Ibeneme S1,2, Newstead A3
1University of Nigeria, Enugu Campus, Department of Medical Rehabilitation, Faculty of Health Sciences, Enugu, Nigeria, 2University of the Witwatersrand, Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, Johannesburg, South Africa, 3AHNew Physical Therapy, Helotes, United States
Background: Aging has been associated with limitations in social participation, which should increase physical inactivity, and likewise the risk of various non-communicable diseases, especially cancer - of which the most common forms include cervix, breast, liver, prostate and Kaposi's sarcoma. Similarly, chronic inflammation has also been implicated in cancer induction, and biomarkers of inflammation, especially, C-reactive protein (CRP), vary proportionate to the level of physical activity. Therefore, if physical inactivity is common with aging, chronic inflammation should likewise be high in this population, and should be amenable to physical activity intervention regimens.
Purpose: Therefore, we propose to present the profile of physical activity level in older adults and FDRs to illuminate how the trends of physical activity level may explain cancer induction in this high-risk populations considering its likely impact on inflammatory processes as profiled in a current study. We project to bridge the gap between clinical and molecular sciences by highlighting the need to investigate the molecular basis and outcome of physiotherapy intervention in chronic diseases, which is pertinent to prevention - primary, secondary and tertiary.
Methods: In a multiple case study of 49 consenting participants comprising: 28 BRCApts (aged 43.07±9.87yrs) and 21 of their FDRs (aged 39.62±11.93yrs). Participants' PAL was measured and classified into high(HPAL), moderate(MPAL) and low(LPAL) levels, using the short form of the International physical activity questionnaire. Subsequently, 23 of them (13 BRCApts and 10 FDRs), who consented. participated in a laboratory study to determine the serum concentration of CRP (normal range=0-12mg/L). Participants' cardiopulmonary function and QoL were also measured. Data obtained were tested for normality using Kolmogorov´s test and analyzed with Kruskal-Wallis H test, after adjusting for lifestyle factors (dietary habits, smoking). Alpha was set at p 0.05.
Results: The mean CRP for BRCApts was 12.09±3.16mg/L unlike FDR(11.78±2.29mg/L). Though the majority (61.9%) of FDRs than BRCApts(28.5%) were classified into the overweight/class 1 obesity category, yet more of the BRCApts(32.1%) than FDRs(9.5%) had a lifestyle of LPAL. About 57.1% and 33.33% of FDRs were categorized into HPAL and MPAL, respectively, compared to 42.29% and 25% of BRCApts. CRP was high in only 30% of FDRs unlike 46.15%of BRCApts and varied significantly (F=5.436,df=2,p=0.038) with PAL, in the FDRs but not the BRCApts (F=0.375,p=0.696).
Conclusion(s): Overall, the high-grade inflammatory state of BRCApts contrasted with a subclinical(borderline) moderate-grade inflammatory state of FDRs, who were more obese/overweight and should be more prone to high-grade inflammation but were not. Apparently, being more physically active, was a protective factor that may have modulated inflammatory responses which may lie on the path of biological plausibility for breast cancer induction. Therefore, moderate/high physical activity level may be a target for lifestyle modification intervention required to prevent breast cancer induction in individuals who are likely to be at high risk
Implications: Lifestyle modification involving physical activity could be a primary preventive measure in public health action for cancer prevention. Targeting various biomarkers of diseases amenable to physiotherapy intervention as was done in this study will elucidate the molecular basis of physiotherapy intervention and bring science to the art of Physiotherapy.
Keywords: cancer, prevention, aging
Funding acknowledgements: University of the Witwatersrand
Purpose: Therefore, we propose to present the profile of physical activity level in older adults and FDRs to illuminate how the trends of physical activity level may explain cancer induction in this high-risk populations considering its likely impact on inflammatory processes as profiled in a current study. We project to bridge the gap between clinical and molecular sciences by highlighting the need to investigate the molecular basis and outcome of physiotherapy intervention in chronic diseases, which is pertinent to prevention - primary, secondary and tertiary.
Methods: In a multiple case study of 49 consenting participants comprising: 28 BRCApts (aged 43.07±9.87yrs) and 21 of their FDRs (aged 39.62±11.93yrs). Participants' PAL was measured and classified into high(HPAL), moderate(MPAL) and low(LPAL) levels, using the short form of the International physical activity questionnaire. Subsequently, 23 of them (13 BRCApts and 10 FDRs), who consented. participated in a laboratory study to determine the serum concentration of CRP (normal range=0-12mg/L). Participants' cardiopulmonary function and QoL were also measured. Data obtained were tested for normality using Kolmogorov´s test and analyzed with Kruskal-Wallis H test, after adjusting for lifestyle factors (dietary habits, smoking). Alpha was set at p 0.05.
Results: The mean CRP for BRCApts was 12.09±3.16mg/L unlike FDR(11.78±2.29mg/L). Though the majority (61.9%) of FDRs than BRCApts(28.5%) were classified into the overweight/class 1 obesity category, yet more of the BRCApts(32.1%) than FDRs(9.5%) had a lifestyle of LPAL. About 57.1% and 33.33% of FDRs were categorized into HPAL and MPAL, respectively, compared to 42.29% and 25% of BRCApts. CRP was high in only 30% of FDRs unlike 46.15%of BRCApts and varied significantly (F=5.436,df=2,p=0.038) with PAL, in the FDRs but not the BRCApts (F=0.375,p=0.696).
Conclusion(s): Overall, the high-grade inflammatory state of BRCApts contrasted with a subclinical(borderline) moderate-grade inflammatory state of FDRs, who were more obese/overweight and should be more prone to high-grade inflammation but were not. Apparently, being more physically active, was a protective factor that may have modulated inflammatory responses which may lie on the path of biological plausibility for breast cancer induction. Therefore, moderate/high physical activity level may be a target for lifestyle modification intervention required to prevent breast cancer induction in individuals who are likely to be at high risk
Implications: Lifestyle modification involving physical activity could be a primary preventive measure in public health action for cancer prevention. Targeting various biomarkers of diseases amenable to physiotherapy intervention as was done in this study will elucidate the molecular basis of physiotherapy intervention and bring science to the art of Physiotherapy.
Keywords: cancer, prevention, aging
Funding acknowledgements: University of the Witwatersrand
Topic: Oncology, HIV & palliative care; Health promotion & wellbeing/healthy ageing; Older people
Ethics approval required: Yes
Institution: University of the Witwatersrand
Ethics committee: Department of Physiotherapy
Ethics number: Johannesburg, South Africa
All authors, affiliations and abstracts have been published as submitted.
