Telehealth system: A randomized controlled trial evaluating the impact of an internet‐based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors

BACKGROUND The chronicity status of breast cancer survivors suggests a growing need for cancer rehabilitation. Currently, the use of technology is a promising strategy for providing support, as reflected in the emergence of research interest in Web‐based interventions in cancer survivorship. METHODS A randomized controlled trial was conducted that included a total of 81 participants who had completed adjuvant therapy (except hormone treatment) for stage I to IIIA breast cancer. Participants were randomly assigned to an 8‐week Internet‐based, tailored exercise program (n = 40) or to a control group (n = 41).The instruments used at baseline, 8 weeks, and 6‐month follow‐up were the European Organization for Research and Treatment of Cancer Quality‐of‐Life Questionnaire Core 30 and its breast cancer module, the Brief Pain Inventory, the handgrip dynamometer, the isometric abdominal test, the back dynamometer, the multiple sit‐to‐stand test, and the Piper Fatigue Scale. RESULTS After the intervention, the telerehabilitation group had significantly improved scores for global health status, physical, role, cognitive functioning, and arm symptoms (all P < .01) as well as pain severity (P = .001) and pain interference (P = .045) compared with the control group. Significant improvements also were observed favoring the telerehabilitation group for affected and nonaffected side handgrip (both P = .006), abdominal, back and lower body strength (all P < .01), and total fatigue (P < .001). These findings were maintained after 6 months of follow‐up, except for role functioning, pain severity, and nonaffected side handgrip. Analysis was based on an intention‐to‐treat principle. CONCLUSIONS This program may improve adverse effects and maintain benefits in breast cancer survivors. The results of this study have encouraging implications for cancer care. Cancer 2016;122:3166–74. © 2016 American Cancer Society. This is one of the most extensive randomized controlled trials to report effect sizes for telerehabilitation in breast cancer survivors using an adequate follow‐up period. This nonface‐to‐face approach could help the growing number of cancer survivors who use information and communications technology as a delivery method.