Preventing falls after cancer: Tai chi vs. strength training

描述（由申请人提供）：患有癌症的女性比其他女性更容易摔倒，这使她们面临更高的摔倒相关骨折，其他伤害和残疾的风险。我们对患癌妇女的福尔斯的了解相对较新。目前，还没有专门针对女性癌症幸存者的循证跌倒预防策略。这项拟议研究的目的是比较两种非常不同类型的运动，太极与力量训练，以防止福尔斯在妇女谁已经完成治疗癌症的疗效。我们提出了一个三组，单盲，平行设计，随机对照试验的妇女，年龄在50-75岁，谁已经完成化疗的癌症比较1）太极2）力量训练3）安慰剂对照组的坐姿伸展运动。女性将参加每周三次的监督学习计划，为期六个月，并在正式培训停止后再接受六个月的随访。本研究的具体目的是：1）确定和比较太极拳训练和力量训练对减少老年女性癌症幸存者福尔斯的疗效，2）确定太极拳和力量训练各自减少福尔斯的机制，3）确定结构化训练停止后每种干预措施的益处是否持续。拟议的研究在方法上是创新的，因为它是第一次尝试直接比较两种主要的锻炼方式（例如，太极和力量训练），每种都具有不同的训练特性，以减少癌症幸存者群体中的福尔斯。这一创新将导致更好地理解潜在的机制，这些机制是平衡和力量改善的基础，并随后减少癌症妇女的福尔斯。这一创新也可能影响临床实践，选择最有效的康复方法来治疗癌症患者，降低跌倒风险。拟议研究的长期目标是针对癌症幸存者的特定健康需求制定有效和实用的干预措施。该应用程序解决了国家癌症研究所的战略目标，即投资于癌症幸存者长期健康的干预研究，以及医学研究所的建议，以扩大癌症护理，以防止不断增长的癌症幸存者人口中的功能障碍和残疾。这项研究与公共卫生有关，因为有600多万妇女从癌症中幸存下来，但她们有很大的跌倒风险。目前，在癌症康复领域还没有针对癌症女性跌倒预防的循证治疗方案。因此，拟议的研究既解决了一个重要的公共卫生问题，也解决了临床实践中的一个关键障碍。如果目标成功实现，这项研究的结果不仅将产生关于两种运动治疗方案有效性的新知识，而且还将推动临床康复实践。这些因素，再加上这两种运动方案在实践中很容易获得和实施，增加了这项研究对癌症妇女生活质量的潜在影响。

DESCRIPTION (provided by applicant): Women with cancer are significantly more likely to fall than other women and this puts them at higher risk of fall-related fractures, other injuries and disability. Our understanding of falls in women with cancer is relatively new. Currently, there are no evidence-based fall prevention strategies that specifically target female cancer survivors. The purpose of the proposed study is to compare the efficacy of two very distinct types of exercise, tai chi versus strength training, to prevent falls in women who have completed treatment for cancer. We propose a three-group, single-blind, parallel design, randomized controlled trial in women, aged 50-75 years old, who have completed chemotherapy for cancer comparing 1) tai chi to 2) strength training against 3) a placebo control group of seated stretching exercise. Women will participate in supervised study programs three times per week for six months and will be followed for an additional six months after formal training stops. The specific aims of this study are to: 1) Determine and compare the efficacy of both tai chi training and strength training to reduce falls in older female cancer survivors, 2) Determine the mechanism(s) by which tai chi and strength training each reduces falls and, 3) Determine whether or not the benefits of each intervention last after structured training stops. The proposed study is innovative in its approach because it is the very first attempt at a direct comparison of two prominent exercise modalities (e.g., tai chi and strength training), each with distinct training properties, to reduce falls in a population of cancer survivors. This innovation will lead to a better understanding of potential mechanisms that underlie improvements in balance and strength and subsequently, reduced falls in women with cancer. This innovation may also impact clinical practice in terms of choosing most effective rehabilitative methods for treating cancer patients with an elevated risk of falling. The long-term goal of the proposed research is to develop effective and practical interventions that target the specific health needs of cancer survivors. This application addresses the National Cancer Institute's strategic goals to invest in intervention research on long-term health in cancer survivors and the Institute of Medicine recommendations to broaden cancer care to prevent dysfunction and disability in the growing population of cancer survivors. This study is relevant to public health because there are over 6 million women who have survived cancer but who are at great risk of falling. Currently, evidence-based therapeutic treatment options specific to fall prevention in women with cancer are not available in the cancer rehabilitation field. The proposed study, therefore, addresses both an important public health problem and a critical barrier in clinical practice. If the aims are successfully achieved, findings from this study will not only generate new knowledge about the effectiveness of two exercise-based treatment options but will also advance clinical rehabilitative practice. These factors, combined with the fact that the two exercise regimens are easily accessible and implementable in practice, increase the potential impact of this research on the quality of life in women with cancer.