Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial

Nancy M Gell; Kim Dittus; Jacqueline Caefer; Anita Martin; Myeongjin Bae; Kushang V Patel

doi:10.1007/s11764-022-01292-y

Remotely delivered exercise to older rural cancer survivors: a randomized controlled pilot trial

J Cancer Surviv. 2024 Apr;18(2):596-605. doi: 10.1007/s11764-022-01292-y. Epub 2022 Nov 14.

Authors

Nancy M Gell^{1

2}, Kim Dittus^{3

4}, Jacqueline Caefer⁵, Anita Martin⁶, Myeongjin Bae⁶, Kushang V Patel^{7

8}

Affiliations

¹ Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA. nancy.gell@med.uvm.edu.
² University of Vermont Cancer Center, Burlington, VT, USA. nancy.gell@med.uvm.edu.
³ University of Vermont Cancer Center, Burlington, VT, USA.
⁴ Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA.
⁵ Department of Physical Therapy Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA.
⁶ Department of Rehabilitation and Movement Science, University of Vermont, 306B Rowell 106 Carrigan Drive, Burlington, VT, 05405, USA.
⁷ Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA.
⁸ Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, USA.

Abstract

Purpose: The study aimed to determine the feasibility of remotely delivered exercise (tele-exercise) for older, rural cancer survivors and to explore the effects of tele-exercise on physical function, physical activity, and patient-reported outcomes.

Methods: Participants were rural cancer survivors age $\geq$ 60 years (79% female; mean age 70.4 ± 5.7) randomly assigned to the remotely delivered EnhanceFitness (tele-EF) exercise program, inclusive of aerobic, strength, and balance training and led by American Council on Exercise certified instructors for 1 h, 3 days/week for 16 weeks (n = 20) or to a waitlist control group (n = 19). We assessed feasibility, physical function, accelerometer-measured physical activity, and patient-reported outcomes at baseline and post intervention.

Results: Among those screened as eligible, 44 (64%) consented to participate with 39 randomized after completing baseline measures. Attrition was equivalent between groups (n = 1, each) with 95% completing the study. The median class attendance rate was 86.9% (interquartile range: 79-94%). Compared to controls, tele-EF participants had statistically significant improvement in the five-time sit-to-stand test (- 3.4 vs. - 1.1 s, p = 0.03, effect size = 0.44), mean daily light physical activity (+ 38.5 vs 0.5 min, p = 0.03, effect size = 0.72) and step counts (+ 1977 vs. 33, p = 0.01, effect size = 0.96). There were no changes in self-efficacy for exercise, fatigue, or sleep disturbance between groups.

Conclusions: Findings indicate that tele-EF is feasible in older, rural cancer survivors and results in positive changes in physical function and physical activity.

Implications for cancer survivors: Tele-EF addresses common barriers to exercise for older, rural cancer survivors, including limited accessible opportunities for professional instruction and supervision.

Keywords: Cancer; EnhanceFitness; Older adults; Physical function; Tele-exercise.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cancer Survivors*
Exercise
Exercise Therapy / methods
Female
Humans
Male
Middle Aged
Neoplasms* / therapy
Pilot Projects
Quality of Life

Grants and funding

R01 AG060992/AG/NIA NIH HHS/United States