Breast cancer survivors (BCS) live with treatment-related side effects for years after treatments have ended. Upper extremity (UE) impairment, such as lymphedema (swelling) and decreased range of motion (ROM), is a leading cause of decreased function in survivors. Failure to recognize and manage UE impairment can lead to restrictions in activity. Accessible, easy to use tools are needed to help survivors prevent complications and identify and manage changes themselves, if they do occur.

The goal of this project is to create a mobile system to prevent, track and manage UE impairments in BCS.

To do this we will:

1. Create an mobile system for BCS, which measures, tracks and suggests management strategies based on measurements taken
2. Explore usability of the system
3. Determine reliability and validity of the system’s measurement tools

This project has three stages:

1. System development: The system will include a digital goniometer, to measure ROM, and digital tape measure, to measure arm girth. The system will store and track measurements over time.
2. Usability testing: Participants will be given instructions on how to use the system and use the think-aloud method while they complete various tasks in the system. They will also complete two usability questionnaires.
3. Reliability and validity testing: Once weekly, for six weeks, participants will measure ROM and arm circumference using the system and also have these measures taken at in-person assessments by a trained professional.

This project has the potential to prevent UE impairment, a common side effect of breast cancer treatment. A system, such as this, is needed for survivors to use independently at home to prevent and identify UE impairment early. This mobile system will put the survivor in control of their health and tells them when to seek additional medical care. Over time, prevention and early identification will decrease burden on the individual and the healthcare system.

*This project is funded by the Canadian Institutes of Health Research.

By 2030, 23 per cent of Canadians will be over 65 years of age. Two in five of these individuals will be diagnosed with cancer in their lifetime.

Older adults have high levels of functional decline and morbidity, and a cancer diagnosis adds prolonged physical and psychosocial sequalae to the natural aging process. Many of these sequalae can be mitigated by regular physical activity. However, older adults with cancer are significantly less likely to meet current activity guidelines compared to their younger counterparts.

The COVID-19 pandemic has disproportionately affected older adults with chronic conditions, with reports of decreased activity levels and low social interaction. Physical deterioration and psychological symptoms from fewer social interactions has led to decreased quality of life (QOL) among older Canadians during the pandemic. Social support is the perception of being part of a supportive social network. Social support is positively associated with activity levels and QOL, however, there is little research on peer support interventions to promote social support and physical activity in older adults and in cancer populations and no literature among older cancer populations. Further, few studies have included a systemic examination of the influence of different forms of support within physical activity interventions (i.e., professional versus peer support).

The overall objective of this study is to compare the feasibility and preliminary effects of two forms of social support, peer support and professional support, to improve QOL, feelings of support and facilitate activity levels in older adult cancer survivors.

This is a two-year, two-arm pilot randomized controlled trial informed by the Social Ecological Model. Participants will be matched with a peer, given a peer support guide, infographic on current exercise guidelines and a Fitbit. Peers will independently communicate and support each other for the duration of the study. In addition, dyads in the AgeMatchPLUS group will receive virtual professional support from a qualified exercise professional (QEP) for 10 weeks. The QEP will provide informational (around physical activity) and esteem (encouragement) support for both survivors. Participants in the AgeMatch group will independently communicate and support their partner around physical activity for 10 weeks, they will have no contact with a QEP during the study period.

The primary outcome of this pilot trial is feasibility. Feasibility will be assessed by measuring recruitment, retention and adherence rates, acceptability and satisfaction. Preliminary effectiveness outcomes include QOL, social support, physical activity level and physical activity enjoyment. Additionally, perceived peer match quality, time spent with the peer, perceptions of important characteristics of an activity partner and therapeutic alliance will be assessed post intervention and used in exploratory subanalysis to determine how different constructs and types of support affect outcomes.

*This project is funded by the Social Sciences and Humanities Research Council of Canada.

More Canadians are surviving cancer.

However, individuals with cancer live with side effects for years after treatments have ended. The physical and psychosocial benefits of regular physical activity (PA) during and after cancer treatment are well established. However, less than 30 per cent of individuals with cancer meet current PA recommendations and PA levels decline significantly during treatment. PA services within the cancer institution to support well-being during treatment are not available for survivors across Ontario. Strategies are needed within cancer centres to close the gap between the evidence and clinical practice.

What is the purpose?

To evaluate the effectiveness of a novel exercise and education strategy for individuals with cancer during treatment.

What are we proposing to do?

This project includes two parts. In part one, participants will be put into one of three groups:

• Group 1 (exercise and self-management) will include eight sessions of supervised, institution-based exercise and self-management education.
• Group 2 (self-management only) will include eight virtual self-management education sessions with an exercise professional.
• Group 3 will receive usual care (i.e., no intervention).

In part two, participants who attended less than 75 per cent of their sessions will be asked to complete an interview on the barriers to continuing with the study during cancer treatment.

Why is this work important?

Findings from this trial will inform the way PA services are provided within cancer institutions across Ontario. This novel strategy incorporates both institution-based and home-based exercise strategies during treatment and highlights the importance of individuals with cancer taking an active role in managing their condition during treatment. This can prevent future complications and decrease burden on the individual and the healthcare system. Results will inform future decisions on PA implementation strategies for cancer survivors with diverse needs across Ontario.

*This project was funded by the Canadian Cancer Society.

Frailty, sepsis, and cancer are commonly diagnosed conditions in Canadians. While these conditions have been investigated individually, the interaction of these conditions is not well understood, nor is the potential for rehabilitation to improve survivor outcomes. To address this gap, we propose the I-CaRe project examining the intersection of frailty, sepsis and cancer and potential for rehabilitation to manage these conditions.

There are two parts to the I-CaRe project:

1. We will conduct a review to explore the literature on the intersection of frailty, sepsis and cancer.
2. We will then work with patients/caregivers and health professionals to create meaningful educational modules describing these conditions and the potential of rehabilitation services for individuals with these conditions.

To create the educational modules, we will interview patients/caregivers and health professionals and conduct focus groups to ask about their experiences with frailty, cancer and sepsis, and their rehabilitation needs. We will also ask about preferred content and format of educational modules. These stakeholders will assist in creating the modules and will provide feedback in many project stages.

The I-CaRe project will be the first step in exploring the intersection of frailty, sepsis and cancer and describing the potential for rehabilitation services for these populations. Study outputs will include three manuscripts, three conference presentations, communication materials and two modules to be distributed to diverse stakeholder groups.

Results will help to improve outcomes for Canadians living with cancer, sepsis and frailty, and will inform future research and clinical practice.

*This project was jointly funded by Sepsis Canada and the Canadian Frailty Network.

The incidence of sepsis is growing. While mortality is improving, sepsis survivors suffer from health consequences that last for years post-hospital discharge. Rehabilitation interventions are designed to optimize function in individuals with various health issues and has proven effective for many conditions.

However, there is little research available describing the use of rehabilitation for individuals with sepsis. To address this gap, we propose the RISE Project, exploring the use of rehabilitation in sepsis care and examining rehabilitation needs, preferences, barriers and facilitators for those with sepsis.

There are two parts to this project.

1. We will conduct a review exploring the literature on rehabilitation for individuals with sepsis.
2. We will conduct interviews exploring rehabilitation needs, preferences, barriers/facilitators for individuals with sepsis.

The RISE Project will provide foundational knowledge on rehabilitation in sepsis care, which can be used to create rehabilitation strategies to implement and assess in future work.

*This project was funded by Sepsis Canada.