Preventing Falls and Frailty in Prostate Cancer Survivors: GET FIT Prostate

预防前列腺癌幸存者跌倒和虚弱：GET FIT Prostate

• 批准号: 10439785
• 负责人: KERRI M WINTERS-STONE
• 金额: $ 63.29万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-23 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10439785
• 关键词: Address; Aging; Androgens; Cancer Survivor; Cancer Survivorship; Caring; Cessation of life; Clinical; Clinical Treatment; Communities; Control Groups; Drops; Elderly; Ensure; Equilibrium; Ethics; Evidence based program; Exercise; Exposure to; Fall prevention; Fracture; Functional disorder; Future; Goals; Guidelines; Health; Health Benefit; Incidence; Injury; Integration Host Factors; Intervention; Knowledge; Lead; Life; Link; Literature; Malignant Neoplasms; Medical Care Costs; Modality; Morbidity - disease rate; Muscular Atrophy; Oncology; Outcome Study; Patient Self-Report; Patients; Pattern; Physical Function; Placebo Control; Placebos; Population; Prevalence; Prevention program; Prevention strategy; Property; Prostate; Prostate Cancer therapy; Provider; Public Health; Quality of life; Randomized Controlled Trials; Recommendation; Rehabilitation therapy; Reporting; Research; Risk; Single-Blind Study; Sleep; Stretching; Structure; Supervision; Survivors; Tai Ji; Testing; Therapeutic; Time; Training; Treatment Factor; androgen deprivation therapy; attentional control; base; cancer care; cancer survival; cancer therapy; clinical practice; comparative efficacy; conventional therapy; cost; design; disability; efficacy trial; evidence base; exercise intervention; exercise program; exhaustion; fall risk; falls; follow-up; frailty; head-to-head comparison; high risk; improved; injury-related death; innovation; insight; men; mode of exercise; mortality; muscle strength; novel; older men; patient oriented; patient population; placebo group; prevent; primary outcome; programs; prostate cancer survivors; randomized controlled design; secondary outcome; side effect; strength training; tumor

Based on recent findings from our team and others, we confirm initial reports that prostate cancer (PC) survivors treated with androgen deprivation therapy (ADT) are significantly more likely to fall and to become frail than PC survivors who do not receive this treatment or men without cancer, placing nearly half of all PC survivors at higher risk of fall-related fractures, other life-threatening injuries, disability and death. Currently, there are no evidence-based fall prevention strategies that specifically target PC survivors on ADT. The purpose of the proposed study is to determine and compare the efficacy of two very distinct types of exercise, tai chi versus strength training, to prevent falls specifically linked to ADT for prostate cancer. We will examine additional endpoints of frailty and physical function that are also worsened with ADT and contribute to the risk of falls and future disability. We propose a 3-group, single-blind, parallel design, randomized controlled trial in PC survivors treated with ADT (N=360) comparing 1) tai chi to 2) strength training against 3) a placebo control group of seated stretching exercise. Men will participate in supervised study programs 3x/wk for 6 months and will be followed for 6 more months after formal training stops. The specific aims of this study are to determine and compare the efficacy of both tai chi and strength training to 1) reduce falls and 2) lessen frailty (shrinking, weakness, slowness, exhaustion, and inactivity) and dysfunction (mobility, balance, self-report function) in PC survivors on ADT, 3) Determine whether or not the benefits of each intervention last after structured training stops and 4) Explore the patterns and predictors of men who respond best to each intervention. The proposed study is innovative in its approach because it applies two well-characterized fall prevention exercise programs (e.g., tai chi and strength training) to a new population just recently identified at high risk of falls and for whom the causes of falls and effective countermeasures remain unclear. This study is the very first attempt at a direct comparison of two known exercise modalities, each with distinct training properties, to reduce falls, frailty and dysfunction in PC survivors. The proposed project responds to an urgent research agenda in cancer survivorship that calls for developing appropriately targeted, effective, and sustainable exercise programs for cancer survivors and to NCI and IOM priorities to expand cancer care to prevent disability in older survivors. This study is relevant to public health because up to 45% of the 2 million PCS alive in the U.S. are prescribed ADT. Men on ADT can survive 16 years or longer, lengthening the time they grow susceptible to falls, frailty and dysfunction from aging and cancer treatment, yet there are no evidence-based therapeutic treatment options for these men. This study addresses this significant barrier in clinical practice by proposing a safe, low- cost, and scalable exercise-based approach. If the aims are achieved, an effective solution to prevent falls and reduce frailty associated with ADT will be readily available to clinical and rehabilitative practice. Importantly, this study would address a NCI Cancer MoonshotSM goal to reduce cancer's debilitating side effects.

基于我们团队和其他人的最新发现，我们确认了前列腺癌(PC)的初步报告。 接受雄激素剥夺疗法(ADT)治疗的幸存者明显更有可能摔倒并成为 比没有接受这种治疗的PC幸存者或没有患癌症的人更虚弱，使近一半的PC 幸存者有较高的跌倒相关骨折、其他危及生命的伤害、残疾和死亡的风险。目前， 目前还没有专门针对服用ADT的PC幸存者的循证预防跌倒策略。这个 这项拟议的研究的目的是确定和比较两种非常不同类型的锻炼的效果， 太极拳与力量训练，以防止与前列腺癌ADT有关的跌倒。我们将研究 身体虚弱和身体功能的其他终点，也会因ADT而恶化，并导致风险 跌倒和未来的残疾。我们提出了一项三组、单盲、平行设计、随机对照试验。 接受ADT治疗的PC幸存者(N=360)比较1)太极拳和2)力量训练与3)安慰剂对照组 一组坐着做伸展运动。男性将参加为期6个月的3次/周的监督研究计划 在正式培训结束后，将再跟踪6个月。这项研究的具体目的是确定 并比较太极拳和力量训练在1)减少跌倒和2)减少虚弱(收缩， 虚弱、迟缓、疲惫和不活动)和功能障碍(活动、平衡、自我报告功能) ADT的幸存者，3)确定每次干预的益处是否在有组织的训练后持续 停止和4)探索对每种干预反应最好的男性的模式和预测因素。建议数 研究在方法上是创新的，因为它应用了两个特点良好的预防跌倒演习计划 (例如，太极拳和力量训练)提供给最近被确定为跌倒高危人群的新人群 坠落的原因和有效的对策尚不清楚。这项研究是第一次尝试直接 比较两种已知的运动方式，每种运动方式都有不同的训练属性，以减少跌倒、虚弱和 PC幸存者的功能障碍。这项拟议的项目响应了癌症研究的紧迫议程。 生存需要制定适当的、有针对性的、有效的和可持续的锻炼计划 癌症幸存者以及NCI和国际移民组织的优先事项，以扩大癌症护理，以防止老年幸存者的残疾。 这项研究与公共健康有关，因为在美国200万活着的PCS中，高达45%是开处方的 ADT.服用ADT的男性可以存活16年或更长时间，延长他们容易摔倒、虚弱的时间 衰老和癌症治疗导致的功能障碍，但还没有循证的治疗方法 这些人的选择。这项研究解决了临床实践中的这一重大障碍，提出了一种安全、低成本的 成本和可扩展的基于练习的方法。如果目标实现，有效的预防跌倒和 减少与ADT相关的脆弱性将很容易用于临床和康复实践。重要的是 这项研究将解决NCI癌症登月SM的目标，以减少癌症的衰弱副作用。

项目成果

Protocol for GET FIT Prostate: a randomized, controlled trial of group exercise training for fall prevention and functional improvements during and after treatment for prostate cancer.

• DOI: 10.1186/s13063-021-05687-7
• 发表时间: 2021-11-06
• 期刊: Trials
• 影响因子: 2.5
• 作者: Winters-Stone KM;Li F;Horak F;Dieckmann N;Hung A;Amling C;Beer TM
• 通讯作者: Beer TM

A cognitively enhanced online Tai Ji Quan training intervention for community-dwelling older adults with mild cognitive impairment: A feasibility trial.

• DOI: 10.1186/s12877-021-02747-0
• 发表时间: 2022-01-25
• 期刊: BMC geriatrics
• 影响因子: 4.1
• 作者: Li F;Harmer P;Fitzgerald K;Winters-Stone K
• 通讯作者: Winters-Stone K

Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines.

• DOI: 10.1002/cam4.4273
• 发表时间: 2021-11
• 期刊: Cancer medicine
• 影响因子: 4
• 作者: Yang L;Winters-Stone K;Rana B;Cao C;Carlson LE;Courneya KS;Friedenreich CM;Schmitz KH
• 通讯作者: Schmitz KH