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A web-based exercise system (e-CuidateChemo) to counter the side effects of chemotherapy in patients with breast cancer: randomized controlled trial
Ariza-Garcia A, Lozano-Lozano M, Galiano-Castillo N, Postigo-Martin P, Arroyo-Morales M, Cantarero-Villanueva I
Journal of Medical Internet Research 2019 Jul;21(7):e14418
clinical trial
7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Breast cancer patients have to face a high-risk state during chemotherapy, which involves deterioration of their health including extensive physical deterioration. Face-to-face physical exercise programs have presented low adherence rates during medical treatment, and telehealth systems could improve these adherence rates. OBJECTIVE: This study aimed to evaluate the effectiveness of a web-based exercise program (e-CuidateChemo) to mitigate the side effects of chemotherapy on the physical being, anthropometric aspects, and body composition. METHODS: A total of 68 patients diagnosed with breast cancer, who were undergoing chemotherapy, were enrolled. The patients were categorized into two groups: e-CuidateChemo (n = 34) and controls (n = 34). The e-CuidateChemo group participated in an adapted 8-week tailored exercise program through a web-based system. A blinded, trained researcher assessed functional capacity, strength, anthropometric parameters, and body composition. The intervention effects were tested using analysis of covariance and Cohen d tests. RESULTS: Functional capacity improved significantly in the e-CuidateChemo group compared to the control group (6-minute walk test 62.07 (SD 130.09) m versus -26.34 (SD 82.21) m; 6-minute walk test % distance predicted 10.81% (SD 22.69%) m versus -4.60% (SD 14.58%); between-group effect p = 0.015 for both). The intervention group also showed significantly improved secondary outcomes such as between-group effects for abdominal (24.93 (SD 26.83) s versus -18.59 (SD 38.69) s), back (12.45 (SD 10.20) kg versus 1.39 (10.72) kg), and lower body (-2.82 (SD 3.75) s versus 1.26 (SD 2.84) s) strength; all p < 0.001 compared to the control group. CONCLUSIONS: This paper showed that a web-based exercise program was effective in reversing the detriment in functional capacity and strength due to chemotherapy. TRIAL REGISTRATION: ClinicalTrials.gov NCT02350582; https://ClinicalTrials.gov/ct2/show/NCT02350582.

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