THE PHYSIOLOGICAL AND PSYCHOLOGICAL EFFECTS OF INDOOR VERSUS OUTDOOR AEROBIC EXERCISE IN FEMALE CANCER SURVIVORS: A LITERATURE REVIEW

Moderate aerobic exercise is advantageous to physiological and psychological well-being among healthy and diseased populations. Investigating the physiological and psychological effects of indoor and outdoor aerobic training on ROS, antioxidants, QOL, vitamin D, estrogen, kynurenine, cardiovascular disease, obesity, and the immune system within cancer patients and survivors may be imperative to their recovery and survival. Outdoor aerobic exercise within a greenery-rich environment elicits greater positive changes within overall well-being compared to outdoor exercise in an urban setting or indoor exercise. However, both indoor and outdoor aerobic exercise produce benefits in mood state, the immune system, cardiovascular health, bone health, and countering oxidative stress that damages cells. Exercise is able to help counter the psychological, cognitive, and negative physiological effects of cancer treatments. Moderate aerobic exercise helps to decrease depression and tumor proliferation through an increase in kynurenic acid and lower risk of breast cancer by an increased energy expenditure to reduce fat tissue, thus decreasing the production of estrogen in post-menopausal women. Adequate levels of vitamin D are important to combat depression and tumor proliferation as well, which can be controlled through outdoor exercise in the sun or supplementation. Cancer patients and survivors can benefit from engaging in moderate aerobic exercise in both indoor and outdoor environments, however the outdoor environment may provide more benefit psychologically