Tele-resistance training during chemotherapy for advanced upper gastrointestinal cancer

项目摘要 阻力训练可以改善癌症治疗期间的健康，临床和生活质量。 患有晚期上消化道（GI）癌症的个体经常表现出骨骼肌损失， 可能在化疗期间恶化。阻力训练在这种情况下可能是有益的，但其可行性和 有效性尚未建立。对于许多癌症患者来说，以家庭为基础的锻炼计划可能更可取 幸存者，包括那些在家附近接受治疗并面临时间，财务， 使参与癌症中心或其他健身中心的监督计划变得复杂的疾病流行 设施在以前的家庭练习中坚持我们的阻力训练建议 胰腺癌治疗期间的干预措施很差。参与者列举了缺乏熟悉感等因素 低社会支持是阻力训练的障碍。该项目的目的是“连接” 方便和偏好以家庭为基础的阻力训练，以支持和监督的人 通过开发虚拟或“远程阻力训练”（“远程RT”）方法进行阻力训练。我们还旨在 比较肌肉力量和耐力，骨骼肌健康，健康相关生活质量， 疲劳和身体功能之间的个人随机参加远程RT和个人 在一线化疗期间随机接受常规治疗。我们假设干预将是 可行、安全和可接受，参与将与结局改善相关 与常规护理相比。接受一线化疗治疗晚期上消化道疾病的患者 癌症患者（N=100）将随机接受常规护理与远程阻力训练， 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，以安全地随着时间的推移增加强度。可行性（入组、保留和 坚持锻炼课程和规定的锻炼量）和安全将由教练监测。 参与后将通过问卷对可接受性进行评级。参与者将完成以下措施： 肌肉力量和耐力，骨骼肌健康，健康相关的生活质量，疲劳，和身体 一线化疗前后（约3个月）的功能。阻力训练有 改善晚期癌症患者健康和福祉的重要潜力，但这些益处 取决于坚持。在这个项目中，我们的目标是评估一种新的策略，以鼓励阻力训练 通过提供虚拟监督来遵守。这种干预具有鼓励抵抗的广泛潜力 培训并在各种癌症生存环境中的个体中获得益处。

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.