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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a telerehabilitation program designed to help Veterans treated for lung cancer improve their physical and mental well-being. It aims to reduce symptoms such as shortness of breath, fatigue, and anxiety through home-based exercises and mindfulness training. Participants can choose activities like breathing exercises, walking, resistance training, and mindfulness to suit their personal needs. Veterans who have had stage I-III lung cancer and completed treatment within the past six months might be suitable candidates. As an unphased trial, this study provides Veterans with a unique opportunity to enhance their well-being through personalized, home-based care.

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 prior data suggests that telerehabilitation is safe for lung cancer survivors?

Research shows that telerehabilitation is safe and well-received by cancer survivors. Studies have found that it not only works well but also aids recovery for those who have undergone cancer treatment. For instance, telerehabilitation has been effective in aiding recovery after lung cancer surgery.

Another study found that telerehabilitation programs are safe and that patients tend to adhere to them. Participants generally reported a positive experience. This suggests that telerehabilitation could be a good option for managing symptoms and improving quality of life after cancer treatment.

The studies did not specifically mention any negative side effects related to telerehabilitation, which can reassure those considering a trial that includes this treatment option. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about telerehabilitation for lung cancer because it offers a flexible, home-based approach that targets multiple challenges faced by patients. Unlike traditional rehabilitation programs that require in-person visits, telerehabilitation allows patients to engage in inspiratory muscle training, resistance training, and mindfulness practices from home, which can reduce dyspnea, fatigue, and anxiety. This method empowers patients to choose their focus areas, potentially improving adherence and outcomes by personalizing the rehabilitation experience. By reducing the need for travel and allowing for tailored interventions, this approach could significantly enhance quality of life and overall well-being for those living with lung cancer.

What evidence suggests that telerehabilitation is effective for lung cancer survivors?

Research shows that telerehabilitation can aid lung cancer patients in recovery after surgery. Studies have found that pulmonary rehabilitation, a program designed to enhance lung function, reduces symptoms like shortness of breath and fatigue in these patients. In this trial, participants in the targeted telerehabilitation arm will engage in exercises such as breathing muscle training and mindfulness to lower anxiety and improve physical abilities. Although exercising at home might not significantly boost physical strength, it can help manage symptoms. Overall, telerehabilitation appears promising in enhancing the quality of life for lung cancer survivors. ^{1 2 6 7 8}

Who Is on the Research Team?

Duc M Ha, MD MAS

Principal Investigator

Rocky Mountain Regional VA Medical Center, Aurora, CO

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39527799/

Effectiveness and Feasibility of Digital Pulmonary ... Background: Pulmonary rehabilitation (PR) has been shown to effectively support postsurgical recovery in patients with lung cancer (LC) at ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S1438887124007702

Effectiveness and Feasibility of Digital Pulmonary ... Pulmonary rehabilitation (PR) has been shown to effectively support postsurgical recovery in patients with lung cancer (LC) at various ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05179408

Targeted Telerehabilitation Following Curative Intent ... This study will evaluate multi-targeted telerehabilitation with Veterans following lung cancer treatment, with goals to reduce symptom burden, improve physical ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10314696/

Lung cancer survivors' views on telerehabilitation following ... Eighty-five percent of participants had prior experience with telemedicine, but none with telerehabilitation or rehabilitation for lung cancer.

5. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2827190

Home-Based Exercise and Self-Management After Lung ... The findings suggest that although a home-based exercise and self-management program did not improve physical function, it improves some important clinical ...

6. cancer.jmir.org cancer.jmir.org/2021/4/e33130/

Telerehabilitation's Safety, Feasibility, and Exercise Uptake in ... Conclusions: Telerehabilitation is safe, feasible, and improved outcomes for cancer survivors. Learnings from this study may inform the ongoing ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT05179408

Targeted Telerehabilitation Following Curative Intent ... This study will evaluate multi-targeted telerehabilitation with Veterans following lung cancer treatment, with goals to reduce symptom burden, improve physical ...

8. researchprotocols.org researchprotocols.org/2022/7/e38553

Efficacy of Group Exercise–Based Cancer Rehabilitation ... Telerehabilitation interventions are safe, have good adherence, and provide a positive patient experience among cancer survivors [ ...