Telerehabilitation for Lung Cancer

Overseen By Duc M Ha, MD MAS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Orthopedic conditions, Severe cardiopulmonary disease, Dementia, Hospice, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 8 weeks

40 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Telerehabilitation for lung cancer?

Research shows that telerehabilitation can help lung cancer patients by improving their physical capacity, quality of life, and reducing symptoms like anxiety and depression. It also helps overcome barriers to exercise, which is important for cancer recovery. ^{1 2 3 4 5}

Is telerehabilitation safe for humans?

Research shows that telerehabilitation is generally safe for people with lung cancer and other conditions like COPD (a lung disease that makes it hard to breathe). Studies suggest it can be as safe as traditional rehabilitation programs, but more research is needed to fully understand its long-term safety. ^{1 2 3 6 7}

How is the treatment Telerehabilitation unique for lung cancer?

Telerehabilitation is unique for lung cancer as it allows patients to engage in physical activity remotely, overcoming barriers like travel and access to facilities, which can improve their physical capacity, quality of life, and manage symptoms throughout different stages of the disease. ^{1 2 3 8 9}

What is the purpose of this trial?

Lung cancer is the second-most commonly diagnosed cancer among U.S. Veterans. Substantial advances have been made in early detection through screening and treatment. The longevity of Veterans following lung cancer diagnosis and treatment has increased. Following treatment however, many Veterans experience increased symptom burden, particularly in shortness of breath, fatigue, and fear/anxiety about lung cancer, and impairments in physical and psychosocial functioning. Rehabilitation services are needed to address these survivorship challenges. This study will evaluate multi-targeted telerehabilitation with Veterans following lung cancer treatment, with goals to reduce symptom burden, improve physical and psychosocial function, and enhance health-related quality of life. This research will also develop the career of a physician researcher to acquire expertise in rehabilitation for many Veteran survivors of lung and other cancers.

Research Team

Duc M Ha, MD MAS

Principal Investigator

Rocky Mountain Regional VA Medical Center, Aurora, CO

Eligibility Criteria

This trial is for U.S. Veterans who have had stage I-IIIA lung cancer and finished their main treatment between 1-6 months ago. They must be able to follow directions and consent to the study, with a life expectancy over 6 months, no severe heart or lung disease, major orthopedic issues, or conditions that would stop them from doing exercises via telerehabilitation.

Inclusion Criteria

I am a veteran who had early-stage lung cancer.

I finished my cancer treatment aimed at curing it between 1 to 6 months ago.

Exclusion Criteria

You are expected to live for less than 6 months.

I have conditions related to my bones or muscles, like having both legs amputated below the knee.

I can follow directions and provide informed consent.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 8 weeks of participant-chosen targeted telerehabilitation or waitlist condition

8 weeks

Virtual sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Telerehabilitation

Trial Overview The study tests a telerehabilitation program designed to help improve function and quality of life in Veterans after lung cancer treatment. It's about finding out if rehabilitation services can be effectively delivered remotely and how they impact survivors' health outcomes.

Participant Groups

Group I: Targeted telerehabilitation Experimental Treatment 1 Intervention

Participant-chosen targets: 1) inspiratory muscle training + walking (to reduce dyspnea and improve physical activity/endurance; 2) resistance training (to reduce fatigue and improve role/social function; 3) mindfulness training (to reduce fear of cancer recurrence and anxiety)

Group II: Waitlist Active Control 1 Intervention

8-week waiting period prior to participating in targeted telerehabilitation

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

Telerehabilitation for lung cancer patients is safe and can improve quality of life, muscle mass, and reduce symptoms of depression and anxiety, although it does not significantly enhance physical capacity except in the preoperative phase.

Despite low recruitment and attendance rates, telerehabilitation serves as a valuable complementary intervention to traditional hospital-based programs, especially for patients unable to attend in-person training due to various barriers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telerehabilitation physical exercise for patients with lung cancer through the course of their disease: A systematic review. Burton, M., Valet, M., Caty, G., et al.[2022]

Tele-rehabilitation (Tele-R) significantly improves exercise capacity and reduces dyspnea and COPD symptoms in patients compared to no rehabilitation, with improvements of 48 meters in the 6-minute walk test and reductions in dyspnea and COPD assessment scores, based on a meta-analysis of 758 COPD patients.

When compared to traditional center-based rehabilitation, Tele-R showed no significant differences in exercise capacity or symptom control, suggesting it is a valid alternative but highlighting the need for further research to optimize patient selection and Tele-R methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of respiratory tele-rehabilitation in COPD patients: Systematic review and meta-analysis. Ora, J., Prendi, E., Attinà, ML., et al.[2022]

Tele-pulmonary rehabilitation has emerged as a feasible and effective alternative to traditional in-person pulmonary rehabilitation for patients with chronic obstructive pulmonary disease (COPD), especially during the COVID-19 pandemic.

A hybrid model combining both in-person and remote components may be the best approach for delivering pulmonary rehabilitation in the future, but further high-quality studies and collaboration are needed to optimize this model.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pulmonary rehabilitation in a postcoronavirus disease 2019 world: feasibility, challenges, and solutions. Wen, J., Milne, S., Sin, DD.[2023]

A scoping review of 107 studies involving 3991 participants with stroke found that safety measures during asynchronous telerehabilitation exercises are rarely reported, with only 10 studies detailing such measures.

Common safety strategies included assessing exercise locations, using seated positions, and implementing live warning systems to prevent risky exercises, highlighting the need for more comprehensive reporting in future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measures to ensure safety during telerehabilitation of people with stroke: A scoping review. Gutierrez-Arias, R., González-Mondaca, C., Marinkovic-Riffo, V., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Telerehabilitation physical exercise for patients with lung cancer through the course of their disease: A systematic review. [2022]

2. Canada pubmed.ncbi.nlm.nih.gov

Telerehabilitation's Safety, Feasibility, and Exercise Uptake in Cancer Survivors: Process Evaluation. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Telerehabilitation programmes for patients with cancer and survivors: a protocol for a systematic review. [2022]

4. Italy pubmed.ncbi.nlm.nih.gov

Efficacy of respiratory tele-rehabilitation in COPD patients: Systematic review and meta-analysis. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Pulmonary rehabilitation in a postcoronavirus disease 2019 world: feasibility, challenges, and solutions. [2023]

6. France pubmed.ncbi.nlm.nih.gov

[Respiratory telerehabilitation in cases of COPD]. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Measures to ensure safety during telerehabilitation of people with stroke: A scoping review. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Telerehabilitation in pulmonary diseases. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Telerehabilitation for people with breast cancer through the COVID-19 pandemic in Chile. [2020]