Feasibility and Acceptability of Tele-exercise to Improve Physical Function in WTC Responders with Prostate Cancer

University Of Vermont & St Agric College, Burlington VT

Investigators

Abstract

PROJECT SUMMARY World Trade Center rescue and recovery workers (Responders) have an excess risk of prostate cancer, making them vulnerable to adverse effects on health, including physical function impairment. Evidence shows that physical functioning impairment in cancer survivors is associated with decreased quality of life, and elevated risk of falls and all-cause mortality. Supportive exercise programs that address aerobic capacity, strength, and balance can mitigate the detrimental effects of cancer on physical function, and physical and mental health. However, prior studies have identified critically low levels of physical activity and strength training participation among men living with and beyond prostate cancer. Videoconferencing technology enables Responders who are no longer living in relative proximity to each other or to New York to participate in supervised, group exercise from home. Unlike self-guided exercise, videoconferencing enables live interaction among participants and an instructor. Real-time instruction online overcomes transportation barriers and helps adults to exercise by establishing accountable relationships, fostering social support, and providing supportive feedback from instructors. Enhance Fitness (EF) is an evidence- and community-based, group exercise program for adults aged 50 and older involving strength, aerobic, and balance training that has been adapted for remote delivery (EFR). The EFR program is well-suited to Responders living with and beyond prostate cancer who could benefit from social support from other Responders and need adaptations for their long-term symptoms including pain, fatigue, and physical function limitations. We propose to assess feasibility and acceptability of the intervention as a lifestyle medicine approach. We will conduct a fully remote, pilot randomized controlled trial to determine feasibility and acceptability of EFR, including feasibility of remote biomarker sample collection for examining epigenetic changes with exercise, and examine the effects of EFR on physical function, patient-reported outcomes, and physical activity among Responders living with and beyond prostate cancer. We will also identify adaptation needs for participating in remote exercise. WTC Responders with a history of prostate cancer will be recruited, tested at baseline, and randomized to EFR (1 hour, 3 times/week x 16 weeks) or a waitlist control group. At the completion of the 16-week intervention period, participants will undergo post-intervention testing and will be invited to partake in semi-structured interviews to share perceptions of the program including barriers and facilitators of participating. Results will allow us to 1) identify critical adaptation needs to engage the WTC Responder population in remotely delivered exercise; 2) determine feasibility of procedures; and 3) identify the nature of the effect size of our intervention. We hypothesize that the remotely delivered Enhance Fitness exercise program is a feasible and effective lifestyle medicine approach to improving physical function and health for WTC Responders.