Effects of Home-Based Exercise With Telehealth Guidance in Lymphoma Survivors Entering Cardio-Oncology Rehabilitation: A Randomized Controlled Trial
Katerina Chamradova, Ladislav Batalik, Petr Winnige, Filip Dosbaba, Martin Hartman, Marian Felsoci, Garyfallia Pepera, Jing SuIntroduction
Lymphoma survivors are at increased cardiovascular risk due to cardiotoxic therapies and commonly experience reduced cardiorespiratory fitness and quality of life. Telehealth-supported home-based exercise (HBE) may extend access to cardio-oncology rehabilitation (CORE); however, evidence from randomized trials in lymphoma survivors remains limited. This trial compared the short-term effects of telehealth-supported HBE versus center-based exercise (CBE) in lymphoma survivors entering CORE.
Materials and Methods
In this single-center, single-blind, parallel-group randomized controlled trial, lymphoma survivors in remission were randomized 1:1 to a 12-week telehealth-supported HBE program or supervised CBE. The primary endpoint was cardiorespiratory fitness, operationalized as peak oxygen uptake (pVO 2 , mL·kg -1 ·min -1 ) assessed by cardiopulmonary exercise testing (CPET) at 12 weeks. Key secondary outcomes were maximal workload (W) and SF-36 Physical Functioning. Between-group effects were estimated using ANCOVA with baseline adjustment (intention-to-treat; missing outcomes handled by multiple imputation).
Results
Eighty participants were randomized (HBE n=40; CBE n=40); post-intervention CPET outcomes were available for 69 participants (HBE n=34; CBE n=35). pVO 2 improved in both groups, with no significant baseline-adjusted between-group difference at 12 weeks (adjusted mean difference HBE–CBE −0.60 mL·kg -1 ·min -1 , 95% CI −2.38 to 1.17; p=0.504). No between-group differences were observed for maximal workload (2.05 W, 95% CI −9.20 to 13.30; p=0.721) or SF-36 Physical Functioning (1.69 points, 95% CI −3.37 to 6.74; p=0.512). Adherence was high in both groups (HBE 80.1% vs CBE 77.9%). No adverse events were reported. Costs per participant were CZK 13,032 for HBE versus CZK 24,900 for CBE (48% lower for HBE).
Conclusion
Telehealth-supported HBE achieved comparable short-term improvements in exercise capacity and physical functioning to supervised CBE among lymphoma survivors entering CORE, with high adherence, no reported adverse events, and substantially lower provider costs. Telehealth-guided HBE represents a pragmatic, lower-cost delivery option to expand access to CORE.