Telerehabilitation improves function, pain symptoms in cancer patients

  • Cheville AL & al.
  • JAMA Oncol
  • 4 Apr 2019

  • International Clinical Digest
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  • A pain management regimen that included collaborative telerehabilitation with remote and center-based care yielded improvement in function and pain symptoms and decreased hospital length of stay and the need for postacute care in patients with stage IIIC or IV solid or hematologic cancer.
  • The results were similar even when pain medication was added.

Why this matters

  • Collaborative telerehabilitation could expand rehabilitation services, which can reduce functional losses in patients with cancer, to many patients who have limited access to center-based programs.

Study design

  • 3 COPE trial: 516 patients with stage IIIC-IV solid/hematologic cancer were randomly assigned 1:1:1 to automated monitoring for pain with no individualized intervention (control group) or tailored telerehabilitation only or telerehabilitation plus nurse-coordinated pharmacological pain management.
  • Centralized telerehabilitation was provided by a physical therapist-physician team.
  • Funding: National Cancer Institute.

Key results

  • Telerehabilitation only improved function (difference, 1.3; P=.03) and QoL (difference, 0.04; P=.01) vs control group.
  • Both telerehabilitation only and telerehabilitation+pain management groups vs control group significantly reduced:
    • pain interference (for both: difference, −0.4; P=.01), and
    • average intensity (difference, −0.4 [P=.02] and −0.5 [P=.006], respectively).
  • Telerehabilitation only (OR, 4.3; P=.02) and telerehabilitation+pain management (OR, 3.8; P=.03) were associated with increased odds of home discharge.


  • Limited generalizability.

Coauthored with Antara Ghosh, PhD

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