Delivering exercise medicine to cancer survivors: has COVID-19 shifted the landscape for how and who can be reached with supervised group exercise?

Due to stay-at-home orders during COVID-19, we transitioned supervised, group, in-person resistance training interventions in two clinical trials in cancer survivors to live, online delivery using video-conferencing technology. We describe the feasibility, preliminary efficacy, and safety of live online group training and compare to in-person training.

Adherence (% sessions attended), retention (% participants completing intervention), and safety (# adverse events) data of resistance training groups from two randomized controlled trials in cancer survivors that participated before or during the COVID-19 pandemic were collated. Participants were post-treatment breast cancer survivors and their spouses (n = 62) and prostate cancer survivors (n = 32) (age range: 38-82 years). During COVID-19, delivery of supervised, group resistance exercise sessions was delivered live online via video-conference. Preliminary evidence for training efficacy was assessed by chair stand performance over the 6-month intervention.

Feasibility of online resistance training was better than in-person for both studies (adherence: 86% vs 82% and 91% vs. 81% and retention 95% vs. 80% and 92% vs. 84% for online and in-person classes). Improvements in chair stand time were similar in prostate cancer and spouse groups that trained online vs. in-person, except for breast cancer survivors who improved more with in-person training (7% vs. 14% for online vs. in-person). Safety was similar between formats (12 vs. 11 adverse events for online vs. in-person).

Supervised, in-person group resistance training can be feasibly adapted for live, online delivery and could help broaden approaches to exercise delivery in cancer survivors, including older adults.

The studies described in this commentary were registered on on August 3, 2018 (NCT03630354) and on October 30, 2018 (NCT03741335).

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2021 Nov 06 [Epub ahead of print]

Kerri M Winters-Stone, Cassie Boisvert, Fuzhong Li, Karen S Lyons, Tomasz M Beer, Zahi Mitri, Gabrielle Meyers, Elizabeth Eckstrom, Kristin L Campbell

Knight Cancer Institute, Oregon Health & Science University, KCRB-CPC, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA. ., Knight Cancer Institute, Oregon Health & Science University, KCRB-CPC, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA., Oregon Research Institute, Eugene, OR, USA., Connell School of Nursing, Boston College, Boston, MA, USA., Division of General Internal Medicine and Geriatrics, School of Medicine, Oregon Health & Science University, Portland, OR, USA., Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.