A Randomized Study of the Effect of Tai Chi Chuan Compared to Exercise

太极拳与运动效果比较的随机研究

• 批准号: 7964984
• 负责人: Robert Nussenblatt
• 金额: $ 27.5万
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7964984
• 关键词: Adult; Aerobic; Aerobic Exercise; Annual Reports; Area; Asians; Body fat; Cancer Survivor; Cardiovascular Diseases; Characteristics; Childhood; Combined Modality Therapy; Conflict (Psychology); Control Groups; Data; Daughter; Diagnosis; Disabled Persons; Eligibility Determination; Enrollment; Evaluable Disease; Exercise; Family; Fatigue; Frequencies; Future; Healed; Hyperlipidemia; Incidence; Intervention; Life; Long-Term Survivors; Malignant - descriptor; Metabolic; Metabolic syndrome; Musculoskeletal; Nervous system structure; Operative Surgical Procedures; Participant; Patients; Performance; Personal Satisfaction; Population; Pregnancy; Process; Psychological Stress; Qi; Quality of life; Radiation therapy; Randomized; Role; Schedule; Screening procedure; Solid Neoplasm; Stress; Survivors; Tai Ji; Telephone; Time; Upper arm; Waiting Lists; Work; base; cancer therapy; chemotherapy; cohort; design; falls; follow-up; healing; improved; interest; programs; psychological distress; sarcoma; stressor

Diagnosis and treatment for cancer represent a major life-time stressor for any patient. While the diagnosis of a life-threatening illness is stressful, undergoing treatment for cancer including surgery, radiotherapy and chemotherapy result in stress to the patient. In addition, cancer treatment frequently is associated with fatigue, physical de-conditioning and metabolic abnormalities characteristic of the metabolic syndrome, leading to speculations that cancer therapy may render survivors more prone to developing metabolic syndrome and its sequelae, cardiovascular disease. In a recently conducted study we detected a high incidence of hyperlipidemia and increased body fat content, decreased aerobic performance and musculoskeletal functioning and a high frequency of parameters of psychological distress in long-term survivors of pediatric sarcoma (1, 3). Based on these data and findings, it appears desirable to devise a program that would help cancer survivors not only to improve musculoskeletal functioning and aerobic performance, as a physical exercise program would offer, but in addition relieve psychological stress and enhance the well-being of cancer survivors after completion of treatment with multimodality therapy. Tai Chi Chuan (TCC) has been used in Asian culture for centuries to improve wellness, reduce stress, and to promote healing by improving the flow of Qi. While a number of studies have provided scientific support for these claims in different populations, a beneficial role for TCC in the management of cancer survivors has not been established. We received a total 233 referrals from PRPL since the study began, 135 of which were referred in the past year since 8/31/07. Of these 233 referrals, 55 (24%) have been enrolled on-study, 13 (6%) are potential candidates currently in the screening process, 53 (23%) were ineligible by phone screen, 12 (5%) are to be re-evaluated later to determine eligibility, and 100 (43%) were not interested, not good candidates, or lost-to-follow-up. Thus, since our last annual report, we have enrolled an additional 37 study participants on-study (49% increase since last year). Of the total 55 study participants enrolled on-study, 8 of them completed the wait-list control arm and were re-randomized into one of the exercise interventions; thus, there are a total of 63 total evaluable participants. Of these, 36 (57%) completed the 12 week study period, 19 (30%) are in process (2 are completing the current cohort, 10 are enrolled for the fall 2008 cohort, and 7 have requested a future cohort), and 9 (14%) withdrew prior to beginning or while participating on-study. Of the 9 participants who withdrew, 4 withdrew prior to starting the study (1 due to pregnancy, 2 due to family/work scheduling conflicts, and 1 didnt want to be in the control group) and 5 withdrew while on-study (1 due to worsening plantar fascitis and 4 due to conflicts with work schedule). Three additional participants who completed the wait list control group chose to withdraw participation before re-randomization; their reasons for withdrawing included relocation from the area, scheduling conflicts due to a disabled daughter, and not wanting to be in the cycling arm of the study. This study aims to compare in a randomized, wait-list controlled design, the efficacy of TCC to an exercise program in improving aerobic exercise capacity and endurance, reducing stress and improving Quality of Life in adult survivors of malignant solid tumors.

癌症的诊断和治疗是任何患者的主要生活压力源。虽然诊断威胁生命的疾病是压力很大，但接受癌症的治疗，包括手术，放疗和化学疗法会给患者带来压力。此外，癌症治疗经常与代谢综合征的疲劳，物理脱发和代谢异常有关，导致人们猜测癌症治疗可能使幸存者更容易发生代谢综合征及其后遗症心血管疾病。在最近进行的一项研究中，我们检测到高脂血症的高发病率和增加的体内脂肪含量，有氧性能和肌肉骨骼功能降低以及小儿肉瘤长期幸存者的心理困扰参数的高频率（1，3）。基于这些数据和发现，似乎可以设计一项计划，该计划将帮助癌症幸存者不仅可以改善肌肉骨骼功能和有氧运动，作为体育锻炼计划，而且还可以缓解心理压力，并增强了通过多态治疗完成治疗后癌症幸存者的幸福感。 Tai Chi Chuan（TCC）已在亚洲文化中使用了几个世纪，以改善健康，减轻压力并通过改善气流来促进愈合。尽管许多研究为不同人群中的这些主张提供了科学支持，但尚未确定TCC在癌症幸存者管理中的有益作用。 自从研究开始以来，我们总共收到了PRPL的233次转诊，自07年8月31日以来，在过去的一年中，其中有135个转诊。 在这233个推荐人中，有55名（24％）被录入研究，目前正在筛选过程中有13名（6％）是潜在的候选人，有53名（23％）不符合电话屏幕符合条件，稍后将重新评估12名（5％）以确定资格，而100（43％）则不感兴趣，或者不感兴趣，或者没有良好的候选人或失败。因此，自上次年度报告以来，我们已经招募了37名研究参与者（自去年以来增长49％）。 在参加研究的55名研究参与者中，其中8个完成了等待名单控制组，并将其重新融合为一种运动干预措施。因此，共有63个可评估参与者。 在其中，有36周（57％）完成了12周的研究期，19（30％）正在进行过程中（2个正在完成当前队列，其中10个招募了2008年秋季队列，有7人要求将来有一个队列），在开始进行研究之前或在开始研究之前，有9名（14％）在开始之前或退出。 在撤回研究之前的9名参与者中，有4名参与者（由于怀孕而撤回了1名参与者，由家庭/工作时间表冲突引起的2名，而1名不想参加对照组），而5名撤回了研究时（1个是由于plant骨筋膜炎恶化而导致的4个，而4个由于工作时间表的冲突）。 完成等待列表对照组的另外三名参与者选择在重新传递之前撤回参与。他们退出的原因包括从该地区搬迁，安排残疾女儿引起的冲突，也不想进入研究的骑行部门。 这项研究旨在比较随机的等待名单受控设计，TCC对运动计划提高有氧运动能力和耐力，减轻压力和改善恶性实体瘤成人幸存者的生活质量的疗效。