ZET JE SPIEREN IN BIJ KANKER - Oncologie in perspectief · ZET JE SPIEREN IN . BIJ KANKER . MASSA ....

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Jaap Dronkers ZET JE SPIEREN IN BIJ KANKER

Transcript of ZET JE SPIEREN IN BIJ KANKER - Oncologie in perspectief · ZET JE SPIEREN IN . BIJ KANKER . MASSA ....

MASSA KRACHT ACTIVITEIT

1-2% per dag

ZIEKTE LEEFTIJD

MASSA

Spiermassaverlies

Baracos V, Kazemi-Bajestani SM. Clinical outcomes related to muscle mass in humans with cancer and catabolic illnesses. Int J Biochem Cell Biol. 2013 Oct;45(10):2302-8

ZIEKTE LEEFTIJD

INACTIVITEIT

Inactiviteit

Kortebein P, et al. Functional impact of 10 days of bed rest in healthy older adults. J Gerontol A Biol Sci Med Sci. 2008 Oct;63(10):1076-81.

jong

oud

Functionele mobiliteit

INACTIVITY

83 % of the measured hospital stay was spent

lying in bed

Brown CJ, Redden DT, Flood KL, Allman RM. The underrecognized epidemic of low mobility during hospitalization of older adults. J Am Geriatr Soc. 2009 Sep;57(9):1660-5.

P A M A C C E L E R O M E T E R

ZIEKTE LEEFTIJD

INACTIVITEIT BEHANDELING

young

old

hospital

OPERATIESTRESS

ZIEKTE LEEFTIJD

INACTIVITEIT BEHANDELING

VOEDING

Anabolic resistance Physical activity

… have demonstrated that 2 weeks of inactivity (muscle disuse via limb immobilization), or even simply decreased physical activity (reduced step count), can also induce anabolic resistance to amino acid administration or protein ingestion …

Wall BT, Cermak NM, van Loon LJ. Dietary protein considerations to support active aging. Sports Med. 2014 Nov;44 Suppl 2:S185-94.

MASSA KRACHT POWER

Percentage of the maximal muscle function

30% 100% 0 % 80% 60%

Dai

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ioni

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Indicatie

Dronkers JJ, Preoperative physical fitness in older patients, 2013

100% 0 % 45% 25%

Indicatie

Dronkers JJ, Preoperative physical fitness in older patients, 2013

Dai

ly f

unct

ioni

ng

Percentage of the maximal muscle function

30% 100% 0 %

Frailty

Dronkers JJ, Preoperative physical fitness in older patients, 2013

Dai

ly f

unct

ioni

ng

Percentage of the maximal muscle function

S C R E E N I N G

Santoni G, Angleman S, Welmer AK, Mangialasche F, Marengoni A, Fratiglioni L Age-related variation in health status after age 60. PLoS One. 2015 Mar 3;10(3):e0120077...

1

2

3

Onderzoek ZGV

Mortaliteit X 6

Verpleeghuis X 4

Spiermassa ↓

Spierkracht ↓

Gezondheid Stimuleer het gebruik van de trap in het algemeen. Vergroot gezondheid en vermindert ziekteverzuim

0 1 2 3 4 5 6 7 8 9

Muscle mass (HGS)Respiratory function (RCE)Respiratory function (MIP)Lower leg function (CRT)

ADL (TUG)

Activity level (LAPAQ)

CoughSmoking

COPDHeart diseases

DiabetesMetastatic cancer

Age (> 80)

Odds ratio (p<0.1)

DISCHARGE DESTINATION 10 % nursing home n=169

Dronkers JJ, Chorus AM, van Meeteren NL, Hopman-Rock M. The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery. Anaesthesia. 2013;68(1):67-73.

0 1 2 3 4 5 6 7

Muscle mass (HGS)Respiratory function (RCE)Respiratory function (MIP)Lower leg function (CRT)

ADL (TUG)

Activity level (LAPAQ)

CoughSmoking

COPDHeart diseases

DiabetesMetastatic cancer

Age (> 80)

Odds ratio (p<0.1)

MORTALITY

Dronkers JJ, Chorus AM, van Meeteren NL, Hopman-Rock M. The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery. Anaesthesia. 2013;68(1):67-73.

Muscle mass (HGS)Respiratory function (RCE)Respiratory function (MIP)Lower leg function (CRT)

ADL (TUG)

Activity level (LAPAQ)

CoughSmoking

COPDHeart diseases

DiabetesMetastatic cancer

Age (> 80)

B-value (p<0.05)Odds ratio (p<0.1)

Muscle mass (HGS)Respiratory function (RCE)Respiratory function (MIP)Lower leg function (CRT)

ADL (TUG)

Activity level (LAPAQ)

CoughSmoking

COPDHeart diseases

DiabetesMetastatic cancer

Age (> 80)

Odds ratio (p<0.1)

Mortality

Discharge destination

Muscle mass (HGS)Respiratory function (RCE)Respiratory function (MIP)Lower leg function (CRT)

ADL (TUG)

Activity level (LAPAQ)

CoughSmoking

COPDHeart diseases

DiabetesMetastatic cancer

Age (> 80)

Odds ratio (p<0.05)

3 A C T I V I T E I T

Fiuza-Luces C, Garatachea N, Berger NA, Lucia A. Exercise is the real polypill. Physiology (Bethesda). 2013 Sep;28(5):330-58.

SPIER

Pedersen BK. Muscle as a secretory organ. Compr Physiol. 2013 Jul;3(3):1337-62.

Pedersen BK. Muscle as a secretory organ. Compr Physiol. 2013 Jul;3(3):1337-62.

Scand J Med Sci Sports. 2017 Apr 28. Effect of an Acute Exercise Bout on Immediate Post-Exercise Irisin Concentration in Adults: A Meta-Analysis. Fox J, Rioux BV, Goulet EDB, Johanssen NM, Swift DL, Bouchard DR, Loewen H, Sénéchal M.

IRISINE

Hippocrates (400 v Chr)

“Walking is man’s best medicine”

Exercise is medicine

Activiteitenniveau en PPC

Dronkers JJ, Lamberts H, Reutelingsperger IM, Naber RH, Dronkers-Landman CM, Veldman A, van Meeteren NL. Preoperative therapeutic programme for elderly patients scheduled for elective abdominal oncological surgery: a randomized controlled pilot study. Clin Rehabil. 2010 Jul;24(7):614-22

Front Public Health. 2017 Feb 14;5:19. Physical Activity and Survival among Long-term Cancer Survivor and Non-Cancer Cohorts. Gunnell AS, Joyce S, Tomlin S, Taaffe DR, Cormie P, Newton RU, Joseph D, Spry N, Einarsdóttir K, Galvão DA.

18 METHOURS PER WEEK

Peter Schnohr, James H. O’Keefe, Jacob L. Marott, Peter Lange, Gorm B. Jensen Dose of Jogging and Long-Term Mortality J Am Coll Cardiol. 2015 Jan 16;65(5)

Duvivier BM, Schaper NC, Hesselink MK, van Kan L, Stienen N, Winkens B, Koster A, Savelberg HH. Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes. Diabetologia. 2016 Dec 1. [Epub ahead of print]

Barreto P d S BMJ 2015;350:bmj.h23 ©2015 by British Medical Journal Publishing Group

Adapted form Warburton D E et al. CMAJ 2006;174:801-809

Simpson RJ1, Bosch JA2. Special issue on exercise immunology: current perspectives on aging, health and extreme performance Brain Behav Immun. 2014 Jul;39:1-7.