The One Foot Forward Challenge Outcome!

In case you missed our post earlier this month (One foot forward for mental health!), I decided that throughout October I would participate in the one foot forward challenge. It is run by the Black Dog Institute with the aim of raising awareness for mental health and to fundraise for mental health research.

For this challenge, I set myself the goal of walking 100km. To do this, I would record the total distance that I walk throughout each day and keep a tally to track my progress. I started off really well and ended up increasing this goal to 150km, as I ended up completing just over 75km in the first two weeks!

In this post, we will discuss the outcome of this challenge and some key lessons that we can take away from it. If you would like to read about mental health, the impact it has on modern society and how exercise can help, I would recommend checking out our previous posts – It’s not just our body that we need to look after, but our mind as well! and One foot forward for mental health!

Did I reach my target?

I am pleased to report that I have smashed my goal out of the park so to speak. With another 3 days left in the month, I have managed to walk 170.7km, 20km over my adjusted goal! And yes, I was definitely surprised to see that number. To think that I was able to travel that far within a month is mind boggling!

But the question is, how did I do it? I always like to look for lessons (and solutions) to take away from my experiences, and this is no different. From this challenge, there were two key lessons.

What We Can Take Away From This

Incorporate Exercise Into Your Routine!

Sounds simple enough, but what exactly does this mean? Let’s look at an example from the challenge.

When I drive into work, there are plenty of options to park – we have some spaces out the front, and a couple of nearby streets with no parking limit. Instead of parking as close to the building as I can, I often go into a neighbouring street and park at the opposite end. By doing this, I am able to add some extra walking as I go to and from work. Just by doing that, I’ve completed 5 to 10 minutes of exercise. And when we consider that 30 minutes each day is the national guideline, I’m already a third of the way there just by going to work!

Of course, this is dependant on your individual circumstances, but there is always a way to modify your daily routine slightly to fit in more exercise. Here are some other examples that have worked well for people that I have trained:

      • Completing an exercise (such as calf raises) while brushing their teeth or watching TV
      • Standing while completing household tasks (like folding the clean washing)
      • Taking their pet for more frequent walks
      • Parking slightly further away at the shops
      • Taking the stairs instead of an elevator

The key lesson: you don’t need to drastically change your daily routine to add in exercise. All you need to do is be creative and modify your routine to create an exercise opportunity!

Every Step Matters

When we think of exercising, or walking in this particular situation, we automatically think of bigger workouts. For example, we might think of walking a few kilometres, having a full gym workout or another form of exercise that lasts for at least 30-minutes.

But who says that we need to complete all of our daily exercise at once? What matters is what you have done before the end of the day, not when you have done it. For me, I more frequently did smaller bouts of walking throughout the day instead of one big long walk. By completing multiple 5 to 10 minute walks (or less) throughout the day, I would still accrue at least 30 minutes of walking before the end of the day. This made it easier to complete, as I didn’t need to find one big block of time to fit in my walk. Instead, I could go for small walks in by breaks and small gaps during my day.

This strategy worked wonders for me during this challenge, but it applies to all forms of exercise as well. Let’s say you are completing a home exercise program that involves resistance training. Instead of needing to find time to complete all 30 minutes at once, we could break it up into 3 blocks of 10 minutes. By the end of the day, we have still done the same amount of exercise and will still get the same benefits from it.

In short, don’t feel like you need to complete all your daily exercise at the same time. Completing multiple shorter efforts throughout a day is just as effective!

Need Some Help?

Are you fighting your own mental health battle? Do you want to become a healthier version of yourself? Need some help finding ways to fit exercise into your daily routine? No matter what the goal is, our Exercise Physiologists can help! Contact us to organise an appointment to see one of our Exercise Physiologists and kick-start your health journey!

Check out some of our other posts!

Here are some related posts that may interest you:

Keep your eyes open for more posts coming in the near future – there will be a new post every Thursday! In particular, we are working on a brand new series “How I live strong and prosper”. In this series, we’ll be chatting with Simply Stronger clients and finding out what they do to live strong and prosper!

Please leave a comment below if you have any topic ideas that you would like us to discuss!

Follow us on Social Media!

References

One Foot Forward image provided by the Black Dog Institute

Photos provided by Bruno Nacsimento and Jusfilm via Unsplash.com

Exercise: enhancing the lives of osteoarthritis patients!

A large portion of our population are affected by musculoskeletal conditions at some stage during their lifetime. One of the more prominent musculoskeletal conditions is arthritis, with 1 in 7 Australians being diagnosed with a form of arthritis. That’s around 15% of the population (or 3.6 million), with 50% of these people reporting physical limitations due to moderate or severe joint pain. In addition to this, 3 in 4 Australians over the age of 45 with arthritis report having at least one other chronic medical condition. This means that not only is the impact of arthritis is widespread, but it affects more than just our joints. Hence the importance in reducing our likelihood of developing arthritis. In today’s post, we’ll have a look at how exercise can help with this endeavour. But first, let’s have a brief chat about arthritis and exactly what it is!

What is Arthritis?

In simple terms, arthritis is a joint disease that encompasses a range of conditions affecting the bones and muscles around our joints. It describes permanent joint changes that can cause pain. In some cases, these changes are visible but most of the time the damages can only be seen on an X-ray.

There are over 100 different types of arthritis that are split into 4 main categories: 

      • Degenerative arthritis (e.g. osteoarthritis)
      • Inflammatory arthritis (e.g. rheumatoid arthritis)
      • Infectious arthritis
      • Metabolic arthritis

The most common types of arthritis are osteoarthritis affecting 2.2 million Australians (9.3%) and rheumatoid arthritis affecting 456,000 Australians (1.9%). So, instead of trying to talk about all of the different types and making this post ridiculously long, let’s just focus on osteoarthritis!

What is Osteoarthritis?

As I mentioned previously, osteoarthritis is a type of degenerative arthritis and is the most commonly diagnosed form of arthritis. 

Osteoarthritis occurs when the soft cushioning between the bones, also known as cartilage, breaks down. This can cause the joint to become painful, swollen and hard to move. It most commonly occurs in the hands, knees, hips, lower back and neck.

Causes and Risk Factors

The popular belief is that osteoarthritis is caused by the joints wear and tear. But significant research has revealed that the following factors all contribute to the development of osteoarthritis:

      • Age (particularly over the age of 50)
      • Previous joint injury
      • Overuse
      • Obesity (or being overweight)
      • Weak muscles
      • Genetics and family history
      • Gender (more common in women)

Symptoms

Osteoarthritis affects people in many ways, including:

      • Joint pain during:
          • Physical activity
          • After a long bout of exercise
          • At the end of a busy day
      • Joint stiffness
      • Reduced range of motion
      • Joint clicking or cracking
      • Swelling
      • Muscle weakness around the joint
      • Joint instability or buckling

How can exercise help?

Exercise has been proven to provide many benefits for individuals with osteoarthritis. In particular, exercise does an effective job in lowering our arthritis risk and reducing associated symptoms (see the risk factors and symptoms above).

Individuals with osteoarthritis are less likely to participate in physical activity due to their pain or the fear of aggravating their pain. Due to this, many osteoarthritis patients will have reduced muscular strength and endurance, aerobic capacity, flexibility and overall ability to complete daily tasks. Regular exercise can negate this and help osteoarthritis patients improve their physical capabilities (including muscular strength, endurance and range of motion). 

As the statistics indicate, osteoarthritis patients have an increased risk of developing a secondary medical condition. Exercise training, along with an increase in physical activity levels, will assist in reducing the likelihood of developing additional medical conditions.

As mentioned above, exercise will also help osteoarthritis patients minimise the impact of arthritis symptoms, particularly improving their:

      • Joint stiffness and pain
      • Energy expenditure, which helps with:
          • Weight loss
          • Body composition
      • Stress and anxiety
      • Self-esteem and quality of life
      • Overall mental health (i.e. risk of depression)

How much exercise should I do?

The American College of Sports Medicine (ACSM) suggests that to reduce the risk of developing or reducing the impact of osteoarthritis, individuals should complete a combination of resistance, aerobic and flexibility training. In summary, in order to maximise the benefits of exercise, you should complete:

      • Resistance Training: 2 to 3 days/week of moderate or vigorous intensity exercises. For each exercise, you should complete 2 to 4 sets of 8 to 12 repetitions.
      • Aerobic Training: it is ideal to complete the equivalent of 150-minutes of moderate or 75-minutes of vigorous intensity exercise across 3 to 5 days each week. Optimal activities include cycling, walking or swimming (low joint stress)
      • Flexibility Training: daily training that involves moving through your range of motion until you get the feeling of tightness/ stretching without pain. A 10 to 30 second stretch is ideal, using a combination of static and dynamic stretches.

Where should I start?

There are many ways to exercise, but as the ACSM suggest, it is best to use a mixture of strength, aerobic and flexibility training. This will ensure that we are maximising the benefits for our joints. Having some variety can also be a great way to keep things interesting and fresh – as they say, variety is the spice of life!

If you would like some suggestions on some various exercises that you could use, check out No gym? No problem! Effective ways to exercise outside the gym! It has some great suggestions of strength exercises and cardiovascular activities (such as walking, running or cycling) that you can complete, as well as providing an insight on how to complete them safely. 

Here is a sneak peek of some general bodyweight and resistance band exercises that are discussed in this post:

Bodyweight exercises

Resistance band exercises

As for flexibility training, the 5 strategies to avoid that post-exercise muscle soreness! has some great sections about stretching and self-massage techniques that help improve range of motion. To help get you started, here are some great stretches for different parts of the body:

Stretches

It is important to consider that the optimal exercises are dependant on which joint is affected by osteoarthritis – this is different for each person. For example, we have a wonderful video (shown below) that demonstrates some exercises that are perfect for hand osteoarthritis. Although the title specifically mentions rheumatoid arthritis, they are perfect for anyone with any form of arthritis.

Keeping your exercise safe

As it is with any form of exercise, it is important to consult an exercise professional before getting started. This is especially important when you are experiencing any limitations or joint pain due to osteoarthritis. Exercise professionals, such as Exercise Physiologists, will be able to help you identify the most effective and safest exercises for your particular situation to ensure that you are maximising the benefits without any additional risk.

One Foot Forward Update!

As I mentioned in the One foot forward for mental health! and The benefits of exercise on breast cancer! posts, I am embarking on the journey to complete 150km of walking to help raise awareness for mental health. Here is a quick update on my progress:

So far, I have managed to walk 127.6km! I am on track to achieve my goal of 150km by the end of the month. To do this, I’ll need to walk 2.26km each day. But lets up the ante a little bit – I’m going to aim to reach 150km before next weeks post. This means I have 7 days to go and I’ll instead need to walk 3.2km each day! Thankfully, we are now back to face-face appointments, which means I’ll be on my feet a lot more throughout the day, so I’m confident about achieving this goal. I’m on the home stretch now and the finish line is in sight!

Stay tuned for next weeks post as I will let you know how I go during the final week of the challenge! Make sure to let us know in the comments section how you are going with your One Foot Forward challenge!

Need Some Help?

Whether it is osteoarthritis or another health condition, exercise can provide tremendous benefits! Exercise Physiologist’s specialise in helping those with various medical conditions with exercise-based treatment. So, if you would like some assistance with this or in achieving your health or performance goals, contact us to organise an appointment with one of our Exercise Physiologists.

Check out some of our other posts!

Here are some related posts that may interest you:

Keep your eyes open for more posts coming in the near future – there will be a new post every Thursday! In particular, we are working on a brand new series “How I live strong and prosper”. In this series, we’ll be chatting with Simply Stronger clients and finding out what they do to live strong and prosper!

Please leave a comment below if you have any topic ideas that you would like us to discuss!

Follow us on Social Media!

References and Useful Resources

Arthritis Foundation, 2020, Osteoarthritis, viewed 21/10/2020, https://www.arthritis.org/diseases/osteoarthritis

Arthritis Foundation, 2020, What is Arthritis?, viewed 21/10/2020, https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis 

Australian Institute of Health and Welfare, 2020, Arthritis, last viewed, 21/10/2020. https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/arthritis/contents/arthritis

Photos provided by Aan Nizal, Luis Quintero, Marcel Strauss, Mathew Schwartz and Sriyoga Ashram via Unsplash.com

Riebe, D 2016, ACSM’s guidelines for exercise testing and prescription, Philadelphia Wolters Kluwer/Lippincott Williams & Wilkins Health, 2014. 10th ed.

The benefits of exercise on breast cancer!

A large portion of our population is affected by breast cancer, particularly women. This makes breast cancer a prominent issue in modern society. 

Firstly, breast cancer is the most commonly diagnosed cancer among women. Additionally, it is the second most common cancer overall, accounting for 14% of all cancer diagnosis!

Secondly, in Australia alone 19,974 are estimated to be diagnosed with breast cancer in 2020 (19,807 of which are in women). That’s 55 new cases every day! In addition to this, 1 in 7 women and 1 in 675 men will be diagnosed within their lifetime. 

Thirdly, breast cancer will result in approximately 3,301 deaths in Australia this year, 2,997 being women – that’s 8 deaths every day! The mortality rate for breast cancer is the 5th highest among cancers, accounting for 6.4% of all cancer related deaths!

October happens to be Breast Cancer Awareness Month! So it’s a great opportunity discuss this important topic. In today’s post, we will dive into the world of breast cancer. We will start our journey with a quick explanation of what breast cancer is and how it affects us before discussing how exercise can help! Without further ado, let’s get started!

What is Breast Cancer?

To put it simply, breast cancer is the abnormal growth of cancerous cells in the breast lobules or ducts. These cells grow uncontrollably and have the potential to spread to different parts of the body.

Risk Factors (and Causes)

Certain factors can increase the risk of breast cancer. Some of these factors are uncontrollable and cannot be changed. These unmodifiable risk factors include:

      • Increasing age
      • Family history
      • Genetics (inheritance of mutations)
      • Increased oestrogen and progesterone exposure
      • Previous breast cancer diagnosis
      • History of non-cancerous breast conditions.

Conversely, controllable lifestyle factors can also increase the risk of breast cancer. By positively adjusting the following factors we are able to actively reduce our likelihood of a diagnosis:

      • Increased body weight (overweight or obesity)
      • Sedentary lifestyle (decreased physical activity)
      • Excess alcohol consumption.

Diagnosis

Before a breast cancer diagnosis is given, there are a variety of tests that may be administered. These can include a physical examination, Mammogram, Ultrasound or Biopsy. 

This is a manual examination that aims to find any lumps that are within the breast. If there are lumps, further investigating will be completed.

An X-Ray is used to look for changes (or lumps) in the breast tissues that may be too small to be felt during a physical examination. There are two types of Mammogram:

      1. Screening Mammogram: checks for breast cancer when no signs or symptoms are present
      2. Diagnostic Mammogram: checks for breast cancer after a lump (or other sign or symptom) has been found. 

An ultrasound is used to gather further information if the mammogram has picked up tissue changes. It is a painless scan that uses sound-waves to create a picture of the breast.

A biopsy is completed after an ultrasound. It involves removing part of the affected breast tissue for further examination under a microscope.

If cancer is detected, additional scans (such as a CT or MRI scan) help determine the grade and stage of the cancer. They also determine if the cancer is centralised to the breast or if it has spread to other parts of the body.

Treatments

Treatment of breast cancer depends on its stage and severity. The various treatment methods that may be used include: Staging, Surgery, Chemotherapy, Radiotherapy and Hormone Therapy.

This is an assessment that determines the size of the breast cancer and whether or not it has spread to the lymph nodes under the arm. To do this, CT scans of the chest and liver, as well as a bone scan, are completed to check the sites to which it most commonly spreads to.

For localised cancer, surgery may be completed to remove the breast and lymph nodes under the arms. There are two types of surgery that may be performed:

    1. Lumpectomy (or breast conserving surgery): the removal of only part of the breast 
    2. Mastectomy: the removal of the whole breast. This may be followed with reconstructive surgery.

Chemotherapy helps shrink the cancer prior to surgery, as well as reducing the risk of the cancer returning after surgery. It can also be administered after surgery if the cancer returns. It can also be given in conjunction with other treatments such as radiotherapy.

Radiotherapy (or radiation therapy) is used to destroy any cancer cells. This can be applied in isolation or as an adjacent treatment with surgery or chemotherapy.

This method uses drugs to reduce the levels of oestrogen and progesterone within the body. It aims to stop or slow the growth of hormone receptor positive cancer cells. which require these hormones to survive and spread.  

The Side Effects of Treatment

While breast cancer treatment can be quite effective at treating the cancerous cells, it also has many potential side effects. These side effects include, but are not limited to:

      • Fatigue
      • Musculoskeletal dysfunction or atrophy
      • Reduced bone mineral density
      • Lymphedema
      • Changes in body composition
      • Peripheral neuropathy or other nerve problems
      • Arthralgia / Myalgia
      • Cardiovascular toxicity
      • Increased stress and anxiety
      • Changes in mood
      • Decreased concentration and focus
      • Functional decline
      • Compromised immune system

Thankfully, exercise helps reduce the impact of many of these side effects. Speaking of which, let’s now have a look at the role of exercise in helping breast cancer patients and survivors!

Exercise for Breast Cancer

Physical activity is an effective intervention for breast cancer patients. Research concludes that exercise is helpful for patients both during and after cancer treatment.

Goals of Exercise

Exercise goals vary depending on the stage of cancer treatment, the treatments prescribed and the resultant symptoms experienced by an individual.

As I mentioned earlier, exercise prior to a cancer diagnosis can have a positive impact on some lifestyle factors known to be linked with cancer development. This makes exercise a great option in helping reduce the risk of cancer development in the first place – as they say, prevention is the best form of treatment!

Once diagnosed, exercise can provide many benefits throughout treatment. During this stage, it aims to reduce the associated symptoms, in addition to maintaining physical capabilities and function along with maintaining your quality of life.

In addition, exercise also provides many post-treatment benefits for survivors. After treatment, exercise aims to help the survivor return to their pre-treatment physical function, in addition to reducing the risk of cancer reoccurrence. 

Benefits of Exercise for Breast Cancer

No matter the stage of treatment, the benefits remain the same – the only difference is the goal!

Overall, an effective exercise intervention can allow patients and survivors to:

      • Improve their:
        • Physical function (ability to complete daily activities)
        • Physical fitness, including:
          • Cardiorespiratory fitness
          • Muscular strength and endurance
          • Muscle mass
        • Self-esteem and quality of life
        • Energy levels (or reducing fatigue)
        • Body composition
        • Tolerance of treatment and completion rate (or efficacy)
        • Cancer survival rate
      • Reduce their:
        • Risk of reoccurrence
        • Stress and anxiety
        • Risk of depression

So how much exercise should I do?

Exercise and Sport Science Australia (ESSA) suggests that breast cancer patients and survivors should follow the national physical activity guidelines and complete a minimum of 150 minutes of moderate, or 75 minutes of vigorous intensity aerobic physical activity (cardiovascular training) each week. In addition, it is recommended to complete at least 2 strength training sessions each week. That’s equivalent to 30 minutes of moderate exercise or 15 minutes of vigorous exercise 5 days a week. 

Of course, it is important to consider that everyone has different physical capabilities. Although this level of exercise may be realistic for some people, for others it won’t be. Hence, it is important to start at a level that is realistic for you to complete and gradually build up until you reach these recommendations. And at the end of the day, something is always better than nothing! 

If you are not sure how you can fit 30 minutes of exercise into your daily schedule, you could complete your exercise in intervals throughout the day. For example, you could complete 15 minutes in the morning and another 15 minutes in the evening. That would still be 30 minutes for the day – it doesn’t have to be completed all at once!

I want to start, but I'm not sure how to...

There are many ways to exercise, but it is recommended that we use a mixture of strength and cardiovascular training. This will ensure that we are maximising the benefits for both our muscles (regarding strength, endurance and mass) and our lungs (cardiovascular fitness). Having some variety can also be a great way to keep things interesting and fresh – as they say, variety is the spice of life!

If you would like some suggestions on some various exercises that you could use, check out our No gym? No problem! Effective ways to exercise outside the gym! post. It has some great suggestions of strength exercises and cardiovascular activities that you can complete at home, as well as providing an insight on how to complete them. Here is a sneak peek of the bodyweight and resistance band exercises that are discussed in this post:

Bodyweight exercises

Resistance band exercises

Keep in mind that you can purchase your own resistance band from Simply Stronger. We are able to post it to you anywhere in Australia at $5/m plus postage – contact us for more information.

Preventing muscle soreness

Anyone that exercises frequently can tell you about the muscle soreness that you can get after a good workout! It happens to everyone. In particular if you are starting to exercise more frequently – any increase in overall load can result in this soreness, which can potentially hold you back.

There are many ways to help manage our load to help prevent this. Some of these strategies include gradually building up your load, self-massage and stretching. Our 5 strategies to avoid that post-exercise muscle soreness! post addresses this topic in depth and can help you avoid that soreness and maximise the exercise benefits.

Keeping your exercise safe

As it is with any form of exercise, it is important to consult an exercise professional before getting started. This is especially important if you are currently going through cancer treatment. 

Although exercise provides many health benefits, it is important to make sure that you are completing the right exercises for your situation. Exercise professionals, such as Exercise Physiologists are able to help with identifying the most effective and safest exercises for your particular situation to ensure that you are maximising the benefits without any additional risk.

One Foot Forward Update!

As I mentioned in last weeks One foot forward for mental health! post, I am embarking on the journey to complete 100km of walking to help raise awareness for mental health. As promised, I’ve got a quick update ready for you.

So far, I have managed to walk 78.9km! Thats right, I’ve somehow managed to surpass 75% of my goal even though we are only half way through the month. For those who are wondering, I’ve been focussing on staying on my feet throughout the day and allocating time each day to go out for walks around my neighbourhood.

However, I never expected to go this far so quickly – maybe I underestimated my capabilities? So, I’ve decided that I’ll increase my goal to 150km. This is still realistic to achieve, as I will only need to maintain what I am already doing to achieve it. At the end of the day, the goal needs to be challenging and realistic at the same time, and I think this adjustment will help with that.

Stay tuned for next weeks post as I will provide you with another update! Make sure to let us know in the comments section how you are going with your One Foot Forward challenge!

Need Some Help?

Whether it is Breast Cancer or another health condition, exercise can provide tremendous benefits! Exercise Physiologist’s specialise in helping those with various medical conditions with exercise-based treatment. So, if you would like some assistance with this or in achieving your health or performance goals, contact us to organise an appointment with one of our Exercise Physiologists.

Check out some of our other posts!

Keep your eyes open for more posts coming in the near future – there will be a new post every Wednesday!

Here are some related posts that may interest you:

Keep your eyes open for more posts coming in the near future – there will be a new post every Wednesday! In particular, we are working on a brand new series “How I live strong and prosper”. In this series, we’ll be chatting with Simply Stronger clients and finding out what they do to live strong and prosper!

Please leave a comment below if you have any topic ideas that you would like us to discuss!

Follow us on Social Media!

References and Useful Resources

Australian Government – Cancer Australia, 2020. Breast Cancer in Australia Statistics, viewed 11/10/2020. https://www.canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/statistics

Bernstein, L., Henderson, B.E., Hanisch, R., Sullivan-Halley, J. and Ross, R.K., 1994. Physical exercise and reduced risk of breast cancer in young womenJNCI: Journal of the National Cancer Institute86(18), pp.1403-1408.

Cancer Council, 2020. Breast Cancer, viewed 11/10/2020. https://www.cancer.org.au/cancer-information/types-of-cancer/breast-cancer 

Courneya, K.S., Mackey, J.R., Bell, G.J., Jones, L.W., Field, C.J. and Fairey, A.S., 2003. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomesJournal of clinical oncology21(9), pp.1660-1668.

Hayes, S.C., Newton, R.U., Spence, R.R. and Galvão, D.A., 2019. The Exercise and Sports Science Australia position statement: Exercise medicine in cancer management. Journal of science and medicine in sport22(11), pp.1175-1199.

McNeely, M.L., Campbell, K.L., Rowe, B.H., Klassen, T.P., Mackey, J.R. and Courneya, K.S., 2006. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysisCmaj175(1), pp.34-41.

Mock V, Dow KH, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncology Nursing Forum. 1997 Jul;24(6):991-1000.

National Breast Cancer Foundation, 2020. Breast Cancer Stats, viewed 11/10/2020. https://nbcf.org.au/about-breast-cancer/breast-cancer-stats/?gclid=Cj0KCQjwt4X8BRCPARIsABmcnOp6W6x_mQUpRxDTLRNn-pWEhwDYRpPii1GVH8IQRK1ihKQS6X1h5hYaApt1EALw_wcB

Photos provided by Angiola Harry, Jenny Hill, Jon Tyson, Marcelo Leal and Peter Boccia via Unsplash.com

Schwartz, A.L., Mori, M.O.T.O.M.I., Gao, R.E.N.L.U., NAIL, L.M. and KING, M.E., 2001. Exercise reduces daily fatigue in women with breast cancer receiving chemotherapyMedicine & Science in Sports & Exercise33(5), pp.718-723.