Home-Based Physiotherapy in Oncology

This study is a prospective, single-centre, single-arm feasibility clinical trial conducted at the Geneva University Hospitals (HUG). It evaluates the implementation of a long-duration supervised home-based physiotherapy programme for adult oncology patients.

A total of 21 participants will be enrolled in three sequential cohorts of approximately seven participants each. Each participant will follow a single 6-month intervention period; cohorts are implemented sequentially for logistical and organisational reasons but follow identical study procedures.

The intervention consists of a 6-month home-based physiotherapy programme combining aerobic cycling exercise, resistance training, and mental preparation strategies. At study initiation, a stationary exercise bike is delivered and installed in the participant's home. An individualized exercise prescription is developed by oncology-trained physiotherapists based on baseline functional assessments and clinical status.

Participants are asked to complete three supervised exercise sessions per week. Each session includes approximately 20 minutes of moderate-intensity aerobic cycling followed by 20 minutes of resistance training. Exercise intensity is prescribed and monitored using perceived exertion and heart rate criteria consistent with current oncology exercise guidelines. A connected activity watch is provided to each participant and worn only during exercise sessions to record heart rate and exercise duration.

Supervision is ensured through weekly contact with oncology physiotherapists, alternating between in-person hospital visits and structured telephone calls. In-person visits include functional reassessments, programme adjustments, symptom review, safety monitoring, and mental preparation sessions. Mental preparation integrates motivational interviewing techniques, goal setting, routine development, and basic mindfulness and imagery strategies aimed at supporting adherence and self-management.

The primary focus of the study is feasibility, assessed through recruitment capability, adherence to prescribed exercise sessions, participant retention over the 6-month period, and successful delivery and use of the home-based equipment. Safety is assessed through systematic monitoring and reporting of adverse events related to the intervention.

Secondary outcomes include changes in physical function and patient-reported outcomes. Functional performance is assessed using standardized physical tests at baseline and at the end of the intervention. Patient-reported outcomes, including health-related quality of life, fatigue, and programme acceptability, are collected at baseline, mid-program (3 months), and study completion (6 months).

All analyses are descriptive and aim to provide feasibility indicators and operational insights to inform the design of a future controlled trial and potential integration of supervised home-based physiotherapy into routine oncology care.

Inclusion criteria

• Age ≥ 18 years
• Diagnosis of solid cancer, undergoing or recently completed treatment.
• Overall survival greater than 12 months, as judged by the treating oncologist
• Clinically stable and deemed fit for moderate exercise by the treating oncologist
• Able to use an exercise bike
• Home environment suitable for delivery and installation of the exercise bike
• Able to understand the study language and follow study instructions
• Able to give a written informed consent

Exclusion criteria

• Medical contraindication to moderate exercise (e.g. uncontrolled cardiac or pulmonary disease, recent myocardial infarction, severe anemia or acute infection, unstable bone metastases or high fracture risk)
• Cognitive impairment preventing active participation
• Physical inability to perform the prescribed exercise programme, including cycling and resistance exercises.
• Participation in another intensive rehabilitation program
• Any other condition that, in the opinion of the treating oncologist or investigator, makes participation unsafe or not feasible
• Pregnant or lactating women.