Remotely delivered resistance training program in adult sarcoma survivors: a pilot study

BACKGROUND: Treatment of sarcoma often leads to serious long-term health consequences, including decreased physical functioning. Supervised progressive resistance training (PRT) has been shown to improve physical functioning in survivors of carcinomas. We conducted a single-arm, pre-post study to assess the feasibility of remote delivery of a supervised, individualized resistance training program in sarcoma survivors. METHODS: Survivors of extremity sarcomas who were more than 2 years from final sarcoma treatment with no evidence of recurrent disease were eligible. Participants followed a PRT program of exercises that were tailored to each patient's exercise capacity. Each week for 12 weeks, participants engaged in one unsupervised session and one supervised session delivered remotely by videoconferencing. Feasibility was measured by retention rate, session completion rate, and safety. Changes in self-reported physical function, health-related quality of life, and fatigue were assessed with patient reported outcome measures, while objective physical function was assessed by the short physical performance battery (SPPB). The COVID pandemic emerged during the accrual period, requiring protocol modification to objective assessments. RESULTS: Ten participants aged 27-69 enrolled in the study; the majority had a lower extremity tumor (70%) and all participants had undergone surgery and chemotherapy for sarcoma. Nine participants completed end-of-intervention assessments (90% retention). Adherence to twice-weekly exercise sessions was 86%. Significant improvements in pre-post 36-Item Short Form Survey (SF-36) physical component summary score showed a moderate-to-large effect size (Cohen's d > 0.50). Self-reported fatigue also improved (FACIT-Fatigue 9 point improvement, d = 0.61, p = 0.06). SPPB data was incomplete due to COVID-related study disruption of in-person testing. CONCLUSION: Remote delivery of PRT was feasible and safe in sarcoma survivors and improved several domains of health-related quality of life. A larger, definitive exercise trial could inform specific exercise prescription(s) for sarcoma patients, who currently have little evidence-based exercise guidance. TRIAL REGISTRATION: Registered with ClinicalTrials.gov (NCT04247425) on 2020-01-24.