A 5-month digital therapeutics-based cardiac telerehabilitation program significantly improved maximal oxygen uptake peak (3.66 vs 1.09 mL/Kg/min) compared to usual care in early-stage non-small cell lung cancer survivors.
RCT (n=47)
Single-blind
Randomized
No
Does digital therapeutics-based cardiac telerehabilitation improve cardiopulmonary fitness and quality of life in early-stage non-small cell lung cancer survivors post-surgery?
A 5-month digital therapeutics-based cardiac telerehabilitation program significantly improved cardiopulmonary fitness and quality of life in early-stage non-small cell lung cancer survivors.
Absolute Event Rate: 3.66% vs 1.09%
p-value: p=0.02
Background Lung cancer ranks as the leading cause of cancer-related deaths. For lung cancer survivors, cardiopulmonary fitness is a strong independent predictor of survival, while surgical interventions impact both cardiovascular and pulmonary function. Home-based cardiac telerehabilitation through wearable devices and mobile apps is a substitution for traditional, center-based rehabilitation with equal efficacy and a higher completion rate. However, it has not been widely used in clinical practice. Objective The objective of this study was to broaden the use of digital health care in the cardiopulmonary rehabilitation of lung cancer survivors and to assess its impact on cardiopulmonary fitness and quality of life (QOL). Methods Early-stage nonsmall cell lung cancer survivors aged 18-70 years were included. All the participants received surgery 1-2 months before enrollment and did not require further antitumor therapy. Participants were randomly assigned to receive cardiac telerehabilitation or usual care for 5 months. Artificial intelligence–driven exercise prescription with a video guide and real-time heart rate (HR) monitoring was generated based on cardiopulmonary exercise testing. Aerobic exercise combining elastic band–based resistance exercises were recommended with a frequency of 3-5 d/wk and a duration of 90-150 min/wk. The effective exercise duration was recorded when patients’ HR reached the target zone (HRresting + HRmax – HRresting × ≈40%-60%), representing the duration under the target intensity. The prescription used a gradual progression in duration and action intensity based on the exercise data and feedback. Outcome measurements included cardiopulmonary fitness; lung function; cardiac function; tumor marker; safety; compliance; and scales assessing symptoms, psychology, sleep, fatigue, and QOL. Results A total of 40 (85%) out of 47 patients finished the trial. The average prescription compliance rate of patients in the telerehabilitation group reached 101.2%, with an average exercise duration of 151.4 min/wk and an average effective exercise duration of 92.3 min/wk. The cardiac telerehabilitation was associated with higher improvement of maximal oxygen uptake peak (3.66, SD 3.23 mL/Kg/min vs 1.09, SD 3.23 mL/Kg/min; P=.02) and global health status or QOL (16.25, SD 23.02 vs 1.04, SD 13.90; P=.03) compared with usual care. Better alleviation of affective interference (–0.88, SD 1.50 vs 0.21, SD 1.22; P=.048), fatigue (–8.89, SD 15.96 vs 1.39, SD 12.09; P=.02), anxiety (–0.31, SD 0.44 vs –0.05, SD 0.29; P=.048), and daytime dysfunction (–0.55, SD 0.69 vs 0.00, SD 0.52; P=.02) was also observed in the telerehabilitation group. No exercise-related adverse events were identified during the intervention period. Conclusions The 5-month, digital therapeutics–based telerehabilitation improved cardiorespiratory fitness in lung cancer survivors with good compliance and safety. Patients receiving telerehabilitation also reported improved QOL with reduced levels of fatigue, anxiety, and daytime dysfunction. Trial Registration Chinese Clinical Trial Registry ChiCTR2200064000; https://www.chictr.org.cn/showproj.html?proj=180594
Li et al. (Tue,) conducted a rct in Early-stage non-small cell lung cancer (n=47). Digital therapeutics-based cardiac telerehabilitation vs. Usual care was evaluated on Improvement in maximal oxygen uptake peak (VO2 peak) in mL/Kg/min (p=0.02). A 5-month digital therapeutics-based cardiac telerehabilitation program significantly improved maximal oxygen uptake peak (3.66 vs 1.09 mL/Kg/min) compared to usual care in early-stage non-small cell lung cancer survivors.