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Grant Details

Grant Number: 4R01CA163474-05 Interpret this number
Primary Investigator: Winters-Stone, Kerri
Organization: Oregon Health & Science University
Project Title: Preventing Falls After Cancer: Tai Chi Vs. Strength Training
Fiscal Year: 2016


Abstract

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.



Publications

Reply to E. Shash.
Authors: Shah V. , Muzyka D. , Guidarelli C. , Sowlasky K. , Horak F. , Winters-Stone K. .
Source: Jco Precision Oncology, 2024 Oct; 8, p. e2400585.
EPub date: 2024-10-21 00:00:00.0.
PMID: 39432878
Related Citations

Chemotherapy-Induced Peripheral Neuropathy and Falls in Cancer Survivors Relate to Digital Balance and Gait Impairments.
Authors: Shah V.V. , Muzyka D. , Guidarelli C. , Sowalsky K. , Horak F.B. , Winters-Stone K.M. .
Source: Jco Precision Oncology, 2024 Jun; 8, p. e2300312.
PMID: 38885463
Related Citations

Can strength training or tai ji quan training reduce frailty in postmenopausal women treated with chemotherapy? A secondary data analysis of the GET FIT trial.
Authors: Winters-Stone K.M. , Stoyles S.A. , Dieckmann N.F. , Eckstrom E. , Luoh S.W. , Horak F.B. , Roeland E.J. , Li F. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2024-04-20 00:00:00.0; , .
EPub date: 2024-04-20 00:00:00.0.
PMID: 38642204
Related Citations

Can strength training or tai ji quan training reduce frailty in postmenopausal women treated with chemotherapy? A secondary data analysis of the GET FIT trial.
Authors: Winters-Stone K.M. , Stoyles S. , Dieckmann N. , Eckstrom E. , Luoh S.W. , Horak F. , Roeland E.J. , Li F. .
Source: Research Square, 2023-10-17 00:00:00.0; , .
EPub date: 2023-10-17 00:00:00.0.
PMID: 37886571
Related Citations

GET FIT: A Randomized Clinical Trial of Tai Ji Quan Versus Strength Training for Fall Prevention After Chemotherapy in Older, Postmenopausal Women Cancer Survivors.
Authors: Winters-Stone K.M. , Horak F. , Dieckmann N.F. , Luoh S.W. , Eckstrom E. , Stoyles S.A. , Roeland E.J. , Li F. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2023-06-20 00:00:00.0; 41(18), p. 3384-3396.
EPub date: 2023-03-08 00:00:00.0.
PMID: 36888933
Related Citations

A cognitively enhanced online Tai Ji Quan training intervention for community-dwelling older adults with mild cognitive impairment: A feasibility trial.
Authors: Li F. , Harmer P. , Fitzgerald K. , Winters-Stone K. .
Source: Bmc Geriatrics, 2022-01-25 00:00:00.0; 22(1), p. 76.
EPub date: 2022-01-25 00:00:00.0.
PMID: 35078407
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Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines.
Authors: Yang L. , Winters-Stone K. , Rana B. , Cao C. , Carlson L.E. , Courneya K.S. , Friedenreich C.M. , Schmitz K.H. .
Source: Cancer Medicine, 2021 11; 10(21), p. 7447-7456.
EPub date: 2021-09-17 00:00:00.0.
PMID: 34533284
Related Citations

Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable.
Authors: Campbell K.L. , Winters-Stone K.M. , Wiskemann J. , May A.M. , Schwartz A.L. , Courneya K.S. , Zucker D.S. , Matthews C.E. , Ligibel J.A. , Gerber L.H. , et al. .
Source: Medicine And Science In Sports And Exercise, 2019 Nov; 51(11), p. 2375-2390.
PMID: 31626055
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Postural sway, falls, and self-reported neuropathy in aging female cancer survivors.
Authors: Fino P.C. , Horak F.B. , El-Gohary M. , Guidarelli C. , Medysky M.E. , Nagle S.J. , Winters-Stone K.M. .
Source: Gait & Posture, 2019-01-17 00:00:00.0; 69, p. 136-142.
EPub date: 2019-01-17 00:00:00.0.
PMID: 30716669
Related Citations

Patient-reported and objectively measured physical function in older breast cancer survivors and cancer-free controls.
Authors: Winters-Stone K.M. , Medysky M.E. , Savin M.A. .
Source: Journal Of Geriatric Oncology, 2018-10-18 00:00:00.0; , .
EPub date: 2018-10-18 00:00:00.0.
PMID: 30344000
Related Citations

The Effects of Resistance Exercise on Biomarkers of Breast Cancer Prognosis: A Pooled Analysis of Three Randomized Trials.
Authors: Winters-Stone K.M. , Wood L.J. , Stoyles S. , Dieckmann N.F. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2018 Feb; 27(2), p. 146-153.
EPub date: 2017-11-15 00:00:00.0.
PMID: 29141853
Related Citations

A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017).
Authors: Stout N.L. , Baima J. , Swisher A.K. , Winters-Stone K.M. , Welsh J. .
Source: Pm & R : The Journal Of Injury, Function, And Rehabilitation, 2017 Sep; 9(9S2), p. S347-S384.
PMID: 28942909
Related Citations

Falls, Functioning, and Disability Among Women With Persistent Symptoms of Chemotherapy-Induced Peripheral Neuropathy.
Authors: Winters-Stone K.M. , Horak F. , Jacobs P.G. , Trubowitz P. , Dieckmann N.F. , Stoyles S. , Faithfull S. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2017-08-10 00:00:00.0; 35(23), p. 2604-2612.
EPub date: 2017-06-06 00:00:00.0.
PMID: 28586243
Related Citations

Skeletal response to resistance and impact training in prostate cancer survivors.
Authors: Winters-Stone K.M. , Dobek J.C. , Bennett J.A. , Maddalozzo G.F. , Ryan C.W. , Beer T.M. .
Source: Medicine And Science In Sports And Exercise, 2014 Aug; 46(8), p. 1482-8.
PMID: 24500540
Related Citations

Attention to principles of exercise training: a review of exercise studies for survivors of cancers other than breast.
Authors: Winters-Stone K.M. , Neil S.E. , Campbell K.L. .
Source: British Journal Of Sports Medicine, 2014 Jun; 48(12), p. 987-95.
PMID: 23293010
Related Citations

Tai Ji Quan for the aging cancer survivor: Mitigating the accelerated development of disability, falls, and cardiovascular disease from cancer treatment.
Authors: Winters-Stone K. .
Source: Journal Of Sport And Health Science, 2014-03-01 00:00:00.0; 3(1), p. 52-57.
PMID: 25285233
Related Citations

Exercise and cancer.
Authors: Knobf M.T. , Winters-Stone K. .
Source: Annual Review Of Nursing Research, 2013; 31, p. 327-65.
PMID: 24894145
Related Citations

Comparison of tai chi vs. strength training for fall prevention among female cancer survivors: study protocol for the GET FIT trial.
Authors: Winters-Stone K.M. , Li F. , Horak F. , Luoh S.W. , Bennett J.A. , Nail L. , Dieckmann N. .
Source: Bmc Cancer, 2012-12-05 00:00:00.0; 12, p. 577.
EPub date: 2012-12-05 00:00:00.0.
PMID: 23217054
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