Home-based cardio-oncology rehabilitation using a telerehabilitation platform in hematological cancer survivors: a feasibility study

Abstract

Purpose Cardiovascular disease is a competing mortality cause in hematological cancer survivors due to toxic oncological treatment, accumulation of risk factors, and decline of cardiorespiratory fitness. Cardio-oncology rehabilitation (CORE) is an emerging treatment model to optimize the prognosis of hematological cancer patients and survivors; however, its accessibility during the COVID-19 pandemic is poor. The study aimed to evaluate the feasibility, safety, and effect of a 12-week home-based CORE intervention in telerehabilitation approach among hematological cancer survivors. Methods A prospective single-arm interventional study was conducted at a faculty hospital in Brno, Czech Republic. This study provided 12 weeks of the home-based CORE using a telerehabilitation approach that allows remote supervision by a clinician from a medical facility. The telerehabilitation approach consists of three components: a heart rate sensor (PolarM430, Kempele, Finland), a web platform compatible with the sensor, and telesupervising via telephone call (1 call per week). To improve adherence, a physiotherapist called participants to assess or address adverse effects, exercise feedback, and participant-related concerns. The anthropometry, body composition, and cardiorespiratory fitness were measured immediately after the intervention. Results Eleven hematological cancer survivors with an average age of 60.3 ± 10 years participated in the study. Most participants were diagnosed with Follicular lymphoma and received maintenance treatment. Participants had a significant (p < 0.05) increase in cardiorespiratory fitness by 2.6 ml/kg/min; and in peak workload, from 143.3 ± 60.6 W to 158.6 ± 67.5 W (p < 0.05). Improvement in anthropometry and body composition was observed but yielded no statistical significance. Most (80%) participants completed the three times/per week telesupervising exercise session for 12 weeks.No adverse event was identified. Conclusion Findings from this study suggest that home-based CORE may provide hematological cancer survivors with an increase in CRF during the rehabilitation period after hospital discharge. The telerehabilitation CORE model is effective, feasible, safe, and has demonstrated good adherence. Further randomized controlled efficacy study with larger sample size is needed before clinical implementation. Clinical trial registration Clinical trial registration number NCT04822389 (30/03/2021).

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“…However, our study results failed to confirm the findings of two smaller studies, which reported a difference of 4.0 ml/kg/min in postmenopausal women [ 48 ], or a reduction in male patients ( n = 21) with colorectal cancer of − 1.7 [ 49 ] in comparison to the change in control patients. So far, home-based exercise or telerehabilitation interventions in cancer patients has demonstrated only minor to moderate effects on functional capacity, measured via the 6-min walking distance or oxygen uptake [ 50 , 51 ]. Nevertheless, minor changes in cardiorespiratory performance result in an inverse and clinically relevant change in mortality risk and contribute to improved health [ 18 ].…”

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“…The findings reveal the presence of obesity, depression and smoking in the patients which can be managed by conducting physical and telehealth exercises for each patient. In article 122 researchers have highlighted the safety and impact of a home-based cardio-oncology rehabilitation (CORE) intervention utilizing a telerehabilitation among individuals who have survived hematological cancer. The approach encompassed three components: a sensor to measure heart rate, an https://doi.org/10.2147/IJGM.S453903…”