Exercise-based cancer telerehabilitation is safe but not superior to a single session of physiotherapy for improving quality of life: a randomised trial

QUESTIONS: What is the effect of group exercise-based telerehabilitation compared with a single session of in-person assessment and advice on health-related quality of life in cancer survivors? What are the effects on activity, function, safety and cost-effectiveness? DESIGN: An assessor-blinded, pragmatic randomised controlled trial with embedded cost analysis, concealed allocation and intention-to-treat analysis. PARTICIPANTS: Adult cancer survivors with any cancer diagnosis who were receiving treatment or within 12 months of treatment completion. INTERVENTION: The experimental group received an 8-week, twice-weekly, physiotherapist-led exercise group via videoconferencing, supplemented with support resources and a single in-person session of assessment and advice (TeleCaRe). The control group received a single in-person session of exercise assessment and advice. OUTCOME MEASURES: Assessments were completed at baseline, after the intervention (week 9) and at follow-up (week 26). The primary outcome was health-related quality of life, measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, at week 9. Secondary measures were walking capacity (6-minute walk test), physical activity (accelerometer), self-efficacy (Health Action Process Approach Questionnaire), adverse events, and health service and cost data. RESULTS: In total, 117 participants were recruited. Their mean age was 59 years, 82 (70%) were female, and 47 (40%) had breast cancer. Participants attended an average of seven out of 16 sessions (SD 6). There were no major adverse events. Intention-to-treat analysis found that TeleCaRe was not superior for improving quality of life (MD -5.3 units, 95% CI -13.3 to 2.6) or any secondary outcomes. TeleCaRe cost AU$363 per participant. CONCLUSION: Group exercise-based cancer telerehabilitation was safe but attendance was poor. The addition of telerehabilitation to assessment and advice was not superior to a single in-person physiotherapy session alone for improving quality of life. REGISTRATION: ACTRN12621001417875.