Group Exercise Training for Functional Improvement After Treatment (The GET FIT Trial)

• Change in the number of falls [ Time Frame: Monthly for 12 months ] [ Designated as safety issue: Yes ]
  In this study, a fall is defined as unintentionally coming to rest on the ground or at some other lower level, not as a result of a major intrinsic event (e.g., stroke or syncope) or overwhelming hazard. The study will track the number of falls, the number of injurious falls, and medical care resulting from a fall during the intervention and follow-up periods.
  
  

• Change in leg muscle strength [ Time Frame: Baseline, 3, 6, and 12 months ] [ Designated as safety issue: No ]
  The 1-repetition maximum for leg press will be used to determine changes in maximum lower extremity muscle strength. The timed chair stand test will determine changes in functional leg strength so that strength changes can also be interpreted in a clinical context.
  
  
• Change in postural stability [ Time Frame: Baseline, 3, 6, and 12 months ] [ Designated as safety issue: No ]
  Postural stability will be determined using the Sensory Organization Test (SOT) to identify balance problems consistent with neuropathy, vestibular loss, and CNS disorders that contribute to fall risk. The composite equilibrium score, the somatosensory ratio, and the vestibular sensory ratio will be used to evaluate the specific effects of the intervention the physiologic systems affected by cancer chemotherapy that impair stability (i.e., neuropathy and vestibular impairment).
  
  
• Change in physical function [ Time Frame: Baseline, 3, 6, and 12 months ] [ Designated as safety issue: No ]
  To evaluate the effects of the different exercise programs on physical functioning, the Physical Performance Battery (PPB) will be assessed across the study period. The PPB consists of 3 timed performance tests: time to rise and sit 5 times from a chair, the time to maintain up to 3 standing positions (tandem, near tandem and side-by-side), and average walking speed over 4 meters.
  
  

The purpose of the study is to compare the efficacy of two very distinct types of exercise, tai chi versus strength training, to prevent falls in women who have completed chemotherapy for cancer. The study is a three-group, single-blind, parallel design, randomized controlled trial in women, aged 50-75 years old, who have completed chemotherapy for cancer comparing 1) tai chi to 2) strength training against 3) a placebo control group of seated stretching exercise. Women participate in supervised study programs two times per week for six months and are followed for an additional six months after formal training stops. The specific aims of this study are to: 1) Determine and compare the efficacy of both tai chi training and strength training to reduce falls in older female cancer survivors, 2) Determine the mechanism(s) by which tai chi and strength training each reduces falls by measuring changes in muscle strength and postural stability across the study period and, 3) Determine whether or not the benefits of each intervention last after structured training stops by repeating measures six months after training ends. If the aims are successfully achieved, findings from this study will not only generate new knowledge about the effectiveness of two exercise-based treatment options to reduce falls after cancer but will also advance clinical rehabilitative practice. These factors, combined with the fact that the two exercise regimens are easily accessible and implementable in practice, increase the potential impact of this research on the quality of life in women with cancer.