A feasibility and usability study of a virtual exercise platform in patients with non–small cell lung cancer in a large academic center.

Abstract

e13794 Background: Exercise during cancer treatment improves cardiorespiratory fitness, reduces fatigue, and enhances quality of life, with post-diagnosis physical activity associated with 24-31% reduction in cancer-specific mortality for lung, prostate and colorectal cancer (Ligibel et al. JCO, 2022). However, sustained adherence remains challenging for patients with lung cancer. We conducted a feasibility study evaluating the integration of a physician-prescribed virtual exercise platform into the care of patients with NSCLC and its impact on health outcomes. Methods: This single-center, prospective cohort study enrolled patients with stage I–IV NSCLC. Eligible patients had an ECOG score 0–2 and were deemed appropriate for exercise participation by PM&R. Individualized exercise programs were prescribed by PM&R physicians and delivered through a virtual platform supported by Salaso. The primary outcome was feasibility, defined by enrollment and continued participation over 12 months. Secondary outcomes included patient and provider satisfaction assessed by the System Usability Scale (SUS), Technology Acceptance Model (TAM) for perceived usefulness, and Net Promoter Score (NPS). Exploratory outcome included pulmonary function test (PFT), which were compared at baseline and 12 months using the paired t-test . Results: Among the 41 patients screened, 24 (59%) remained active at follow-up, 7 (17%) failed initial screening, and 10 (24%) withdrew. Median NPS was 33.3, indicating favorable patient satisfaction. Median TAM for perceived usefulness score was 4.65, reflecting patients’ agreement regarding the value of the platform. Median SUS score was 55, suggesting suboptimal usability of the platform with room for improvement. Provider acceptance was high, with 90% reporting they were very or extremely likely to use the platform. Only 5% of patients evaluated by PM&R were deemed inappropriate for participation due to safety concerns, suggesting the potential for streamlining the onboarding process by selective PM&R screening. Fourteen active patients (58.3%) completed baseline PFTs, and five completed repeat testing at 12 months. Mean predicted FVC, predicated FEV1, FEV1/FVC, and DLCO were 89.2%, 85.8%, 74%, and 15.2 at enrollment and 86.2%, 84.2%, 74%, and 11.7 at 12 months, respectively. There is no significant difference between pre and post exercise PFTs (p > 0.05 for all four metrics), suggesting a potential role of exercise in maintaining pulmonary function in this patient group. Conclusions: A physician-prescribed virtual exercise platform is feasible for patients with NSCLC across disease stages. Improvements in platform usability and streamlining of the onboarding process may enhance platform scalability. Virtual exercise delivery represents a promising strategy to support survivorship and functional status in patients with NSCLC. Clinical trial information: NCT06540495 .