EXERCISING TOGETHER: A randomized controlled trial of partnered exercise training on the health of couples coping with cancer

一起锻炼：一项随机对照试验，研究合作运动训练对癌症夫妇健康的影响

基本信息

批准号：
10524089
负责人：
KERRI M WINTERS-STONE
金额：
$ 14.4万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-01 至 2024-03-31
项目状态：
已结题

项目摘要

Prostate (PC), breast (BC) and colorectal (CRC) cancer are the most common and survivable cancers; most survivors of these cancers will be married when diagnosed. Compared to couples that aren't facing a chronic illness, both cancer survivors and their spouses suffer from poorer physical and mental health and higher mortality. Cancer often disrupts the marriage and declines in relationship quality are linked to shorter survival. Exercise has been shown to offer symptomatic relief from side effects of cancer treatment and improve quality of life among cancer survivors; but, has not been used to simultaneously improve the physical and mental health of survivors and spouses and protect the marriage by adapting it to be a shared, team-based activity. Our pilot study of a novel partnered exercise program, Exercising Together, has shown preliminary feasibility and acceptability, but was limited to couples facing PC and fitness outcomes. We propose a larger, more rigorous evaluation of Exercising Together expanding the sample to include couples coping early on with other common cancers, measuring clinically relevant outcomes and including comparison groups that will allow us to distinguish the unique benefits of partnered training on individual and couple health from the possible benefits of exercising in a group with others and/or of engaging both partners in a new health behavior. We plan to conduct a 3-arm, single-blind, parallel design, randomized trial in 294 couples (N=588 participants) coping with PC, BC or CRC, aged 40-70 years old and within 2 years of completion of primary treatment for cancer. Our study compares couples randomized partnered strength training (Exercising Together) in a supervised group setting to (Arm 2) separate supervised group exercise (survivor-only and spouse-only classes) and (Arm 3) separate unsupervised exercise where survivors and spouses exercise on their own at home. Couples will train 2x/wk for 6 months with a 6-month follow-up. The aims of this study are to determine the efficacy of Exercising Together on 1) relationship quality in couples coping with PC, BC, or CRC, 2) physical (body composition, lipids, insulin resistance, blood pressure, inflammation, physical function) and mental (anxiety, depression, fear of recurrence) health of both the survivor and spouse and to evaluate the sustainability and interdependence of benefits from Exercising Together. This study is relevant to public health because the number of cancer survivors and caregivers in the healthcare system will double by 2050, yet there are no programs whatsoever that address the triple threat that cancer poses to the physical and mental health of both survivors and spouses and to their marital relationship. We are the first to focus on the interdependent nature of the couple through partnered exercise that promotes relationship building making this program unlike any other. Exercising Together is a completely new approach to cancer survivorship because it considers the health of the survivor and his/her spouse and their relationship as equally important targets. If successful, this unique approach could be applied to survivors of other cancers or diseases increasing the potential impact of this study.

前列腺（PC），乳房（BC）和结直肠癌（CRC）癌症是最常见和可生存的癌症。最多这些癌症的幸存者在诊断后将结婚。与不面对慢性的夫妇相比疾病，癌症幸存者及其配偶的身体和心理健康状况较差，更高死亡。癌症通常会破坏婚姻，并且关系质量下降与较短的生存有关。运动已被证明可以减轻癌症治疗的副作用并提高质量的症状。癌症幸存者的生活；但是，尚未被用来同时改善身心幸存者和配偶的健康，并通过将其改编成共享的，基于团队的活动来保护婚姻。我们对一项新型合作锻炼计划进行锻炼的试点研究显示了初步的可行性和可接受性，但仅限于面对PC和健身结果的夫妇。我们提出了更大，更多的严格评估练习共同扩展样本以包括夫妻尽早应对其他夫妇常见癌症，测量临床相关结果，包括将我们能够使我们得以实现的比较组区分合作培训对个人和夫妇健康的独特好处与可能的好处与他人一起锻炼和/或与两个伴侣一起参与新的健康行为。我们计划在294对夫妇（n = 588名参与者）应对的3臂单盲，平行设计，随机试验 PC，BC或CRC，年龄40-70岁，在完成初级治疗癌症后的2年内。我们的研究比较了夫妻在监督小组中随机合作的力量训练（一起锻炼）设置（ARM 2）单独的监督小组锻炼（仅幸存者和仅配偶班）和（ARM 3）单独的无监督运动，幸存者和配偶在家中自己运动。夫妻将训练 2倍/周6个月，随访6个月。这项研究的目的是确定锻炼的功效共同1）夫妻在应对PC，BC或CRC的夫妻中的关系质量，2）身体成分，脂质，胰岛素抵抗，血压，炎症，身体功能）和心理（焦虑，抑郁，恐惧幸存者和配偶的健康状况），并评估可持续性和相互依存一起锻炼的好处。这项研究与公共卫生有关，因为癌症的数量医疗保健系统中的幸存者和照顾者将在2050年增加一倍，但没有任何计划该解决癌症对幸存者和配偶的身心健康构成的三重威胁以及他们的婚姻关系。我们是第一个通过促进建立关系的合作练习，使该计划与众不同。锻炼一起是一种全新的癌症生存方法，因为它考虑了幸存者的健康以及他/她的配偶及其关系作为同样重要的目标。如果成功，这种独特的方法可以应用于其他癌症或疾病的幸存者，从而增加了这项研究的潜在影响。