Feasibility of a home-based exercise intervention with remote guidance for patients with stable grade II and III gliomas: a pilot randomized controlled trial

• Published in: Clinical rehabilitation Vol. 32; no. 3; pp. 352 - 366
• Main Authors: Gehring, Karin, Kloek, Corelien JJ, Aaronson, Neil K, Janssen, Kasper W, Jones, Lee W, Sitskoorn, Margriet M, Stuiver, Martijn M
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2018
• Subjects: Aged; Brain Neoplasms - diagnosis; Brain Neoplasms - rehabilitation; Brain Neoplasms - surgery; Exercise Therapy - methods; Feasibility Studies; Female; Gait - physiology; Glioma - diagnosis; Glioma - rehabilitation; Glioma - surgery; Home Care Services - organization & administration; Humans; Male; Middle Aged; Netherlands; Pilot Projects; Postural Balance - physiology; Quality of Life; Risk Assessment; Telerehabilitation - methods; exercise; Glioma; physical fitness; brain tumour; physical training
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215517728326

Objective: In this pilot study, we investigated the feasibility of a home-based, remotely guided exercise intervention for patients with gliomas. Design: Pilot randomized controlled trial (RCT) with randomization (2:1) to exercise or control group. Subjects: Patients with stable grade II and III gliomas. Intervention: The six-month intervention included three home-based exercise sessions per week at 60%–85% of maximum heart rate. Participants wore heart rate monitors connected to an online platform to record activities that were monitored weekly by the physiotherapist. Main measures: Accrual, attrition, adherence, safety, satisfaction, patient-reported physical activity, VO2 peak (by maximal cardiopulmonary exercise testing) and body mass index (BMI) at baseline and at six-month follow-up. Results: In all, 34 of 136 eligible patients (25%) were randomized to exercise training (N = 23) or the control group (N = 11), of whom 19 and 9, respectively, underwent follow-up. Mean adherence to prescribed sessions was 79%. Patients’ experiences were positive. There were no adverse events. Compared to the control group, the exercise group showed larger improvements in absolute VO2 peak (+158.9 mL/min; 95% CI: −44.8 to 362.5) and BMI (−0.3 kg/m²; 95% CI: −0.9 to 0.2). The median increase in physical activity was 1489 metabolic equivalent of task (MET) minutes higher in the exercise group. The most reported reasons for non-participation were lack of motivation or time. Conclusion: This innovative and intensive home-based exercise intervention was feasible in a small subset of patients with stable gliomas who were interested in exercising. The observed effects suggest that the programme may improve cardiorespiratory fitness. These results support the need for large-scale trials of exercise interventions in brain tumour patients.