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Physician’s Weekly talked with Alaina S. Bell, PT, about a virtual exercise program that improved function and quality of life in patients with lung cancer.

A virtual exercise program helps patients with advanced lung cancer improve their physical well-being, according to findings published in Lung Cancer.

“The development of a virtual exercise intervention leverages the growing acceptance of video-based healthcare delivery,” researchers wrote. “MoVE [mitigation of decline with Virtual Exercise], a 12-week, virtual, supervised, group exercise program demonstrated high attendance and adherence rates, significant improvements in physical function, and overwhelmingly positive participant feedback.”

The study team noted that the approach shows the potential to overcome barriers to in-person exercise programs, as well as a lack of real-time feedback in telephone-based home-based exercises for patients with advanced lung cancer.

Feasibility Study

To determine the feasibility of virtual exercise for patients with advanced lung cancer, researchers developed the 12-week, twice-per-week, 45- to 50-minute MoVE with Lung Cancer group exercise program.

During the Zoom sessions, a clinical exercise physiologist led patients in workouts targeting their major upper and lower body muscle groups, incorporating aerobic exercises such as marching in place and resistance training using resistance bands.

The study team found significant improvements in gait speed (P=0.006), 30-second bicep curl (P<0.001), 30-second chair stand (P<0.001), 8-foot timed up and go test (P=0.002), six-minute walk test (P=0.002), and quality of life (P=0.005). Skeletal muscle index increased by 0.9 cm² (P=0.033), and satisfaction was high.

Physician’s Weekly (PW) spoke with physical therapist Alaina S. Bell, PT, DPT, CCS, who was not involved in the study, about the findings and their potential impact on patients with lung cancer.

PW: Why was it important to do this study?

Ailana S. Bell, PT, DPT, CCS: Transportation issues, appointments, fatigue, treatments, and fear are some reasons patients often express for not attending traditional brick-and-mortar exercise sessions. This specific patient population would benefit greatly from exercise that is accessible to them in their treatment journey. MoVE with Lung Cancer is a good start to providing patients with this exercise.

A significant strength was the improvement, though not statistically significant, in the patient’s reported quality of life. When treating a patient, no matter the diagnosis, treating the whole person should always be at the forefront of our treatment plan. Whether that improvement in the study came from interacting with others who had a similar diagnosis or from the exercise itself is not known. Either way, this is a win for the patient, in my book!

How could the findings impact patients with lung cancer?

 I can see this going both ways. There could be significant benefits for patients who need exercise but are unable to attend brick-and-mortar facilities.

There is also the potential for adverse events. Because exercise physiologists run these sessions, they are not considered physical therapy rehabilitative services. Physical therapists are providers who are trained at the doctoral level to manage patients through exercise, focusing on areas such as cardiovascular and pulmonary responses to interventions. They assess and maintain patient safety by balancing various factors, including medication side effects, other comorbidities that may arise during an exercise session, and many other aspects of the patient’s care.

What further related research might you recommend?

 The exercise physiologist supervised the participants; however, was another person required to be available for balance or in the event of an adverse event? What specific exercises were performed with the patients, and were they encouraged to complete exercises on their own? How can this program reach those who may not have the technology needed to join a video group class?

What additional comments would you like to share with clinicians?

An oncology specialty area within physical therapy has existed since 2019, and by June 2024, the American Board of Physical Therapy Specialties certified 216 oncologic clinical specialists. Although exercise physiologists can create an exercise plan for a patient, referring your patient to and encouraging them to attend physical therapy will address the whole person throughout their treatment journey.