Feasibility of a home-based exercise intervention with remote guidance for patients with stable grade II and III gliomas: a pilot randomized controlled trial.

Gehring K, Kloek CJ, Aaronson NK, Janssen KW, Jones LW,
Sitskoorn MM, Stuiver MM

Clin Rehabil. 2018 Mar;32(3):352-366. doi: 10.1177/0269215517728326. Epub 2017
Sep 8.

OBJECTIVE: In this pilot study, we investigated the feasibility of a home-based,
remotely guided exercise intervention for patients with gliomas.
DESIGN: Pilot randomized controlled trial (RCT) with randomization (2:1) to
exercise or control group.
SUBJECTS: Patients with stable grade II and III gliomas.
INTERVENTION: The six-month intervention included three home-based exercise
sessions per week at 60%-85% of maximum heart rate. Participants wore heart rate
monitors connected to an online platform to record activities that were monitored
weekly by the physiotherapist.
MAIN MEASURES: Accrual, attrition, adherence, safety, satisfaction,
patient-reported physical activity, VO2 peak (by maximal cardiopulmonary exercise
testing) and body mass index (BMI) at baseline and at six-month follow-up.
RESULTS: In all, 34 of 136 eligible patients (25%) were randomized to exercise
training ( N = 23) or the control group ( N = 11), of whom 19 and 9,
respectively, underwent follow-up. Mean adherence to prescribed sessions was 79%.
Patients’ experiences were positive. There were no adverse events. Compared to
the control group, the exercise group showed larger improvements in absolute VO2
peak (+158.9 mL/min; 95% CI: -44.8 to 362.5) and BMI (-0.3 kg/m²; 95% CI: -0.9 to
0.2). The median increase in physical activity was 1489 metabolic equivalent of
task (MET) minutes higher in the exercise group. The most reported reasons for
non-participation were lack of motivation or time.
CONCLUSION: This innovative and intensive home-based exercise intervention was
feasible in a small subset of patients with stable gliomas who were interested in
exercising. The observed effects suggest that the programme may improve
cardiorespiratory fitness. These results support the need for large-scale trials
of exercise interventions in brain tumour patients.