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Zelfmanagementondersteuning voor longkankerpatiënten met cachexie
Werkzaamheid van zelfmanagementondersteuning op voedingsstatus bij longkankerpatiënten met kankercachexiesyndroom: een gerandomiseerd klinisch spoor
Het doel van deze gerandomiseerde klinische studie is het testen van de werkzaamheid van op zelfmanagement gebaseerde, op lichaamsbeweging gebaseerde, gecombineerde voedingsinterventie bij longkankerpatiënten met kankercachexie en anorexiasyndroom. De belangrijkste vraag die het wil beantwoorden is:
• Zou lichaamsbeweging en voedingsinterventie de voedingstoestand van longkankerpatiënten verbeteren? Deelnemers maken een aangepast oefenplan en eten voldoende eiwitrijk voedsel na op zelfmanagement gebaseerde ondersteuning.
En er is een vergelijkingsgroep: onderzoekers zullen vergelijkingsgroepen vergelijken om de voedingsstatus te zien die routinematig gezondheidsvoorlichting krijgen.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Changhua
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Changhua, Changhua, Taiwan, 51052
- Changhua Christian Hospital
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Taipei
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Taipei, Taipei, Taiwan, 11219
- Taipei Veterans General Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Beschrijving
Inclusiecriteria:
- Gediagnosticeerde longkanker (ICD-10-code: C33-C34)
- Gewichtsverlies: gewichtsverlies 2% vóór rekrutering 2 maanden of lichaamsgewichtverlies 5% vóór rekrutering 6 maanden.
- Arts oordeelt mag thuis sporten zonder begeleider.
- Heeft een smartphone en stemt ermee in om de bijbehorende applicatie te gebruiken.
- Ga ermee akkoord om de Xiaomi smartband zo lang mogelijk te dragen.
- Bewust helder en communicatie.
- Eastern Cooperative Oncology Group (ECOG) 0-1.
Uitsluitingscriteria:
- Deelnemers met hart- en vaatziekten kunnen niet sporten zonder begeleider.
- Diabetes Mellitus met slechte controle van de bloedsuikerspiegel.
- Chronische obstructieve longziekte met dyspnoe bij inspanning.
- Bloedplaatjes < 50000 mm3 door ziekte of behandeling.
- Hemoglobine <10mg/dl.
- Onlangs gestruikeld, hevige pijn, cognitieve en gedragsverandering.
- Verdachte of vastgestelde hersenmetastase.
- Verdachte of gediagnosticeerde botmetastasen.
- Krijg nasogastrische sondevoeding of parenterale voeding.
- Arts oordeelde dat hij geen thuisoefeningen kan doen.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Combined Exercise and Nutrition Self-management Support Program
Participants receive a 12-week multimodal intervention.
This includes personalized exercise prescriptions (aerobic, resistance, and flexibility training) guided by wearable technology and structured nutritional counseling focused on adequate protein intake (e.g., 1.2 g/kg/day).
All activities are supported by a self-management behavioral framework to enhance adherence.
In addition, both arms receive baseline cancer care from hospital case managers to ensure ethical standards of care are met.
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A structured 12-week multimodal support program.
(1) Exercise: Personalized home-based aerobic, resistance, and flexibility training (at least 3 times/week, 30 min/session) monitored via Xiaomi smart bands.
(2) Nutrition: Goal-oriented counseling focused on achieving a high-protein intake (e.g., 1.2-1.5 g/kg/day).
(3) Self-management: Continuous support using a self-monitoring manual, wearable device feedback, and a dedicated Line@ social media platform for real-time interaction with researchers, providing counseling and symptom management support to enhance patient adherence.
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Geen tussenkomst: Routine health education group
Participants will receive standard of care provided by cancer case managers, including education on medication adherence, symptom/side-effect management, and nutritional supplement trials as needed.
To maintain study blinding, participants in this group will also wear Xiaomi smart bands and undergo the same assessment schedule (Baseline, Week 8, Week 12) without the additional self-management support program.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change from baseline Mini Nutrition Assessment(MNA)
Tijdsspanne: baseline, Week 8, Week 12.
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The MNA consists of 18 self-reported questions covering ingestion, weight loss, mobility, acute illness/stress, neuropsychological problems, BMI, living arrangements, polypharmacy, skin ulcers, meal frequency, food/fluid intake, and mode of feeding.
The maximal score is 30.
A score >23.5 means well-nourished, 17-23.5 means risk of malnutrition, and <17 means malnutrition.
Higher scores indicate better nutritional status.
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baseline, Week 8, Week 12.
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Feasibility of the self-management support program
Tijdsspanne: Week 12
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Assessed by recruitment rate (percentage of eligible patients enrolled), retention rate (percentage of participants completing the 12-week study), and adherence to the wearable device and Line@ interaction.
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Week 12
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Change from balseline in Body Mass Index(BMI)
Tijdsspanne: Baseline, Week 8, Week 12
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BMI is calculated as weight in kilograms divided by the square of height in meters (kg/m^2), measured using Bioelectrical Impedance Analysis (BIA) with the InBodyDial H20 device.
Data are recorded and rounded to one decimal place.
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Baseline, Week 8, Week 12
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Change from baseline in skeletal muscle mass
Tijdsspanne: Baseline, Week 8, Week 12
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Measured using Bioelectrical Impedance Analysis (BIA) with the InBodyDial H20 device.
Data are recorded in percentage (%) and rounded to one decimal place.
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Baseline, Week 8, Week 12
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Change from basleline body fat mass at 12weeks
Tijdsspanne: Baseline, Week 8, Week 12
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The body fat mass will be detected by InBodyDial H20.
Data record with percentage and after the first decimal place.
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Baseline, Week 8, Week 12
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Change from Baseline in Upper Body Muscle Endurance (30-Second Arm Curl Test)
Tijdsspanne: Baseline, Week 8, Week 12
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Used to evaluate upper body muscle endurance.
The participant sits on a chair with back supported and performs as many bicep curls as possible in 30 seconds using a dumbbell (5 lbs for females; 8 lbs for males).
The total number of completed curls is recorded.
Higher scores (more repetitions) indicate better upper body muscle endurance.
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Baseline, Week 8, Week 12
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Change from Baseline in Lower Body Muscle Strength (30-Second Chair-Stand Test)
Tijdsspanne: Baseline, Week 8, Week 12
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Used to evaluate lower body muscle strength.
The participant sits in the middle of a chair with back straight and feet flat on the floor, then stands up completely and sits down repeatedly for 30 seconds.
The total number of completed stands is recorded.
Higher scores (more repetitions) indicate better lower body muscle strength.
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Baseline, Week 8, Week 12
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Change from Baseline in cardiopulmonary function (6-Minute Walk Test)
Tijdsspanne: Baseline, Week 8, Week 12
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Examine cardiopulmonary function in this study.
Let the participant sit and rest 10 minutes before test.
Check vital signs and oxygen situation for patient safety.
Position the participant at the starting line, and walking back and forth along the mark on the floor.
When the participant starts to walk, starts the times.
Don't walk nor talk with him/ her, and count the laps attentively.
Participant can walk longer distance means better cardiopulmonary function.
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Baseline, Week 8, Week 12
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Change from basline in quality of life (FACT-L)
Tijdsspanne: Baseline, Week 12
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The Functional Assessment of Cancer Therapy-Lung (FACT-L) is used to determine quality of life in lung cancer patients.
It contains 5 dimensions: physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), functional well-being (7 items), and lung cancer subscale (9 items).
Items are rated on a 5-point Likert scale with total scores ranging from 0 to 144.
Higher scores indicate better quality of life."
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Baseline, Week 12
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Change from Baseline in Cancer anorexia-cachexia syndrome nutrition knowledge (CACSNKQ)
Tijdsspanne: Baseline, Week 12
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The CACSNKQ is designed to assess patients' knowledge regarding cancer anorexia-cachexia syndrome.
All items are multiple-choice with one correct answer.
The total score ranges from 0 to 21, with higher scores indicating better nutritional knowledge and self-management ability against the syndrome.
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Baseline, Week 12
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Change from baseline in dietary intake (24 hours dietary recall)
Tijdsspanne: Baseline, Week 8, Week12
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To assess participants' nutritional intake.
A 24-hour dietary recall interview is conducted to record all food and beverage consumption (including dish names, portion sizes, and preparation methods).
Data are converted into total calories (kcal) and macronutrients (protein, fat, and carbohydrates in grams) by a registered dietitian using nutritional analysis software.
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Baseline, Week 8, Week12
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Change from Baseline in amount of exercise
Tijdsspanne: Baseline to Week 8, and Week 8 to Week 12
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Measured using the Xiaomi Smart Band and a self-management support manual.
The Xiaomi Smart Band is worn daily by participants to record continuous physical activity data, including daily step count, exercise duration, walking distance, and heart rate.
Additionally, participants use the self-management support manual to log the specific duration and frequency of resistance training and stretching exercises.
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Baseline to Week 8, and Week 8 to Week 12
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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Li Chun Chang, Master, Changhua Christian Hospital
- Studie directeur: Tsae Jyy Wang, PhD, National Taipei University of Nursing and Health Sciences
Publicaties en nuttige links
Algemene publicaties
- Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011 May;12(5):489-95. doi: 10.1016/S1470-2045(10)70218-7. Epub 2011 Feb 4.
- Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116.
- Ozaki H, Nakagata T, Yoshihara T, Kitada T, Natsume T, Ishihara Y, Deng P, Kobayashi H, Machida S, Naito H. Effects of Progressive Walking and Stair-Climbing Training Program on Muscle Size and Strength of the Lower Body in Untrained Older Adults. J Sports Sci Med. 2019 Nov 19;18(4):722-728. eCollection 2019 Dec.
- Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Hutterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Muhlebach S, Oldervoll L, Ravasco P, Solheim TS, Strasser F, de van der Schueren M, Preiser JC, Bischoff SC. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021 May;40(5):2898-2913. doi: 10.1016/j.clnu.2021.02.005. Epub 2021 Mar 15.
- Peddle-McIntyre CJ, Singh F, Thomas R, Newton RU, Galvao DA, Cavalheri V. Exercise training for advanced lung cancer. Cochrane Database Syst Rev. 2019 Feb 11;2(2):CD012685. doi: 10.1002/14651858.CD012685.pub2.
- Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hutterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, Muhlebach S, Muscaritoli M, Oldervoll L, Ravasco P, Solheim T, Strasser F, de van der Schueren M, Preiser JC. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017 Feb;36(1):11-48. doi: 10.1016/j.clnu.2016.07.015. Epub 2016 Aug 6.
- Schreiber M, Bucher T, Collins CE, Dohle S. The Multiple Food Test: Development and validation of a new tool to measure food choice and applied nutrition knowledge. Appetite. 2020 Jul 1;150:104647. doi: 10.1016/j.appet.2020.104647. Epub 2020 Feb 29.
- Anderson LJ, Albrecht ED, Garcia JM. Update on Management of Cancer-Related Cachexia. Curr Oncol Rep. 2017 Jan;19(1):3. doi: 10.1007/s11912-017-0562-0.
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 220582
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