Effect of an Internet-based telehealth system on functional capacity and cognition in breast cancer survivors: a secondary analysis of a randomized controlled trial.

Noelia Galiano-Castillo, Manuel Arroyo-Morales, Mario Lozano-Lozano, Carolina Fernández-Lao, Lydia Martín-Martín, Rosario Del-Moral-Ávila, Irene Cantarero-Villanueva
Author Information
  1. Noelia Galiano-Castillo: Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.
  2. Manuel Arroyo-Morales: Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain. marroyo@ugr.es.
  3. Mario Lozano-Lozano: Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain.
  4. Carolina Fernández-Lao: Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.
  5. Lydia Martín-Martín: Department of Physical Therapy, Health Science Faculty, University of Granada, Avda de la Ilustración 60, 18016, Granada, Spain.
  6. Rosario Del-Moral-Ávila: Radiotherapy Breast Oncology Unit, University Hospital Virgen de las Nieves, Granada, Spain.
  7. Irene Cantarero-Villanueva: Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of Granada, University of Granada, Granada, Spain.

Abstract

PURPOSE: This trial determines the effect of an Internet-based tailored exercise program compared to usual care control for improving functional capacity and cognition among breast cancer survivors.
METHODS: A two-arm, assessor-blinded, parallel, randomized controlled efficacy trial was conducted. Participants were recruited from the Oncology and Breast unit at the Virgen de las Nieves Hospital (Granada, Spain) between March 2012 to November 2013 and randomized to either the experimental group (an 8-week Internet-based tailored exercise program) or control group (usual care). The outcome measures were the 6-min walk test, Auditory Consonant Trigrams, and Trail Making Test. All were assessed at baseline, post-intervention, and 6-month follow-up.
RESULTS: After intervention, the telerehabilitation group had significantly improved distances (d = 0.92, P < 0.001) as well as percentage of predicted of the 6-min walk test (d = 0.93, P < 0.001) compared with the control group. Significant improvement was also observed favoring the telerehabilitation group for the number of consonants recalled in total compared with the control group (d = 0.47, P = 0.04). These findings were maintained after 6-month follow-up (d = 0.80, P = 0.001; d = 0.76, P = 0.002; and d = 0.57, P = 0.02, respectively). Analysis was based on intention-to-treat principle.
CONCLUSIONS: These findings support the effectiveness of a telehealth system based on an 8-week physical exercise to achieve improvements and maintain them after 6-month follow-up in terms of functional and cognitive performance in breast cancer survivors. This broad-reach modality could help the growing number of cancer survivors to face their disabling side effects.

Keywords

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Grants

  1. FIS PI10/02749-02764/Instituto de Salud Carlos III
  2. FIS PI10/02749-02764/PN I+D+I 2008-2011 (FEDER funds)
  3. FPU AP2010-6075/Education Ministry, Madrid, Spanish Government
  4. FPU 14/01069/Education Ministry, Madrid, Spanish Government
  5. PI-0457-2010/Andalusian Health Service, Junta de Andalucía

MeSH Term

Breast Neoplasms
Cancer Survivors
Female
Humans
Internet
Male
Middle Aged
Quality of Life
Telemedicine

Word Cloud

Created with Highcharts 10.0.0groupd = 0cancercontrolP = 0trialInternet-basedexercisecomparedfunctionalbreastsurvivorsrandomized6-monthfollow-up001tailoredprogramusualcarecapacitycognitioncontrolledBreast8-week6-minwalktesttelerehabilitationP < 0numberfindingsbasedtelehealthsystemPURPOSE:determineseffectimprovingamongMETHODS:two-armassessor-blindedparallelefficacyconductedParticipantsrecruitedOncologyunitVirgendelasNievesHospitalGranadaSpainMarch2012November2013eitherexperimentaloutcomemeasuresAuditoryConsonantTrigramsTrailMakingTestassessedbaselinepost-interventionRESULTS:interventionsignificantlyimproveddistances92wellpercentagepredicted93Significantimprovementalsoobservedfavoringconsonantsrecalledtotal4704maintained80760025702respectivelyAnalysisintention-to-treatprincipleCONCLUSIONS:supporteffectivenessphysicalachieveimprovementsmaintaintermscognitiveperformancebroad-reachmodalityhelpgrowingfacedisablingsideeffectsEffectsurvivors:secondaryanalysisE-healthExerciseTelehealthTelerehabilitation

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