NAME: Winters-Stone, Kerri, Marcella comb No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015) BIOGRAPHICAL SKETCH Provide the following information for the Senior/key personnel and other significant contributors. Follow this format for each person. DO NOT EXCEED FIVE PAGES. era COMMONS USER NAME: WINTERS-STONE POSITION TITLE: Research Professor EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.) INSTITUTION AND LOCATION DEGREE (if applicable) Completion Date MM/YYYY FIELD OF STUDY University of California at Davis, Davis, CA BS 06/1991 Physical Education University of California at Davis, Davis, CA MS 12/1993 Exercise Science Oregon State University, Corvallis, OR PhD 06/2000 Human Performance A. Personal Statement I am an exercise physiologist with specific research and academic training in application of physical activity to improve physical function and body composition in adult, older adult and clinical populations. My research program focuses on the identification of cancer treatment related side effects and symptoms that impact wellbeing and physical functioning in cancer survivors and developing targeted strategies to maximize quality and quantity of life in survivorship. I have conducted numerous observational and randomized, controlled exercise trials in both healthy adult and cancer survivor populations including four trials examining the benefits of exercise training for physical function in breast and prostate cancer survivors, a recently completed trial in older prostate cancer survivors and their spouses and a current trial comparing tai chi to strength training for fall prevention in female cancer survivors treated with chemotherapy. I have experience in the conduct of observation and intervention trials in adult and older cancer survivors, including recruitment and retention of participants, management of large study teams and collaboration with investigators from medical oncology, gerontology, biomedical engineering, neurology, neuroscience and behavioral science. Our research team engages with community members and organizations throughout Oregon to recruit participants for studies, to disseminate findings to the broader community and to engage in collaborative discussions about our collective goals to improve the lives of people with cancer. I also serve as the Co-Program Leader of the OHSU Knight Cancer Institute Cancer Prevention and Control program, where my role is to facilitate collaborative research among investigators that serves to reduce the burden of cancer in the state of Oregon and beyond. An important feature of my academic and research careers has been working with students in the classroom and research environments. I have taught undergraduate and graduate students in multiple disciplines, including methodological coursework and coursework in the area of physical activity and health behaviors. In the research setting, I have worked with approximately 14 undergraduate students from various majors who were involved in research as paid research assistants, as a course requirement, or completing practicum or independent study projects. Over the course of my career, I have supervised or been on the graduate committee for 14 master s theses and doctoral dissertations, mentored 5 postdoctoral fellows and currently mentor 3 junior faculty in their early career development. a. Winters-Stone, KM. Exercise and Cancer: How much is enough? JAMA Oncology 1(6):776-777, 2015. b. Winters-Stone, KM, Mick DM, Bennett, JA. Preventing frailty in older cancer survivors. Topics in Geriatr Rehab (in press) c. Winters-Stone KM, Dobek JC, Bennett JA, Dieckmann NF, Maddalozzo GF, Ryan CW, Beer TM. Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial. Arch Phys Med Rehabil 96(1):7-14, 2015. PMID: 251944502014.
d. Winters-Stone KM, Li F, Horak F, Luoh SW, Bennett JA, Nail LM, Dieckmann N. Comparison of Tai Chi vs. Strength Training for Fall Prevention among Female Cancer Survivors: Study protocol for the GET FIT trial. BMC Cancer 12;577, 2012. PMCID: PMC3537635 B. Positions and Honors Positions and Employment 8/00-5/02 Assistant Professor, Department of Exercise Science, Northern Arizona University, Flagstaff, AZ 6/02-5/08 Assistant Professor, School of Nursing, Oregon Health & Science University, Portland, OR 6/08-5/13 Associate Professor, School of Nursing, Oregon Health & Science University, Portland, OR 4/09-6/11 Associate Professor, Department of Nutrition and Exercise Science, Oregon State University, Corvallis, OR 4/12-present Co-Program Leader, Cancer Prevention and Control Scientific Program, Knight Cancer Institute, Oregon Health & Science University, Portland, OR 6/13-present Professor, School of Nursing, Oregon Health & Science University, Portland, OR 8/14-present Co-Director, OHSU Knight Community Cancer Partnership Program Other Experience and Professional Memberships 1994-present Member, American College of Sports Medicine 1997-2009 Member, American Society for Bone and Mineral Research 2006-2010 Expert consultant, Lance Armstrong Foundation-YMCA Joint Collaborative. 2007-2009 Expert consultant, Physical activity and cancer exercise specialist certification. American College of Sports Medicine and American Cancer Society. 2012-14 Grant reviewer, NIH R15 Academic Research Enhancement Special Emphasis Panel 2013 Ad-hoc reviewer, Neurological, Aging and Musculoskeletal Epidemiology Review Panel 2014-present Design Team Leader, Movember/Prostate Cancer Foundation A Survivorship Action Plan USA 2015 Reviewer, NIH ZCA1 RPRB-B (M1) P - NCI Program Project Meeting I (P01) 2015 Reviewer, NIH Member Conflict Special Emphasis Panel, Kidney, Nutrition, Obesity and Diabetes (KNOD) Study Section 2014-present Member, NIH Rehabilitation Medicine Department Cancer Rehabilitation Panel Honors 2000: Vic Brook s Standard of Commitment Award, Instructor Recipient, Oregon State University Faculty Staff Fitness Program 2008 Fellow, American College of Sports Medicine 2008 Outstanding Research Award, 6 th Biennial NIH/ACS/LAF Cancer Survivorship Conference, Atlanta, GA 2012 Oregon Health & Science University Distinguished Faculty Award for Outstanding Research C. Contribution to Science 1. Specificity of Exercise Training to Improve Musculoskeletal Health My initial work began with the objective to design exercise programs that specifically targeted the musculoskeletal system in a manner to strengthen bones susceptible to osteoporotic fracture and also to strengthen muscles and improve postural stability to reduce fall risk. At the time of this research, the optimal exercise training regimen to reduce the risk of osteoporotic fractures was completely unknown and traditional weight bearing exercises, such as walking, were not effectively halting bone loss. Using the specificity and overload principles of exercise training, and modeling training programs after those used by athletes with high musculoskeletal fitness (e.g., gymnasts, weight lifters, wrestlers), I developed a novel regimen of resistance and impact training that targeted the hip and spine and lower body musculature. The program incorporated functional movements (e.g., squatting, lunging) to also improve functioning used in every day movements. We tested this program in premenopausal and postmenopausal women and reported that the program built hip and spine bone density in premenopausal and preserved bone density in postmenopausal women, improved body composition (increased muscle, reduced fat mass), muscle strength and power, and stability. We also demonstrated the site-specific effects of exercise on bone mass, suggesting that exercise programs need to target skeletal sites of interest in order to effectively reduce fracture risk and we also found the program to be most beneficial in women who were at most risk, e.g., with low initial bone density and strength. This program contributed to national recommendations for exercise and bone health and provided a model program for subsequent evaluation in clinical populations at risk for fracture.
a. Winters, K.M. and Snow, C. Detraining reverses positive effects of exercise on the musculoskeletal system in premenopausal women. J Bone Min Res. 15:2495-2503, 2000. b. Snow, C.M., Shaw, J.M., Winters, K.M., Witzke, K.A. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol. 55A:M489, 2000. c. Winters-Stone, K.M. and Snow, C.M. Musculoskeletal response to exercise is greatest in women with low initial values. Med Sci Sports Exerc. 35(10): 1691-1696, 2003. d. Winters-Stone, K. and Snow, C. Site-specific response of bone to exercise in premenopausal women. Bone. 39(6):1203-9, 2006. 2. Impact of Cancer Treatment on Long-Term Health of Cancer Survivors With increasing numbers of cancer survivors living well past their diagnosis their unique long-term health needs have become increasingly known. Breast and prostate cancer survivors had increased rates of fractures, falls, osteoporosis, disability and heart disease, but these data were from observations studies that relied on self-report and/or medical records rather than objective measures that might better document prevalence and also help better understand the causes that underlie poor health outcomes. I conducted several case-control studies in breast cancer survivors using objective measures of physical function, postural stability, and body composition (including bone density) and collaborated with others who investigated inflammation as a biological mechanism linking cancer treatment to fatigue, weight gain and possibly increased risk of recurrence. These studies confirmed that breast cancer survivors had lower bone density, muscle strength and balance and higher rates of falls and physical frailty than women without cancer and also that inflammation was a likely driver of cancer-treatment related fatigue. Collectively, this work suggested that cancer treatment may accelerate aging and also pointed to targets for exercise interventions that could lower inflammation and improve musculoskeletal health and body composition in order to reduce the risk of poor long-term health in cancer survivors. a. Bennett JA, Winters-Stone KM, Dobek J, Nail L. Frailty in older breast cancer survivors: prevalence and associated factors. Oncol Nurs For 40(3):E126-34, 2013. PMC3988495 b. Winters-Stone K, Torgrimson B, Horak F, Eisner A, Leo M, Nail L, Chui S, Luoh S. Identifying risk factors for falls in postmenopausal breast cancer survivors: a multi-disciplinary approach. Arch Phys Med Rehab, 92(4):646-52, 2011. PMCID: PMC3430739 c. Winters-Stone KM, Nail L, Bennett J, Schwartz A. Bone Health and Falls: Fracture Risk in Breast Cancer Survivors with Chemotherapy-Induced Amenorrhea. Oncol Nurs For. 36(3):315-325, 2009. d. Wood L, Nail L, Gilster A, Winters K, Elsea C. Cancer chemotherapy-related symptoms: evidence for a role of proinflammatory cytokines. Oncol Nurs For 33(3): 535-546, 2006 3. Resistance Training to Combat Threats to Survival in Cancer Survivors Breast and prostate cancer survivors have increased rates of fractures, disability, and recurrence and our research pointed to resistance training as a targeted strategy to address these problems. At the time, exercise, particularly resistance training, was not being considered as a strategy to improve musculoskeletal health and body composition in cancer survivors. Using the resistance + impact training intervention developed for women without cancer, I conducted three year long randomized controlled trials in breast (2 trials; N=106 and N=87) and prostate cancer survivors (1 trial; N=58) at risk of fractures, weight gain and disability. In our 2 trials in breast cancer survivors who either a) were older (50+ yrs.) at diagnosis or b) had experienced chemotherapyinduced menopause, resistance + impact training significantly slowed bone loss at the spine and hip, prevented fat gain, and increased muscle strength. In prostate cancers survivors, resistance + impact training significantly reduced total body fat and trunk fat mass compared to gains in controls. Loss of fat mass mediated the relationship between group and one-year change in insulin, pointing to a potential protective effect of exercise against cancer recurrence and CVD. Resistance + impact training was also found to slow bone loss at the spine, improve muscle strength, improve physical function and lessen disability. Collectively, these studies demonstrated that resistance + impact training was safe and feasible in breast and prostate cancer survivors and improved musculoskeletal health, physical function, and body composition which have important implications for reducing threats to survival from cancer recurrence and other non-cancer causes. a. Winters-Stone KM, Dieckmann N, Maddalozzo GF, Bennett JA, Ryan CW, Beer TM. Resistance Exercise Reduces Body Fat and Insulin During Androgen Deprivation Therapy for Prostate Cancer. Oncol Nurs For, in press b. Winters-Stone KM, Dobek J, Bennett JA, Maddalozzo GM, Ryan CW, Beer TM. Skeletal response to resistance and impact training in prostate cancer survivors. Med Sci Sports Exerc 46(8):1482-8, 2014, PMID: 24500540
c. Winters-Stone KM, Dobek J, Nail LM, Bennett JA, Leo MC, Torgrimson-Ojerio T, Luoh SW, Schwartz A. Impact + resistance training improves bone health and body composition in prematurely menopausal breast cancer survivors: A randomized controlled trial. Osteoporos Intl 24(5):1637-1646, 2013. PMC3856427 d. Winters-Stone, K.M., Dobek J., Bennett J.A., Nail L.M., Leo M.C., Schwartz A. The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial. J Cancer Surviv 6(2):189-199 (2012). PMID: 22193780 4. Prescriptive Exercise Training Programs for Cancer Survivors Building on our successful exercise trials that used targeted training programs to address fracture and disability risk in cancer survivors, we expanded our work to consider other targeted approaches that could address health problems that cancer survivors experience but for which there is no successful solution. We conducted preliminary work identifying risk factors for falls in breast cancer survivors, while a collaborative effort was focused on impact of cancer on patients and their spouse caregivers. We believe non-traditional forms of exercise or unique approaches to traditional exercise may be a novel approach to address these other problems. Tai chi is an ancient martial art form and emphasizes slow, controlled movements and may be easier to perform by older cancer survivors. I am currently investigating whether tai chi might be as effective or better than resistance training to prevent falls in women cancer survivors (1R01 CA163474). I am also using exercise as an approach to improve physical and mental health in cancer survivors and their spouse caregivers by having them exercise as a training team in a partnered strength training program. We also believe this partnered approach could improve the couples marital relationship. I recently completed a preliminary investigation (1R21 CA137272) of this partnered exercise approach in couples coping with prostate cancer and manuscripts are currently under review. Collectively, this work should broaden the thinking around exercise as a tool, that when delivered in non-traditional and/or unconventional formats could be effective at addressing multiple outcomes relevant to cancer survivors and their families. a. Winters-Stone KM. Tai Ji Quan for the aging cancer survivor: Mitigating the accelerated development of disability, falls, and cardiovascular disease from cancer treatment. J Sport Health Sci. 3(1):52-57, 2014. PMCID: PMC4180213 b. Winters-Stone KM, Beer TM. Review of exercise studies in prostate cancer survivors receiving androgen deprivation therapy calls for an aggressive research agenda to generate high-quality evidence and guidance for exercise as standard of care. J Clin Oncol 10;32(23):2518-9, 2014. PMID: 25002711 c. Winters-Stone KM, Neil S, Campbell K. Attention to Principles of Exercise Training: A review of exercise studies for survivors of cancers other than breast. Br J Sports Med 48:12 987-995, 2014. d. Winters-Stone, K. M., Lyons, K. S., Nail, L. M., Beer, T. M. The Exercising Together Project: Design and recruitment for a randomized, controlled trial to determine the benefits of partnered strength training for couples coping with prostate cancer. Contemp Clin Trials 33(2):342-350, 2012. PMCID: PMC3268842 Complete List of Published Work in MyBibliography: http://www.ncbi.nlm.nih.gov/sites/myncbi/18sf3cazmev/bibliography/40036495/public/?sort=date&direction=descending D. Research Support Ongoing Research Support Movember Foundation Winters-Stone (Co-PI) 4/1/2015 3/31/2018 TrueNTH USA Community of Wellness The goal of this project is to develop a web-based portal to deliver tailored exercise recommendations, training and support to prostate cancer survivors and enlist the support of their partners and medical providers. 1U48DP005006-01 Winters-Stone (Co-PI) 09/30/2014 09/29/2019 Centers for Disease Control and Prevention Oregon Cancer Community Research Collaborative The Oregon Cancer Community Research Collaborative at OHSU is a member institution of the CDC Cancer Prevention and Control Research Network designed to address the cancer prevention and control needs of rural, tribal and other underserved communities through community-driven research Role: Co-PI P30-CA069533 Winters-Stone (PI) 09/01/2013 012/31/2015
Development and feasibility of a remote sensing system to capture symptoms and functional consequences of peripheral neuropathies in cancer patients This project will develop a remote sensing system to detect the onset and severity of peripheral neuropathy and related changes in gait and mobility in persons treated with neurotoxic chemotherapy for cancer 1R01CA163474-04 Winters-Stone (PI) 02/24/2012 01/31/2017 Preventing falls after cancer: Tai chi vs. strength training The purpose of the proposed 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 treatment for cancer. 1R21CA164661-02 Winters-Stone (PI) 02/20/2012 01/31/2016 Influence of Exercise and Adiposity on Biomarkers of Breast Cancer Recurrence The purpose of the proposed study is to determine the influence of exercise and body fat changes on 3 types of biomarkers (sex and metabolic hormones and adipocytokines) associated with cancer progression in BCS. 1R21HL115251 Winters-Stone (PI) 07/01/2014 06/30/2016 NIH/NHLBI Whole Body Vibration Training for Healthy Body Composition in Young Adults The goal of this project is to evaluate the therapeutic benefits and feasibility of implementing a whole body vibration training program as a method of preventing weight gain in physically inactive young adults 1R01AG006457-29 Horak (PI) 05/01/2014 03/30/2019 NIH/NIA Peripheral and Central Postural Disorders in the Elderly The goals of this project are to characterize postural and cognitive impairments in patients with Frontal Gait Disorders and determine which circuitry deficits predict responsiveness to Agility Boot Camp rehabilitation. Role: Co-Investigator P30CA069533 Druker (PI) 07/20/2011 06/30/2016 OHSU Knight Cancer Institute The major goals of this project are to support the Knight Cancer Institute, its programs, shared resources, and administration. The resources and instruments of the institute foster interdisciplinary coordination and collaboration of cancer research faculty at OHSU in basic, clinical, and population research. Role: Scientific Program Co-Leader Completed Research Support in the past 3 years 1R01CA120123-011 Winters-Stone (PI) 07/01/2007 06/31/2012 National Cancer Institute Comparison of Aerobic and Resistance Training in Older Breast Cancer Survivors 1R21CA137272-01 Winters-Stone (PI) 08/01/2009 07/31/2012 National Cancer Institute Exercising Together: An Intervention for Prostate Cancer Survivors and their Spouses 5R01NR012479-02 Wood (PI) 09/28/2010 06/30/2015 NIH/NINR Mechanisms of Cancer Treatment Related Symptoms The goal of the project is to understand CTRS/CTRF (Cancer Treatment Related Symptoms/Cancer Treatment Related Fatigue) and what causes them in order to eventually prevent or decrease them, thereby improving quality of life, physical functioning and the long-term health of cancer survivors. Role: Co-Investigator
1R21AG047543-01A1 Vlarmov (PI) 04/01/2013 03/31/2015 NIH/NIA Attenuation of androgen deprivation therapy-induced metabolic syndrome by diet Role: Co-Investigator