EXERCISING TOGETHER: A randomized controlled trial of partnered exercise training on the health of couples coping with cancer

前列腺癌(PC)、乳腺癌(BC)和结直肠癌(CRC)是最常见和可存活的癌症；大多数 这些癌症的幸存者在确诊时会结婚。与那些没有面临慢性病的夫妇相比 疾病，癌症幸存者和他们的配偶都患有较差的身心健康和 死亡率。癌症通常会破坏婚姻，关系质量的下降与存活期缩短有关。 运动已被证明可以缓解癌症治疗的副作用并提高质量。 癌症幸存者的生活质量；但并未被用于同时改善身体和精神 保护幸存者和配偶的健康，保护婚姻，使之成为一项共享的、以团队为基础的活动。 我们对一种新的结伴锻炼计划的初步研究表明，这一计划是可行的 和可接受性，但仅限于面临PC和健身结果的夫妇。我们提出了一个更大、更多的 对共同锻炼的严格评估将样本扩大到包括夫妇早期应对其他 常见癌症，测量临床相关结果，并包括对照组，这将允许我们 区分合作培训对个人和夫妇健康的独特好处和可能的好处 与其他人一起锻炼和/或让双方都参与新的健康行为。我们计划 在294对夫妇(N=588名参与者)中进行了一项三臂、单盲、平行设计的随机试验 PC、BC或CRC，年龄40-70岁，在完成癌症初级治疗后2年内。我们的 一项研究比较了监督组中随机配对进行力量训练(一起锻炼)的夫妇 设置为(ARM 2)单独监督的集体演习(仅限幸存者和仅限配偶的班级)和(ARM 3) 单独的无人监督的锻炼，幸存者和配偶在家里自己锻炼。情侣们将会训练 2次/周，疗程6个月，随访6个月。这项研究的目的是确定锻炼的效果。 1)应对PC、BC或CRC的夫妇的关系质量，2)身体(身体成分， 血脂、胰岛素抵抗、血压、炎症、身体功能)和精神(焦虑、抑郁、恐惧 复发率)幸存者和配偶的健康，并评估 从一起锻炼中获益。这项研究与公共健康相关，因为癌症的数量 到2050年，医疗系统中的幸存者和照顾者将翻一番，但没有任何计划 它解决了癌症对幸存者和配偶的身心健康构成的三重威胁 以及他们的婚姻关系。我们是第一个通过以下方式关注这对夫妇相互依存性质的人 促进关系建立的合作练习使这个项目与众不同。锻炼身体 Together是一种全新的癌症生存方法，因为它考虑到幸存者的健康 以及他/她的配偶和他们的关系是同样重要的目标。如果成功，这种独特的方法 可应用于其他癌症或疾病的幸存者，增加了这项研究的潜在影响。

Prostate (PC), breast (BC) and colorectal (CRC) cancer are the most common and survivable cancers; most survivors of these cancers will be married when diagnosed. Compared to couples that aren't facing a chronic illness, both cancer survivors and their spouses suffer from poorer physical and mental health and higher mortality. Cancer often disrupts the marriage and declines in relationship quality are linked to shorter survival. Exercise has been shown to offer symptomatic relief from side effects of cancer treatment and improve quality of life among cancer survivors; but, has not been used to simultaneously improve the physical and mental health of survivors and spouses and protect the marriage by adapting it to be a shared, team-based activity. Our pilot study of a novel partnered exercise program, Exercising Together, has shown preliminary feasibility and acceptability, but was limited to couples facing PC and fitness outcomes. We propose a larger, more rigorous evaluation of Exercising Together expanding the sample to include couples coping early on with other common cancers, measuring clinically relevant outcomes and including comparison groups that will allow us to distinguish the unique benefits of partnered training on individual and couple health from the possible benefits of exercising in a group with others and/or of engaging both partners in a new health behavior. We plan to conduct a 3-arm, single-blind, parallel design, randomized trial in 294 couples (N=588 participants) coping with PC, BC or CRC, aged 40-70 years old and within 2 years of completion of primary treatment for cancer. Our study compares couples randomized partnered strength training (Exercising Together) in a supervised group setting to (Arm 2) separate supervised group exercise (survivor-only and spouse-only classes) and (Arm 3) separate unsupervised exercise where survivors and spouses exercise on their own at home. Couples will train 2x/wk for 6 months with a 6-month follow-up. The aims of this study are to determine the efficacy of Exercising Together on 1) relationship quality in couples coping with PC, BC, or CRC, 2) physical (body composition, lipids, insulin resistance, blood pressure, inflammation, physical function) and mental (anxiety, depression, fear of recurrence) health of both the survivor and spouse and to evaluate the sustainability and interdependence of benefits from Exercising Together. This study is relevant to public health because the number of cancer survivors and caregivers in the healthcare system will double by 2050, yet there are no programs whatsoever that address the triple threat that cancer poses to the physical and mental health of both survivors and spouses and to their marital relationship. We are the first to focus on the interdependent nature of the couple through partnered exercise that promotes relationship building making this program unlike any other. Exercising Together is a completely new approach to cancer survivorship because it considers the health of the survivor and his/her spouse and their relationship as equally important targets. If successful, this unique approach could be applied to survivors of other cancers or diseases increasing the potential impact of this study.