Personalised exercise rehabilitation in cancer survivorship: Findings from a triage and referral feasibility study.

Abstract

Screening, triage and referral systems are proposed as efficient, needs-based models of cancer rehabilitation. This study aimed to evaluate the feasibility of the PERCS triage and referral system. Utilising a pre-post design, the feasibility of PERCS was evaluated quantitatively in the context of a physiotherapy-led clinic for patients diagnosed with cancer during COVID-19. Assessments at baseline and 12weeks (T1) included medical, social and physical activity history; patient-reported outcomes and performance-based measures. Following the assessment, the PERCS system allocated participants to one of three exercise pathways. Sixty-four participants were recruited over 5months (25.2% recruitment rate; female n = 39; mean age 61.4 (12.4) years). Almost all participants (90.6%) required support to become more physically active. The majority (n = 43, 66%) were referred to community exercise programmes, and n = 15 (23%) required physiotherapy rehabilitation. Five required medical pre-clearance, and one was re-triaged at 1week. The mean cost per participant for community exercise services was €107.70. At T1, adherence to physical activity guidelines increased for aerobic (44 to 83%) and resistance (13 to 67%) exercise. Improvements were observed in hand grip strength (x̄ 2.59kg, p = 0.001), 30-s sit-to-stand (x̄ + 3.7 stands, p < 0.001) and 6-min walk test (x̄ + 37.3m, p = 0.001). PERCS appropriately triaged patients to the right level of exercise and rehabilitation for individual needs. Participants experienced improvements in physical activity and physical functioning metrics. The PERCS triage and referral system is feasible to complete and may support the effective and patient-centred implementation of exercise into cancer care. ClinicalTrials.gov registration: NCT05615285.