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基于远程医疗的随机干预设计和方法,以改善运动不耐受的儿童癌症幸存者的健康状况。

Design and methods of a randomized telehealth-based intervention to improve fitness in survivors of childhood cancer with exercise intolerance.

机构信息

Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-735, Memphis, TN 38105, USA.

Department of Medicine, University of Tennessee Health Science Center, 920 Madison Avenue, Memphis, TN 38163, USA.

出版信息

Contemp Clin Trials. 2023 Oct;133:107339. doi: 10.1016/j.cct.2023.107339. Epub 2023 Sep 18.

Abstract

BACKGROUND

Exercise intolerance among childhood cancer survivors substantially increases risk for early mortality, reduced cognitive function, poor quality of life, emotional distress, and sub-optimal participation in social roles. Fortunately, exercise intolerance is modifiable, even among individuals with impaired cardiopulmonary and neuromuscular health. This study aims to evaluate the impact of tailored exercise intervention remotely supervised by fitness professionals in survivors with exercise intolerance. Telehealth-based delivery of the intervention aims to enhance uptake by removing the burden of travel and allowing participants to gain confidence with exercise and physical activity at home.

METHODS

This is an ongoing single-blind, two-arm, prospective, clinical trial that will randomize 160 participants 1:1 to intervention (n = 80) and attention control (n = 80) groups. The intervention group receives an individually tailored exercise prescription based on results from baseline assessments performed remotely via a Health Insurance Portability and Accountability Act-compliant virtual platform and personal preferences for aerobic exercise. Each prescription includes aerobic and strengthening components designed to progress gradually to 150-300-min of moderate aerobic activity and twice weekly strengthening exercises over 20-weeks. The first two weeks are supervised for 6 sessions, tapering to twice/week for weeks 3-4, once/week for weeks 5-8, every other week for weeks 9-16 and once midway between weeks 17-20. The schedule is modifiable depending on participant need, adherence, and response to exercise. Each session is approximately one hour.

CONCLUSION

This study tests the efficacy of an individually prescribed, virtually supervised exercise intervention on exercise intolerant childhood cancer survivors.

CLINICALTRIALS

gov registration: NCT04714840.

摘要

背景

儿童癌症幸存者的运动不耐受大大增加了早逝、认知功能下降、生活质量差、情绪困扰和社会角色参与不足的风险。幸运的是,即使在心肺和神经肌肉健康受损的个体中,运动不耐受也是可以改变的。本研究旨在评估由健身专业人员远程监督的个性化运动干预对运动不耐受幸存者的影响。基于远程医疗的干预措施旨在通过消除旅行负担并允许参与者在家中对运动和体育活动建立信心,从而提高参与度。

方法

这是一项正在进行的、单盲、双臂、前瞻性临床试验,将随机将 160 名参与者按 1:1 比例分配到干预组(n=80)和对照组(n=80)。干预组根据通过符合《健康保险流通与责任法案》的虚拟平台远程进行的基线评估结果和对有氧运动的个人偏好,获得个性化的运动处方。每个处方包括有氧和强化成分,旨在逐渐进展到 150-300 分钟的中等有氧运动和每周两次强化锻炼,持续 20 周。前两周有 6 次监督,第 3-4 周减少到每周两次,第 5-8 周每周一次,第 9-16 周每两周一次,第 17-20 周每周一次。时间表可根据参与者的需求、依从性和对运动的反应进行调整。每次会议大约一个小时。

结论

本研究测试了针对运动不耐受儿童癌症幸存者的个性化、虚拟监督运动干预的疗效。

临床试验

gov 注册:NCT04714840。

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