Discussion
cancer, CRC, breast cancer
RECRUITMENT, BREAST CANCER, ADVERSE EVENTS, CANCER, MINOR, SECONDARY
Among the seven participants in our trial, we found that stage II-III CRC survivors’ post-resection and adjuvant therapy tolerated and expressed acceptability for an mHealth, home-based exercise intervention. We observed an 88.6% completion rate of prescribed workouts, 100% retention rate, no adverse events, and qualitative data indicating improved quality of life and positive feedback related to ease of use, accountability, motivation, and autonomy. Our exercise intervention included HIIT and MICE exercise prescriptions. The inclusion of HIIT addresses time, an important barrier to exercise engagement among cancer survivors [In addition to our feasibility results, findings related to safety support previous research using HIIT interventions [In the present investigation, participant trends indicate a minor reduction in weight after 12 weeks, which has been shown in previous research from a 10-week mHealth delivered exercise intervention in post-treatment breast cancer survivors [Exercise patterns and increased engagement in CRC survivors have been used as a prognostic indicator of quality of life and improved survivorship [We are the first, to our knowledge, to evaluate an mHealth, home-based delivered exercise intervention, including a HIIT prescription, among stage II-III CRC survivors’ post-resection and adjuvant therapy. We consider this a strength of our work. Other strengths include: a personalized exercise prescription based on measured peak heart rate, choice of exercise modality to complete the exercise prescription, a 4-week progression to goal exercise prescription, and inclusion of qualitative data to place results in context and further inform feasibility and acceptability of the intervention. Our trial is not without limitations. When measuring heart rate during exercise with the Polar device, there is a short delay in heart rate measurement output when changing exercise intensity. This likely contributed to some of the apparent non-adherence to measured heart rate within the prescribed training zones. Additionally, we had a homogenous and small sample within this pilot study. The small sample size is related to challenges with accrual secondary to the impact of the COVID-19 pandemic on in-person research, as our trial required in-person assessment sessions. Recruitment was on hold at the start of the pandemic and resumed approximately 3.5 months later; however, potential participants were still hesitant to attend assessment sessions in person. Our experience accruing and carrying out our trial during the beginning of the pandemic echoes what has been found in previous research, where clinical trials that undergo even short temporary suspension can lead to trial breakdown[