Exercise during CHemotherapy for Recurrent Ovarian cancer (ECHO-R)

Exercise intervention: The intervention will span 6 months and involve the individual prescription of aerobic and resistance-based exercise, with a dosage target of at least 150 minutes per week at moderate-intensity (moderate intensity = RPE of 11-13 on Borg RPE 6-20 scale). Examples of exercises that are likely to be prescribed include: aerobic exercise - walking, cycling, cycle/rowing ergometers, aerobics; resistance exercise - sessions focussing on major muscle groups, utilising bodyweight, free weights, exercise bands and/or gym equipment (e.g., sit-to-stands, barbell chest press, exercise-band shoulder press, cable row). The location of prescribed exercise (e.g., home-based, local neighbourhood/ parks, gym) will depend on what is appropriate and preferred by each participant. An Exercise Professional (ExP; undergraduate training in exercise science) with study-specific prescription training will prescribe and monitor exercise type, duration and frequency on a regular basis and modify prescription according to the presentation of symptoms and by adhering to the exercise principle of gradual progression. Across the 6-month intervention, approximately 12 telephone/video-health exercise sessions between participants and their allocated ExP will be scheduled, with an average duration of each contact being approximately 60 minutes. The foundation intervention schedule is as follows: weeks 1 to 4 - once per week (4 sessions) weeks 5 to 16 - once per fortnight (6 sessions) weeks 17 to 26 – one per month (2-3 sessions) In the context of this pragmatic trial, women experiencing difficulty adhering to the prescribed exercise dose will be provided with more telehealth sessions (maximum number of sessions: 20 sessions). Less frequent contact may occur for those adhering to their exercise prescription and for whom weekly contact is therefore unnecessary or burdensome to the participant (minimum number of sessions: 8). When possible and when participants approve, the telehealth intervention will be supported by 5 face-to face visits with an exercise professional scheduled throughout the intervention (this intervention feature aligns with Australia’s Chronic Disease Management Plan, which allows for up to 5 reimbursable visits per year with an accredited Exercise Physiologist or Physiotherapist. Duration of these sessions will be approximately 60 minutes). These visits will occur at a location convenient to the participant (e.g., local park or exercise clinic; participant's home) Intervention adherence (i.e., participant attendance at scheduled sessions), fidelity (i.e., quality of delivery: exercise prescribed by ExPs; delivered dose: exercise completed by participants) will be assessed by the senior exercise physiologist (>10 years clinical experience) via monthly review of ExP session notes and patient-reported exercise doses. Participants struggling to adhere to the intervention schedule or exercise dosage will be offered modified contact with the ExP.