Telehealth system: A randomized controlled trial evaluating the impact of an internet-based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors

Cancer. 2016 Oct 15;122(20):3166-3174. doi: 10.1002/cncr.30172. Epub 2016 Jun 22.

Abstract

Background: The chronicity status of breast cancer survivors suggests a growing need for cancer rehabilitation. Currently, the use of technology is a promising strategy for providing support, as reflected in the emergence of research interest in Web-based interventions in cancer survivorship.

Methods: A randomized controlled trial was conducted that included a total of 81 participants who had completed adjuvant therapy (except hormone treatment) for stage I to IIIA breast cancer. Participants were randomly assigned to an 8-week Internet-based, tailored exercise program (n = 40) or to a control group (n = 41).The instruments used at baseline, 8 weeks, and 6-month follow-up were the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 and its breast cancer module, the Brief Pain Inventory, the handgrip dynamometer, the isometric abdominal test, the back dynamometer, the multiple sit-to-stand test, and the Piper Fatigue Scale.

Results: After the intervention, the telerehabilitation group had significantly improved scores for global health status, physical, role, cognitive functioning, and arm symptoms (all P < .01) as well as pain severity (P = .001) and pain interference (P = .045) compared with the control group. Significant improvements also were observed favoring the telerehabilitation group for affected and nonaffected side handgrip (both P = .006), abdominal, back and lower body strength (all P < .01), and total fatigue (P < .001). These findings were maintained after 6 months of follow-up, except for role functioning, pain severity, and nonaffected side handgrip. Analysis was based on an intention-to-treat principle.

Conclusions: This program may improve adverse effects and maintain benefits in breast cancer survivors. The results of this study have encouraging implications for cancer care. Cancer 2016;122:3166-74. © 2016 American Cancer Society.

Keywords: Internet; breast cancer; e-health; exercise; telehealth; telerehabilitation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy*
  • Case-Control Studies
  • Exercise Therapy*
  • Fatigue / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Internet / statistics & numerical data*
  • Middle Aged
  • Muscle Strength / physiology
  • Neoplasm Staging
  • Pain Measurement*
  • Prognosis
  • Quality of Life*
  • Survivors / statistics & numerical data
  • Telemedicine / methods*