Abstract
Background: Exercise rehabilitation programmes, traditionally involving supervised exercise sessions, have had to rapidly adapt to virtual delivery in response to the coronavirus disease 2019 (COVID-19) pandemic to minimise patient contacts. In the absence of an effective vaccine, the pandemic is likely to persist in the medium term and during this time it is important that the feasibility and effectiveness of remote solutions is considered. We have previously established the feasibility of the Rehabilitation Strategies following Oesophago-gastric Cancer (ReStOre) intervention - a face to face multidisciplinary rehabilitation programme for upper gastrointestinal (UGI) cancer survivors. This study will examine the feasibility of a virtually delivered 12-week multi-component ReStOre@Home programme. Methods: This single arm feasibility study will recruit 12 patients who have completed curative treatment for oesophago-gastric cancer. Participants will complete the 12-week ReStOre@Home programme consisting of exercise (aerobic and resistance training), 1:1 dietary counselling and group education sessions through virtual delivery. Underpinned by the Medical Research Council (MRC) Framework, feasibility will be determined by recruitment rates, adherence, retention, incidents, and acceptability. Acceptability will be assessed qualitatively through post-intervention interview and the Telehealth Usability Questionnaire. Secondary outcomes will be assessed pre and post-intervention and will include measures of physical performance (cardiopulmonary exercise test, short physical performance battery, hand grip strength, Godin Leisure Time Questionnaire, and body composition), health related quality of life (European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30) and oesophago-gastric cancer specific subscale (EORTC-QLQ-OG25), fatigue (Multidimensional Fatigue Inventory (MFI-20), and venous blood samples will be collected for the UGI Cancer Survivorship Biobank. Discussion: The ReStOre@Home feasibility study will provide important data regarding the amenability of a multidisciplinary programme designed for UGI cancer survivors to virtual delivery. Trial registration: ClinicalTrials.gov NCT04603339 (26/10/2020).
Highlights
We have previously established the safety, feasibility and initial efficacy of multidisciplinary rehabilitation in oesophagogastric cancer survivorship, an understudied cohort of cancer survivors with significant nutritional, functional, and quality of life needs[1,2,3]
The ReStOre (Rehabilitation Strategies following Oesophago-gastric Cancer) feasibility study[4,5] and pilot randomised controlled trial (RCT)[6,7] demonstrated that a 12-week programme of supervised and homebased exercise, 1:1 dietary counselling, and health education could result in clinically significant improvements in cardiorespiratory fitness and physical and mental well-being without compromise to body composition in this nutritionally vulnerable cohort
In the absence of an effective vaccine, the COVID-19 pandemic is likely to persist into the medium term
Summary
We have previously established the safety, feasibility and initial efficacy of multidisciplinary rehabilitation in oesophagogastric cancer survivorship, an understudied cohort of cancer survivors with significant nutritional, functional, and quality of life needs[1,2,3]. Whilst video-conferencing provides an ideal vehicle for delivery of established rehabilitation programmes at this time, successful transition to a virtual model needs to be multidimensional, delivering all the essential components of the planned rehabilitative intervention including group exercise sessions, 1:1 dietary consultations, group education sessions and opportunity for group discussion. These contrasting modes of participant engagement and interaction requires rigorous evaluation to establish effectiveness and comparability to face-to-face models of care. Participants will complete the 12-week ReStOre@Home programme version 2
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