Telehealth-Supported Home Rehab Matches Center-Based Care in Lymphoma Survivors

Telehealth-supported, home-based exercise rehabilitation may offer comparable long-term benefits to traditional center-based programs for lymphoma survivors, highlighting a potential path to expanding access to cardio-oncology care. The findings have been published in Archives of Rehabilitation Research and Clinical Translation.¹

As cancer survival rates improve, a growing number of patients are living with long-term complications from treatment, including reduced physical fitness, cardiovascular risk, and functional limitations. Exercise-based rehabilitation has become a key component of survivorship care across cancer types, helping to improve cardiorespiratory fitness, strength, and quality of life (QOL). In one phase 3 trial of patients with colon cancer, structured exercise following chemotherapy was associated with improved disease-free survival.² However, access to structured, facility-based programs remains uneven due to geographic, logistical, and personal barriers.

In response, researchers have increasingly explored telehealth-supported home-based exercise as a scalable alternative. The new study, a randomized controlled trial conducted at a tertiary care center, directly compared this approach with traditional supervised rehabilitation over a 12-month period. The trial enrolled 80 clinically stable adult lymphoma survivors who had completed chemotherapy and were entering cardio-oncology rehabilitation.

Both interventions were matched in structure, including a 12-week program of aerobic and resistance training performed 3 times per week. Patients in the home-based group used wearable heart rate monitors and uploaded their activity data to a digital platform, allowing physiotherapists to provide weekly remote coaching and feedback, and those in the center-based group completed supervised sessions using standard rehabilitation equipment. After the initial 12-week intervention, both groups were advised to continue exercising independently without ongoing structured support, a design intended to reflect real-world conditions.

At 12 months, results showed no statistically significant difference in peak oxygen uptake (peak VO₂), a gold-standard measure of cardiorespiratory fitness and the study’s primary end point, between the 2 groups. Adjusted peak VO₂ values were nearly identical, 24.53 mL/kg/min in the home-based group and 24.63 mL/kg/min in the center-based group (P = .901).

Importantly, both groups demonstrated improvement in fitness from baseline to the end of the 12-week program, and gains were largely maintained at 12 months, with peak VO₂ increasing early and remaining above baseline levels in both groups over time.

Secondary outcomes, including muscular strength, body composition, and health-related QOL, were also similar between groups. Although the home-based group showed a modest numerical advantage in physical functioning scores on the 36-Item Short Form Survey for QOL, the difference did not reach statistical significance.

These findings suggest that, when properly supported, home-based exercise programs can deliver outcomes comparable to traditional facility-based rehabilitation, at least in terms of long-term fitness and functional measures, wrote the researchers. However, the group cautioned against overinterpreting the results. The study was not designed to prove equivalence or noninferiority between the 2 approaches, meaning that although no significant differences were observed, definitive conclusions about interchangeability cannot yet be made.

“From a systems perspective, telehealth-supported rehabilitation may reduce reliance on facility capacity and travel burden, but successful scale-up will need to address digital literacy, access to devices/internet, and integration into clinical workflows,” explained the researchers. “Hybrid care pathways may therefore represent a pragmatic next step to preserve benefits beyond the intervention window.”

The study also highlighted an ongoing challenge of sustaining exercise behavior after structured support ends. While fitness gains were maintained over the 12 months, some attenuation was observed following the initial intervention period, underscoring the importance of long-term engagement strategies.

These researchers noted several limitations of the study, including the relatively small sample size, single-center design, and lack of objective monitoring during the follow-up period. Additionally, participation in the home-based program required access to digital tools and internet connectivity, which may limit generalizability in some populations.

References

1. Batalik L, Su JJ, Liska D, et al. Twelve-month outcomes of telehealth-supported home-based versus centre-based cardio-oncology rehabilitation in lymphoma survivors: a randomized controlled trial. Arch Rehabil Res Clin Transl. Published online April 3, 2026. doi:10.1016/j.arrct.2026.100621
2. Courneya KS, Vardy JL, O’Callaghan CJ, et al; CHALLENGE Investigators. Structured exercise after adjuvant chemotherapy for colon cancer. N Engl J Med. 2025;393(1):13-25. doi:10.1056/NEJMoa2502760