What is the clinical evidence from this study?

Study design: RCT. Population: Cancer (n=116). Intervention: Group exercise-based cancer telerehabilitation vs. Usual care. Primary outcome: Health-related quality of life (EORTC QLQ-C30) at week 9.

July 18, 2022Open Access

Efficacy of Group Exercise–Based Cancer Rehabilitation Delivered via Telehealth (TeleCaRe): Protocol for a Randomized Controlled Trial

Key Result

Group exercise-based cancer rehabilitation delivered via telehealth will be evaluated for its efficacy in improving health-related quality of life compared to usual care in a planned randomized controlled trial of 116 cancer survivors.

Study Design

Type

RCT (n=116)

Blinding

Assessor-blinded

Randomization

Web-based computer-generated randomization program using permuted blocks of 4, 6, and 8

Multicenter

Yes

Structured PICO

Does group exercise-based cancer rehabilitation delivered via telehealth improve health-related quality of life in cancer survivors compared to usual care?

Population

116 adult cancer survivors receiving treatment or within 12 months of completing adjuvant therapy, functioning independently in the community, to be followed for 26 weeks.

Intervention

8-week, twice-weekly, 60-minute group exercise sessions (cardiovascular and resistance training) supervised via videoconferencing (Zoom) by a physiotherapist, supplemented by a web-based home exercise program (Physitrack), an information portal (iLearn), and a physical activity tracker (Fitbit Inspire).

Comparator

Usual care including standardized verbal and written advice to complete physical activity in line with current recommendations (aim for 3 times weekly exercise for 30 minutes, including twice weekly strength training), plus standard information booklets.

Outcome

Health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9 (post-intervention).patient reported

Limitations

Requirement of participants to have access to their own technology infrastructure to support telehealth, which may bias the population to those with high digital health literacy.
Does not consider other models of rehabilitation such as 1:1 care.
Possible effects of the telerehabilitation intervention may be diluted owing to the inability to interact 1:1 in a web-based group setting.

Abstract

BACKGROUND: Access to rehabilitation to support cancer survivors to exercise is poor. Group exercise-based rehabilitation may be delivered remotely, but no trials have currently evaluated their efficacy. OBJECTIVE: We aimed to evaluate the efficacy of a group exercise-based cancer rehabilitation program delivered via telehealth compared to usual care for improving the quality of life of cancer survivors. METHODS: A parallel, assessor-blinded, pragmatic randomized controlled trial with embedded cost and qualitative analysis will be completed. In total, 116 cancer survivors will be recruited from a metropolitan health network in Melbourne, Victoria, Australia. The experimental group will attend an 8-week, twice-weekly, 60-minute exercise group session supervised via videoconferencing supplemented by a web-based home exercise program and information portal. The comparison group will receive usual care including standardized exercise advice and written information. Assessments will be completed at weeks 0 (baseline), 9 (post intervention), and 26 (follow-up). The primary outcome will be health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire), and adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semistructured interviews will be completed within an interpretive description framework to explore the patient experience. The primary outcome will be analyzed using linear mixed effects models. A cost-effectiveness analysis will also be performed. RESULTS: The trial commenced in April 2022. As of June 2022, we enrolled 14 participants. CONCLUSIONS: This trial will inform the future implementation of cancer rehabilitation by providing important data about efficacy, safety, cost, and patient experience. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12621001417875; https://tinyurl.com/yc5crwtr. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/38553.

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