Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 2, 2024
Open Peer Review Period: May 2, 2024 - May 22, 2024
Date Accepted: Feb 4, 2025
(closed for review but you can still tweet)
DTx-based cardio-oncology rehabilitation for lung cancer survivors: a randomized controlled trial
ABSTRACT
Background:
For lung cancer survivors, cardiopulmonary fitness is a strong independent predictor of survival. Home-based cardiac telerehabilitation through wearable devices and mobile apps is a substitution for traditional center-based rehabilitation with equal efficacy and a higher completion rate. However, it has not been widely used in clinical practice.
Objective:
Early-stage non-small cell lung cancer survivors aged 18-70 years. All the participants received surgery 1-2 months before enrollment and did not require further antitumor therapy.
Methods:
Participants were randomized to receive cardiac telerehabilitation or usual care for 5 months. AI-driven exercise prescription with video guide & real-time HR monitoring was generated based on cardiopulmonary exercise testing and optimized dynamically. Outcome measurements included cardiopulmonary fitness, lung function, cardiac function, tumor marker, safety, compliance, and scales assessing symptoms, psychology, sleep, fatigue, and quality of life.
Results:
Forty of 47 patients (85%) finished the trial. The average prescription compliance rate of patients in the telerehabilitation group reached 101.2%, with an average exercise duration of 151.4 min per week and an average effective exercise duration of 92.3 min per week. The cardiac telerehabilitation was associated with higher improvement of VO2peak (3.66±3.23 mL/Kg/min vs 1.09±3.23 mL/Kg/min, p=0.02) and global health status/QOL (16.25±23.02 vs 1.04±13.90, p=0.03) compared with usual care. Better alleviation of affective interference (-0.88±1.50 vs 0.21±1.22, p=0.048), fatigue (-8.89±15.96 vs 1.39±12.09, p=0.02), anxiety (-0.31±0.44 vs -0.05±0.29, p=0.048), and daytime dysfunction (-0.55±0.69 vs 0.00±0.52, p=0.02) were also observed in the telerehabilitation group. No exercise-related adverse events were identified during the intervention period.
Conclusions:
Cardio-oncology telerehabilitation improved cardiorespiratory fitness and quality of life in lung cancer survivors with good compliance and safety. Clinical Trial: chictr.org.cn ChiCTR2200064000
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