Ann Christin Helgesen Bjørke

• Mazzoni, Anne-Sophie; Bjørke, Ann Christin Helgesen; Stenling, Andreas; Börjeson, Sussanne; Sjövall, Katarina & Berntsen, Sveinung [Show all 8 contributors for this article] (2023). The Role of Long-Term Physical Activity in Relation to Cancer-Related Health Outcomes: A 12-Month Follow-up of the Phys-Can RCT. Integrative Cancer Therapies. ISSN 1534-7354. 22, p. 1–10. doi: 10.1177/15347354231178869. Full text in Research Archive Show summary

  Purpose: While moderate-to-vigorous intensity physical activity (MVPA) is associated with various health improvements shortly after completion of exercise interventions, it remains unclear which health benefits can be expected when MVPA levels are maintained in the long term in cancer survivors. We aimed to assess the associations of (1) MVPA level at 12-month follow-up and (2) long-term MVPA patterns (from immediately post-intervention to 12-month follow-up) with different cancer-related health outcomes. Methods: In the Physical training and Cancer (Phys-Can) RCT, 577 participants diagnosed with breast (78%), prostate (19%), or colorectal (3%) cancer were randomized to 6 months of exercise during curative cancer treatment. Accelerometer-assessed physical activity and outcome data (ie, cancer-related fatigue, health-related quality of life [HRQoL], anxiety and depression, functioning in daily life, cardiorespiratory fitness, sedentary time and sleep) were collected immediately post-intervention and at 12-month follow-up. Based on the sample’s median of MVPA immediately post-intervention (65 minutes/day) and the changes between the 2 measurement points, 4 categories with different long-term MVPA patterns were created: High & Increasing, High & Decreasing, Low & Increasing, and Low & Decreasing. Multiple linear regression analyses were performed for the analyses. Results: A total of 353 participants were included in the analyses. At 12-month follow-up, a higher MVPA level was significantly associated with lower fatigue in 3 domains (general fatigue [β = −.33], physical fatigue [β = −.53] and reduced activity [β = −.37]), higher cardiorespiratory fitness (β = .34) and less sedentary time (β = −.35). For long-term MVPA patterns, compared to the participants in the “Low & Decreasing” category, those in the “High & Increasing” category reported significantly lower fatigue in 3 domains (general fatigue [β = −1.77], physical fatigue [β = −3.36] and reduced activity [β = −1.58]), higher HRQoL (β = 6.84) and had less sedentary time (β = −1.23). Conclusion: Our results suggest that long-term physical activity is essential for improving health outcomes post-intervention in cancer survivors. Cancer survivors, including those who reach recommended MVPA levels, should be encouraged to maintain or increase MVPA post-intervention for additional health benefits.

• Bjørke, Ann Christin Helgesen; Buffart, Laurien M.; Raastad, Truls; Demmelmaier, Ingrid; Stenling, Andreas & Nordin, Karin [Show all 7 contributors for this article] (2022). Exploring Moderators of the Effect of High vs. Low-to-Moderate Intensity Exercise on Cardiorespiratory Fitness During Breast Cancer Treatment – Analyses of a Subsample From the Phys-Can RCT. Frontiers in Sports and Active Living. ISSN 2624-9367. 4. doi: 10.3389/fspor.2022.902124. Full text in Research Archive
• Demmelmaier, Ingrid; Brooke, Hannah L.; Henriksson, Anna; Mazzoni, Anne-Sophie; Bjørke, Ann Christin Helgesen & Igelström, Helena [Show all 23 contributors for this article] (2021). Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 31(5), p. 1144–1159. doi: 10.1111/sms.13930. Full text in Research Archive Show summary

  Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie <2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.

• Bjørke, Ann Christin Helgesen; Raastad, Truls & Berntsen, Sveinung (2020). Criteria for the determination of maximal oxygen uptake in patients newly diagnosed with cancer: Baseline data from the randomized controlled trial of physical training and cancer (Phys-Can). PLOS ONE. ISSN 1932-6203. 15(6). doi: 10.1371/journal.pone.0234507. Full text in Research Archive Show summary

  Introduction: Maximal oxygen uptake () is a measure of cardiorespiratory fitness often used to monitor changes in fitness during and after treatment in cancer patients. There is, however, limited knowledge in how criteria verifying work for patients newly diagnosed with cancer. Therefore, the aim of this study was to describe the prevalence of fulfillment of typical criteria verifying and to investigate the associations between the criteria and the test leader’s evaluation whether a test was performed “to exhaustion”. An additional aim was to establish new cut-points within the associated criteria. Methods: From the Phys-Can randomized controlled trial, 535 patients (59 ±12 years) newly diagnosed with breast (79%), prostate (17%) or colorectal cancer (4%) performed an incremental test on a treadmill. The test was performed before starting (neo-)adjuvant treatment and an exercise intervention. Fulfillment of different cut-points within typical criteria verifying was described. The dependent key variables included in the initial bivariate analysis were achievement of a plateau, peak values for maximal heart rate, respiratory exchange ratio (RER), the patients’ rating of perceived exertion on Borg’s scale6-20 and peak breathing frequency (fR). A receiver operating characteristic analysis was performed to establish cut-points for variables associated with the test leader’s evaluation. Last, a cross-validation of the cut-points found in the receiver operating characteristic analysis was performed on a comparable sample of cancer patients (n = 80). Results: The criteria RERpeak (<0.001), Borg’s RPE (<0.001) and fR peak (p = 0.018) were associated with the test leader’s evaluation of whether a test was defined as “to exhaustion”. The cut-points that best predicted the test leader’s evaluation were RER ≥ 1.14, RPE ≥ 18 and fR ≥ 40. Maximal heart rate and plateau was not associated with the test leader’s evaluation. Conclusion: We recommend a focus on RER (in the range between ≥1.1 and ≥1.15) and RPE (≥17 or ≥18) in addition to the test leader’s evaluation. Additionally, a fR peak of ≥40 breaths/min may be a cut-point to help the test leader evaluate the degree of exhaustion. However, more research is needed to verify our findings, and to investigate how these criteria will work within a population that are undergoing or finished with cancer treatment.

• Bjørke, Ann Christin Helgesen; Sweegers, Maike G.; Buffart, Laurien M.; Raastad, Truls; Nygren, Peter & Berntsen, Sveinung (2019). Which exercise prescriptions optimize V̇O2max during cancer treatment?—A systematic review and meta‐analysis. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 29(9), p. 1274–1287. doi: 10.1111/sms.13442. Full text in Research Archive Show summary

  The aims of the present systematic review and meta‐analysis were to investigate the effect of exercise on maximal oxygen uptake (urn:x-wiley:09057188:media:sms13442:sms13442-math-0003) and to investigate whether exercise frequency, intensity, duration, and volume are associated with changes in urn:x-wiley:09057188:media:sms13442:sms13442-math-0004 among adult patients with cancer undergoing treatment. Medline and Embase through OvidSP were searched to identify randomized controlled trials. Two reviewers extracted data and assessed the risk of bias. The overall effect size and differences in effects for different intensities and frequencies were calculated on change scores and post‐intervention urn:x-wiley:09057188:media:sms13442:sms13442-math-0005 data, and the meta‐regression of exercise duration and volumes was analyzed using the Comprehensive Meta‐Analysis software. Fourteen randomized controlled trials were included in the systematic review, comprising 1332 patients with various cancer types receiving (neo‐)adjuvant chemo‐, radio‐, and/or hormone therapy. Exercise induced beneficial changes in urn:x-wiley:09057188:media:sms13442:sms13442-math-0006 compared to usual care (effect size = 0.46, 95% Confidence Interval = 0.23‐0.69). Longer session duration (P = 0.020), and weekly duration (P = 0.010), larger weekly volume (P < 0.001), and shorter intervention duration (P = 0.005) were significantly associated with more beneficial changes in urn:x-wiley:09057188:media:sms13442:sms13442-math-0007. No differences in effects between subgroups with respect to frequency and intensity were found. In conclusion, exercise has beneficial effects on urn:x-wiley:09057188:media:sms13442:sms13442-math-0008 in patients with cancer undergoing (neo‐)adjuvant treatment. As interventions with larger exercise volumes and longer session durations resulted in larger beneficial changes in urn:x-wiley:09057188:media:sms13442:sms13442-math-0009, exercise frequency, intensity, and duration should be considered carefully for sufficient exercise volume to induce changes in urn:x-wiley:09057188:media:sms13442:sms13442-math-0010 for this patient group.

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• Bjørke, Ann Christin Helgesen & Fasting, Merete Lund (2023). «Hele gressfamilien må samles her» . Fædrelandsvennen. ISSN 0805-3790.
• Kjær, Ingirid Geirsdatter Heald; Fasting, Merete Lund & Bjørke, Ann Christin Helgesen (2022). Derfor er leken så viktig for barnas livsmestring . lokalavisen fedrelandsvennen.
• Fasting, Merete Lund; Bjørke, Ann Christin Helgesen & Kjær, Ingirid Geirsdatter Heald (2022). «Hvorfor er leken så viktig for barnas livsmestring?» . Forskersonen.no.
• Bjørke, Ann Christin Helgesen & Fossheim, Kjetil (2021). Friluftsliv, når alt håp er ute? . Adresseavisen. ISSN 0805-3804.
• Bjørke, Ann Christin Helgesen & Fossheim, Kjetil Farsund (2021). Friluftsliv, når alt håp er ute? . Folkebladet.no.
• Bjørke, Ann Christin Helgesen & Fossheim, Kjetil (2021). Friluftsliv, når alt håp er ute? . Fædrelandsvennen. ISSN 0805-3790.
• Bjørke, Ann Christin Helgesen (2021). Hvordan påvirker ulik treningsintensitet fysisk form blant pasienter som gjennomgår kreftbehandling? Onkonytt. ISSN 1503-7886. 2(19), p. 48–51.
• Bjørke, Ann Christin Helgesen (2020). Kreft + trening = bra. [Newspaper]. fvn.no.
• Bjørke, Ann Christin Helgesen (2020). Sørlandssendinga. [Radio]. Nrk sørlandet .
• Bjørke, Ann Christin Helgesen (2020). Råd til dei i kreftbehandling: – Tren så mykje du klarer. [Business/trade/industry journal]. Forskning.no.

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