Feasibility of a home-based exercise intervention with remote guidance for patients with stable grade II and III gliomas: a pilot randomized controlled trial.
Karin Gehring, Corelien Jj Kloek, Neil K Aaronson and 4 others
PMID 28882061WHAT IT FOUND
Most exercise participants completed a home exercise programme combining prescribed aerobic activity, patient choice, a heart-rate watch, weekly upload, and remote physiotherapist feedback.
Average adherence was 79%, aerobic fitness improved by 6.0% from baseline, and no exercise-induced injuries occurred, but recruitment was poor.
Key findings
01The study aimed to include 60 patients but recruited 34 of 136 invited patients (25%).
02In the exercise group, mean adherence was 79% of prescribed sessions, and 19 of 23 participants completed the full 24-week programme.
03The exercise group's mean absolute VO2 peak improved 6.0% from baseline, and after baseline correction it was 158.9 ml/min higher than the control group (95% CI 44.8 to 362.5; d=0.24).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a small pilot and was not powered to test effectiveness. It aimed to include 60 patients but randomised 34, and no a priori significance level was set. Recruitment was poor. Only 34 of 136 invited patients entered the study, and many declined because of lack of time, lack of motivation, or physical inability. The results apply mainly to motivated patients. Patients and most assessors were not blinded to allocation. Only the sports physicians who performed the exercise tests were blinded. The paper did not report cognitive outcomes. It states that detailed cognitive and patient-reported findings will be reported later. Follow-up analyses included fewer patients than were randomised. Six patients dropped out before follow-up measurement, satisfaction was available for 20 patients, and the control group analysis included 9 patients. The exercise test was always on a cycle ergometer, but some patients trained by running or swimming. Fitness changes may not reflect their chosen activity. The control group also reported increased physical activity. This may have reduced the apparent difference between groups.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that this programme improves cognitive function in glioma patients. The paper did not report cognitive outcomes. It states that those results will come later, and the current analysis only assessed feasibility and physical fitness.