PROJECT ALLIFE-EXERCISE AND LEUKEMIA SURVIVORS

描述(申请人提供)：儿童白血病的成年幸存者是不断增长的人群，他们的全原因和心血管(CVD)相关死亡率过高，并面临多种健康问题的风险，包括心血管疾病、骨质疏松症和肥胖症。体力活动具有保护作用，可以降低患心血管疾病、高血压、2型糖尿病和骨质疏松症的风险。生活方式体力活动干预在提高中等强度体力活动和心肺健康的可持续水平、改善心血管风险状况和心理健康方面在普通人群中是有效的。为白血病幸存者量身定做的有针对性的干预措施，旨在增加可持续的中等强度体力活动水平，不仅是必要的，而且是至关重要的。当务之急是采取各种方法来降低这一年轻人口的发病率和死亡率，同时提高生活质量和生产力。这项拟议的研究名为ALLIFE(日常急性白血病生活方式干预)，是一项为期12个月的有效性试验，有120名儿童白血病的年轻成年幸存者被随机分为生活方式体力活动干预(ALLIFE-I)或标准对照组，后者将定期收到通用健康通讯(ALLIFE-SC)。主要数据收集将在基线、6个月和12个月进行，两个主要结果是通过7天体力活动回忆衡量的体力活动水平，以及通过有氧适应测试衡量的心肺健康。次要结果将包括其他公认的体力活动、心血管风险概况、步态和平衡评估以及心理测量。要检验的主要研究假设是，与标准护理相比，生活方式干预将显著增加儿童白血病成年幸存者的体力活动和心肺功能。需要解决的另外三个问题是：确定这样的干预是否导致心血管风险状况的改善；确定步态和平衡障碍是否与白血病幸存者的身体缺乏活动有关，以及这些障碍是否随着干预而改善；以及确定预测预后改善或缺乏改善的因素。这项研究将是旨在增加白血病幸存者体力活动的第一次临床试验，并将促进我们对这一脆弱群体的了解。

DESCRIPTION (provided by applicant): Adult survivors of childhood leukemia are a growing population that have an excess in all-cause and cardiovascular (CVD)-related mortality and are at risk for multiple health problems, including CVD, osteoporosis, and obesity. Physical activity is protective and reduces risk for CVD, hypertension, Type 2 diabetes mellitus, and osteoporosis. The Lifestyle Physical Activity intervention has been efficacious in the general population in increasing sustainable levels of moderate-intensity physical activity and cardiorespiratory fitness and improving cardiovascular risk profiles and mental health. A targeted intervention tailored to the needs of leukemia survivors and intended to increase sustainable levels of moderate-intensity physical activity is not only warranted, but critical. It is imperative that methods to reduce morbidity and mortality of this young population while enhancing quality of life and productivity be addressed. The proposed study, Project ALLIFE (Acute Leukemia Lifestyle Intervention For Everyday), is a 12- month effectiveness trial with 120 young adult survivors of childhood leukemia randomized to either the Lifestyle Physical Activity intervention (ALLIFE-I) or a standard control group who will receive a periodic generic health newsletter (ALLIFE-SC). Major data collections will be at baseline, 6- and 12-months, with the two primary outcomes being levels of physical activity, as measured by 7-day physical activity recall, and cardiorespiratory fitness, as measured by the Aerobic Adaptation Test. Secondary outcomes will include other well-established measures of physical activity, cardiovascular risk profiles, gait and balance assessment, and psychological measurements. The primary research hypothesis to be tested is that the Lifestyle intervention will significantly increase physical activity and cardiorespiratory fitness in adult survivors of childhood leukemia in comparison with standard care. Three additional questions to be addressed are: determining if such an intervention leads to improvement in cardiovascular risk profile; determining if gait and balance disturbances are related to physical inactivity in leukemia survivors and if these disturbances improve with the intervention; and identifying factors that are predictive of improvement or lack of improvement in outcomes. This study will represent the first clinical trial aimed at increasing physical activity in leukemia survivors and will advance our understanding of this vulnerable population.