Tele-resistance training during chemotherapy for advanced upper gastrointestinal cancer

项目总结 抵抗训练可以改善癌症治疗期间的体能、临床和生活质量。 晚期上消化道(GI)癌症患者经常表现为骨骼肌丧失， 在化疗期间可能会恶化。在这种情况下，抵抗训练可能是有益的，但它的可行性和 有效性尚未确定。以家庭为基础的锻炼计划可能是许多癌症的首选 幸存者，包括那些在家附近接受治疗并面临时间、资金和医疗费用等障碍的人 疾病大流行，使参与癌症中心或其他健身机构的监督计划变得复杂 设施。在之前的一次家庭训练中坚持我们的抵抗训练建议 胰腺癌治疗期间的干预措施很差。参与者提到了一些因素，比如不熟悉 低社会支持是阻力训练的障碍。这一项目的目的是“沟通” 对以家庭为基础的抵抗力训练的便利性和对当面支持和监督的偏好 通过开发一种虚拟的或“远程抵抗训练”(“Tele-RT”)方法进行抵抗训练。我们的目标还包括 比较肌肉力量和耐力、骨骼肌健康、与健康相关的生活质量、 随机参加远程放射治疗的个体和个体之间的疲劳和身体功能 在一线化疗期间随机接受常规护理。我们假设干预将是 可行、安全和可接受，参与将与结果的改善相关 与平时的护理相比，采取的措施更多。接受一线化疗的晚期上消化道疾病患者 癌症患者(N=100)将随机接受常规护理，而不是参加由以下人员监督的远程抵抗训练 使用视频会议软件和平板电脑的认证培训师。运动处方将是 单独定制和监督，以随着时间的推移安全地增加实力。可行性(注册、保留和 坚持锻炼课程和规定的运动量)和安全性将由训练员监测。 可接受性将在参与后通过问卷调查进行评分。参与者将完成以下测量 肌肉力量和耐力、骨骼肌健康、与健康相关的生活质量、疲劳和身体 在一线化疗之前和之后(大约3个月)。抵抗力训练 对改善晚期癌症患者的健康和福祉具有重要潜力，但这些好处 依赖于坚守。在这个项目中，我们旨在评估一种鼓励抵抗力训练的新策略 通过提供虚拟监督来坚持。这种干预具有鼓励抵抗的广泛潜力 培训并在不同癌症生存环境中的个体中获得好处。

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.