Comparison of exercise-based cancer rehabilitation delivered in-person or via telehealth (TeleCaRe): a randomised controlled trial protocol (Preprint)

2021 ◽  
Author(s):  
Amy M Dennett ◽  
Katherine E Harding ◽  
Casey L Peiris ◽  
Nora Shields ◽  
Christian Barton ◽  
...  

BACKGROUND Access to rehabilitation to support cancer survivors to exercise is poor. Exercise-based rehabilitation may be delivered remotely but it is unknown how it compares to in-person cancer rehabilitation. OBJECTIVE To evaluate the effectiveness of an exercise-based cancer rehabilitation program delivered via telehealth compared to a traditional in-person model for improving quality of life of cancer survivors. METHODS A parallel, assessor-blinded, pragmatic, non-inferiority randomised controlled trial with embedded cost-effectiveness and qualitative analysis will be completed. One-hundred and twenty-four cancer survivors will be recruited from a metropolitan health network in Melbourne, Australia. The experimental group will attend an 8-week, twice weekly, 60-minute, exercise group supervised via videoconferencing supplemented by an online home exercise program and information portal. The comparison group will attend an 8-week, twice weekly, 60-minute, supervised exercise group in person, supplemented by a written home exercise program and information booklets. Assessments will be completed at week 0 (baseline), week 9 (post-intervention) and week 26 (follow-up). The primary outcome will be health related quality of life measured by the EORTC QLQ-C30 at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire) and recording of adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semi-structured interviews will be completed and analysed using a framework approach to determine the impact of delivery mode on patient experience. The primary outcome will be analysed using linear mixed effects models. RESULTS Trial not yet recruiting. Anticipated commencement January 2022. CONCLUSIONS This trial will inform the future implementation of cancer rehabilitation by providing important data about safety, effectiveness, cost and patient experience. CLINICALTRIAL The TeleCaRe Trial has been approved by the Eastern Health Human Research Ethics Committee (E21-012-74698) and is funded by the Victorian Cancer Agency. This trial is prospectively registered with the Australian New Zealand Clinical Trials Registry ACTRN12621001417875. Registered 21st October, 2021.

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e104412 ◽  
Author(s):  
Catherine Sherrington ◽  
Stephen R. Lord ◽  
Constance M. Vogler ◽  
Jacqueline C. T. Close ◽  
Kirsten Howard ◽  
...  

2018 ◽  
Vol 32 (12) ◽  
pp. 1656-1665 ◽  
Author(s):  
Marianne Roos ◽  
Jean-Sébastien Roy

Objective: To explore the feasibility of a rehabilitation program and its effect on the performance-related musculoskeletal symptoms and functional limitations of orchestral musicians. Design: Single-blind pilot randomized controlled trial with exercise group and control group. Setting: Workplace of professional symphony orchestra and tertiary-level conservatory orchestral musicians. Participants: Professional and student orchestral musicians with or without performance-related musculoskeletal disorders. Interventions: A rehabilitation program including an educational presentation, an 11-week home exercise program and three supervised exercise sessions, versus no intervention. Measures: Feasibility measures included adherence and drop-out rate. The Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians (MPIIQM) measured symptom intensity and functional limitations, while the Nordic Musculoskeletal Questionnaire (NMQ) measured symptom prevalence and frequency. Results: A total of 30 participants were recruited ( n = 15 per group). Exercise group adherence was 97.7% for the supervised sessions and 89% for the home exercise program. There were no drop-outs. Significant group-time interactions were obtained for both the pain intensity (partial η2 = 0.166; P = 0.025) and pain interference (partial η2 = 0.186; P = 0.017) sections of the MPIIQM. Mean (standard deviation) pain intensity score changes from baseline to 11 weeks were control group: 0.40 (5.04); P = 0.763; partial η2 = 0.007; and exercise group: –4.07 (5.31); P = 0.010; partial η2 = 0.386. For pain interference, mean score changes were control group: 0.20 (9.10); P = 0.933; partial η2 = 0.001; and exercise group: –9.00 (10.73); P = 0.006; partial η2 = 0.430. NMQ analyses revealed no significant interaction ( P > 0.05). Conclusion: Results suggest that the studied program is feasible and effective in decreasing the intensity and functional impact of musicians’ symptoms. However, no significant medium-term effect on the prevalence and frequency of symptoms was shown.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1944.2-1944
Author(s):  
S. Y. Cetin ◽  
B. Basakci Calik ◽  
A. Ayan

Background:Systemic sclerosis (SSc) is an autoimmune disease that not only affects the skin but also causes symptoms that involve important internal organs such as joints, muscles, and heart and lungs. Due to all these multiple system involvements, the quality of life of individuals with scleroderma decreases. Tai Chi Chuan is a combination of physical exercise and relaxation techniques, and it is a traditional Chinese exercise method used to improve mental and physical health of people. There are many studies showing that Tai Chi improves the body’s aerobic capacity and psychological well-being. In the literature, Tai Chi has been shown to reduce pain, improve physical function, improve healing effects on depression and quality of life, especially, in the elderly, individuals with musculoskeletal diseases such as rheumatoid arthritis and osteoarthritis, and improve cardiac vascular risk factors such as hypertension and diabetes.Objectives:The aim of the study is to examine the effectiveness of Tai Chi on cardiopulmonary functions and quality of life in patients with SSc.Methods:28 SSc patients (25 females, 3 males) with an average age of 53.00 ± 10.00 were included in the study. For training, patients were divided into two groups by block randomization method. Group 1 received 60 minutes of Tai Chi exercise program and Group 2 received 60 minutes of home exercise for 2 days a week for 8 weeks. 6-min walk test (6MWT) and St. George Respiratory Questionnaire was used to evaluate the cardiopulmonary functions, Short form 36 (SF-36) was used to evaluate the quality of life. All evaluations were performed at baseline and at the end of the 8th weekResults:When the groups were compared before training, there was no significant difference (p> 0.05). In post-training comparisons, there was a significant difference in all parameters in Tai Chi group (p: 0.001-0.045); there was a significant difference in the physical function sub-parameter of SF-36 and 6MWT in the home exercise group (p: 0.045, p: 0.038, respectively). Comparing the post-training groups, Tai Chi group was found to be superior in terms of all parameters compared to the home exercise group (p: 0.00-0.04). No side effects were observed during the exercises.Conclusion:As a result of our study; Tai Chi has a possitive effect on cardiopulmonery function and quality of life in patients with SS. Tai Chi should be included in rehabilitation programs as a safe alternative type of exercise to improve cardiopulmonery function and quality of life in patients with SSc.References:[1]de Oliveira NC, Portes LA, Pettersson H, Alexanderson H, Boström C. Aerobic and resistance exercise in systemic sclerosis: State of the art. Musculoskeletal Care. 2017;15:316–323.[2]Jia X, Jiang C, Tao J, Li Y, Zhou Y, Chen LD. Effects of core strength training combined with Tai Chi Chuan for the musculoskeletal system and cardiopulmonary function in older adults: A study protocol for a randomized controlled trial. Medicine (Baltimore). 2018;97(35):e12024.[3]Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, McAlindon T. Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Rheum. 2009; 61:1545–1553.[4]Wang C, Roubenoff R, Lau J, Kalish R, Schmid CH, Tighiouart H, Rones R, Hibberd PL Effect of Tai Chi in adults with rheumatoid arthritis. Rheumatology (Oxford) 2005; 44:685–687.Disclosure of Interests:None declared


2020 ◽  
Author(s):  
Julie Lorraine O'Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  

Abstract Background: Non-pharmacological interventions (NPI) can improve cognitive and non-cognitive symptoms in nursing home residents living with dementia. However, delivery of suitable NPI can be challenging in everyday nursing home settings. Internet and communication technologies (ICT) may be promising tools for supporting NPI delivery in nursing homes. Methods: A two-arm cluster-randomised controlled trial was conducted to investigate global and momentary effects of a novel ICT-based NPI for nursing home residents with dementia. Ten nursing homes were randomly allocated to the tablet-based intervention (TBI) or conventional activity sessions (CAS) group (each with five nursing homes) between April 2016 and May 2017. A total of N = 162 participants received either regular TBI (n = 80) or CAS (n = 82) over a period of eight weeks. Linear mixed models were used to analyse group differences regarding the primary outcome apathy (AES-I), and secondary outcomes quality of life (QOL-AD, QUALIDEM), neuropsychiatric (NPI-NH, psychotropic medication) and depressive symptoms (GDS). Ecological Momentary Assessments (EMA) of quality of life were also conducted in both groups before and after each activity session.Results: No significant group difference in the change of apathy (AES-I score, primary outcome) was found post intervention (mean group difference: B = .19; 95% CI: -3.90 to 4.28, p = .93). Regarding secondary outcomes, a reduction of psychotropic medication was found for TBI compared to CAS (B = .42; 95% CI: .15 to .69, p < .01). Further analyses revealed a post-intervention improvement of informant-rated quality of life across both groups (B = 3.69; 95% CI: .68 to 6.69, p = .02). Analysis of EMA also rendered short-term post-session improvements of quality of life in the CAS group (B = .43; 95% CI: .30 to .57, p < .001). Conclusions: These findings suggest that NPI involving individually tailored activities have a beneficial impact on quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, ICT have the potential to support NPI delivery and facilitate regular assessments of fluctuating momentary states in nursing home residents with dementia. Trial registration: The trial was retrospectively registered with the ISRCTN registry (Trial registration number: ISRCTN98947160) on 01/09/2016 http://www.isrctn.com/ISRCTN98947160.


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