Tormod Skogstad Nilsen

• Solberg, Aleksander; Grydeland, May; Nilsen, Tormod Skogstad; Storås, Anne Marie Holck; Davis, Ian D. & Greaves, Natalie [Show all 23 contributors for this article] (2026). Prevalence of meeting aerobic physical activity and resistance training guidelines in advanced prostate cancer: a descriptive study of racial and regional disparities in the IRONMAN registry. Supportive Care in Cancer. ISSN 0941-4355. 34. doi: 10.1007/s00520-026-11251-3. Full text in Research Archive Show summary

  Purpose To estimate guideline-based aerobic physical activity and resistance training participation in an international population of people with newly diagnosed metastatic hormone-sensitive or castration-resistant prostate cancer, and to assess racial and regional differences. Methods Participants in the international IRONMAN registry (NCT 03151629) of advanced prostate cancer reported leisure-time activity at 6, 18, and 30 months post-enrolment. The proportion meeting guidelines of≥150 min/week moderate to vigorous physical activity and≥2 weekly resistance training sessions were quantified. Mixed-effects logistic regression estimated odds of meeting guidelines averaged across timepoints using all follow-up data by self-identified race (White, Black, Other) and geographic region (Europe, Australia, North America, Africa, Other). Results Among 2485 participants, 58–63% met aerobic physical activity guidelines and 19–23% met resistance training guidelines across timepoints. Resistance training participation was especially low in African geographic regions (0–3%). Participants self-identifying as Black had lower odds of meeting aerobic physical activity guidelines than White participants (crude odds ratio [cOR] 0.23, 95% CI 0.15–0.36), and participants from Africa had lower odds than those from Europe (cOR 0.08, 95% CI 0.03–0.21). Crude patterns were similar for resistance training. Aerobic physical activity disparities persisted after multivariable adjustments, and in sensitivity analyses excluding Black participants from African geographic regions, while resistance training estimates were attenuated. Conclusions Targeted strategies are warranted to increase participation rates in aerobic physical activity and resistance training among advanced prostate cancer patients self-identifying as Black, or those from African geographic regions.

• Sanchez-Lastra, Miguel Adriano; Cruz, Borja del Pozo; Tarp, Jakob; Dalene, Knut Eirik; Nilsen, Tormod Skogstad & Ding, Ding [Show all 7 contributors for this article] (2026). Dose‒response associations of self-reported and device-measured physical activity with major adverse cardiovascular events in people with prevalent diseases. Journal of Sport and Health Science. ISSN 2095-2546. 15. doi: 10.1016/j.jshs.2025.101116. Full text in Research Archive Show summary

  Purpose: To investigate the dose-response associations of self-reported and device-measured physical activity with major adverse cardiovascular events (MACE) and cardiovascular disease (CVD) mortality in individuals with a history of CVD, type 2 diabetes mellitus (T2DM), or cancer. Methods: We analyzed data from 34,183 UK Biobank participants (CVD: n = 8703; T2DM: n = 11,623; cancer: n = 13,857; age = 60.0 ± 7.1 years, mean ± SD; 45.3% women). Physical activity was assessed using self-reports and wrist-worn accelerometers in a subsample (n = 6077). Dose‒response associations with MACE and CVD mortality were evaluated using Fine-Gray competing-risk models with penalized splines, adjusting for confounders. Results: During a median follow-up of 13.1 years, 8729 MACE and 982 CVD deaths were recorded. Self-reported physical activity showed non-linear inverse associations with MACE, with the optimal dose (nadir) observed at ≈4000 MET-min/week in CVD (hazard ratio (HR) = 0.95) and cancer (HR = 0.92) and ≈6000 MET-min/week in T2DM (HR = 0.91), compared to participants in the 5th centiles of activity. For CVD mortality, the optimal dose was observed at ≈5000 MET-min/week in CVD (HR = 0.86) and cancer (HR = 0.62), respectively. Device-measured moderate-to-vigorous intensity physical activity showed stronger dose‒response associations with MACE for T2DM (optimal dose observed at ≈200 min/week, HR = 0.88) and cancer (optimal dose at ≈700 min/week, HR = 0.27, wide confidence intervals). Conclusion: Physical activity could reduce MACE risk in people with a history of CVD, T2DM, or cancer. While a similar shape of dose-response patterns was observed across these groups, self-reported data suggested the minimal effective dose might exceed current World Health Organization recommendations. However, device-measured data supported existing guidelines for people with T2DM and cancer survivors.

• Johansen, Sara Hassing; Reinertsen, Kristin Valborg; Wisløff, Torbjørn; Sæter, Mali; Sarvari, Sebastian & Kiserud, Cecilie E. [Show all 11 contributors for this article] (2025). Effects of aerobic exercise on late effects and quality of life in long-term breast cancer survivors: A randomized controlled trial. JNCI Cancer Spectrum. 9(6). doi: 10.1093/jncics/pkaf102. Full text in Research Archive Show summary

  Background Breast cancer survivors (BCSs) are at increased risk of late effects. While research has reported positive effects of exercise therapy on fatigue and health-related quality of life (HRQoL) among short-term BCSs, evidence in long-term survivors remains scarce. Methods The CAUSE (CArdiovascUlar Survivors Exercise) trial was a 2-armed randomized controlled trial. Long-term BCSs were assigned to 5 months of thrice-weekly supervised aerobic exercise or usual care. Late effects and HRQoL were assessed by Chalder Fatigue Questionnaire, European Organization for Research and Treatment of Cancer QLQ-BR23 and QLQ-C30 questionnaires, and Scale for Chemotherapy-Induced Long-term Neurotoxicity at baseline (T0), post-intervention (T1), and 1-year follow-up (T2). Results In total, 140 BCSs (mean age 59.0 ± 6.4 years, 11 ± 1 years post-treatment) were included. Loss to follow-up at T1 was 6% and 19% in the exercise- and usual care group, respectively. From T0 to T1, the exercise group significantly improved total fatigue (between groups mean difference [MD] = –3.0, P < .001), body image (MD = 6.7, P = .043), physical- (MD = 3.2, P ≤ .001), role- (MD = 9.6, P = .019), and cognitive function (MD = 3.4, P = .038), insomnia (MD = –9.0, P = .017), and global health/QoL (MD = 5.3, P ≤ .001) compared to usual care. The exercise benefits were more pronounced in BCSs experiencing versus not experiencing late effects at baseline. At 1-year follow-up, most improvements regressed toward baseline values. Conclusion Aerobic exercise significantly improves fatigue, body image, physical-, role-, and cognitive function, insomnia, and HRQoL in long-term BCSs. These findings suggest that exercise therapy should be a core component of managing late effects and enhancing HRQoL in long-term BCSs. Clinical trial registration URL: https://www.clinicaltrials.gov/. Registration number: NCT04307407

• Sæter, Mali; Johansen, Sara Hassing; Reinertsen, Kristin Valborg; Thorsen, Lene; Haugaa, Kristina Ingrid Helena Hermann & Nilsen, Tormod Skogstad [Show all 7 contributors for this article] (2025). Cardiorespiratory fitness, cardiac morphology and function, and cardiovascular risk factors in long-term breast cancer survivors compared with non-cancer controls. Cardio-Oncology. 11. doi: 10.1186/s40959-024-00296-0. Full text in Research Archive Show summary

  Background Although anthracycline-related cardiotoxicity is widely studied, only a limited number of echocardiographic studies have assessed cardiac function in breast cancer survivors (BCSs) beyond ten years from anthracycline treatment, and the knowledge of long-term cardiorespiratory fitness (CRF) in this population is scarce. This study aimed to compare CRF assessed as peak oxygen uptake (V̇O2), cardiac morphology and function, and cardiovascular (CV) risk factors between long-term BCSs treated with anthracyclines and controls with no history of cancer. Methods The CAUSE (Cardiovascular Survivors Exercise) trial included 140 BCSs recruited through the Cancer Registry of Norway, who were diagnosed with breast cancer stage II to III between 2008 and 2012 and had received treatment with epirubicin, and 69 similarly aged activity level-matched controls. All the participants underwent blood sampling, blood pressure measurements, echocardiography and cardiopulmonary exercise testing from October 2020 to August 2022. Results BCSs were aged 59 ± 6 years and had received a cumulative dose of 357 (243 to 366) mg/m2 of epirubicin on average 11 ± 1 years before inclusion. There was no difference between BCSs and controls with respect to peak V̇O2 (27.6 ± 5.4 mL/kg/min vs. 27.1 ± 5.4 mL/kg/min, P = 0.25), 2D left ventricular ejection fraction (57 ± 3% vs. 57 ± 3%, P = 0.43), left ventricular global longitudinal strain (-20.5 ± 1.0% vs. -20.6 ± 1.0%, P = 0.46) or the proportion with N-terminal pro-brain natriuretic peptide ≥ 125 (22% vs. 20%, P = 0.93). The proportions with hypertension, dyslipidemia or diabetes did not differ between the groups. Conclusion We found that CRF, cardiac function, and CV risk profile in BCSs examined a decade after treatment with anthracyclines were similar to that in women with no history of cancer.

• Johansen, Sara Hassing; Wisløff, Torbjørn; Edvardsen, Elisabeth; Kollerud, Sofie Taugbøl; Jensen, Johanne Sofia Steen & Agwu, Ginika [Show all 9 contributors for this article] (2025). Effects of Systemic Anticancer Treatment on Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. JACC: CardioOncology. 7(2), p. 96–106. doi: 10.1016/j.jaccao.2024.11.004. Full text in Research Archive Show summary

  Background: Poor cardiorespiratory fitness (CRF) is associated with a higher symptom burden and an increased prevalence of long-term treatment–related cardiovascular disease risk factors in cancer survivors. However, the magnitude of systemic therapy–related CRF impairment remains unclear. Objectives: The aim of this study was to evaluate the effects of systemic anticancer treatment on CRF and identify physiological determinants underpinning CRF impairment. Methods: A systematic literature search was performed in PubMed, Embase, CINAHL, SPORTDiscus, and the Cochrane Library. The primary endpoint was the change in CRF, measured by peak oxygen consumption (Vo2peak), from before to after systemic treatment. Secondary endpoints included post-treatment differences in Vo2peak between cancer survivors and noncancer control subjects, along with physiological determinants of Vo2peak. Two meta-regressions were conducted to examine the association between CRF and cardiac output and arteriovenous oxygen difference. Results: A total of 44 studies were included, comprising 27 prospective trials (61%; n = 1,234 cancer survivors, median age 52.4 years) and 17 cross-sectional studies (39%; n = 1,372 cancer survivors, median age 54.0 years; n = 1,923 noncancer control subjects, median age 56.0 years). Systemic anticancer treatment was associated with a significant decrease in Vo2peak (weighted mean difference −2.13 mL·kg−1·min−1; 95% CI: −2.76 to −1.50 mL·kg−1·min−1). No significant differences were observed between patient subgroups (esophagogastric, breast, and colon or rectal cancers). At a median follow-up of 2 years (range: 6 weeks to 12 years) post-therapy, cancer survivors had a significantly lower Vo2peak (weighted mean difference −6.39 mL·kg−1·min−1; 95% CI: −7.60 to −5.18 mL·kg−1·min−1) compared with noncancer control subjects. Reduced arteriovenous oxygen difference was associated with lower Vo2peak (β = 2.55; 95% CI: 2.05-3.06; P

• Edvardsen, Elisabeth; Nilsen, Tormod Skogstad; Novo, Robert; Curry, Michael; Adams, Scott C. & Matsoukas, Konstantina [Show all 11 contributors for this article] (2025). Exercise Testing Characteristics, Safety, and Quality in Patients with Cancer: A Systematic Review. Mayo Clinic Proceedings: Innovations, Quality & Outcomes (MCP:IQ&O). 9(4). doi: 10.1016/j.mayocpiqo.2025.100628. Full text in Research Archive
• Johansen, Sara Hassing; Sæter, Mali; Sarvari, Sebastian; Reinertsen, Kristin Valborg; Edvardsen, Elisabeth & Wisløff, Torbjørn [Show all 18 contributors for this article] (2025). Effects of Aerobic Exercise on Cardiorespiratory Fitness and Cardiovascular Risk Factors in Long-Term Breast Cancer Survivors: A Randomized Controlled Trial. JACC: CardioOncology. 7(4), p. 414–426. doi: 10.1016/j.jaccao.2025.04.006. Full text in Research Archive
• Bøhn, Synne-Kristin Hoffart; Oldervoll, Line Merethe; Reinertsen, Kristin Valborg; Selland, Mette; Fosså, Alexander & Kiserud, Cecilie E. [Show all 17 contributors for this article] (2024). The feasibility of a multidimensional intervention in lymphoma survivors with chronic fatigue. Supportive Care in Cancer. ISSN 0941-4355. 32(1). doi: 10.1007/s00520-023-08204-5. Full text in Research Archive Show summary

  Purpose: Chronic fatigue (CF) affects 25–30% of lymphoma survivors, but interventions designed to reduce fatigue are lacking. The main aim of this study was to test the feasibility of a multidimensional intervention study in lymphoma survivors with CF. Secondary aims were to describe individual changes in fatigue, quality of life (QoL) and physical performance from pre (T0) to post (T1) intervention. Methods: This feasibility study was as a one-armed intervention study performed in 2021. Hodgkin or aggressive non-Hodgkin lymphoma survivors received mailed study information and Chalder Fatigue Questionnaire and were asked to respond if they suffered from fatigue. The 12-week intervention included patient education, physical exercise, a cognitive behavioural therapy (CBT)-based group program and nutritional counselling. Feasibility data included patient recruitment, completion of assessments, adherence to the intervention and patient-reported experience measures. Participants responded to questionnaires and underwent physical tests at T0 and T1. Results: Seven lymphoma survivors with CF were included. Of all assessments, 91% and 83% were completed at T0 and T1, respectively. Adherence to the interventional components varied from 69% to 91%. At T1, all participants rated exercise as useful, of whom five rated the CBT-based program and five rated individual nutritional counselling as useful. Five participants reported improved fatigue, QoL and physical performance. Conclusion: Lymphoma survivors with CF participating in a multidimensional intervention designed to reduce the level of fatigue showed high assessment completion rate and intervention adherence rate. Most of the participants evaluated the program as useful and improved their level of fatigue, QoL and physical performance after the intervention.

• Novo, Robert T.; Thomas, Samantha M.; Khouri, Michel G.; Alenezi, Fawaz; Herndon, James E & Michalski, Meghan [Show all 11 contributors for this article] (2024). Machine Learning-Driven Phenogrouping and Cardiorespiratory Fitness Response in Metastatic Breast Cancer. JCO Clinical Cancer Informatics. 8. doi: 10.1200/CCI.24.00031. Full text in Research Archive Show summary

  Purpose The magnitude of cardiorespiratory fitness (CRF) impairment during anticancer treatment and CRF response to aerobic exercise training (AT) are highly variable. The aim of this ancillary analysis was to leverage machine learning approaches to identify patients at high risk of impaired CRF and poor CRF response to AT. Methods We evaluated heterogeneity in CRF among 64 women with metastatic breast cancer randomly assigned to 12 weeks of highly structured AT (n = 33) or control (n = 31). Unsupervised hierarchical cluster analyses were used to identify representative variables from multidimensional prerandomization (baseline) data, and to categorize patients into mutually exclusive subgroups (ie, phenogroups). Logistic and linear regression evaluated the association between phenogroups and impaired CRF (ie, ≤16 mL O2·kg–1·min–1) and CRF response. Results Baseline CRF ranged from 10.2 to 38.8 mL O2·kg–1·min–1; CRF response ranged from –15.7 to 4.1 mL O2·kg–1·min–1. Of the n = 120 candidate baseline variables, n = 32 representative variables were identified. Patients were categorized into two phenogroups. Compared with phenogroup 1 (n = 27), phenogroup 2 (n = 37) contained a higher number of patients with none or >three lines of previous anticancer therapy for metastatic disease and had lower resting left ventricular systolic and diastolic function, cardiac output reserve, hematocrit, lymphocyte count, patient-reported outcomes, and CRF (P

• Johansen, Merethe Lia; Eriksrud, Ola; Thorkildsen, Joachim; Norum, Ole-Jacob Anderssen; Wisløff, Torbjørn & Taksdal, Ingeborg [Show all 7 contributors for this article] (2023). Muscle strength characteristics following megaprosthetic knee reconstruction for bone sarcoma. Surgial oncology. ISSN 0960-7404. 48. doi: 10.1016/j.suronc.2023.101944. Full text in Research Archive Show summary

  Objective: To assess muscle strength characteristics in patients with resection and megaprosthetic reconstruction of the knee for bone sarcoma compared to age- and sex-matched controls. Methods: This was a cross-sectional, case-control study. Muscle strength characteristics for knee extension and -flexion were assessed isokinetically at three different joint velocities: 60, 120 and 180°/s, and by the rate of force development (RDFmax) in knee extension. The Toronto Extremity Salvage Score (TESS) was used in patients. Results: Eighteen patients (91.6 months postop.) and 18 controls were included. Relative to controls, patients generated maximal torques of 19%, 23% and 23% in knee extension at 60, 120 and 180°/s, respectively. For knee flexion, patients generated maximal torques of 58%, 53% and 60% at 60, 120, and 180°/s, relative to the controls. RDFmax of the operated leg was 2.75 ± 2.13 N/ms, 7.16 ± 4.78 N/ms for the non-operated leg, and 7.95 ± 4.29 N/ms for the controls. The mean TESS score was 84.0. Conclusion: Patients reached approximately 20% of the maximal knee extension torque. In isometric assessments, they used double the amount of time to generate one-third of the maximal force compared to the controls despite good TESS scores.

• Gorski, Piotr Patryk; Raastad, Truls; Ullrich, Max; Turner, Daniel; Hallén, Jostein & Sarvari, Sebastian [Show all 8 contributors for this article] (2022). Aerobic Exercise Training Resets the Human Skeletal Muscle Methylome Ten Years after Breast Cancer Treatment and Survival. The FASEB Journal. ISSN 0892-6638. 37(1). doi: 10.1096/fj.202201510RR. Full text in Research Archive Show summary

  Background: Cancer survivors suffer impairments in skeletal muscle in terms of reduced mass and function. Interestingly, human skeletal muscle possesses an epigenetic memory of earlier stimuli, such as exercise. Long-term retention of epigenetic changes in skeletal muscle following cancer survival and/or exercise training have not yet been studied. We therefore investigated genome-wide DNA methylation (methylome) in skeletal muscle following a 5-month, 3/week aerobic-training intervention in breast cancer survivors 10-14 years after diagnosis and treatment. These results were compared to breast cancer survivors who remained untrained and to age-matched controls with no history of cancer, who undertook the same training intervention. Methods: Skeletal muscle biopsies were obtained from 23 females before(pre) and after(post) the 5-month training period. InfiniumEPIC 850K DNA methylation arrays and RT-PCR for gene expression performed. Results: The breast cancer survivors displayed a significant retention of increased DNA methylation (i.e.,hypermethylation) at a larger number of differentially methylated positions (DMPs) compared with healthy age-matched controls pre-training. Training in cancer survivors led to an exaggerated number of DMPs with a hypermethylated signature occurring at non-regulatory regions compared with training in healthy age-matched controls. However, the opposite occurred in important gene regulatory regions, where training in cancer survivors elicited a considerable reduction in methylation (i.e.,hypomethylation) in 99% of the DMPs located in CpG islands within promoter regions. Importantly, training was able to reverse the hypermethylation identified in cancer survivors back towards a hypomethylated signature that was observed pre-training in healthy age-matched controls at 300 (out of 881) of these island/promoter associated CpGs. Pathway enrichment analysis identified training in cancer survivors evoked this predominantly hypomethylated signature in pathways associated with: Cell cycle, DNA replication/repair, transcription, translation, mTOR signalling and the proteosome. Differentially methylated region (DMR) analysis also identified genes: BAG1, BTG2, CHP1, KIFC1, MKL2, MTR, PEX11B, POLD2, S100A6, SNORD104 and SPG7 as hypermethylated in breast cancer survivors, with training reversing these CpG island/promoter associated DMRs towards a hypomethylated signature. Training also elicited a largely different epigenetic response in healthy individuals than that observed in cancer survivors, with very few overlapping changes. Only one gene, SIRT2, was identified as having altered methylation in cancer survivors at baseline and after training in both the cancer survivors and healthy controls. Conclusions: Human skeletal muscle muscle may retain a hypermethylated signature as long as 10-14 years after breast cancer treatment/survival. Five months of aerobic training reset the skeletal muscle methylome towards signatures identified in healthy age-matched individuals in gene regulatory regions.

• Nilsen, Tormod Skogstad; Johansen, Sara Hassing; Thorsen, Lene; Fairman, Ciaran M.; Wisløff, Torbjørn & Raastad, Truls (2022). Does Androgen Deprivation for Prostate Cancer Affect Normal Adaptation to Resistance Exercise? International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(7). doi: 10.3390/ijerph19073820. Full text in Research Archive Show summary

  Background: Loss of muscle mass and muscle function is a common side effect from androgen deprivation therapy (ADT) for prostate cancer (PCa). Here, we explored effects of heavy-load resistance training (RT) on lean body mass and muscle strength changes reported in randomized controlled trials (RCTs) among PCa patients on ADT and in healthy elderly men (HEM), by comparison of results in separate meta-analysis. Methods: RCTs were identified through databases and reference lists. Results: Seven RCTs in PCa patients (n = 449), and nine in HEM (n = 305) were included. The effects of RT in lean body mass change were similar among PCa patients (Standardized mean difference (SMD): 0.4, 95% CI: 0.2, 0.7) and HEM (SMD: 0.5, 95% CI: 0.2, 0.7). It is noteworthy that the within group changes showed different patterns in PCa patients (intervention: 0.2 kg; control: −0.6 kg) and HEM (intervention: 1.2 kg; control: 0.2 kg). The effects of RT on change in muscle strength (measured as 1 RM) were similar between PCa patients and HEM, both for lower body- (PCa: SMD: 1.9, 95% CI: 1.2, 2.5; HEM: SMD: 2.2, 95% CI: 1.0, 3.4), and for upper body exercises (PCa: SMD: 2.0, 95% CI: 1.3, 2.7; HEM: SMD: 1.9, 95% CI: 1.3, 2.6). Conclusions: The effects of RT on lean body mass and 1 RM were similar in PCa patients on ADT and HEM, but the mechanism for the intervention effect might differ between groups. It seems that RT counteracts loss of lean body mass during ADT in PCa patients, as opposed to increasing lean body mass in HEM.

• Scott, Jessica M.; Thomas, Samantha M.; Herndon, James E.; Douglas, Pamela S.; Yu, Anthony F. & Rusch, Valerie [Show all 15 contributors for this article] (2021). Effects and tolerability of exercise therapy modality on cardiorespiratory fitness in lung cancer: a randomized controlled trial. Journal of Cachexia, Sarcopenia and Muscle. ISSN 2190-5991. 12(6), p. 1456–1465. doi: 10.1002/jcsm.12828. Full text in Research Archive Show summary

  Background: Poor cardiorespiratory fitness (CRF) is a cardinal feature of post-treatment primary lung cancer. The most effective exercise therapy regimen to improve CRF has not been determined. Methods: In this parallel-group factorial randomized controlled trial, lung cancer survivors with poor CRF (below age–sex sedentary values) were randomly allocated to receive 48 consecutive supervised sessions thrice weekly of (i) aerobic training (AT)—cycle ergometry at 55% to >95% of peak oxygen consumption (VO2peak); (ii) resistance training (RT)—lower and upper extremity exercises at 50–85% of maximal strength; (iii) combination training (CT)—AT plus RT; or (iv) stretching attention control (AC) for 16 weeks. The primary endpoint was change in CRF (VO2peak, mL O2·kg−1·min−1). Secondary endpoints were body composition, muscle strength, patient-reported outcomes, tolerability (relative dose intensity of exercise), and safety. Analysis of covariance determined change in primary and secondary endpoints from baseline to post-intervention (Week 17) with adjustment for baseline values of the endpoint and other relevant clinical covariates. Results: Ninety patients (65 ± 9 years; 66% female) were randomized (AT, n = 24; RT, n = 23; CT, n = 20; and AC, n = 23) of the planned n = 160. No serious adverse events were observed. For the overall cohort, the lost-to-follow-up rate was 10%. Mean attendance was ≥75% in all groups. In intention-to-treat analysis, VO2peak increased 1.1 mL O2·kg−1·min−1 [95% confidence interval (CI): 0.0, 2.2, P = 0.04] and 1.4 mL O2·kg−1·min−1 (95% CI: 0.2, 2.5, P = 0.02) in AT and CT, respectively, compared with AC. There was no difference in VO2peak change between RT and AC (−0.1 mL O2·kg−1·min−1, 95% CI: −1.2, 1.0, P = 0.88). Favourable improvements in maximal strength and body composition were observed in RT and CT groups compared with AT and AC groups (Ps < 0.05). No between-group changes were observed for any patient-reported outcomes. Relative dose intensity of exercise was lower in RT and CT compared with AT (Ps < 0.05). Conclusions: In the context of a smaller than planned sample size, AT and CT significantly improved VO2peak in lung cancer survivors; however, the tolerability-to-benefit ratio was superior for AT and hence may be the preferred modality to target impaired CRF in post-treatment lung cancer survivors.

• Fairman, Ciaran M.; Nilsen, Tormod Skogstad; Newton, Robert U.; Taaffe, Dennis R.; Spry, Nigel & Joseph, David [Show all 13 contributors for this article] (2020). Reporting of Resistance Training Dose, Adherence, and Tolerance in Exercise Oncology. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 52(2), p. 315–322. doi: 10.1249/MSS.0000000000002127. Full text in Research Archive Show summary

  Purpose: While general guidelines (such as CONSORT or Consensus on Exercise Reporting Template) exist to enhance the reporting of exercise interventions in the field of exercise science, there is inadequate detail facilitating the standardized reporting of resistance training adherence in the oncology setting. The purpose of this study was to apply a novel method to report resistance training dose, adherence, and tolerance in patients with cancer. Methods: A total of 47 prostate cancer patients (70.1 ± 8.9 yr, body mass index, 28.6 ± 4.0) with bone metastatic disease completed an exercise program for 12 wk. We assessed traditional metrics of adherence (attendance and loss to follow-up), in addition to novel proposed metrics (exercise-relative dose intensity, dose modification, and exercise interruption). Total training volume in kilograms (repetitions × sets × training load (weight)) was calculated for each patient. Results: Attendance assessed from traditional metrics was 79.5% ± 17.0% and four patients (9%) were lost to follow-up. The prescribed and actual cumulative total dose of resistance training was 139,886 ± 69,150 kg and 112,835 ± 83,499 kg, respectively, with a mean exercise-relative dose intensity of 77.4% ± 16.6% (range: 19.4% –99.4%). Resistance training was missed (1–2 consecutive sessions) or interrupted (missed ≥3 consecutive sessions) in 41 (87%) and 24 (51%) participants, respectively. Training dose was modified (reduction in sets, repetitions, or weight) in 40 (85%) of patients. Importantly, using attendance as a traditional metric of adherence, these sessions would have all counted as adherence to the protocol. Conclusions: Traditional reporting metrics of resistance training in exercise oncology may overestimate exercise adherence. Our proposed metrics to capture resistance training dose, adherence, and tolerance may have important applications for future studies and clinical practice.

• Scott, Jessica M; Li, Nan; Liu, Qi; Yasui, Yutaka; Leisenring, Wendy & Nathan, Paul C [Show all 15 contributors for this article] (2018). Association of Exercise with Mortality in Adult Survivors of Childhood Cancer. JAMA Oncology. ISSN 2374-2437. 4(10), p. 1352–1358. doi: 10.1001/jamaoncol.2018.2254. Full text in Research Archive Show summary

  Importance: Adult survivors of childhood cancer are at excess risk for mortality compared with the general population. Whether exercise attenuates this risk is not known. Objective: To examine the association between vigorous exercise and change in exercise with mortality in adult survivors of childhood cancer. Design, Setting, and Participants: Multicenter cohort analysis among 15 450 adult cancer survivors diagnosed before age 21 years from pediatric tertiary hospitals in the United States and Canada between 1970 and 1999 enrolled in the Childhood Cancer Survivor Study, with follow-up through December 31, 2013. Exposures: Self-reported vigorous exercise in metabolic equivalent task (MET) hours per week. The association between vigorous exercise and change in vigorous exercise and cause-specific mortality was assessed using multivariable piecewise exponential regression analysis to estimate rate ratios. Main Outcomes and Measures: The primary outcome was all-cause mortality. Secondary end points were cause-specific mortality (recurrence/progression of primary malignant neoplasm and health-related mortality). Outcomes were assessed via the National Death Index. Results: The 15 450 survivors had a median age at interview of 25.9 years (interquartile range [IQR], 9.5 years) and were 52.8% male. During a median follow-up of 9.6 years (IQR, 15.5 years), 1063 deaths (811 health-related, 120 recurrence/progression of primary cancer, 132 external/unknown causes) were documented. At 15 years, the cumulative incidence of all-cause mortality was 11.7% (95% CI, 10.6%-12.8%) for those who exercised 0 MET-h/wk, 8.6% (95% CI, 7.4%-9.7%) for 3 to 6 MET-h/wk, 7.4% (95% CI, 6.2%-8.6%) for 9 to 12 MET-h/wk, and 8.0% (95% CI, 6.5%-9.5%) for 15 to 21 MET-h/wk (P < .001). There was a significant inverse association across quartiles of exercise and all-cause mortality after adjusting for chronic health conditions and treatment exposures (P = .02 for trend). Among a subset of 5689 survivors, increased exercise (mean [SD], 7.9 [4.4] MET-h/wk) over an 8-year period was associated with a 40% reduction in all-cause mortality rate compared with maintenance of low exercise (rate ratio, 0.60; 95% CI, 0.44-0.82; P = .001). Conclusions and Relevance: Vigorous exercise in early adulthood and increased exercise over 8 years was associated with lower risk of mortality in adult survivors of childhood cancer.

• Nilsen, Tormod Skogstad; Scott, Jessica M; Michalski, Meghan; Capaci, Catherine; Thomas, Samantha M & Herndon, James E [Show all 9 contributors for this article] (2018). Novel Methods for Reporting of Exercise Dose and Adherence: An Exploratory Analysis. Medicine & Science in Sports & Exercise. ISSN 0195-9131. 50(6), p. 1134–1141. doi: 10.1249/MSS.0000000000001545. Full text in Research Archive Show summary

  Purpose: The purpose of this study was to explore whether methods adapted from oncology pharmacological trials have utility in reporting adherence (tolerability) of exercise treatment in cancer. Methods: Using a retrospective analysis of a randomized trial, 25 prostate cancer patients received an aerobic training regimen of 72 supervised treadmill walking sessions delivered thrice weekly between 55% and 100% of exercise capacity for 24 consecutive weeks. Treatment adherence (tolerability) was assessed using conventional (lost to follow-up and attendance) and exploratory (e.g., permanent discontinuation, dose modification, and relative dose intensity) outcomes. Results: The mean total cumulative ‘‘planned’’ and ‘‘completed’’ dose was 200.7 T 47.6 and 153.8 T 68.8 METIh, respectively, equating to a mean relative dose intensity of 77% T 24%. Two patients (8%) were lost to follow-up, and mean attendance was 79%. A total of 6 (24%) of 25 patients permanently discontinued aerobic training before week 24. Aerobic training was interrupted (missing Q3 consecutive sessions) or dose reduced in a total of 11 (44%) and 24 (96%) patients, respectively; a total 185 (10%) of 1800 training sessions required dose reduction owing to both health-related (all nonserious) and non–health-related adverse events. Eighteen (72%) patients required at least one session to be terminated early; a total of 59 (3%) sessions required early termination. Conclusions: Novel methods for the conduct and reporting of exercise treatment adherence and tolerability may provide important information beyond conventional metrics in patients with cancer.

• Sedliak, Milan; Zeman, Michal; Buzgó, Gabriel; Cvečka, Ján; Hamar, Dušan & Laczo, Eugen [Show all 15 contributors for this article] (2018). Morphological, molecular and hormonal adaptations to early morning versus afternoon resistance training. Chronobiology International. ISSN 0742-0528. 35(4), p. 450–464. doi: 10.1080/07420528.2017.1411360. Full text in Research Archive Show summary

  It has been clearly established that maximal force and power is lower in the morning compared to noon or afternoon hours. This morning neuromuscular deficit can be diminished by regularly training in the morning hours. However, there is limited and contradictory information upon hypertrophic adaptations to time-of-day-specific resistance training. Moreover, no cellular or molecular mechanisms related to muscle hypertrophy adaptation have been studied with this respect. Therefore, the present study examined effects of the time-of-day-specific resistance training on muscle hypertrophy, phosphorylation of selected proteins, hormonal concentrations and neuromuscular performance. Twenty five previously untrained males were randomly divided into a morning group (n = 11, age 23 ± 2 yrs), afternoon group (n = 7, 24 ± 4 yrs) and control group (n = 7, 24 ± 3 yrs). Both the morning and afternoon group underwent hypertrophy-type of resistance training with 22 training sessions over an 11-week period performed between 07:30–08:30 h and 16:00–17:00 h, respectively. Isometric MVC was tested before and immediately after an acute loading exclusively during their training times before and after the training period. Before acute loadings, resting blood samples were drawn and analysed for plasma testosterone and cortisol. At each testing occasion, muscle biopsies from m. vastus lateralis were obtained before and 60 min after the acute loading. Muscle specimens were analysed for muscle fibre cross-sectional areas (CSA) and for phosphorylated p70S6K, rpS6, p38MAPK, Erk1/2, and eEF2. In addition, the right quadriceps femoris was scanned with MRI before and after the training period. The control group underwent the same testing, except for MRI, between 11:00 h and 13:00 h but did not train. Voluntary muscle strength increased significantly in both the morning and afternoon training group by 16.9% and 15.2 %, respectively. Also muscle hypertrophy occurred by 8.8% and 11.9% (MRI, p < 0.001) and at muscle fibre CSA level by 21% and 18% (p < 0.01) in the morning and afternoon group, respectively. No significant changes were found in controls within these parameters. Both pre- and post-training acute loadings induced a significant (p < 0.001) reduction in muscle strength in all groups, not affected by time of day or training. The post-loading phosphorylation of p70S6Thr421/Ser424 increased independent of the time of day in the pre-training condition, whereas it was significantly increased in the morning group only after the training period (p < 0.05). Phosphorylation of rpS6 and p38MAPK increased acutely both before and after training in a time-of-day independent manner (p < 0.05 at all occasions). Phosphorylation of p70S6Thr389, eEF2 and Erk1/2 did not change at any time point. No statistically significant correlations were found between changes in muscle fibre CSA, MRI and cell signalling data. Resting testosterone was not statistically different among groups at any time point. Resting cortisol declined significantly from pre- to post-training in all three groups (p < 0.05). In conclusion, similar levels of muscle strength and hypertrophy could be achieved regardless of time of the day in previously untrained men. However, at the level of skeletal muscle signalling, the extent of adaptation in some parameters may be time of day dependent.

• Scott, Jessica M; Iyengar, Neil M; Nilsen, Tormod Skogstad; Michalski, Meghan; Thomas, Samantha M & Herndon, James G. [Show all 14 contributors for this article] (2018). Feasibility, safety, and efficacy of aerobic training in pretreated patients with metastatic breast cancer: A randomized controlled trial. Cancer. ISSN 0008-543X. 124(12), p. 2552–2560. doi: 10.1002/cncr.31368. Full text in Research Archive
• Scott, Jessica M; Zabor, Emily C; Schwitzer, Emily; Koelwyn, Graeme J; Adams, Scott C & Nilsen, Tormod Skogstad [Show all 11 contributors for this article] (2018). Efficacy of exercise therapy on cardiorespiratory fitness in patients with cancer: A systematic review and meta-analysis. Journal of Clinical Oncology. ISSN 0732-183X. 36(22), p. 2297–2304. doi: 10.1200/JCO.2017.77.5809. Full text in Research Archive Show summary

  Purpose: To evaluate the effects of exercise therapy on cardiorespiratory fitness (CRF) in randomized controlled trials (RCTs) among patients with adult-onset cancer. Secondary objectives were to evaluate treatment effect modifiers, safety, and fidelity. Methods: A systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library was conducted to identify RCTs that compared exercise therapy to a nonexercise control group. The primary end point was change in CRF as evaluated by peak oxygen consumption (VO2peak; in mL O2 × kg−1 × min−1) from baseline to postintervention. Subgroup analyses evaluated whether treatment effects differed as a function of exercise prescription (ie, modality, schedule, length, supervision), study characteristics (ie, intervention timing, primary cancer site), and publication year. Safety was defined as report of any adverse event (AE); fidelity was evaluated by rates of attendance, adherence, and loss to follow-up. Results: Forty-eight unique RCTs that represented 3,632 patients (mean standard deviation age, 55 ± 7.5 years; 68% women); 1,990 (55%) and 1,642 (45%) allocated to exercise therapy and control/usual care groups, respectively, were evaluated. Exercise therapy was associated with a significant increase in CRF (+2.80 mL O2 × kg−1 × min−1) compared with no change (+0.02 mL O2 × kg−1 × min−1) in the control group (weighted mean differences, +2.13 mL O2 × kg−1 × min−1; 95% CI, 1.58 to 2.67; I2, 20.6; P < .001). No statistical significant differences were observed on the basis of any treatment effect modifiers. Thirty trials (63%) monitored AEs; a total of 44 AEs were reported. The mean standard deviation loss to follow-up, attendance, and adherence rates were 11% ± 13%, 84% ± 12%, and 88% ± 32%, respectively. Conclusion: Exercise therapy is an effective adjunctive therapy to improve CRF in patients with cancer. Our findings support the recommendation of exercise therapy for patients with adult-onset cancer.

• Scott, Jessica M; Nilsen, Tormod Skogstad; Gupta, Dipti & Jones, Lee W. (2018). Exercise therapy and cardiovascular toxicity in cancer. Circulation. ISSN 0009-7322. 137(11), p. 1176–1191. doi: 10.1161/CIRCULATIONAHA.117.024671. Full text in Research Archive Show summary

  Cardio-oncology is an emerging discipline focused predominantly on the detection and management of cancer treatment– induced cardiac dysfunction (cardiotoxicity), which predisposes to development of overt heart failure or coronary artery disease. The direct adverse consequences, as well as those secondary to anticancer therapeutics, extend beyond the heart, however, to affect the entire cardiovascular-skeletal muscle axis (ie, whole-organism cardiovascular toxicity). The global nature of impairment creates a strong rationale for treatment strategies that augment or preserve global cardiovascular reserve capacity. In noncancer clinical populations, exercise training is an established therapy to improve cardiovascular reserve capacity, leading to concomitant reductions in cardiovascular morbidity and its attendant symptoms. Here, we overview the tolerability and efficacy of exercise on cardiovascular toxicity in adult patients with cancer. We also propose a conceptual research framework to facilitate personalized risk assessment and the development of targeted exercise prescriptions to optimally prevent or manage cardiovascular toxicity after a cancer diagnosis.

• Nilsen, Tormod Skogstad; Thorsen, Lene; Fosså, Sophie Dorothea; Wiig, Martin; Kirkegaard, Camilla & Skovlund, Eva [Show all 8 contributors for this article] (2016). Effects of strength training on muscle cellular outcomes in prostate cancer patients on androgen deprivation therapy. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 26(9), p. 1026–1035. doi: 10.1111/sms.12543. Full text in Research Archive Show summary

  Androgen deprivation therapy (ADT) improves lifeexpectancy in prostate cancer (PCa) patients, but is asso-ciated with adverse effects on muscle mass. Here, weinvestigated the effects of strength training during ADTon muscle fiber cross-sectional area (CSA) and regulatorsof muscle mass. PCa patients on ADT were randomizedto 16 weeks of strength training (STG) (n = 12) or acontrol group (CG; n = 11). Muscle biopsies wereobtained from m. vastus lateralis and analyzed by immu-nohistochemistry and western blot. Muscle fiber CSAincreased with strength training (898 μm2, P = 0.04), withthe only significant increase observed in type II fibers(1076 μm2, P = 0.03). There was a trend toward a differ-ence in mean change between groups myonuclei number(0.33 nuclei/fiber, P = 0.06), with the only significantincrease observed in type I fibers, which decreased themyonuclear domain size of type I fibers (P = 0.05). Satel-lite cell numbers and the content of androgen receptorand myostatin remained unchanged. Sixteen weeks ofstrength training during ADT increased type II fiber CSAand reduced myonuclear domain in type I fibers in PCapatients. The increased number of satellite cells normallyseen following strength training was not observed.

• Nilsen, Tormod Skogstad; Thorsen, Lene; Kirkegaard, Camilla; Ugelstad, Ingrid; Fosså, Sophie Dorothea & Raastad, Truls (2016). The effect of strength training on muscle cellular stress in prostate cancer patients on ADT. Endocrine Connections. 5(2), p. 74–82. doi: 10.1530/EC-15-0120. Full text in Research Archive Show summary

  Background: Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with several side effects, including loss of muscle mass. Muscle atrophy is associated with reduced mitochondrial function and increased muscle cellular stress that may be counteracted by strength training. Thus, the aim of this study was to investigate the effect of strength training on mitochondrial proteins and indicators of muscle cellular stress in PCa patients on ADT. Methods: Men diagnosed with locally advanced PCa receiving ADT were randomised to a strength training group (STG) (n=16) or a control group (CG) (n=15) for 16 weeks. Muscle biopsies were collected pre- and post-intervention from the vastus lateralis muscle, and analysed for mitochondrial proteins (citrate synthase, cytochrome c oxidase subunit IV (COXIV), HSP60) and indicators of muscle cellular stress (heat shock protein (HSP) 70, alpha B-crystallin, HSP27, free ubiquitin, and total ubiquitinated proteins) using Western blot and ELISA. Results: No significant intervention effects were observed in any of the mitochondrial proteins or indicators of muscle cellular stress. However, within-group analysis revealed that the level of HSP70 was reduced in the STG and a tendency towards a reduction in citrate synthase levels was observed in the CG. Levels of total ubiquitinated proteins were unchanged in both groups. Conclusion: Although reduced HSP70 levels indicated reduced muscle cellular stress in the STG, the lack of an intervention effect precluded any clear conclusions.

• Nilsen, Tormod Skogstad; Raastad, Truls; Skovlund, Eva; Courneya, Kerry S.; Langberg, Carl W. & Lilleby, Wolfgang [Show all 8 contributors for this article] (2015). Effects of strength training on body composition, physical functioning, and quality of life in prostate cancer patients during androgen deprivation therapy. Acta Oncologica. ISSN 0284-186X. 54(10), p. 1805–1813. doi: 10.3109/0284186X.2015.1037008. Full text in Research Archive
• Sedliak, Milan; Zeman, Michal; Buzgó, Gabriel; Cvečka, Ján; Hamar, Dušan & Laczo, Eugen [Show all 14 contributors for this article] (2013). Effects of time of day on resistance exercise-induced anabolic signaling in skeletal muscle. Biological rhythm research. ISSN 0929-1016. 44(5), p. 756–770. doi: 10.1080/09291016.2012.740314. Full text in Research Archive Show summary

  This study examined the effect of morning versus afternoon exercise on acute responses in phosphorylation of proteins regulating muscle size and metabolism. Twenty-two untrained men, divided into the morning (n = 11) or afternoon (n = 11) group, performed maximal isometric leg extensions before and after resistance loading at 07:30–08:30 h and 16:00–17:00 h, respectively. Muscle pre- and postloading biopsies were analyzed for phosphorylated Akt, p70S6K, rpS6, p38 mitogen-activated protein kinase (MAPK), Erk1/2, and eukaryotic elongation factor (eEF) 2. Muscle force declined after exercise in both groups (p < 0.001). p70S6K Thr389 (p < 0.05) and Thr421/Ser424 and rpS6 (all p < 0.001) increased after exercise in both groups. The afternoon but not morning group showed postloading decrease (p < 0.05) and increase (p < 0.01) in eEF2 and p38MAPK, respectively. Akt and Erk1/2 were statistically unchanged. In conclusion, the time of day did not have an overall effect on protein synthesis signaling, but morning phosphorylated eEF2 and p38MAPK showed significantly larger between-subject variability in the exercise response compared to the afternoon.

• Wernbom, Mathias; Apro, William; Paulsen, Gøran; Nilsen, Tormod Skogstad; Blomstrand, Eva & Raastad, Truls (2013). Acute low‑load resistance exercise with and without blood flow restriction increased protein signalling and number of satellite cells in human skeletal muscle. European Journal of Applied Physiology. ISSN 1439-6319. 113(12), p. 2953–2965. doi: 10.1007/s00421-013-2733-5. Full text in Research Archive Show summary

  Purpose: To investigate hypertrophic signalling after a single bout of low-load resistance exercise with and without blood flow restriction (BFR). Methods: Seven subjects performed unilateral knee extensions at 30 % of their one repetition maximum. The subjects performed five sets to failure with BFR on one leg, and then repeated the same amount of work with the other leg without BFR. Biopsies were obtained from m. vastus lateralis before and 1, 24 and 48 h after exercise. Results: At 1-h post-exercise, phosphorylation of p70S6KThr389 and p38MAPKThr180/Tyr182 was elevated in the BFR leg, but not in the free-flow leg. Phospho-p70S6KThr389 was elevated three- to fourfold in both legs at 24-h post-exercise, but back to baseline at 48 h. The number of visible satellite cells (SCs) per muscle fibre was increased for all post-exercise time points and in both legs (33–53 %). The proportion of SCs with cytoplasmic extensions was elevated at 1-h post in the BFR leg and the number of SCs positive for myogenin and/or MyoD was increased at 1- and 24-h post-exercise for both legs combined. Conclusion: Acute low-load resistance exercise with BFR resulted in early (1 h) and late (24 h) enhancement of phospho-p70S6KThr389, an early response of p38MAPK, and an increased number of SCs per muscle fibre. Enhanced phospho-p70S6KThr389 at 24-h post-exercise and increases in SC numbers were seen also in the free-flow leg. Implications of these findings for the hypertrophic effects of fatiguing low-load resistance exercise with and without BFR are discussed.

• Wernbom, Mathias; Paulsen, Gøran; Nilsen, Tormod Skogstad; Hisdal, Jonny & Raastad, Truls (2012). Contractile function and sarcolemmal permeability after acute low-load resistance exercise with blood flow restriction. European Journal of Applied Physiology. ISSN 1439-6319. 112(6), p. 2051–2063. doi: 10.1007/s00421-011-2172-0. Full text in Research Archive Show summary

  Conflicting findings have been reported regarding muscle damage with low-intensity resistance exercise with blood flow restriction (BFR) by pressure cuffs. This study investigated muscle function and muscle fibre morphology after a single bout of low-intensity resistance exercise with and without BFR. Twelve physically active subjects performed unilateral knee extensions at 30% of their one repetition maximum (1RM), with partial BFR on one leg and the other leg without occlusion. With the BFR leg, five sets were performed to concentric torque failure, and the free-flow leg repeated the exact same number of repetitions and sets. Biopsies were obtained from vastus lateralis before and 1, 24 and 48 h after exercise. Maximum isometric torque (MVC) and resting tension were measured before and after exercise and at 4, 24, 48, 72, 96 and 168 h post-exercise. The results demonstrated significant decrements in MVC (lasting ≥48 h) and delayed onset muscle soreness in both legs, and increased resting tension for the occluded leg both acutely and at 24 h post-exercise. The percentage of muscle fibres showing elevated intracellular staining of the plasma protein tetranectin, a marker for sarcolemmal permeability, was significantly increased from 9% before exercise to 27–38% at 1, 24 and 48 h post-exercise for the BFR leg. The changes in the free-flow leg were significant only at 24 h (19%). We conclude that an acute bout of low-load resistance exercise with BFR resulted in changes suggesting muscle damage, which may have implications both for safety aspects and for the training stimulus with BFR exercise.

• Hanssen, Knut Egil; Kvamme, Nils Helge; Nilsen, Tormod Skogstad; Rønnestad, Bent; Ambjørnsen, Inger Karine & Norheim, Frode [Show all 10 contributors for this article] (2012). The effect of strength training volume on satellite cells, myogenic regulatory factors, and growth factors. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 23(6), p. 728–739. doi: 10.1111/j.1600-0838.2012.01452.x. Full text in Research Archive
• Thorsen, Lene; Nilsen, Tormod Skogstad; Raastad, Truls; Courneya, Kerry S.; Skovlund, Eva & Fosså, Sophie Dorothea (2012). A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design. BMC Cancer. 12. doi: 10.1186/1471-2407-12-123. Full text in Research Archive Show summary

  Background: Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC) trial is designed to determine the effectiveness of strength training on clinical and muscle cellular outcomes in non-metastatic prostate cancer patients after high-dose radiotherapy and during ongoing androgen deprivation therapy. Methods/design: Patients receiving androgen deprivation therapy for 9-36 months combined with external high-dose radiotherapy for locally advanced prostate cancer are randomized to an exercise intervention group that receives a 16 week high-load strength training program or a control group that is encouraged to maintain their habitual activity level. In both arms, androgen deprivation therapy is continued until the end of the intervention period. Clinical outcomes are body composition (lean body mass, bone mineral density and fat mass) measured by Dual-energy X-ray Absorptiometry, serological outcomes, physical functioning (muscle strength and cardio-respiratory fitness) assessed with physical tests and psycho-social functioning (mental health, fatigue and health-related quality of life) assessed by questionnaires. Muscle cellular outcomes are a) muscle fiber size b) regulators of muscle fiber size (number of myonuclei per muscle fiber, number of satellite cells per muscle fiber, number of satellite cells and myonuclei positive for androgen receptors and proteins involved in muscle protein degradation and muscle hypertrophy) and c) regulators of muscle fiber function such as proteins involved in cellular stress and mitochondrial function. Muscle cellular outcomes are measured on muscle cross sections and muscle homogenate from muscle biopsies obtained from muscle vastus lateralis. Discussion: The findings from the PEPC trial will provide new knowledge on the effects of high-load strength training on clinical and muscle cellular outcomes in prostate cancer patients during androgen deprivation therapy.

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• Grindaker, Eirik; Valnes, Thomas André & Nilsen, Tormod Skogstad (2026). Krav til fysisk yteevne i Forsvaret - Universitetet i Innlandet. Full text in Research Archive Show summary

  Fagsak som belyser hvilke krav som stilles til fysisk yteevne i Forsvaret, og hvordan dette er avgjørende for å kunne løse operative oppdrag. Soldater må håndtere både langvarig belastning og korte, intensive arbeidsperioder under krevende forhold. Videre understrekes betydningen av en allsidig fysisk kapasitet, inkludert utholdenhet, styrke og evne til å tåle belastning over tid, som grunnlag for operativ evne og gjennomføringsevne i militære operasjoner.

• Grindaker, Eirik; Nilsen, Tormod Skogstad & Valnes, Thomas André (2026). Hva er totalbelastning i Forsvaret og hvorfor er en helhetlig tilnærming så viktig? - Universitetet i Innlandet. Full text in Research Archive Show summary

  Fagsak som forklarer totalbelastning som summen av de fysiske og mentale påkjenningene et individ utsettes for over tid, og hvordan dette påvirker både prestasjon og helse. Videre belyses hvordan faktorer som trening, søvn, ernæring, stress og miljø samlet påvirker denne belastningen, og hvorfor det er avgjørende å balansere belastning og restitusjon for å opprettholde yteevne og redusere risiko for skader i operative sammenhenger.

• Grindaker, Eirik; Nilsen, Tormod Skogstad; Valnes, Thomas Andre & Lognseth, Stig (2025). Krav til fysisk yteevne i Forsvaret. doi: https:/share.transistor.fm/s/a846d81e. Full text in Research Archive Show summary

  Hva skal til for å være fysisk rustet til en militær operasjon? I denne episoden ser vi nærmere på hvilke krav som stilles til fysisk yteevne i Forsvaret, og hvordan soldater kan forberede seg på de fysiske utfordringene de møter i tjenesten. Hva legger vi i begrepet fysisk yteevne, hvordan definerer Forsvaret det, og hva skiller de fysiske kravene i Forsvaret fra kravene i samfunnet ellers? Dette er noen av spørsmålene vi utforsker. Vi diskuterer også hvordan krigens natur stiller helt spesifikke krav til fysisk yteevne, og hvordan testing og kartlegging av kapasitet kan bidra til å forbedre treningsmetoder. Videre ser vi på hvordan Forsvaret kan jobbe enda mer systematisk med fysisk trening i fremtiden for å fremme prestasjon og redusere skader.

• Grindaker, Eirik; Nilsen, Tormod Skogstad; Valnes, Thomas Andre & Lognseth, Stig (2025). Totalbelastning og yteevne. doi: https:/share.transistor.fm/s/3b234953. Full text in Research Archive Show summary

  Hvor mye belastning tåler en soldat før det går ut over prestasjonen og helse? I denne episoden ser vi nærmere på hvordan totalbelastning påvirker yteevnen. Hvordan defineres totalbelastning, og hvorfor er det så sentralt for både soldater og andre operative yrker? Vi diskuterer også hvordan krigens natur stiller store krav til soldaters evne til å håndtere belastning over tid, og hva vi kan lære fra idrettens verden. Videre utforsker vi hvordan målrettet treningsplanlegging og en helhetlig treningsfilosofi kan optimalisere prestasjon og forebygge skader, samt hvordan Forsvaret kan jobbe systematisk og kunnskapsbasert for å fremme dette i egen organisasjon.

• Grindaker, Eirik; Nilsen, Tormod Skogstad; Valnes, Thomas Andre & Lognseth, Stig (2025). Treningsprinsipper og yteevne. doi: https:/share.transistor.fm/s/4063e8ac. Full text in Research Archive Show summary

  Hva skal til for å trene effektivt og målrettet over tid? I denne episoden ser vi nærmere på treningsprinsipper – de grunnleggende retningslinjene som sikrer progresjon, forebygger skader og legger til rette for god yteevne. Hvordan tilpasser Forsvaret disse prinsippene til soldaters operative hverdag, og hvordan balanseres spesifisitet, individualisering, belastning og restitusjon i praksis? Vi diskuterer hvordan prinsippet om spesifisitet gjør oss gode til det vi trener på, hvorfor individualisering er avgjørende for optimal utvikling, og hvordan en helhetlig tilnærming til trening kan sikre langsiktig prestasjonsforbedring. I tillegg ser vi på viktigheten av progresjon og variasjon i treningen, og hvordan prinsipper som periodisering kan bidra til bedre tilpasning over tid.

• Adams, Scott C.; Rivera-Theurel, Fernando; Scott, Jessica M.; Nadler, Michelle B.; Foulkes, Stephen & Leong, Darryl [Show all 15 contributors for this article] (2025). Cardio-oncology rehabilitation and exercise: evidence, priorities, and research standards from the ICOS-CORE working group. European Heart Journal. ISSN 0195-668X. 46(29), p. 2847–2865. doi: 10.1093/eurheartj/ehaf100. Full text in Research Archive
• Kleve, Guro; Santa, Chiara Dalla; Kristiansen, Felicia Iselin Svensson; Tegnander, Marita; Buch, Victoria & Hagemann, Cecilie Steen [Show all 29 contributors for this article] (2025). Digital home-based multimodal prehabilitation of colorectal cancer patients prior to surgery (the dHOPE study): a non-inferiority clinical trial protocol. doi: 10.3389/fdgth.2025.1609678. Full text in Research Archive Show summary

  Cancer surgery is associated with risk of complications and loss of function. Vulnerability factors, such as advanced age, malnutrition, smoking, comorbidity, frailty, and low socioeconomic status increase the risk. Lifestyle intervention prior to surgery, known as prehabilitation, often include physical activity, nutritional support, psychological coaching, and smoking cessation, increase functional reserves and reduce postoperative complications. Most importantly, it prevents loss of functional capacity and dependence. Methods The dHOPE study is a three-armed, open-labelled, parallel-group randomized controlled trial (RCT) with non-inferiority design to compare a digital home-based prehabilitation program with a hospital-based program or no organized prehabilitation. In addition, the dHOPE study aims to identify measurable parameters reflecting the effect of prehabilitation, thus preparing for future personalization of the prehabilitation programs. Discussion The feasibility of multimodal prehabilitation is threatened by low compliance to hospital-based programs due to burdensome commuting, even in central and metropolitan areas. In sparsely populated countries, this challenge is even more pronounced. To ensure equal healthcare to all citizens regardless of address or economic situation, there is a need to transfer the prehabilitation program to the patients’ homes. Thus, the primary hypothesis of dHOPE is that a digital home-based program is not inferior to a hospital-based program. Moreover, given the patient diversity, prehabilitation must be personalized to meet individual profiles or needs. An exploratory subtask of dHOPE is to confirm the utility of clinical, genetic, and molecular factors in evaluating prehabilitation response ultimately to identify new biomarkers and develop medical software for individual risk stratification and development of personalized prehabilitation programs. Clinical Trial registration https://clinicaltrials.gov/ , identifier (NCT06231576).

• Nilsen, Tormod Skogstad; Sæter, Mali; Sarvari, Sebastian; Reinertsen, Kristin Valborg; Johansen, Sara Hassing & Edvardsen, Elisabeth Rustad [Show all 17 contributors for this article] (2023). Effects of Aerobic Exercise on Cardiorespiratory Fitness, Cardiovascular Risk Factors, and Patient-Reported Outcomes in Long-Term Breast Cancer Survivors: Protocol for a Randomized Controlled Trial. JMIR Research Protocols. 12. doi: 10.2196/45244. Full text in Research Archive Show summary

  Background Anthracycline-based chemotherapy has been mainstay of adjuvant breast cancer therapy for decades. Although effective, anthracyclines place long-term breast cancer survivors at risk of late effects, such as reduced cardiorespiratory fitness and increased risk of cardiovascular disease. Previous research has shown beneficial effects of exercise training on cardiorespiratory fitness, but the effects of exercise on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes in long-term survivors are less clear. Whether previous exposure to breast cancer therapy modulates the effects of exercise is also unknown. Objective The primary aim of the CAUSE (Cardiovascular Survivors Exercise) trial is to examine the effect of aerobic exercise on cardiorespiratory fitness in anthracycline-treated long-term breast cancer survivors. Secondary aims are to examine effects of exercise training on limiting factors for cardiorespiratory fitness, cardiovascular risk factors, and patient-reported outcomes, and to compare baseline values and effects of exercise training between similar-aged women with and those without prior breast cancer. A third aim is to examine the 24-month postintervention effects of aerobic exercise on primary and secondary outcomes. Methods The CAUSE trial is a 2-armed randomized controlled trial, where 140 long-term breast cancer survivors, 8-12 years post diagnosis, are assigned to a 5-month nonlinear aerobic exercise program with 3 weekly sessions or to standard care. Seventy similar-aged women with no history of cancer will undergo the same exercise program. Cardiorespiratory fitness measured as peak oxygen consumption (VO2peak), limiting factors for VO2peak (eg, cardiac function, pulmonary function, hemoglobin mass, blood volume, and skeletal muscle characteristics), cardiovascular risk factors (eg, hypertension, diabetes, dyslipidemia, obesity, physical activity level, and smoking status), and patient-reported outcomes (eg, body image, fatigue, mental health, and health-related quality of life) will be assessed at baseline, post intervention, and 24 months post intervention. Results A total of 209 patients were included from October 2020 to August 2022, and postintervention assessments were completed in January 2023. The 24-month follow-up will be completed in February 2025. Conclusions The findings from the CAUSE trial will provide novel scientific understanding of the potential benefits of exercise training in long-term breast cancer survivors. Trial Registration ClinicalTrials.gov NCT04307407; https://clinicaltrials.gov/ct2/show/NCT04307407 International Registered Report Identifier (IRRID) DERR1-10.2196/45244

• Wernbom, Mathias; Paulsen, Gøran; Nilsen, Tormod Skogstad; Hisdal, Jonny & Raastad, Truls (2012). Sarcolemmal permeability and muscle damage as hypertrophic stimuli in blood flow restricted resistance exercise (Reply to Loenneke and Abe). European Journal of Applied Physiology. ISSN 1439-6319. 112(9), p. 3447–3449. doi: 10.1007/s00421-012-2309-9. Full text in Research Archive
• Raastad, Truls; Wernbom, M.; Paulsen, Gøran; Nilsen, Tormod S & Koskinen, Satu (2008). Neuromuscular fatigue, cellular stress and recovery after low load resistance exercise with or without vascular occlusion. Full text in Research Archive
• Nilsen, Tormod Skogstad (2015). Effects of strength training for prostate cancer patients during androgen deprivation therapy. Norges idrettshøgskole. ISSN 9788250205185. Full text in Research Archive Show summary

  Paper III: Nilsen T.S., Thorsen L., Fosså S.D., Wiig M., Kirkegaard C., Skovlund E., Benestad H.B., Raastad T.: Effect of strength training on muscle cellular variables during androgen deprivation for prostate cancer: a randomised trial. Accepted by Scandinavian Journal of Medicine and Science in sports.

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