Virtual exercise regimens can help patients with cancer

Abstract

Social distancing due to the coronavirus disease 2019 (COVID-19) pandemic has forced clinicians and their patients with cancer to adapt in numerous ways. A new study from the Wright State University Department of Kinesiology and Health and the Maple Tree Cancer Alliance, both in Dayton, Ohio, and the Department of Public Health Sciences at the Penn State College of Medicine in Hershey, Pennsylvania, investigated the feasibility, acceptability, and effectiveness of remote exercise programming in lieu of group programs. The findings, published in Current Sports Medicine Reports (2021;20:271-276. 10.1249/JSR.0000000000000846), show benefits in physical and psychological outcomes, and the authors conclude that the remote intervention is a suitable option when in-person exercise training is not feasible.

Researchers evaluated 491 patients undergoing antineoplastic treatment at Kettering Medical Center in Dayton, Ohio, between March and June 2020 who were enrolled in a cancer exercise program for people living with and beyond cancer that was provided at no cost through the nonprofit Maple Tree Cancer Alliance.

Most of the participants (n = 423) were enrolled at the Maple Tree Cancer Alliance before the start of COVID-19–related social distancing. The remaining patients began the exercise program in a virtual format in March 2020. Their ages ranged from 14 to 83 years, with a mean age of 60 years. Eighty-four percent were female; 74.7% were White, 10.2% were African American, 3.9% were Hispanic, and 5.7% were Asian. The ethnicity of the rest was unknown. Most had breast (58.2%), colon (4.5%), prostate (2%), or lung cancer (3.9%).

Researchers developed a virtual assessment for each patient to gauge his or her fitness after they investigated the availability of fitness equipment in each participant’s home. They then created an individualized exercise program focusing on individual patient goals.

The patients provided demographic information and their medical history during the initial visit. They also completed a symptom checklist of 35 items to evaluate possible side effects of their cancer treatment. These included physiological items such as pain, coughing, and dizziness as well as emotional symptoms such as well-being and sadness, with participants rating each symptom from 0 (absent) to 10 (very severe). Then, participants met individually with an exercise oncology trainer in a virtual format. Each patient completed 12 weeks of prescribed, individualized exercise. The goal was for participants to complete 150 minutes of cardiovascular training per week, with each session’s duration being approximately 30 minutes; full-body strength training workouts (using free weights, elastic tubing, and/or body weight exercises, depending on availability) involving all major muscle groups; and flexibility training (static stretching). The exercise trainer met virtually with patients once per week but assigned homework to be active on the “off” days, at least 3 days per week.