High-resistance inspiratory muscle strength training (IMST) is a time-efficient (\~5 minutes/day) form of exercise that employs an affordable, handheld device which impedes inspiratory breathing to train the diaphragm and accessory respiratory muscles and has demonstrated improvements in both cardiovascular health (9 mmHg reduction in systolic blood pressure, 45% improvement in vascular endothelial function) and improve exercise tolerance (12% increase in treadmill exercise time) in generally healthy midlife/older adults. Therefore, this approach may circumvent preventative hurdles to exercise, and augment the effects of exercise for capable survivors.
Cancer survivorship has been steadily improving as a result of earlier detection and improved therapies. Behind cancer recurrence, the primary cause of morbidity and mortality among survivors stems from the onset of cardiovascular disease that arises in part due to cardiotoxic chemo and radiation therapies. The increased risk of cardiovascular disease is particularly high in specific survivor populations, such as lymphoma survivors. Although exercise has been demonstrated to improve both recovery after cancer therapy and quality of life, both physical and logistical hurdles may prohibit certain patients from accessing this intervention. High-resistance inspiratory muscle strength training (IMST) is a time-efficient (\~5 minutes/day) form of exercise that employs an affordable, handheld device which impedes inspiratory breathing to train the diaphragm and accessory respiratory muscles and has demonstrated improvements in both cardiovascular health (9 mmHg reduction in systolic blood pressure, 45% improvement in vascular endothelial function) and improve exercise tolerance (12% increase in treadmill exercise time) in generally healthy midlife/older adults. Therefore, this approach may circumvent preventative hurdles to exercise, and augment the effects of exercise for capable survivors.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
1
High-resistance inspiratory muscle strength training (IMST) is a time-efficient (\~5 minutes/day) form of exercise that employs an affordable, handheld device which impedes inspiratory breathing to train the diaphragm and accessory respiratory muscles
Low-resistance inspiratory muscle strength training
Anschutz Health and Wellness
Aurora, Colorado, United States
University of Colorado Cancer Center
Aurora, Colorado, United States
Total Participants Recruited
Count of number of participants recruited into the study
Time frame: 2 years
Enrolled Participants per Month
Average number of participants enrolled per month of the study
Time frame: 2 years
Valid Assessments per Participant
Adherence to 75% of the program will be deemed acceptable
Time frame: 5 months
Session Attendance per Participant
Adherence to 75% of the program will be deemed acceptable
Time frame: 5 months
Total Participants Completing the Intervention
Adherence to 75% of the program will be deemed acceptable
Time frame: 2 years
Systolic Blood Pressure
Resting systolic blood pressure, collected in triplicate
Time frame: 5 months
Molecular Markers - Acetylcholine-stimulated production of nitric oxide
Serum will be used to perform experiments in which purchased cultured endothelial cells will be exposed to 10% serum from human subjects for 24 hours. The investigators will measure acetylcholine-stimulated production of nitric oxide (NO) in endothelial cells following serum incubation. Serum will be collected via venipuncture performed at the CTRC and stored at -80°C until analysis.
Time frame: 5 months
Molecular Markers - Acetylcholine-stimulated basal reactive oxygen species production
Serum will be used to perform experiments in which purchased cultured endothelial cells will be exposed to 10% serum from human subjects for 24 hours. The investigators will measure acetylcholine-stimulated basal reactive oxygen species (ROS) production in endothelial cells following serum incubation. Serum will be collected via venipuncture performed at the CTRC and stored at -80°C until analysis.
Time frame: 5 months
Cardiorespiratory Fitness (CRF) will be assessed via estimated VO2max
This will be measured by the Tecumseh Step Test. Participants step on and off an 8" step for 3 min, at a metronome-controlled pace of 24 steps/min. Afterward, they immediately sit down, and heart rate is recorded at 30 s and 1 min after completion (using Polar F4 heart rate monitors). These recovery heart rates are then entered into a predictive formula, along with patient biometric information (age, weight, gender), to calculate an estimated VO2max.
Time frame: 5 months
Physical function primarily assessed by the 6MWT
Participants will be instructed to walk as far as possible in a six minute period on an indoor track.
Time frame: 5 months
Metabolomics analyses will be performed on blood samples
Metabolomics analyses will be performed on blood samples collected during a standardized aerobic exercise session. Samples will be collected before exercise, immediately after, and after 30 min of recovery. Samples will be collected with patient-centric Tasso+ devices (Tasso, Inc) which minimize the discomfort of collection.
Time frame: 5 months
Functional Assessment of Cancer Therapy - General (FACT-G, assessing quality of life)
A 27-item scale commonly used to assess overall quality of life in the general cancer survivor population. Scores range from 0-108 with higher scores indicate higher quality of life.
Time frame: 5 months
Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue)
A 13-item scale commonly used to assess cancer-related fatigue in cancer survivors. Scores range from 0-52 with higher scores indicate lower levels of fatigue.
Time frame: 5 months
Godin Leisure Time Physical Activity Questionnaire
A 6-item scale asking participants the amount of time spent in light, moderate, and vigorous physical activity during the past week. Scores start at 0 with no upper range. Higher scores indicate more minutes of activity per week.
Time frame: 5 months
Hospital Anxiety and Depression Scale (HADS)
14 item scale indicating levels of anxiety and depression in clinical populations. Scores range from 0-21 for anxiety and depression scales. Higher scores indicate higher levels of anxiety and depression.
Time frame: 5 months
Cardiac risk factors will be collected from medical history forms
These risk factors will be included in secondary analyses to assess if participants at higher known risk of cardiac disease differ in their response to the intervention.
Time frame: 5 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.