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Regular physical activity is key to helping people living with cancer improve their physical and mental health. But the COVID-19 pandemic has made it more difficult for this vulnerable group to get sufficient exercise – a challenge that's now being investigated by students at the University of Toronto.

“Not only do weakened immune systems put them at a greater risk for severe outcomes from COVID-19, the symptoms normally associated with a cancer diagnosis such as increased fatigue and stress may be amplified due to the pandemic,” says Allyson Tabaczynski, a PhD student in U of T’s Faculty of Kinesiology & Physical Education (KPE).

She adds that most existing resources related to cancer and exercise were developed prior to the pandemic.

“To design effective interventions and resources for cancer survivors as the pandemic progresses, we need to understand their unique experiences since the start of the COVID-19 outbreak,” Tabaczynski says.

With the support , Tabaczynski is now studying the issue alongside fellow kinesiology students Alexis Whitehorn and Denise Bastas. The three students have developed an online survey that will be disseminated to people who are living with cancer in different countries. The survey asks respondents a series of questions about their cancer diagnosis, individual and government mandated COVID-19 prevention measures enacted in their parts of the world, quality of life, cognitive functioning and overall mental and physical health.

The survey will also ask respondents questions about physical activity levels and sedentary behaviours, and how each has changed since the start of the pandemic. 

“We are looking to understand what their attitudes and barriers are toward performing physical activity during the pandemic, what resources they have to stay active, as well as how conducive their home and immediate neighbourhood environments are to performing physical activity,” says Whitehorn, who will be continuing her graduate studies in kinesiology as a doctoral student this fall.

“This will enable us to get a preliminary understanding of the health impact of COVID-19 and identify specific areas that need attention for effective health promotion across cultural and contextual circumstances.”

The students say physical activity is a developed habit that is largely influenced by individual, social and environmental factors – all of which were upended by COVID-19.

“As a group, we noticed that our own relationship with physical activity had changed now that we were practising physical distancing, but as physical activity researchers we were well equipped to adapt our own physical activity to this new reality. Other populations may not be so well equipped,” says Bastas, who will be starting her second year of a master’s degree in kinesiology in September.

People living with cancer, for example, report numerous barriers to regular physical activity participation during COVID-19. For example, they may need to take extra precautions and enact more strict physical distancing or isolation measures. Many have likely also been impacted by the closure of gyms and other resources that they previously used to facilitate physical activity. 

“We found it to be of the utmost importance to understand how these behaviours changed as a result of COVID-19, the resources they have available to be active during this time and how participation at this unique time might relate to survivors’ mental health,” Bastas says. 

Tabaczynski, Whitehorn, and Bastas are all members of KPE’s Exercise Oncology Lab, which is led by Assistant Professor Linda Trinh.  

“With 18 million people living with cancer in the world today, understanding and improving the health and well-being of this population is of global importance,” says Trinh.

“COVID-19 has placed a high burden on health-care systems all over the world. The self-management of health, when possible, through well-established benefits of physical activity can help alleviate some of this burden.”