Physios in Ireland poised to take leading role in European Union-funded cancer prevention project
Physiotherapists in Ireland are set to play a central role in a European initiative that aims to encourage adults to take part in physical activities in a bid to prevent cancer.
The project – titled Urban ACTion for cancer prevention: adult and senior citizens practise physical activity within public urban green spaces to prevent cancer diseases (or UcanACT for short) – is co-funded by the European Union (EU).
Next month, physiotherapists taking part in the initiative will be introduced to a sophisticated ‘citizens engagement strategy’ in the south-eastern county of Kilkenny (population about 104,000), one of three ‘pilot territories’ included in the initiative. As well as students from the University of Limerick, public and private sector physiotherapists will mingle with local citizens at the events in March.
Up-to-date information on the initiative is available in a newsletter (number three in a series). Published last month, it is also available via the Irish Society of Chartered Physiotherapy’s (ISCP) website.
This states that physios and managers will be introduced to the practical intervention methodology, enabling them to ‘learn more about the guidelines and methodological bases for the implementation of cancer-preventive physical exercises’.
Key role for physios
Physiotherapists are being recruited to work alongside local authorities, non-profit organisations, higher education institutions and research institutions to fulfil the project’s main objective. This is to engage ‘adults and senior citizens to practise physical activity as a tool for cancer prevention within public urban green spaces (PUGS)’.
The other two pilots are taking place in Bologna (population about 388,000) in Italy and Munich (population 1,488,000) in Germany – with the contrasting locations chosen to represent ‘diverse urban contexts in terms of geography, mobility, density and population’, according to a UcanACT citizens engagement strategy document. This was written by World Physiotherapy’s Europe region, Kilkenny County Council, the Italian Physiotherapy Association and Outdoor Against Cancer.
Preventing cancer is said to be ‘one of the most significant public health challenges’ in this century, while regular physical activity and maintaining a healthy body weight is the second most important means of cancer prevention (after tobacco controls). The World Health Organization (WHO) recognises physical activity as a possible measure for cancer prevention.
Drawing on the research literature and rounding up the figures, the guidance notes that physical inactivity is responsible for significant amounts of ‘burden of disease’ on the following: coronary heart disease (6 per cent); colon cancer (seven per cent); and premature mortality (nine per cent).
Even a single episode of moderate-to-vigorous physical activity helps to improve sleep, reduce symptoms of anxiety, reduce blood pressure and improve insulin sensitivity on the day the activity is performed, the guidance notes. ‘When physical activity is performed regularly, benefits and improvements become larger.’ Moreover, practising physical exercise in open environments increases the positive benefits.'
In the EU, 3.5 million people are diagnosed with cancer every year and there are some 1.3 million people die from cancer. The WHO identifies cancer as a ‘leading cause of death globally’, with an estimated 10 million deaths from cancer in 2020 – nearly one death in six.
Cancer incidence and survival
- physical activity improves all-cause mortality, cancer-specific mortality, and risk of cancer recurrence or second primary cancer
- physical activity promotes beneficial short and long-term changes in metabolic, hormonal and inflammatory pathways
- higher levels of physical activity after cancer diagnosis are reported to be protective for all-cause mortality following breast cancer, colorectal cancer, female reproductive cancer, glioma, kidney cancer, lung cancer, prostate cancer and stomach cancer
- greater amounts of physical activity after cancer diagnosis are associated with lower risk of cause-specific mortality in breast cancer, colorectal cancer and prostate cancer survivors
Lack of practical guidelines
The UcanACT document notes that there is currently a lack of practical guidelines available for physiotherapists and other health professionals who want to provide cancer preventive physical activity sessions. It notes that a growing number of scientific studies have proved that physical activity is a tool for cancer prevention and rehabilitation.
‘Moreover, existing recommendations on how to provide appropriate physical activity for cancer prevention are mainly done for clinical conditions (hospitals, rehabilitation centres) in spite of the fact that there are numerous scientific evidences showing that practising PA [physical activity] within open nature environments increases positive effects of cancer prevention, provides opportunities for social inclusion of cancer survivors and positively influences on mental health and healthy lifestyle behaviours.’
‘Given that context, the UcanACT project has decided to involve physiotherapists and health professionals in a series of activities that engage adults and senior citizens to practise physical activity as a tool for cancer prevention and empower them to take charge of their own health rather than being passive recipients of services.’
the UcanACT project has decided to involve physiotherapists and health professionals in a series of activities that engage adults and senior citizens to practise physical activity as a tool for cancer prevention and empower them to take charge of their own health [UcanACT]
Exercise app
One of the project's main objectives is to pilot an exercise app that is specifically aimed at cancer patients and cancer prevention, the document notes: Through a better understanding, physiotherapists and health professionals will be able to deliver face to face physical activity sessions to participants, motivating them to perform the exercises by themselves, reminding them of tips on performing the exercises properly to prevent risks, and answering questions that may have arisen with the exercises.
In addition, physios will introduce the target group to the UcanACT App.
The preparation phase of the UcanACT project is based on another EU-funded initiative – known as the InAbled Cities project, which is coordinated by the European Foundation for Physiotherapy and Physical Activity.
Physiotherapist Emer Guinan, an associate professor in cancer rehabilitation and survivorship at Trinity College Dublin, has been named as a collaborator with the UcanACT project.
According to information about her on the Trinity College Dublin website, Dr Guinan has responsibility for building capacity in cancer survivorship research and education across the Trinity St James's Cancer Institute. Her research focuses on 'unmet needs' – particularly physical, practical and psychosocial needs – and the implementation and evaluation of complex interventions to address these issues.
The UcanACT MOOC
The UcanACT MOOC [Massive Open Online Course] is open to every physiotherapist, free of charge. Participants must complete a 40-question exam, achieving a score of at least at 70 per cent to finish the course successfully and receive a UcanACT badge and certificate for completing the MOOC.
UcanACT project partners
The ISCP is one of the UcanACT project's partners, along with the Italian Physiotherapy Association, the ONCE University School of Physiotherapy, Madrid, the University of Sevilla, the University of Bologna and World Physiotherapy’s Europe region.
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