Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma Patients Undergoing Treatment

通过针对接受治疗的淋巴瘤患者进行量身定制的身体活动干预来提高运动能力

• 批准号: 10701107
• 负责人: William Gregory Hundley
• 金额: $ 38.7万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-12-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10701107
• 关键词: Activities of Daily Living; Address; Adherence; Aerobic; Animals; Anthracycline; Attenuated; Cancer Center; Cancer Patient; Cancer Survivor; Cardiac Output; Cardiac rehabilitation; Cardiopulmonary; Cardiotoxicity; Cardiovascular Physiology; Cardiovascular system; Clinical Trials; Cognitive; Communities; Comprehensive Cancer Center; Data; Data Analyses; Enrollment; Event; Exercise; Exercise Tolerance; Fatigue; Feedback; Focus Groups; Fostering; Functional disorder; Funding; Goals; Heart failure; Home; Hospitalization; Human; Immunocompromised Host; Impaired cognition; Individual; Instruction; Intervention; Interview; Knowledge; Lead; Left Ventricular Dysfunction; Left Ventricular Function; Life Style; Lymphoma; Magnetic Resonance; Magnetic Resonance Imaging; Malignant Neoplasms; Measures; Methods; Morbidity - disease rate; Myocardial dysfunction; Non-Hodgkin' s Lymphoma; North America; Outcome; Oxygen; Participant; Patients; Peripheral; Phase; Physical Exercise; Physical Performance; Physical activity; Physiological; Prognosis; Property; Quality of life; Randomized; Randomized Clinical Trials; Rehabilitation Centers; Research Personnel; Structure; Survivors; Testing; Time; Translating; Travel; Treadmill Tests; Treatment-Related Cancer; United States National Institutes of Health; Walking; adverse outcome; arm; base; cancer therapy; cardiovascular risk factor; chemotherapy; clinical practice; cognitive function; design; exercise capacity; exercise intervention; exercise intolerance; exercise program; exercise training; experience; functional decline; health related quality of life; heart function; improved; insight; mortality; non-Hodgkin' s lymphoma patients; novel; participant enrollment; physical inactivity; preservation; primary outcome; programs; screening; secondary outcome; sedentary lifestyle; treadmill; trend

Cardiovascular (CV) events related to the receipt of potentially cardiotoxic anthracycline-based chemotherapy (Anth-bC), are emerging as leading causes of morbidity and mortality for survivors of lymphoma (the 5th most common cancer in North America). The objective of our proposal is to reduce this cancer treatment related CV morbidity by developing, enabling, and testing a physical activity intervention that commences and continues throughout receipt of Anth-bC for the purpose of attenuating physical inactivity, preserving exercise capacity, CV & cognitive function, strength, and health-related quality of life (HRQOL) for those with lymphoma. The need for and the design of this program is based in part on feedback from lymphoma survivor focus groups treated in our NIH funded Comprehensive Cancer Center - preliminary pilot data (Section 3.C.1). Several novel features of this proposal include: 1) Performance of physical activity during receipt of cancer treatment where exercise intolerance originates. 2) Creation of patient communities that enable cancer patients to support one another during treatment. 3) Administration of aerobic & strength activities suited to one's individual lifestyle in the home guided by instruction provided from 4 close to home cardiac rehabilitation facilities experienced in exercising immunocompromised individuals and those with other pre-existing activity limitations due to cancer. 4) Utilization of newly developed magnetic resonance cardiopulmonary exercise treadmill testing methods to measure the two components (cardiac function and peripheral factors) that contribute to peak VO2 (a measure of maximal exercise capacity). This new information will provide mechanistic insight into how physical activity helps preserve exercise capacity and reduce fatigue. 5) Assessment of the relationships between cognitive function, activity, and exercise capacity thereby helping to unravel the association between physical activity, HRQOL and cognitive function in cancer patients. In this application, we propose to refine the physical activity intervention during the R21 Phase in patients who participate in the intervention for 6 months. If suitable milestones are achieved, we will conduct a randomized clinical trial in the R33 Phase to test the utility of the integrated physical activity intervention for sustaining peak V02, 6-min walk distance, cardiac and cognitive function, strength, activity, and HRQOL. If we achieve our study goals, this proposed intervention could reduce CV mortality and heart failure related hospital admissions, translate into clinical practice via extension through cardiac rehabilitation centers (often located close to cancer centers), increase health-related quality of life, reduce fatigue to perform activities of daily living, and attenuate cognitive function decline in lymphoma survivors. The results of this study could help to change existing sedentary behavior paradigms during receipt of chemotherapy and ultimately lead to improved long term outcomes for those with lymphoma and potentially other forms of cancer.

与接收潜在的基于心脏毒性蒽环类化疗有关的心血管（CV）事件 （ANTH-BC）正在成为淋巴瘤幸存者发病和死亡率的主要原因（第5位） 北美最常见的癌症）。我们建议的目的是减少这种癌症治疗 通过开发，启用和测试开始的体育活动干预，与之相关的CV发病率 为了减轻身体不活动，保留运动 患有淋巴瘤患者的容量，简历和认知功能，强度和与健康相关的生活质量（HRQOL）。 该程序的需求和设计部分基于淋巴瘤幸存者重点的反馈 在我们的NIH资助的综合癌症中心进行治疗的小组 - 初步的初步数据（第3.C.1节）。 该提案的几个新颖特征包括： 1）在接受运动不耐受的癌症治疗过程中的体育活动的表现。 2）创建患者社区，使癌症患者在治疗过程中彼此相互支持。 3）在家中适合自己的个人生活方式的有氧和力量活动的管理 从4个靠近家庭心脏康复设施的指导中提供了锻炼 免疫功能低下的个体以及因癌症而引起的其他现有活动限制的人。 4）利用新开发的磁共振心肺运动跑步机测试方法 测量有助于峰值VO2的两个组件（心脏功能和外围因素）（A 衡量最大运动能力）。这些新信息将提供有关如何 体育锻炼有助于保持运动能力并减轻疲劳。 5）评估认知功能，活动和锻炼能力之间的关系，从而帮助 为了揭示癌症患者的体育活动，HRQOL和认知功能之间的关联。 在此应用中，我们建议在R21阶段的体育活动干预中 参加干预六个月。如果实现合适的里程碑，我们将进行随机 R33阶段的临床试验测试综合体育锻炼干预的实用性以维持峰值 V02，步行6分钟，心脏和认知功能，强度，活动和HRQOL。 如果我们实现了学习目标，则提出的干预措施可以降低CV死亡率和心力衰竭 住院入院，通过通过心脏康复中心扩展来转化为临床实践（通常 靠近癌症中心），提高与健康相关的生活质量，减少疲劳以执行活动 日常生活，并衰减淋巴瘤幸存者的认知功能下降。这项研究的结果可能会有所帮助 在接受化疗期间改变现有的久坐行为范例，并最终导致 患有淋巴瘤和可能其他形式的癌症患者的长期结局改善了。