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Can strength training or tai ji quan training reduce frailty in postmenopausal women treated with chemotherapy? A secondary data analysis of the GET FIT trial

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Abstract

Purpose

To determine whether strength training or tai ji quan can reduce frailty in older, postmenopausal women treated with chemotherapy for cancer.

Methods

We conducted a secondary data analysis from a 3-arm, single-blind, randomized controlled trial where older (50–75 years), postmenopausal women cancer survivors were randomized to supervised group exercise programs: tai ji quan, strength training, or stretching control for 6 months. We assessed frailty using a 4-criteria model consisting of weakness, fatigue, inactivity, and slowness. Using logistic regression, we determined whether the frailty phenotype (pre-frailty or frailty) decreased post-intervention, how many and which frailty criteria decreased, and what characteristics identified women most likely to reduce frailty.

Results

Data from 386 women who completed baseline and 6-month testing were used (mean age of 62.0 ± 6.4 years). The odds of reducing overall frailty over 6 months were significantly higher in the strength training group compared to controls (OR [95%CI] 1.86 [1.09, 3.17]) but not for tai ji quan (1.44 [0.84, 2.50]). Both strength training (OR 1.99 [1.10, 3.65]) and tai ji quan (OR 2.10 [1.16, 3.84]) led to significantly higher odds of reducing ≥ 1 frailty criterion compared to controls. Strength training led to a three-fold reduction in inactivity (p < 0.01) and tai ji quan to a two-fold reduction in fatigue (p = 0.08) versus control. Higher baseline BMI, comorbidity score, and frailty status characterized women were more likely to reduce frailty than other women.

Conclusions

Strength training appears superior to tai ji quan and stretching with respect to reducing overall frailty phenotype among postmenopausal women treated with chemotherapy for cancer, but tai ji quan favorably reduced the number of frailty criteria.

Trial registration

ClinicalTrials.gov identifier: GET FIT was registered as a clinical trial in clinicaltrials.gov: NCT01635413.

Implications for Cancer Survivors

Supervised, group exercise training that emphasizes strength training and/or tai ji quan may help combat accelerated aging and reduce frailty after cancer treatment.

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Data availability

Sharing of de-identified data will be considered based upon written request to the study author, Dr. Winters-Stone.

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Acknowledgements

We would like to thank all GET FIT participants for their time and effort. We would also like to thank Carolyn Guidarelli, Lauren Bumgartner, and Jessica Sitemba for their assistance with project management and data collection. We recognize the Oregon State Cancer Registry for their collaboration on recruitment for this trial. The Oregon State Cancer Registry is one of the participating registries funded by the National Program of Cancer Registries under the Centers for Disease Control and Prevention.

Funding

This work was funded by R01CA163474 to Dr. Winters-Stone.

Author information

Authors and Affiliations

  1. Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, 97239, USA

    Kerri M. Winters-Stone

  2. Knight Cancer Institute, Oregon Health & Science University, Portland, OR, 97239, USA

    Kerri M. Winters-Stone, Shiuh-Wen Luoh & Eric J. Roeland

  3. School of Nursing, Oregon Health & Science University, Portland, OR, 97239, USA

    Sydnee A. Stoyles & Nathan F. Dieckmann

  4. Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland, OR, 97239, USA

    Elizabeth Eckstrom

  5. Portland Veteran’s Affairs Medical Center, Portland, OR, 97239, USA

    Shiuh-Wen Luoh

  6. Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, 97239, USA

    Fay B. Horak

  7. Oregon Research Institute, Springfield, OR, 97477, USA

    Fuzhong Li

Authors
  1. Kerri M. Winters-Stone
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  3. Nathan F. Dieckmann
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Contributions

KWS, SS, and ND contributed to the study conception and design. Data analysis was performed by SS and ND. SS created all tables and figures. The first draft of the manuscript was written by KWS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kerri M. Winters-Stone.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Oregon Health & Science University.

Disclaimer

This report does not reflect the opinions of the Veterans Administration nor those of the US Government.

Competing interests

The authors declare no competing interests.

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Winters-Stone, K.M., Stoyles, S.A., Dieckmann, N.F. et al. Can strength training or tai ji quan training reduce frailty in postmenopausal women treated with chemotherapy? A secondary data analysis of the GET FIT trial. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01592-5

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