Tele-resistance training during chemotherapy for advanced upper gastrointestinal cancer

点击翻译按钮获取中文摘要

PROJECT SUMMARY Resistance training can improve fitness, clinical, and quality of life outcomes during cancer treatment. Individuals with advanced upper gastrointestinal (GI) cancers frequently present with skeletal muscle loss that may worsen during chemotherapy. Resistance training may be beneficial in this context, but its feasibility and effectiveness have not been established. Home-based exercise programs may be preferable for many cancer survivors, including those who receive treatment near home and face barriers such as time, finances, and disease pandemics that complicate participation in supervised programs at cancer centers or other fitness facilities. Adherence to our resistance training recommendation in a previous, home-based exercise intervention during pancreatic cancer treatment was poor. Participants cited factors such as lack of familiarity and low social support as barriers to resistance training. The purpose of this project is to “bridge” the convenience of and preference for home-based resistance training to the support and supervision of in-person resistance training by developing a virtual, or “tele-resistance training” (“tele-RT”) approach. We also aim to compare changes in muscular strength and endurance, skeletal muscle health, health-related quality of life, fatigue, and physical functioning between individuals randomized to participate in tele-RT and individuals randomized to receive usual care during first-line chemotherapy. We hypothesize that the intervention will be feasible, safe, and acceptable and that participation will be associated with improvements in outcome measures compared to usual care. Individuals undergoing first-line chemotherapy for advanced upper GI cancer (N=100) will be randomized to receive usual care vs. engage in tele-resistance training supervised by certified trainers using video conferencing software and tablet computers. Exercise prescriptions will be individually-tailored and supervised to safely increase strength over time. Feasibility (enrollment, retention, and adherence to exercise sessions and prescribed exercise volumes) and safety will be monitored by trainers. Acceptability will be rated via questionnaire following participation. Participants will complete measures of muscular strength and endurance, skeletal muscle health, health-related quality of life, fatigue, and physical functioning prior to and following first-line chemotherapy (approximately 3 months). Resistance training has important potential to improve health and well-being for individuals with advanced cancer, but these benefits depend on adherence. In this project, we aim to evaluate a novel strategy to encourage resistance training adherence by providing virtual supervision. This intervention has broad potential to encourage resistance training and elicit benefits among individuals in various cancer survivorship contexts.