Six-month Follow-up Of Fatigue Reduction In Rural Cancer Survivors Participating In A Telehealth Exercise Program

Cancer-related fatigue (CRF) is common in cancer survivors. While clinically supervised exercise is among the best-known interventions for CRF, rural cancer survivors experience geographic disparities in access. The COVID-19 pandemic stimulated rapid advancements in methods to deliver telehealth exercise, though few interventions are designed specifically for rural survivors. Furthermore, little is known about the long-term maintenance of CRF reduction following such interventions. PURPOSE: Investigate the maintenance of CRF reduction in rural cancer survivors six months after completing a telehealth exercise intervention designed specifically for rural survivors. METHODS: Fifteen rural cancer survivors completed a 12-week telehealth exercise intervention. Eligibility included any cancer diagnosis, no planned changes in cancer treatment, and presence of CRF. The intervention included two telehealth physical assessments and two exercise sessions (at Weeks 1 and 6) performed via videoconference. Exercise prescriptions were delivered via smartphone application. CRF was assessed every two weeks and failure to meet predicted improvements triggered additional telehealth sessions to adapt exercise prescriptions. CRF was measured via the Functional Assessment for Chronic Illness Treatment (FACIT) Fatigue scale and group mean and individual changes from baseline were assessed at post-intervention and six-month follow-up. RESULTS: Participants were an average of 60 years old, 73% women, and 40% breast cancer survivors. FACIT-Fatigue scores significantly improved from baseline to post-intervention (+11 ± 7 points, p < 0.01, N = 15) and six-month follow-up (+10 ± 8 points, p < 0.01, N = 13)(Wilcoxon Signed-Rank Test). On the individual level, 13/15 participants achieved a minimal clinically important difference (3 points) in FACIT-Fatigue improvement post-intervention and 11/13 at six-month follow-up. CONCLUSIONS: A 12-week telehealth exercise program for rural cancer survivors resulted in significant improvements in CRF following the intervention and at six-month follow-up. Eighty five percent of participants achieved a meaningful improvement in CRF, which was maintained for six months. Future work should compare maintenance to a standard-of-care control group. Colorado Cancer League, University of Colorado Cancer Center