughout the 3MAOT. Sixty-three (male, n=37, female, n=26) recreationally active college-aged (23.4±3.9 years) subjects completed a 3MAOT while wearing a Stryd foot-pod. The correlations between CS and biomechanical parameters were evaluated using Pearson coefficients. Stepwise multiple linear regressions were used to test if biomechanical parameters could predict CS. Stance time and impact loading rate explained 69% and 63% of the variance in CS, respectively (R2=0.69, p<0.05; R2=0.63, p<0.05). Step-wise multiple linear regression analysis indicated that vertical oscillation, stance time, form power, leg spring stiffness, and impact loading rate explained 90% of the variance in CS (R2=0.90, p<0.05). Throughout the 3MAOT, changes in cadence (-29%), stride length (57%), vertical oscillation (-8%), stance time (82%), form power (-5%), leg spring stiffness (-24%), and impact loading rate (-48%) were observed. Interventions such as auditory cueing or training designed to improve CS should focus on maintaining large impact loading rates and short stance times, and efforts should be made to enhance an athlete's ability to maintain cadence, leg spring stiffness, vertical oscillation, and form power throughout the 3MAOT.

An approach that provides a standardized way of continuing rehabilitative care to help patients return to their lives and activities of daily living (ADL) in an economical and efficient manner is the Team Kinesiology Model (TKM). Many patients who are given a life-altering diagnosis (i.e., paralysis due to spinal cord injury, cerebral palsy, or cancer) are unable to return to employment, their family or a pre-diagnosis quality of life (QOL) given the current health care resources. This is a longstanding, and urgent problem as population aging and rising multi-morbidity is projected to negatively impact all regions of the world. Utilization of mid-level rehabilitation services is a proposed method to increase accessibility to all populations, including those of lower socioeconomic status or minority populations. Capitalizing on this idea, we describe two different programs that use the TKM to provide rehabilitative services to patients who were diagnosed with nervous system dysfunction or cancer. This model benefits the patient by improving physical fitness, psychosocial function, and QOL. Furthermore, we provide specific examples that show how this approach could have further-reaching impacts on society, education and research. Integrating kinesiologists and TKM in health care could assist in workflow, long-term health surveillance, rehabilitation and improvement of QOL.

International Journal of Exercise Science 15(3): 1444-1456, 2022. Phase angle (PhA) is an index of cell membrane integrity and prognostic indicator of survival and quality of life in cancer survivors. The efficacy of exercise-based cancer rehabilitation programs (ExCR) on PhA is unknown. To assess the effect of ExCR on PhA in breast cancer survivors. Fifty-nine female breast cancer survivors (61 ± 9 years) were referred to the ExCR by their oncologist and participated in one-on-one exercise-based training for 90 minutes, 3 times a week, for 12 weeks. Training sessions included 45 minutes of resistance training at intensities between 40-85% of 1-repetition maximum with a rate of perceived exertion (RPE) between 3-8, 30 minutes of cardiorespiratory training at intensities between 40-85% of heart rate reserve with an RPE between 3-8, and 15 minutes of flexibility training. Participants completed pre- and post-measurements of body composition, cardiorespiratory endurance, flexibility, muscular endurance, muscular strength, and PhA (Inbody 770). PhA significantly increased (p < 0.05) after ExCR (PhApre = 4.56; PhApost = 4.64; Δ = 1.8%). Changes in measures of muscular strength have a weak but significant positive relationship (r = 0.20-0.39; p < 0.05) with changes in PhA. There was no relationship between changes in PhA and changes in cardiorespiratory endurance or muscular endurance. A 12-week ExCR significantly improves PhA in breast cancer survivors. Training muscular strength may be an integral component of ExCR with the objective of improving PhA.