PHYSICAL FUNCTION & BODY COMP DURING & AFTER TRT FOR HEMATOLOGIC MALIGNANCY

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 血液系统恶性肿瘤的治疗是积极的，并可能导致在初始治疗期间功能状态下降。 接受高剂量化疗后进行自体外周血干细胞移植的患者面临类似的下降。 在治疗开始时，患者可能因疾病或既往治疗而虚弱。 治疗的后果，如感染，不活动，减少食物摄入量，进一步减少储备和缓慢恢复。 在短期内，患者可能无法接受额外的治疗，并增加了医疗并发症的风险。 从长远来看，功能下降可能会损害恢复工作的能力，增加慢性病的风险，降低生活质量。 有有限的研究确定的生理和功能的变化，发生在激烈的治疗和初始恢复阶段的治疗急性白血病或自体移植。 有氧能力和力量可能会下降。 这可能是由于肌肉质量的损失。 此外，呼吸所需的力量可能会减少。 这些后果可能严重到足以损害老年人完成独立生活所需任务的能力。 识别有害的变化将有助于我们在治疗期间和治疗后为患者制定适当的干预措施，并最终为恶性血液病的幸存者提供上级护理。 在患者生病和住院期间为患者提供运动干预需要仔细规划，并涉及多名医疗保健专业人员。 一项针对少数患者的运动干预试点试验将帮助我们建立安全提供干预的参数，同时在几位医疗保健专业人员之间进行协调。 该试点试验将为我们的血液系统恶性肿瘤住院患者建立标准化干预奠定基础。 将招募共计20名个体参与本研究。 其中16人将在12周内接受监测和测试，其中包括用化疗治疗他们的恶性肿瘤和初始恢复时间。 将测量有氧能力、力量、进行日常活动的能力、身体成分。 将监测能量消耗、能量和蛋白质摄入以及活动水平。 还将评估生活质量和心理社会变化。 将招募四名受试者参加试点运动干预项目。 运动干预将包括有氧、力量和功能训练部分。 参加者每天每项活动20分钟。 在个人参与活动之前必须满足安全参数。 对于有氧活动，参与者将使用坐式自行车测力计，目标是达到他们心率最大值的60%。 力量训练将使用阻力带和脚踝重量。 功能训练将侧重于活动，如转移和步态训练。 活动时间将保持不变，但力量训练的阻力量和功能训练的类型将根据参与者的情况每周改变。 运动干预的参与者将接受与其他受试者相同的测试。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The treatment of hematologic malignancy is aggressive and can result in a decline in functional status during the initial treatment period. Patients receiving high dose chemotherapy followed by autologous peripheral blood stem cell transplant face a similar decline. At the beginning of therapy patients may be debilitated because of the disease or prior therapy. Consequences of treatment such as infection, inactivity, and decreased food intake, further diminish reserves and slow recovery. In the short term patients may not be able to receive additional therapy and are at increased risk for medical complications. In the long term functional decline may impair ability to return to work, increase risk of chronic disease and decrease quality of life. There is limited research identifying physiologic and functional changes that occur during the intense treatment and initial recovery phase of therapy for acute leukemia or autologous transplant. A decrease in aerobic capacity and strength may occur. This may be compounded by loss of muscle mass. Additionally strength need for respiration may be diminished. These consequences may be significant enough to impair an older individuals' ability to preform tasks necessary for independent living. Identifying detrimental changes will help us develop appropriate interventions for patients during and after therapy and will ultimately provide superior care for survivors of hematologic malignancy. To provide an exercise intervention for patients while they are sick and in the hospital will require careful planning and will involve several health care professionals. A pilot trial of an exercise intervention with a small number of patients will help us establish parameters for providing the intervention safely while coordinating between several health care professionals. The pilot trial will lay the ground work for establishing a standardized intervention for our hospitalized patients with hematologic malignancy. A total of 20 individuals will be recruited to participate in the study. Of these 16 will be monitored and tested over 12 weeks which will include treatment of their malignancy with chemotherapy and an initial recovery time. Aerobic capacity, strength, ability to perform daily activities, body composition will be measured. Energy expenditure, energy and protein intake and activity levels will be monitored. Assessments of quality of life and psychosocial changes will also be assessed. Four subjects will be recruited to participate in a pilot exercise intervention project. The exercise intervention will include aerobic, strength and functional training components. The participants will spend 20 minutes on each activity daily. Safety parameters must be met prior to the individuals participating in the activity. For the aerobic activity participants will use a seated bicycle ergometer with a goal or reaching 60% of their heart rate maximum. Strength training will be done using resistance bands and ankle weights. Functional training will focus on activities such as transferring and gait training. The time for the activities will remain the same however the amount of resistance for strength training and the types of functional training will change weekly based on the condition of the participant. The participants of the exercise intervention will receive the same testing as the other subjects.