Background: Cancer and its treatment can significantly impair quality of life, while access to rehabilitation services remains limited for many individuals with cancer. Tele-rehabilitation has emerged as a promising approach to delivering rehabilitation remotely. This study evaluated the feasibility, acceptability, and impact of a 12-week tele-rehabilitation program on health-related quality of life using the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Methods: A prospective single-group interventional feasibility study was conducted among 40 adult individuals with cancer. Participants underwent a 12-week tele-rehabilitation program comprising supervised exercise therapy, breathing exercises, mobility training, and patient education delivered remotely. Health-related quality of life was assessed using the FACT-G questionnaire at baseline, first follow-up, and second follow-up. Feasibility outcomes included recruitment, retention, adherence, and safety. Data were analyzed using descriptive statistics, Student paired t test, and analysis of variance, with P < .05 considered statistically significant. Results: Of the 40 enrolled individuals, 35 completed the study, yielding a retention rate of 87.5%. Mean adherence was 89.9%, with no intervention-related adverse events reported. Mean total FACT-G scores improved significantly from 82.35 ± 17.04 at baseline to 91.60 ± 14.29 at first follow-up and 93.21 ± 19.63 at second follow-up ( P < .001). Significant improvements were observed across the physical, social/family, emotional, and functional well-being domains. Conclusions: A 12-week tele-rehabilitation program was feasible, safe, and acceptable for adult individuals with cancer. Improvements in overall and domain-specific FACT-G scores suggest that tele-rehabilitation may enhance quality of life and expand access to rehabilitation services. Larger controlled studies are warranted to confirm these findings and establish long-term effectiveness.
Background: Multiple myeloma (MM) is an incurable cancer of the plasma cells. Although survival has improved, individuals with MM continue to experience treatment-related symptoms and functional decline. Autologous stem cell transplant (SCT) helps participants attain longer disease-free periods but requires a base level of fitness to proceed safely. Prior work by our group has identified substantial patient-reported barriers to exercise in the pre-SCT setting and highlighted a preference for tailored, flexible, and hybrid exercise delivery models to support participation. The aim of this trial protocol is to evaluate the feasibility of a tailored exercise rehabilitation program delivered using a hybrid model that supports virtual, in-person, or combined participation. The trial was originally limited to transplant-eligible individuals before SCT but, due to low recruitment, was amended to include transplant-ineligible and post-SCT individuals. Methods: This randomized feasibility trial uses 1:2 allocation to standard care or intervention. A minimum of 30 participants will be recruited and stratified by transplant status. The supervised exercise program is delivered over 8-to-12 weeks using in-person, virtual, or hybrid formats. Feasibility outcomes include recruitment, retention, adherence, and safety. Exploratory efficacy outcomes include physical fitness, patient-reported outcomes, and optional thigh ultrasound measures. Conclusion: The trial will inform the feasibility of delivering tailored rehabilitation across diverse MM clinical pathways to inform future research. Importantly, we highlight how real-world recruitment challenges may necessitate adaptive trial design in rehabilitation oncology.
Background: Recovery after discharge is a key goal of cancer rehabilitation in patients undergoing gastrointestinal cancer surgery; however, perioperative factors associated with early postdischarge 6-minute walk distance (6MWD) remain unclear. This exploratory prospective cohort study aimed to identify perioperative factors associated with 6MWD approximately 1 month after discharge. Methods: This exploratory prospective cohort study used convenience sampling and included 27 patients who underwent gastric or colorectal cancer surgery. Assessments were conducted preoperatively, at discharge, and during the early postdischarge period. The primary outcome was the 6MWD measured during the early postdischarge period. Candidate factors included demographic and clinical variables, physical function, cancer-related fatigue, instrumental activities of daily living, and albumin. Accelerometer-derived physical activity variables were examined as secondary exploratory measures. Exploratory multivariable linear regression analyses were performed separately for preoperatively (PRE) and at discharge (DIS) models, and Bayesian linear regression was conducted as a complementary analysis. Results: The 6MWD improved after discharge, increasing by 40.4 m from discharge to the early postdischarge assessment, indicating a clinically meaningful recovery. In the DIS model, discharge 6MWD was positively associated with postdischarge 6MWD, whereas age was negatively associated, and postoperative complications showed a negative trend. In the PRE model, preoperative 6MWD was positively associated with postdischarge 6MWD, whereas preoperative mental fatigue was negatively associated. It improved after discharge, increasing by 40.4 m from discharge to the early postdischarge assessment, indicating a clinically meaningful recovery. In the DIS model, discharge 6MWD was positively associated with postdischarge 6MWD, whereas age was negatively associated and postoperative complications showed a negative trend. In the PRE model, preoperative 6MWD was positively associated with postdischarge 6MWD, whereas preoperative mental fatigue was negatively associated. Conclusions: Early postdischarge 6MWD was associated with perioperative functional capacity, age, and preoperative mental fatigue. These exploratory findings should be interpreted cautiously and may help refine perioperative assessment and postdischarge support strategies.
Background: Virtual fitness assessments offer unique advantages to overcome the barriers many cancer survivors face in accessing in-person assessments. This study evaluated the reliability and concurrent validity of remotely administered functional fitness measures in cancer survivors. Methods: Remote assessments were conducted via Zoom videoconferencing software in participants’ homes. Assessments consisted of four functional fitness measures: right and left one-leg balance test (OLBT), sit-to-stand test (STS), chair sit-and-reach (CSAR), and 2-minute step test (2MST). Participants (n = 31) completed two remote assessments followed by one in-person assessment within a 2-week period. Intrarater reliability and concurrent validity were assessed using intraclass correlation coefficients (ICC) with 95% confidence intervals. Agreement of remote and in-person measures was assessed using the Bland–Altman 95% limits of agreement. Results: All ICCs met the threshold for good reliability: OLBT-R (ICC = 0.823, 0.66,0.91); OLBT-L (ICC = 0.874, 0.75,0.94); STS (ICC = 0.87, 0.75,0.94); CSAR (ICC = 0.90, 0.80,0.95); except the 2MST, which showed moderate reliability (ICC = 0.745, 0.53,0.87). ICCs for concurrent validity ranged from moderate for OLBT-R (ICC = 0.687, 0.44,0.83), good for STS (ICC = 0.87, 0.75,0.94), OLBT-L (ICC = 0.86, 0.72,0.92), and excellent for 2MST (ICC = 0.92, 0.84,0.96) and CSAR (ICC = 0.95, 0.90,0.97). However, some measures exhibited uncertainty, with wide confidence intervals and relatively large minimal detectable change values. Bland–Altman tests demonstrated underestimation between averaged means, with slight variability between limits of agreement. Conclusion: Remote assessment can be considered a reliable and valid alternative to in-person observations of functional fitness measures for cancer survivors.
