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Abstract
Objectives The study aimed to assess the feasibility, acceptability and safety of delivering a home-based telehealth exercise intervention to older patients with hepatocellular carcinoma (HCC).
Design Non-randomised feasibility study.
Setting Patients were recruited from UK outpatient liver cancer clinics.
Participants Patients were aged ≥60 years with HCC, with post-treatment imaging reporting a complete response, partial response or stable disease.
Intervention and data collection Patients were invited to attend synchronous online exercise sessions, twice weekly for 10 weeks. Physical function and patient-reported outcomes were assessed pre-intervention and post-intervention. Qualitative data were collected via semistructured interviews after intervention completion.
Primary outcome measures Recruitment, retention, exercise adherence and safety.
Results 40 patients were invited to participate and 19 (mean age 74 years) provided consent (recruitment rate 48%). Patients completed 76% of planned exercise sessions and 79% returned to the clinic for follow-up. Hand grip strength (95% CI 1.0 to 5.6), Liver Frailty Index (95% CI −0.46 to –0.23) and time taken to perform five sit-to-stands (95% CI −3.2 to –1.2) improved from pre-intervention to post-intervention. Patients reported that concerns they had relating to their cancer had improved following the intervention (95% CI 0.30 to 5.85). No adverse events occurred during exercise sessions.
Qualitative data highlighted the importance of an instructor in real time to ensure that the sessions were achievable, tailored and well balanced, which helped to foster motivation and commitment within the group. Patients reported enjoying the exercise intervention, including the benefits of peer support and highlighted perceived benefits to both their physical and mental health. Patients felt that the online sessions overcame some of the barriers to exercise participation and preferred attending virtual sessions over face-to-face classes.
Conclusions It is feasible, acceptable and safe to deliver supervised group exercise via videoconferencing to patients with HCC in their own homes. These findings will inform the design of a future, adequately powered randomised controlled trial to evaluate the efficacy of the intervention.
Trial registration number ISRCTN14411809.
- ONCOLOGY
- Rehabilitation medicine
- Hepatology
Data availability statement
Data are available on reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data are available on reasonable request.
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Footnotes
X @HallsworthKate, @SamOrange01
Contributors STO, KH and HLR conceived the study idea and are grant holders for this research. All authors were involved in study design and development of the intervention. HLR provided clinical oversight and expertise for the study; STO and KH provided expertise in exercise intervention design/delivery; KH, MVM and RF-B delivered the intervention. MCB provided qualitative research expertise and led the qualitative data analysis. All authors contributed to data acquisition, analysis and interpretation and were involved with drafting the manuscript. All authors approved the final version of the manuscript to be published and agreed to be accountable for all aspects of the work. KH is guarantor for the study.
Funding This research was funded by a grant from the NIHR Newcastle Biomedical Research Centre awarded to the Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University (grant ref: 570556).
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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