Towards best practice in the delivery of prescribed exercise via Telehealth for individuals diagnosed with cancer undergoing active treatment.

INTERVENTION: A two‐arm (1:1) randomised control trial will compare an eight week online supervised exercise program to usual care in patients undergoing active cancer treatment. Telehealth delivery will involve an online exercise intervention in a group setting via the online platform Zoom. Arm 1: Telehealth Exercise Intervention ‐ Delivery of intervention by two ESSA Accredited Exercise Physiologists (AEP) with a minimum of 1 years experience in delivering exercise to cancer patients within a specialist oncology centre. The AEPs involved will also have had additional training and experience in delivering online supervised exercise. ‐ Group exercise sessions will occur via Zoom, with each participant in their own living residence. Group sessions will be capped at 8 participants per session and supervised by an ESSA AEP. ‐ The intervention will be delivered 1hr 1 x week for 8 weeks. ‐ Each exercise program will be individually tailored to suit each participants needs, determined by an initial assessment prior to the intervention which will be conducted by an ESSA AEP. ‐ Symptoms will be monitored pre/post exercise sessions using a symptom assessment scale via an online survey platform. ‐ Participants will be provided with an electronic and hard copy safety booklet outlining best practice for measuring blood pressure (BP), temperature and if diabetic, blood glucose levels (BGLs). In addition, this booklet covers information regarding when not to exercise, and what to do if experiencing an abnormal exercise response. The booklet has been designed specifically for this study, and was designed by a team of Accredited Exercise Physiologists which experience working in exercise oncology. ‐ Exercise programs will be developed according to the equipment eac CONDITION: Cancer ‐ Any cancer Cancer ‐ confirmed via radiological or pathological diagnosis. Any diagnosis, treatment modality and stage of disease will be included. ; ; Cancer ‐ confirmed via radiological or pathological diagnosis. Any diagnosis, treatment modality and stage of disease will be included. Physical Medicine / Rehabilitation ‐ Other physical medicine / rehabilitation SECONDARY OUTCOME: Change in wellbeing, assessed by the FACT‐G questionnaire. [Baseline assessment, week 4 and week 8; Arm 1 and 2. ] Qualitative Experience: Arm 1 only. ; An online interview with a member of the research team will be conducted with a sub‐sample of ten participants from the exercise group. The interview will follow a semi‐structured format and will be audio recorded using a digital recording device. This interview is designed to explore participants experiences of the online exercise sessions and offers an avenue for participants to provide feedback about the program. ; ; The sub‐sample will be determined by the first 10 participants who agree to the interview. ; The interview will be conducted in a one‐on‐one format via an online video conferencing platform. [Within 7 days of completing the 8 week intervention. ] Symptom management ‐ assessed by the Memorial Symptom Assessment Scale. This instrument will be used as a screening tool rather than a specific outcome measure to identify any new or unusual symptoms that may require further investigation or impact exercise participant. [Before and after each exercise session for the entire 8 week intervention; Arm 1 only. ] INCLUSION CRITERIA: ‐ Age equal to or more than 18 years. ‐ Current diagnosis of cancer (confirmed by pathological or radiological diagnosis). ‐ Self‐assessed written and verbal English proficiency. ‐ Ability to provide informed consent. ‐ Written medical clearance from primary care physician or oncologist to participate in online individually prescribed exercise. ‐ Ownership of a smartphone, computer, laptop or tablet to access Zoom platform. PRIMARY OUTCOME: Change in physical activity levels, measured by minutes/hours of activity determined by the Active Australia Survey instrument.[Baseline assessment, week 4 and week 8; Arm 1 and 2. ] Change in psychological wellbeing, measured by a reduction in the DASS‐21.[Baseline assessment, week 4 and week 8; Arm 1 and 2. ] Feasibility statistics: exercise session attendance, drop‐out rates and study completion rates will be analysed as a percentage of the sample size in Arm 1 to determine the feasibility of the study. The percentage of eligible participants who expressed interest but declined to participate (with reasons) will also be recorded. This data will be tracked throughout the intervention and finalised at the completion of the trial. ; Study completion rates: participants will only be considered as having completed the study if more than or equal to 80% of sessions are attended across the eight weeks. [Baseline assessment, week 4 and week 8; Arm 1 and 2. ] ‐ Ownership of an automatic blood pressure monitor, digital thermometer and if diabetic, a blood glucose monitor.