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Phase I Randomized Controlled Trial of Functional Resistance Training in Older Cancer Survivors: The ACES Trial (ACES)

21 de mayo de 2026 actualizado por: Kerri Winters, OHSU Knight Cancer Institute

ACES: Advancing Capacity to Integrate Exercise Into the Care of Older Cancer Survivors

The study will assess the feasibility and preliminary efficacy of live, online supervised group functional resistance training in older cancer survivors who may have difficulty with independent functioning. The study design is a three-arm parallel group randomized controlled trial (immediate resistance training, delayed resistance training, stretching placebo) in 150 older cancer survivors. The resistance training program will be compared to two different types of common control groups: a stretching placebo group and a delayed intervention group. By using two control conditions, this study can also inform the design of future randomized trials on the selection of an appropriate control group.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Descripción detallada

This study is designed to begin addressing the current gap in evidence-based exercise guidelines for older cancer survivors, many of whom are at risk for losing their functional independence. This study is a three-arm parallel group randomized feasibility trial of 16 weeks of live, online supervised group functional resistance training in older (age 65+) cancer survivors (stages I - IV, including hematological malignancies) with or at risk for a functional limitation (n=150). Participants will be randomized in a 1:1:1 ratio to one of three study arms (immediate progressive functional resistance training (PFRT) intervention, stretching placebo; or, delayed PFRT), stratified by disease stage (metastatic vs non-metastatic). For both the immediate PFRT arm and the stretching placebo, participants will attend three 45-minute live, online supervised group sessions per week for 16 weeks. The immediate PFRT arm progresses from low to moderate intensity over 16 weeks based on participant tolerance. The stretching arm will perform stretches seated in a chair and will emphasize whole body range of motion and relaxation. The delayed PFRT arm will receive educational information about healthy lifestyle behaviors and monthly check-in calls over the first 16 weeks, then will follow the same exercise protocol as the immediate PFRT arm for an additional 16 weeks, during which feasibility outcomes will be collected. All participants will undergo two assessments (baseline and post-intervention at 16 weeks), consisting of surveys and performance assessments. The primary objective is to evaluate acceptability, tolerability, and safety of live, online supervised group functional resistance training sessions, as assessed by loss-to-follow-up, permanent discontinuation (i.e., study withdrawal), attendance to exercise sessions, treatment interruption, exercise dose modification, pre-treatment dose modification, tolerability (i.e., relative dose intensity), and prevalence and attribution status of adverse events. The secondary objective is to assess preliminary effects of the intervention on physical and mental health outcomes, including objectively measured physical function (Timed Up and Go, Physical Performance Battery), patient-reported symptoms and health related quality of life (Patient Reported Outcomes Measurement Information System (PROMIS) FACIT-Fatigue, Sleep Disturbance, Depression, Physical Function, Pain Intensity, Cognition, Anxiety; EuroQoL-5 Dimensions, European Organisation for Research and Treatment of Cancer QoL Questionnaire-Core 30), functional independence and disability (Nottingham Extended Activities of Daily Living, Late-Life Function and Disability Instrument), life-space mobility (Life Space Assessment), cognitive screening (Montreal Cognitive Assessment), frailty indicators (Chair Stand Test, 4-Meter Walk Test, self-reported physical activity and fatigue, and unintentional weight loss), and physical activity behaviors (Community Healthy Activities Model Program for Seniors).

Tipo de estudio

Intervencionista

Inscripción (Estimado)

150

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Estados Unidos
    • Oregon
      • Portland, Oregon, Estados Unidos, 97239
        • OHSU Knight Cancer Institute
        • Contacto:
          • Kerri Winters-Stone, Ph.D.
          • Número de teléfono: 503-494-0813
          • Correo electrónico: wintersk@ohsu.edu
        • Investigador principal:
          • Kerri Winters-Stone, Ph.D.

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto Mayor

Acepta Voluntarios Saludables

No

Descripción

Inclusion Criteria:

  • Age 65 years of age or older
  • Diagnosed with stage I-IV cancer =< 5 years ago
  • Completed surgery, chemotherapy, or radiation therapy > 3 months ago (concurrent maintenance therapy, such as hormone therapy for breast or prostate cancer, is permissible)
  • Self-report at least one limitation in Activities of Daily Living (ADLs) OR at clinical risk of developing ADL impairment as evidenced by a 3-meter timed-up-and-go time > 13.5 seconds or 5-time chair stand time > 12 seconds
  • Able to ambulate independently; reliance on assistive devices other than a wheelchair is allowed
  • Currently underactive (an average of < 30 minutes of moderate-vigorous intensity exercise 3 days/week over the past four weeks)
  • Willing to be randomized into any of the three study arms and attend 80% or more of planned exercise sessions
  • Home internet sufficient for videoconferencing

Exclusion Criteria:

  • Contraindication to moderate intensity exercise
  • Health or medical condition that affects movement or neurological disorder, or medication that contraindicates participation in live remote resistance exercise
  • Cognitive impairment consistent with moderate dementia (confirmed by a Montreal Cognitive Assessment (MoCA) score < 14). Cognitive impairment consistent with early-stage dementia (a MoCA score of <20) unless a research partner (e.g., family member, caregiver, close friend) can also be consented and can assist in answering the survey questions, participating in the performance tests, or giving informed consent.
  • Not fluent in English and therefore incapable of answering survey questions, following directions during exercise or performance testing, and providing informed consent in English

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Cuidados de apoyo
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Arm I (IMMEDIATE functional resistance training program)
Participants join a live, online supervised group functional resistance training session, three times per week, over 45 minutes, for 16 weeks. Participants will receive exercise equipment delivered to their home and perform functional exercises that correspond to movement patterns used in everyday activities (Chair Stand, Lateral walk, Step-up, Heel-toe Raise, Plank, Push-up, 1-arm row with chair, single-arm Bicep Curl, and single-arm Tricep Extension). The 16-week program is a progressive, low-to-moderate intensity training program with a planned progression that increases the volume of training (intensity and duration (sets and reps)) gradually over time, beginning with a low volume of training. Exercise dose can be modified per the participants' tolerance to each individual exercise, and participants will be monitored throughout the trial for this purpose. Caregivers may be present for participants that require additional assistance.
Otro: Functional Resistance Training
Participants attend live, online supervised group functional resistance training sessions of low-to-moderate intensity exercises, three times per week, 45 minutes per session for 16 weeks.
Otros nombres:
  • Ejercicio
  • Entrenamiento de fuerza
  • Progressive Functional Resistance Training (PFRT)
Comparador de placebos: Arm II (IMMEDIATE stretching program)
Participants join a live, online supervised group stretching and relaxation training session for 45 minutes, three times per week, for 16 weeks. During the stretching class, participants will perform a series of whole-body flexibility and mobility exercises with a final 15-minute relaxation period (i.e., progressive neuromuscular relaxation, focused breathing). Stretching exercises will be performed according to the ACSM guidelines for flexibility exercise, and from a seated position in order to minimize weight-bearing forces that might increase muscle strength or mass, and to better accommodate participants who may be unable to get down to and up from the floor.
Otro: Stretching
Participants attend live, online supervised group stretching and relaxation training sessions three times per week, 45 minutes per session for 16 weeks.
Otros nombres:
  • Movilidad Funcional
Otro: Arm III (DELAYED functional resistance training program)
Participants do not participate in a group exercise class for 16 weeks and will instead be provided with basic educational information about healthy lifestyle behaviors, and monthly check-in calls from study staff. After 16 weeks, they will be invited to participate in the same 16-week functional resistance training program as Arm I.
Otro: Delayed Functional Resistance Training
Participants will receive educational information about healthy lifestyle behaviors and receive monthly check in calls from study staff. After 16 weeks, participants attend live, online supervised group functional resistance training sessions of low-to-moderate intensity exercises, three times per week, 45 minutes per session for 16 weeks.
Otros nombres:
  • Control de lista de espera

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Loss-to-Follow Up
Periodo de tiempo: 16 weeks
Measured by the percentage of enrolled participants not completing baseline and 16-week survey or performance testing.
16 weeks
Permanent Discontinuation
Periodo de tiempo: 16 weeks
Measured by the percentage of enrolled sample that the participant and/or the investigator withdraws before final study visit.
16 weeks
Attendance
Periodo de tiempo: 16 weeks
Measured by the percentage of prescribed online sessions attended over the intervention period
16 weeks
Treatment Interruption
Periodo de tiempo: 16 weeks
Measured by number of times 3+ consecutive sessions are missed over the 16 week intervention period
16 weeks
Dose Modification
Periodo de tiempo: 16 weeks
Measured by the number of sessions requiring reduction or escalation in intensity and/or duration (sets or repetitions) after the session begins over the intervention period
16 weeks
Pre-treatment Dose Modification
Periodo de tiempo: 16 weeks
Measured by the number of times a session dose (intensity and/or duration) is reduced or escalated prior to the beginning of a session over the intervention period
16 weeks
Tolerability (Relative Dose Intensity)
Periodo de tiempo: 16 weeks
Measured by the cumulative dose of training received divided by the cumulative dose of prescribed training, expressed as a percentage over the intervention period
16 weeks

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Timed Up and Go (TUG) test
Periodo de tiempo: Baseline, 16 weeks
Physical assessment of mobility by evaluating the time that it takes a person to rise from a chair, walk 3 meters, turn around, and return and sit in the chair. Faster times indicate better mobility
Baseline, 16 weeks
Physical Performance Battery (PPB) test
Periodo de tiempo: Baseline, 16 weeks
Physical assessment of three timed tests (five repeated chair stands, standing balance, and usual pace gait speed over 4 meters), scored on a scale of 0 (unable) to 4 (completes without difficulty), based on quartiles of performance, then scores are summed, where higher scores indicate better physical functioning.
Baseline, 16 weeks
Patient Reported Outcomes Measurement Information System (PROMIS) FACIT-Fatigue Short Form 13a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 13 questions about fatigue in the past seven days, on a scale ranging from 1 (not at all) to 5 (very much), where higher total scores indicate more fatigue.
Baseline, 16 weeks
PROMIS Sleep Disturbance Short Form 8a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 8 questions about symptoms of sleep disturbance in the past seven days, on a scale ranging from 1 (not at all) to 5 (very much), where higher total scores indicate greater sleep disturbance.
Baseline, 16 weeks
PROMIS Depression Short Form 4a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 4 questions on depressive symptoms in the past seven days, on a scale ranging from 1 (never) to 5 (always), where higher total scores indicate greater depressive symptoms.
Baseline, 16 weeks
PROMIS Physical Function Short Form 10a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 10 questions of physical capability and instrumental activities of daily living, on a scale from 1 (unable to do) to 5 (without any difficulty), where higher scores indicate greater physical function.
Baseline, 16 weeks
PROMIS Pain Intensity Short Form 10a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 3 questions about pain intensity over the past seven days, and current pain intensity, on a scale from 1 (had no pain) to 5 (very severe), where higher scores indicate greater pain intensity.
Baseline, 16 weeks
PROMIS Cognition Short Form 8a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 8 questions about perceived cognitive function (i.e., memory, concentration, verbal fluency, and mental acuity) over the past seven days, on a scale from 1 (very often [several times a day]) to 5 (never), where higher scores indicate better cognitive function.
Baseline, 16 weeks
PROMIS Anxiety Short Form 4a
Periodo de tiempo: Baseline, 16 weeks
Self-report on 4 questions about fear, anxious misery, hyperarousal, and somatic symptoms related to arousal, on a scale from 1 (never) to 5 (always), where higher scores indicate worse anxiety-related symptoms.
Baseline, 16 weeks
EuroQoL-5 Dimensions (EQ-5D) Questionnaire
Periodo de tiempo: Baseline, 16 weeks
Self-report on health-related quality of life, with two components. 1) Five dimensions related to health (i.e., mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each of which is assigned a level from 1 (no problems) to 5 (extreme problems) and organized into a five-digit number representing the respondent's health state (e.g., 11235). Each 5-digit number corresponds to a health profile. 2) A visual analogue scale from 0 (worst imaginable health) to 100 (best imaginable health), where higher scores indicate better self-perceived health status.
Baseline, 16 weeks
European Organisation for Research and Treatment of Cancer QoL Questionnaire-Core 30 (QLQC-30)
Periodo de tiempo: Baseline, 16 weeks
Self-report on 30 questions about cancer-specific quality of life for five functional scales (physical, cognitive, emotional, social functioning, and role functioning) and one global health scale, on either a 4- (1=not at all to 4=very much) or 7-point (1=very poor to 7=excellent) Likert scale, where higher function-oriented scores indicate better functioning, and higher symptom-oriented scores indicate worse symptom severity. Transformed scores range from 0-100, where higher scores indicate better functioning.
Baseline, 16 weeks
Nottingham Scale for Extended Activities of Daily Living (NEADL)
Periodo de tiempo: Baseline, 16 weeks
Self-report on 22 questions about independence in instrumental activities of daily living (IADL; i.e., functional status) over four domains of activity (mobility, leisure, kitchen, and domestic tasks), on a scale from 0 (not at all) to 3 (on my own), where higher scores indicate more independence.
Baseline, 16 weeks
Life Space Questionnaire (LSQ)
Periodo de tiempo: Baseline, 16 weeks
Self-report on nine questions about movement across different spatial zones (i.e., community mobility) over the preceding three days, scored from 1 (yes) to 0 (no), where higher scores indicate greater mobility.
Baseline, 16 weeks
Late Life Function and Disability instrument (LLFDI)
Periodo de tiempo: Baseline, 16 weeks
Self-report on 16 questions about physical function and disability in two domains (frequency and limitation). The frequency scale is from 1 (never) to 5 (very often), where higher scores indicate more frequent participation in social and life activities. The limitation scale is from 1 (completely) to 5 (not at all), where higher scores indicate less limitations in completing activities.
Baseline, 16 weeks
Montreal Cognitive Assessment (MoCA)
Periodo de tiempo: Baseline, 16 weeks
Researcher-administered test of 11 questions used to screen for cognitive impairment, on a scale of 0-30 points, where higher scores (26+) indicate normal cognition, and lower scores indicate mild (18-15), moderate (10-17), or severe (<10) cognitive impairment.
Baseline, 16 weeks
Adverse Event Prevalence and Attribution [Safety]
Periodo de tiempo: Monthly over the 16-week intervention period.
Self-report on adverse events (AE) experienced throughout study involvement, as reported on a monthly AE survey; prevalence, severity, and attribution to the intervention will be determined.
Monthly over the 16-week intervention period.

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Frailty
Periodo de tiempo: Baseline, 16 weeks

Self-report and physical testing (five individual assessments) that each represent a component of the Frailty Phenotype. Each assessment either does or does not meet the threshold for frailty (Yes = 1, No = 0) and these are summed to determine the total frailty score (> 3 = frail, 1-2 = pre-frail, 0 = robust). Below is each component, the assessment used, and the threshold that determines the presence of frailty:

  1. Weakness (Chair Stand Test, described above in the PPB); >12 seconds.
  2. Slowness (4-Meter Walk Test, described above in the PPB); walking four meters at < 1 meter/second.
  3. Low Activity (self-reported CHAMPS, described below); < 270 kcal/week (female) and < 383 kcal/week (male).
  4. Exhaustion (self-reported fatigue, details described below in the SF-36 Vitality Scale); scores < 40 (normed).
  5. Shrinking (self-reported unintentional weight loss, measured in pounds); >10 pounds lost unintentionally over the prior year.
Baseline, 16 weeks
Community Healthy Activities Model Program for Seniors (CHAMPS)
Periodo de tiempo: Baseline, 16 weeks
Self-report on 41 questions about frequency of physical activity over the past four weeks, scored by calculating the frequency (times per week) and estimated caloric expenditure (kcal/week), where higher scores indicate more physical activity.
Baseline, 16 weeks
Short Form (SF)-36 Vitality Scale
Periodo de tiempo: Baseline, 16 weeks
Self-report on four questions about energy levels and fatigue over the past four weeks, on a scale from 1 (all of the time) to 5 (none of the time), total score is normed (0-100), where higher scores indicate less fatigue (i.e., greater vitality).
Baseline, 16 weeks

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

OHSU Knight Cancer Institute

Colaboradores

National Cancer Institute (NCI)
Oregon Health and Science University

Investigadores

  • Investigador principal: Kerri Winters-Stone, Ph.D., OHSU Knight Cancer Institute

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

18 de mayo de 2026

Finalización primaria (Estimado)

31 de agosto de 2028

Finalización del estudio (Estimado)

31 de agosto de 2028

Fechas de registro del estudio

Enviado por primera vez

28 de abril de 2026

Primero enviado que cumplió con los criterios de control de calidad

21 de mayo de 2026

Publicado por primera vez (Actual)

26 de mayo de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

26 de mayo de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

21 de mayo de 2026

Última verificación

1 de mayo de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • STUDY00028387 (Otro identificador: OHSU Knight Cancer Institute)
  • 4R33CA280996-03 (Subvención/contrato del NIH de EE. UU.)
  • NCI-2025-02748 (Identificador de registro: CTRP (Clinical Trial Reporting Program))

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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