title: Comparison of tai chi vs. strength training for fall prevention among female cancer survivors: study protocol for the GET FIT trial.
abstract: BACKGROUND
  Women with cancer are significantly more likely to fall than women without cancer placing them at higher risk of fall-related fractures, other injuries and disability. Currently, no evidence-based fall prevention strategies exist that specifically target female cancer survivors. The purpose of the GET FIT (Group Exercise Training for Functional Improvement after Treatment) trial is to compare the efficacy of two distinct types of exercise, tai chi versus strength training, to prevent falls in women who have completed treatment for cancer. 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 and, 3) Determine whether or not the benefits of each intervention last after structured training stops.
  
  
  METHODS
  We will conduct 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 2) strength training and 3) a placebo control group of seated stretching exercise. Women will participate in supervised study programs twice per week for six months and will be followed for an additional six months after formal training stops. The primary outcome in this study is falls, which will be prospectively tracked by monthly self-report. Secondary outcomes are maximal leg strength measured by isokinetic dynamometry, postural stability measured by computerized dynamic posturography and physical function measured by the Physical Performance Battery, all measured at baseline, 3, 6 and 12 months. The sample for this trial (N=429, assuming 25% attrition) will provide adequate statistical power to detect at least a 47% reduction in the fall rate over 1 year by being in either of the 2 exercise groups versus the control group.
  
  
  CONCLUSIONS
  The GET FIT trial will provide important new knowledge about preventing falls using accessible and implementable exercise interventions for women following chemotherapy for cancer. ClinicalTrials.gov NCT01635413.
authors.affiliation: School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA. wintersk@ohsu.edu
authors.forename: Kerri M
authors.initials: KM
authors.lastname: Winters-Stone
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Li
authors.forename: Fay
authors.initials: F
authors.lastname: Horak
authors.forename: Shiuh-Wen
authors.initials: SW
authors.lastname: Luoh
authors.forename: Jill A
authors.initials: JA
authors.lastname: Bennett
authors.forename: Lillian
authors.initials: L
authors.lastname: Nail
authors.forename: Nathan
authors.initials: N
authors.lastname: Dieckmann
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012107:Research Design; D055070:Resistance Training; D017741:Survivors; D026302:Tai Ji