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; 这些癌症的幸存者在确诊时将结婚。与那些没有面临慢性疾病的夫妇相比 癌症幸存者及其配偶的身心健康状况较差， mortality.癌症通常会破坏婚姻，关系质量的下降与生存期的缩短有关。 运动已被证明可以缓解癌症治疗副作用的症状并提高质量 癌症幸存者的生活;但是，还没有被用来同时改善身体和精神 保护幸存者和配偶的健康，并通过使其成为一项共同的、以团队为基础的活动来保护婚姻。 我们的试点研究的一个新的合作运动计划，共同锻炼，已显示出初步的可行性 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的， 严格评估一起锻炼扩大样本，包括夫妇应对早期与其他 常见的癌症，测量临床相关的结果，包括比较组，这将使我们能够 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 与其他人一起在一个小组中锻炼和/或让双方参与一种新的健康行为。我们计划 在294对夫妇（N=588名参与者）中进行了一项3臂、单盲、平行设计、随机试验， PC、BC或CRC，年龄在40-70岁之间，完成癌症初级治疗后2年内。我们 一项研究比较了在一个监督组中随机进行力量训练（一起锻炼）的夫妇 设置为（第2组）单独的监督组运动（仅存活者和仅配偶类）和（第3组） 单独的无人监督的运动，幸存者和配偶在家里自己锻炼。情侣们会训练 每周2次，持续6个月，随访6个月。本研究的目的是确定运动的功效 一起研究1）处理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 （b）对幸存者及其配偶的健康状况进行评估，并评估 一起锻炼的好处。这项研究与公共卫生有关，因为癌症的数量 到2050年，医疗系统中的幸存者和护理人员将增加一倍，但没有任何计划 解决癌症对幸存者和配偶身心健康的三重威胁 以及他们的婚姻关系。我们是第一个关注这对夫妇相互依存的本质， 合作练习，促进关系的建立，使这一计划不同于任何其他。行使 Together是一种全新的癌症生存方法，因为它考虑了幸存者的健康 和他/她的配偶以及他们的关系作为同样重要的目标。如果成功，这种独特的方法 可以应用于其他癌症或疾病的幸存者，增加本研究的潜在影响。

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.