Tele-resistance training during chemotherapy for advanced upper gastrointestinal cancer

晚期上消化道癌症化疗期间的远程抗阻训练

• 批准号: 10283272
• 负责人: Nathan H Parker
• 金额: $ 16.2万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10283272
• 关键词: Accountability; Adherence; Advanced Malignant Neoplasm; Aerobic Exercise; Age; Cancer Center; Cancer Survivor; Cancer Survivorship; Cessation of life; Clinical; Communicable Diseases; Computer software; Coupled; Data; Disease; Early treatment; Educational Intervention; Effectiveness; Enrollment; Esophagus; Exercise; Face; Familiarity; Family; Fatigue; Feasibility Studies; Foundations; Future; Geographic Locations; Glean; Gold; Health; Home; Impairment; Individual; Intervention; Interview; Liver; Maintenance; Malignant Neoplasms; Malignant neoplasm of gastrointestinal tract; Malignant neoplasm of pancreas; Measures; Monitor; Muscle; Muscle Development; Muscular Atrophy; Oncology; Outcome; Outcome Measure; Outcomes Research; Pancreas; Participant; Patient Outcomes Assessments; Patients; Performance Status; Personal Satisfaction; Persons; Physical Function; Physiological; Pilot Projects; Population; Prevention; Prognosis; Quality of life; Questionnaires; Randomized; Recommendation; Regimen; Research; Research Personnel; Research Priority; Resistance; Safety; Skeletal Muscle; Social support; Specialist; Stomach; Supervision; Supportive care; Survival Rate; Survivors; Tablet Computer; Testing; Time; Training; Training Programs; Translating; Treatment outcome; Tube; Upper digestive tract structure; Videoconferencing; Work; barrier to care; base; cancer therapy; chemotherapy; cohort; density; design; dissemination research; exercise adherence; exercise intervention; exercise prescription; exercise program; feasibility testing; fitness; functional independence; health related quality of life; implementation research; improved; indexing; innovation; muscle strength; novel strategies; palliative chemotherapy; pandemic disease; preference; programs; sarcopenia; skeletal muscle wasting; skills; strength training; survivorship; therapy development; treatment as usual; upper gastrointestinal cancer; virtual

PROJECT SUMMARY Resistance training can improve fitness, clinical, and quality of life outcomes during cancer treatment. Individuals with advanced upper gastrointestinal (GI) cancers frequently present with skeletal muscle loss that may worsen during chemotherapy. Resistance training may be beneficial in this context, but its feasibility and effectiveness have not been established. Home-based exercise programs may be preferable for many cancer survivors, including those who receive treatment near home and face barriers such as time, finances, and disease pandemics that complicate participation in supervised programs at cancer centers or other fitness facilities. Adherence to our resistance training recommendation in a previous, home-based exercise intervention during pancreatic cancer treatment was poor. Participants cited factors such as lack of familiarity and low social support as barriers to resistance training. The purpose of this project is to “bridge” the convenience of and preference for home-based resistance training to the support and supervision of in-person resistance training by developing a virtual, or “tele-resistance training” (“tele-RT”) approach. We also aim to compare changes in muscular strength and endurance, skeletal muscle health, health-related quality of life, fatigue, and physical functioning between individuals randomized to participate in tele-RT and individuals randomized to receive usual care during first-line chemotherapy. We hypothesize that the intervention will be feasible, safe, and acceptable and that participation will be associated with improvements in outcome measures compared to usual care. Individuals undergoing first-line chemotherapy for advanced upper GI cancer (N=100) will be randomized to receive usual care vs. engage in tele-resistance training supervised by certified trainers using video conferencing software and tablet computers. Exercise prescriptions will be individually-tailored and supervised to safely increase strength over time. Feasibility (enrollment, retention, and adherence to exercise sessions and prescribed exercise volumes) and safety will be monitored by trainers. Acceptability will be rated via questionnaire following participation. Participants will complete measures of muscular strength and endurance, skeletal muscle health, health-related quality of life, fatigue, and physical functioning prior to and following first-line chemotherapy (approximately 3 months). Resistance training has important potential to improve health and well-being for individuals with advanced cancer, but these benefits depend on adherence. In this project, we aim to evaluate a novel strategy to encourage resistance training adherence by providing virtual supervision. This intervention has broad potential to encourage resistance training and elicit benefits among individuals in various cancer survivorship contexts.

项目摘要 抗药性训练可以改善癌症治疗期间的适应性，临床和生活质量。 患有晚期胃肠道（GI）癌症的人经常出现骨骼肌损失 在化疗期间可能会担心。在这种情况下，抵抗训练可能是有益的，但它的可行性和 尚未确定有效性。家庭运动计划可能对许多癌症优选 幸存者，包括在家附近接受治疗和面对障碍的人，例如时间，财务和 疾病大流行病会使参与癌症中心或其他健身的监督计划变得复杂 设施。在以前的家庭锻炼中遵守我们的抵抗训练建议 胰腺癌治疗期间的干预很差。参与者列举了缺乏熟悉的因素 作为抵抗训练的障碍，社会支持较低。该项目的目的是“桥接” 对家庭抵抗培训的便利和偏爱，以支持和监督面对面 通过开发虚拟或“抗电阻培训”（“ tele-rt”）方法来培训抵抗训练。我们也打算 比较肌肉力量和耐力的变化，骨骼肌健康，与健康相关的生活质量， 随机参与tele-rt和个人的个体之间的疲劳和身体功能 在一线化疗期间随机接受通常的护理。我们假设干预将是 可行，安全且可接受，并且参与将与结果改善有关 与通常的护理相比，采取的措施。接受高级上GI的一线化学疗法的个人 癌症（n = 100）将被随机接受常规护理，而不是从事抗电信培训。 使用视频会议软件和平板电脑的认证培训师。锻炼处方将是 进行单独量身定制和监督，以安全地提高力量随着时间的流逝。可行性（入学，保留和 遵守运动和规定的运动量）和安全性将由培训师监控。 参与后，将通过问卷调查对可接受性进行评级。参与者将完成测量 肌肉力量和耐力，骨骼肌健康，与健康相关的生活质量，疲劳和身体 在一线化学疗法之前和之后（大约3个月）发挥作用。抵抗训练已有 改善晚期癌症患者健康和福祉的重要潜力，但是这些好处 取决于依从性。在这个项目中，我们旨在评估一种新的策略来鼓励抵抗训练 通过提供虚拟监督来遵守。这种干预具有鼓励抵抗的广泛潜力 在各种癌症生存环境中，培训和引起个体之间的利益。