To test the preliminary effectiveness of a home-based exercise training (ET) intervention to improve exercise capacity (VO2 peak \& 6-minute walk distance \[6MWD\]) among prostate cancer (PC) patients compared to controls receiving healthy living education (HLE) at 12 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
60
5.1. The behavioral ET and HLE interventions will be delivered over 12 weeks. Before starting the study, men will be asked to attend one (1) in-person small group orientation to provide an overview of each intervention arm, familiarize them with web-based and smartphone applications or hard copy manuals for delivery of intervention content, exercise logs, resistance bands, and equipment for strength training.
During the initial 12 weeks of the study, men randomized to the HLE group will receive educational modules delivered remotely (or manual and telephone call) in a group-based setting to approximately match contact frequency and structure with the ET arm.
Richmond Veterans Affairs Medical Center
Richmond, Virginia, United States
NOT_YET_RECRUITINGVirginia Commonwealth University Massey Cancer Center
Richmond, Virginia, United States
RECRUITINGChange from baseline in maximal exercise capacity (VO2 peak) at 12 weeks
Exercise capacity will be measured by the maximal volume of oxygen utilization (VO2 peak) during a supine graded cardiopulmonary exercise test done in conjunction with cardiac magnetic resonance (exeCMR+CPET). VO2 will be measured in both relative (ml/kg/minute) and absolute (L/minute) terms.
Time frame: Baseline, 12 weeks, and 24 weeks
Change from baseline in sub-maximal exercise capacity (6MWD) at 12 weeks
The distance walked in a sub-maximal 6-minute walk test (6MWD). 6MWD will be reported as meters walked (m).
Time frame: Baseline, 12 weeks, and 24 weeks
Stroke Volume (SV) as a cardiac determinant of exercise capacity among men undergoing ADT following 12 weeks of ET vs HLE controls.
By measuring resting and exercise -associated left ventricular (LV) end-diastolic (EDV) and end-systolic volumes (ESV) we will calculate stroke volume (SV) in milliliters/beat (ml). SV = EDV - ESV
Time frame: Baseline, 12 weeks
Left ventricular ejection fraction (LVEF) as a cardiac determinant of exercise capacity among men undergoing ADT following 12 weeks of ET vs HLE controls.
By measuring resting and exercise-associated stroke volumes (SV) as a proportion of end-diastolic volumes (EDV) we will calculate left ventricular ejection fraction (%). LVEF = SV/EDV
Time frame: Baseline, 12 weeks
Cardiac output (CO) as a cardiac determinant of exercise capacity among men undergoing ADT following 12 weeks of ET vs HLE controls.
By measuring resting and exercise-associated stroke volume (SV) and the heart rate (HR) in conjunction with image acquisition we will calculate cardiac output in liters per minute (L/min). CO = SV x HR
Time frame: Baseline, 12 weeks
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Arterial-venous oxygen (a-vO2) difference as a musculoskeletal determinant of exercise capacity among men undergoing ADT following 12 weeks of ET vs HLE controls.
From the exercise tests we will calculate a-vO2 difference using the FICK equation. The difference in oxygen saturation between the venous circulation and the arterial circulation will be reported in milliliters (ml) and also expressed as ml/100ml of blood (%) a-vO2 = VO2 / CO
Time frame: Baseline, 12 weeks
Change in lean body mass
We will conduct body composition assessments using bioelectrical impedance analysis (BIA) and a Dual Energy X-Ray Absorptiometry (DXA) scan. We will use dual X-ray absorptiometry (DEXA) to assess whole body composition for lean body mass. Lean body mass will be reported as kilograms (kg)
Time frame: Baseline, 12 weeks
Change in fat mass
We will conduct body composition assessments using bioelectrical impedance analysis (BIA) and a Dual Energy X-Ray Absorptiometry (DXA) scan. We will use dual X-ray absorptiometry (DEXA) to assess whole body composition for fat mass as well as distribution patterns of adiposity, e.g., visceral adipose tissue. Fat mass and visceral fat mass will be reported in kilograms (kg) and body fat percentage will be reported as fat mass / body mass (%)
Time frame: Baseline, 12 weeks
Neighborhood Environment & Walkability Survey (NEWS-A)
NEWS-A is a validated self-reported survey used to assess factors that are correlates or determinants of participants ability to engage in physical activity in their neighborhoods. For example, higher walkability is determined by availability of sidewalks and access to nearby facilities.
Time frame: Baseline, 12 weeks, 24 weeks
Change in physical activity assessed with the Godin Leisure-Time Exercise Questionnaire (GLTEQ)
GLTEQ is a self-report survey to determine the level typical activity a participant engages in each week. Higher scores on the index indicate more activity.
Time frame: Baseline, 12 weeks, 24 weeks
Change in physical activity assessed with Accelerometry
The ActivPAL and Actigraph accelerometers provide an objective assessment of sedentary sitting time and increasing intensities of physical activity in minutes per week
Time frame: Baseline, 12 weeks, 24 weeks
Change in self-efficacy to navigate barriers to engaging in exercise
A self report of self-efficacy to engage in exercise or physical activity under different challenging conditions such as when experiencing fatigue. Higher scores indicate increased confidence to navigate barriers.
Time frame: Baseline, 12 weeks, 24 weeks
Change in self-efficacy to walk for increasing periods of time.
A self report of self-efficacy to engage in walking for an increasing period of time. Higher scores indicate increased confidence to walk for a longer periods of time without resting.
Time frame: Baseline, 12 weeks, 24 weeks
Change in Functional Assessment of Cancer Therapy - Prostate (FACT-P) scores
FACT-P is a validated self report measures of different domains of quality of life that are important for men who have been diagnosed with prostate cancer. Subscale scores can be assessed to gauge functional wellbeing, physical wellbeing, social wellbeing and emotional wellbeing as well as prostate specific wellbeing. Higher scores indicate a higher quality of life on overall and sub scales.
Time frame: Baseline, 12 weeks, 24 weeks
Change in health-related quality of life (SF-36) scores
SF-36 (RAND) is a validated self report measure of different domains of health-related quality of life that are important for adults. Higher scores indicate a higher health-related quality of life .
Time frame: Baseline, 12 weeks, 24 weeks
Change in fatigue measured with the patient reported outcomes measurement information system (PROMIS) - Fatigue scores
PROMIS - Fatigue is a validated self-report measure of fatigue among patients diagnosed with cancer and higher scores indicate a lower level of fatigue.
Time frame: Baseline, 12 weeks, 24 weeks
Change in physical function measured with the patient reported outcomes measurement information system (PROMIS) - Physical Functioning scores
PROMIS - Physical Functioning is a validated self-report measure of physical functioning among patients diagnosed with cancer and higher scores indicate a better function.
Time frame: Baseline, 12 weeks, 24 weeks
Change in sleep disturbance measured with the patient reported outcomes measurement information system (PROMIS) - Sleep Disturbance scores
PROMIS - Sleep Disturbance is a validated self-report measure of sleep disturbance among patients diagnosed with cancer and higher scores indicate less sleep disruption.
Time frame: Baseline, 12 weeks, 24 weeks
Change in depressive symptoms measured with the patient reported outcomes measurement information system (PROMIS) - Depression scores
PROMIS - Depression is a validated self-report measure of depressive symptoms among patients diagnosed with cancer and higher scores indicate less symptoms.
Time frame: Baseline, 12 weeks, 24 weeks
Change in anxiety measured with the patient reported outcomes measurement information system (PROMIS) - Anxiety scores
PROMIS - Anxiety is a validated self-report measure of depressive symptoms among patients diagnosed with cancer and higher scores indicate less symptoms.
Time frame: Baseline, 12 weeks, 24 weeks
Change in emotional distress measured with the patient reported outcomes measurement information system (PROMIS) - Emotional Distress scores
PROMIS - Anxiety is a validated self-report measure of depressive symptoms among patients diagnosed with cancer and higher scores indicate less symptoms.
Time frame: Baseline, 12 weeks, 24 weeks
Change in fatigue measured with the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) scale
FACUT-F is a validated self-report measure of fatigue among patients undergoing treatment for a chronic illness and higher scores indicate less fatigue.
Time frame: Baseline, 12 weeks, 24 weeks
Change in perceived stress as measured with Cohen's perceived stress scale (PSS)
PSS is a validated self-report measure of perceived stress and higher scores indicate more perceived stress.
Time frame: Baseline, 12 weeks, 24 weeks
Change in physical function assessed with the Short Physical Performance Battery (SPPB)
SPPB is a validated objective assessment of 3 domains of physical function that includes gait speed, grip strength and time taken to stand from a chair 5 times. Each down is scored on a scale of 0-4 with a total score summed from each domain. A higher score is indicative of better functioning.
Time frame: Baseline, 12 weeks, 24 weeks