Evaluating Daily Assessments Of Fatigue During A Pilot Telehealth Exercise Intervention In Rural Cancer Survivors

PURPOSE:Exercise interventions reduce cancer related fatigue (CRF). However, daily fluctuations in CRF, and how best to assess CRF within and across days during exercise interventions is not well understood. This study examined response rates to daily surveys assessing CRF, and explored average daily fatigue levels during a pilot, telehealth exercise intervention. METHODS: Cancer survivors residing in rural areas of CO participated in a 12-week telehealth exercise intervention comprised of 2x resistance and 3x aerobic sessions per week, tracked with a personal training smartphone app (truecoach.co). Additional components were recorded and live (zoom.com) instructional videos, and optional text communication with a trainer. CRF was measured three times per day (10 am, 2 pm, and 6 pm) with a brief survey (0 = no fatigue - 10 = worst fatigue), sent via smartphone app (lifedatacorp.com). Average response rate for completing the survey at all three timepoints and at each timepoint was calculated. Daily CRF was averaged across all timepoints in the first and last week of the intervention and for exercise and non-exercise days. RESULTS: Participants (N = 7) were M = 63 ± 8.2 years old, female, and diagnosed with breast (n = 4), colorectal/anal (n = 1) ovarian (n = 1) and lung (n = 1) cancer. Responses rate for completing all three daily CRF surveys was 33%. Overall response rates at each timepoint were 64.7% at 10 am, 64.3% at 2 pm, and 69.9% at 6 pm. Response rates at each timepoint in the first vs last week were 66.7% vs. 58.1% at 10 am, 66.7% vs. 71.4% at 2 pm, 66.7% vs. 86.6% at 6 pm. Average daily CRF was 4.4 (median = 4.6, range 1-6) in the first week and 3.4 (median = 3.3, range 0-7) in the last week. Average daily CRF on exercise days (n = 314) was 3.9 (median = 4.5, range 0-7), and 3.8 (median = 4, range 0-7) on non-exercise days (n = 154). CONCLUSIONS:Completion of all three daily CRF surveys was low (33%). Response rate at each timepoint was ≥64%, highest in the evening, and similar at the beginning vs. end of the intervention. Average CRF tended to decrease from beginning to end of the intervention, congruent with previous literature. Interpretation of CRF on exercise vs non-exercise days is limited by lack of information about timing of the exercise session in relation to the surveys.