(P 179) PILOT STUDY OF A REMOTELY DELIVERED RESISTANCE EXERCISE TRAINING PROGRAM IN SARCOMA SURVIVORS

Objective: Treatment of sarcoma may lead to serious long-term health consequences, including decreased physical functioning. Supervised resistance training may improve physical functioning in sarcoma survivors as long as it is accessible and adequately tailored to each patient’s abilities. We conducted a single-arm, pre-post study to assess the feasibility of remote delivery (through videoconferencing technology) of a supervised, individualized resistance training program in post-treatment sarcoma survivors.

Methods: Eligible patients were at least 15 years of age and at least 2 years from end of treatment for a sarcoma of the extremity, axial skeleton, or body wall (intra-thoracic, intra-abdominal, retroperitoneal and cranial not eligible). Participants followed a progressive resistance training (PRT) program of prescribed exercises that could be tailored (e.g., alternate exercises and/or adjusted volume) based on the patient’s initial exercise capacity. Participants engaged in one supervised session delivered remotely by video conferencing and one unsupervised session per week for 12 weeks. Feasibility was measured by 12-week retention rate, session completion rate, and safety. Changes in self-reported physical function, health-related quality of life, and fatigue were assessed with PROMIS, SF-36 and FACIT-F questionnaires. Objective physical function was to be assessed by the short physical performance battery (SPPB), but the COVID pandemic required protocol modification to objective assessments.

Results: Ten participants enrolled in the study and 9 completed end-of-intervention assessments (90% retention). Median age 47 (range 27-69), and subjects were a median of 4 years (range 2-16) from end of sarcoma treatment. Half (5) had a history of bone sarcoma. All participants had undergone surgery and chemotherapy for treatment, and 50% had also received radiation. Adherence to twice-weekly exercise sessions was 78% and no related serious adverse events occurred. Patients who completed the intervention reported improvements in physical functioning, health-related quality of life and fatigue. Significant improvements in SF-36 physical role and bodily pain subscales and physical component summary scores all exceeded minimal clinically important differences in pre-post scores, with moderate-to-large effect size (d>0.50). Self-reported fatigue also significantly improved (FACIT-Fatigue 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. These data suggest that remote exercise training could be adequately scaled and delivered in a larger, definitive exercise trial. Such a trial could inform specific exercise prescription(s) for sarcoma patients, who currently have little evidence-based exercise guidance. (Supported by P30CA069533. ClinicalTrials.gov NCT04247425)