Supportive Care in Cancer

, Volume 25, Issue 11, pp 3551–3559 | Cite as

Effect of an Internet-based telehealth system on functional capacity and cognition in breast cancer survivors: a secondary analysis of a randomized controlled trial

  • Noelia Galiano-Castillo
  • Manuel Arroyo-MoralesEmail author
  • Mario Lozano-Lozano
  • Carolina Fernández-Lao
  • Lydia Martín-Martín
  • Rosario Del-Moral-Ávila
  • Irene Cantarero-Villanueva
Original Article



This trial determines the effect of an Internet-based tailored exercise program compared to usual care control for improving functional capacity and cognition among breast cancer survivors.


A two-arm, assessor-blinded, parallel, randomized controlled efficacy trial was conducted. Participants were recruited from the Oncology and Breast unit at the Virgen de las Nieves Hospital (Granada, Spain) between March 2012 to November 2013 and randomized to either the experimental group (an 8-week Internet-based tailored exercise program) or control group (usual care). The outcome measures were the 6-min walk test, Auditory Consonant Trigrams, and Trail Making Test. All were assessed at baseline, post-intervention, and 6-month follow-up.


After intervention, the telerehabilitation group had significantly improved distances (d = 0.92, P < 0.001) as well as percentage of predicted of the 6-min walk test (d = 0.93, P < 0.001) compared with the control group. Significant improvement was also observed favoring the telerehabilitation group for the number of consonants recalled in total compared with the control group (d = 0.47, P = 0.04). These findings were maintained after 6-month follow-up (d = 0.80, P = 0.001; d = 0.76, P = 0.002; and d = 0.57, P = 0.02, respectively). Analysis was based on intention-to-treat principle.


These findings support the effectiveness of a telehealth system based on an 8-week physical exercise to achieve improvements and maintain them after 6-month follow-up in terms of functional and cognitive performance in breast cancer survivors. This broad-reach modality could help the growing number of cancer survivors to face their disabling side effects.


Breast cancer E-health Exercise Telehealth Telerehabilitation 



The authors thank all participants, without whom this work would not have been possible. This study takes place thanks to the additional funding from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


This work was supported by a research project grant (FIS PI10/02749-02764) from the Health Institute Carlos III and PN I + D + I 2008–2011 (FEDER funds); grants (Program FPU AP2010–6075 and Program FPU 14/01069) from the Education Ministry, Madrid, Spanish Government; and a grant from the Andalusian Health Service, Junta de Andalucía (PI-0457-2010).

Supplementary material

520_2017_3782_MOESM1_ESM.mp4 (6.4 mb)
Explanatory video 1 (MP4 6562 kb)
520_2017_3782_MOESM2_ESM.mp4 (5.4 mb)
Explanatory video 2 (MP4 5502 kb)
520_2017_3782_MOESM3_ESM.mp4 (1.5 mb)
Explanatory video 3 (MP4 1489 kb)


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Noelia Galiano-Castillo
    • 1
    • 2
    • 3
  • Manuel Arroyo-Morales
    • 1
    • 2
    • 3
    Email author
  • Mario Lozano-Lozano
    • 2
  • Carolina Fernández-Lao
    • 1
    • 2
    • 3
  • Lydia Martín-Martín
    • 2
  • Rosario Del-Moral-Ávila
    • 4
  • Irene Cantarero-Villanueva
    • 1
    • 2
    • 3
  1. 1.Institute for Biomedical Research (ibs.GRANADA), University Hospital Complex of GranadaUniversity of GranadaGranadaSpain
  2. 2.Department of Physical Therapy, Health Science FacultyUniversity of GranadaGranadaSpain
  3. 3.Sport and Health Research Center (CIDS)GranadaSpain
  4. 4.Radiotherapy Breast Oncology UnitUniversity Hospital Virgen de las NievesGranadaSpain

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