Effects of a Telehealth Exercise Program for Rural Cancer Survivors With Cancer-related Fatigue Including Integrated Longitudinal Assessments of Objective Physical Function and Fatty Acid Oxidation
Summary
This study investigates the efficacy of a telehealth exercise program designed specifically for rural cancer survivors with cancer-related fatigue (CRF). Small dried blood samples and measures of physical function will be collected throughout the program. The main questions it aims to answer are: * Does the exercise program improve CRF in rural cancer survivors? * How do CRF, metabolism, and physical function change during the exercise program? Researchers will compare the program to a wait-list control group. This group will complete all study measures without without changing current physical activity before receiving the full exercise program. Participants will: * Complete a virtual physical assessment before and after the program. * Complete brief virtual assessments and collect dried blood samples (at home and mailed in) every two weeks during the program. * Receive a personalized exercise program including virtual sessions and remote exercise programming with a cancer exercise specialist (after a 12-week wait period in the wait-list control group). * Optional: Willing participants will visit a study site for a laboratory-based exercise assessment before and after the program.
Detailed description
This study investigates the efficacy of a telehealth exercise program designed specifically for rural cancer survivors with cancer-related fatigue (CRF). The 12-week program is designed to be delivered completely via remote methods including: telehealth exercise sessions with cancer exercise specialists, additional exercise programming delivered through a personal training smartphone/internet application, and regular symptom monitoring via emailed surveys. Symptoms (CRF) are plotted against a reference chart of anticipated changes during the program, with additional telehealth sessions initiated if symptoms do not improve as predicted. Program efficacy is investigated using a randomized controlled trial with a wait-list control group (N=134, Aim 1). The control group will receive the exercise program following a 12-week wait period. Possible mechanisms of action are assessed throughout the program (every two weeks) using accessible methods (Aim 2). Fatty acid oxidation is measured via dried blood spots collected remoted and mailed to the primary study site. Physical function is measured via brief telehealth assessments. Changes in molecular responses to acute exercise and changes in body composition will be explored in a controlled laboratory assessment in participants able and willing to travel to participating sites (N=40, Aim 3). Small blood samples are collected before and after a standardized treadmill exercise session. Body composition is measured non-invasively in a small chamber using air displacement. This laboratory assessment occurs before and after the program (or wait period).
Arms & interventions
- BehavioralTelehealth Exercise Program
BfitBwell-TP is a 12-week telehealth exercise intervention. Exercise prescriptions are created, personalized, and delivered by Cancer Exercise Specialists. Exercise content is delivered using a combination of videoconference sessions and a commercial personal training application (accessible via smartphone or internet browser). Patient-reported symptoms (specifically cancer-related fatigue) are assessed every two weeks via emailed surveys. Survey scores are compared to a reference chart of predicted improvements during the program, developed from an established clinical exercise oncology program. Additional videoconference sessions are initiated for participants demonstrating lower than expected symptom improvement, with the goal of adapting the current exercise prescription to improve symptom response.
Outcome measures
Primary
Change from Baseline in FACIT-Fatigue (cancer-related fatigue) score at Week 12
The Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-Fatigue) is a common standardized measure of cancer-related fatigue. It contains 13 items with total score ranging from 0 to 52, with higher scores indicating less fatigue.
Time frame: Baseline, Week 12
Secondary
Change from Baseline in FACIT-Fatigue (cancer-related fatigue) score at Week 24
Time frame: Baseline, Week 24
Change from Baseline in FACT-G (quality of life) score at Week 12
Time frame: Baseline, Week 12
Pattern of change in FACIT-Fatigue (cancer-related fatigue) score during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Change from Baseline in FACT-G (quality of life) score at Week 24
Time frame: Baseline, Week 24
Change from Baseline in HADS (anxiety and depression) scores at Week 12
Time frame: Baseline, Week 12
Change from Baseline in HADS (anxiety and depression) scores at Week 24
Time frame: Baseline, Week 24
Change from Baseline in EORTC QLQ-FA12 (cancer-related fatigue) scores at Week 12
Time frame: Baseline, Week 12
Change from Baseline in EORTC QLQ-FA12 (cancer-related fatigue) scores at Week 24
Time frame: Baseline, Week 24
Change from Baseline in 2MST (physical function) at Week 12
Time frame: Baseline, Week 12
Change from Baseline in CS (physical function) at Week 12
Time frame: Baseline, Week 12
Change from Baseline in GS (physical function) at Week 12
Time frame: Baseline, Week 12
Change from Baseline in TUG (physical function) at Week 12
Time frame: Baseline, Week 12
Change from Baseline in SLB (physical function) at Week 12
Time frame: Baseline, Week 12
Change from Baseline in daily physical activity (PA) at Week 12
Time frame: Baseline, Week 12
Change from Baseline in average sleep time at Week 12
Time frame: Baseline, Week 12
Change from Baseline in fatty acid oxidation at Week 12
Time frame: Baseline, Week 12
Change from Baseline in dynamic exercise metabolic profiles at Week 12
Time frame: Baseline, Week 12
Change from Baseline in body composition at Week 12
Time frame: Baseline, Week 12
Pattern of change in FACT-G (quality of life) score during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in HADS (anxiety and depression) scores during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in EORTC QLQ-FA12 (cancer-related fatigue) scores during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in 2MST (physical function) during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in CS (physical function) during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in GS (physical function) during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in TUG (physical function) during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in SLB (physical function) during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Pattern of change in fatty acid oxidation during exercise intervention or wait period
Time frame: Baseline, Week 2, Week 4, Week 6, Week 8, Week 10, Week 12
Eligibility criteria
Study locations (2)
University of Colorado Anschutz Medical Campus
Aurora, Colorado, 80045
University of Montana
Missoula, Montana, 59812