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Home-Based Telehealth Exercise Intervention for Older HCC Patients Shows Promise

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Older patients diagnosed with hepatocellular carcinoma (HCC) often face significant challenges in maintaining physical activity. A recent study explored the feasibility, acceptability, and safety of delivering a home-based telehealth exercise intervention to this demographic. The results offer promising insights into how telehealth can bridge the gap in exercise accessibility for older cancer patients.

Study Design and Participants

The non-randomised feasibility study was conducted with patients recruited from UK outpatient liver cancer clinics. The study targeted patients aged 60 and above, all of whom had HCC with post-treatment imaging indicating a complete or partial response, or stable disease. A total of 40 patients were invited, and 19 consented to participate, resulting in a 48% recruitment rate. The average age of participants was 74 years.

Participants engaged in synchronous online exercise sessions twice a week for ten weeks. Physical function and patient-reported outcomes were measured before and after the intervention. Additionally, qualitative data were collected via semi-structured interviews post-intervention to gain deeper insights into the participants’ experiences.

Outcomes and Measurements

Primary outcomes focused on recruitment, retention, exercise adherence, and safety. The study found that participants attended 76% of the planned exercise sessions, and 79% returned for follow-up appointments. Significant improvements were observed in hand grip strength, the Liver Frailty Index, and the time taken to perform five sit-to-stands. Importantly, no adverse events were reported during the exercise sessions.

Qualitative feedback underscored the value of having a real-time instructor, which made the sessions more achievable and personalized. This, in turn, fostered motivation and commitment among participants. The social aspect of peer support during online sessions was also highlighted as beneficial for both physical and mental health.

Key Inferences

  • Telehealth exercise interventions can significantly improve physical function in older HCC patients.
  • Real-time instruction and peer support are critical for the success of remote exercise programs.
  • Online sessions help overcome common barriers to exercise, such as transportation and mobility issues.

In conclusion, the feasibility study demonstrated that supervised group exercise via videoconferencing is both acceptable and safe for HCC patients over 60. These promising results pave the way for a future, adequately powered randomised controlled trial to evaluate the intervention’s efficacy comprehensively.

Original Article: BMJ Open. 2024 Jun 12;14(6):e082155. doi: 10.1136/bmjopen-2023-082155.

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