RESUMO
BACKGROUND: Although facility-based cancer rehabilitation and exercise programs exist, patients are often unable to attend due to distance, cost, and other competing obligations. There is a need for scalable remote interventions that can reach and serve a larger population. METHODS: We conducted a mixed methods pilot study to assess the feasibility, acceptability and impact of CaRE@Home: an 8-week online multidimensional cancer rehabilitation and exercise program. Feasibility and acceptability data were captured by attendance and adherence metrics and through qualitative interviews. Preliminary estimates of the effects of CaRE@Home on patient-reported and physically measured outcomes were calculated. RESULTS: A total of n = 35 participated in the study. Recruitment (64%), retention (83%), and adherence (80%) rates, along with qualitative findings, support the feasibility of the CaRE@Home intervention. Acceptability was also high, and participants provided useful feedback for program improvements. Disability (WHODAS 2.0) scores significantly decreased from baseline (T1) to immediately post-intervention (T2) and three months post-intervention (T3) (p = 0.03 and p = 0.008). Physical activity (GSLTPAQ) levels significantly increased for both Total LSI (p = 0.007 and p = 0.0002) and moderate to strenuous LSI (p = 0.003 and p = 0.002) from baseline to T2 and T3. Work productivity (iPCQ) increased from T1 to T3 (p = 0.026). There was a significant increase in six minute walk distance from baseline to T2 and T3 (p < 0.001 and p = 0.010) and in grip strength from baseline to T2 and T3 (p = 0.003 and p < 0.001). CONCLUSIONS: Results indicate that the CaRE@Home program is a feasible and acceptable cancer rehabilitation program that may help cancer survivors regain functional ability and decrease disability. In order to confirm these findings, a controlled trial is required.
RESUMO
Whole-body vibration (WBV) therapy has been proposed as a therapy to reduce sarcopenia and improve muscle strength. The purpose of this study was to explore whether 12 months of WBV therapy increases myotendinous density and volume of the distal tibia as measured by HR-pQCT in postmenopausal women in a parallel group, randomized controlled trial with 1:1:1 allocation to three arms. Postmenopausal women (N = 202) with low hip BMD were randomized to 20 min daily of 0.3g 30-Hz WBV therapy, 0.3g 90-Hz WBV therapy using the Juvent platform (Juvent, Somerset, NJ, USA), or no WBV. The main outcome measure was myotendinous density (HU) and volume (mm3) at the distal tibia measured at baseline and 12 months with HR-pQCT. There were no significant effects on myotendinous density or volume at the distal tibia after 12 months of daily 30- or 90-Hz WBV therapy compared with no WBV therapy. Mean change (SD) in myotendinous density from baseline was 4.6 (5.7) HU in the 30-Hz WBV group, 3.9 (6.1) HU in the 90-Hz WBV group, and 3.9 (5.4) HU in the control group (p = 0.70). Mean change (SD) in myotendinous volume from baseline was -7 (503) mm3 in the 30-Hz WBV group, 111 (615) mm3 in the 90-Hz WBV group, and 35 (615) mm3 in the control group (p = 0.50). In conclusion, WBV therapy at 30- or 90-Hz for 12 months had no significant effects on myotendinous density or volume at the distal tibia as measured by HR-pQCT in postmenopausal women. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
