Feasibility testing Of telehealth-delivered eXercise TheRapy for Ostomates Treated for cancer (FOXTROT)

The intervention will comprise of a stoma-specific exercise intervention that can be delivered in a remote, telehealth setting. Intervention material will include an exercise manual, web-based exercise videos and guides, and a one-hour individual telehealth exercise and coaching session each week with a stoma-trained exercise professional (ExP), for 12-weeks. Participants will also be encouraged to undertake self-managed sessions twice weekly, to accumulate three organised exercise sessions and progress towards a minimum physical activity target of equal to or greater than 150 minutes per week, consistent with Australian Physical Activity and Exercise Guidelines for Adults. Initial exercise dose and progression will be prescribed based on a baseline assessment that will address the participants needs, stoma specific considerations or barriers to exercise, current ability, and current exercise efficacy. These consults will also allow for ExP-mediated discussions to identify and address current perceived barriers to exercise and safety concerns. Each exercise session will constitute three primary components: Stoma-specific strengthening, aerobic exercise, and resistance exercise. Stoma-specific exercises have been developed and tested elsewhere, and will be adapted for inclusion in the present study aligned with participant capability and goals. Exercise equipment including TheraBands and dumbbells will be provided as needed. Aerobic and resistance-based exercise prescription will adhere to Exercise and Sports Science Australia recommendations. In the present study, resistance training will utilise repetitions in reserve (RIR) to regulate intensity, with 1-4 used as a target intensity for a given set. For the aerobic component, moderate intensity exercise or physical activity prescription may be utilised by ExPs in cases where high intensity interval training (HIIT) is considered either not suitable or is not a preferred modality of a participant. Attention will be extended to perceived barriers to exercise and risk factor management through education and exercise counselling. FOXTROT Exercise Training Session Outline Stoma Specific Strength: 2-3 sets of 2-3 stoma-specific strengthening exercises. Progress from Level 1 to Level 3 across the intervention. Participants will be given materials that include videos demonstrating exercises for activating the body core and abdominal muscles and instructions on techniques and breathing for these exercises, as per the Hernia Active Living Trial (Hubbard et al,. 2020) Resistance Exercise: 2 – 3 sets of 8-12 repetitions; 30-60 seconds of rest between sets; Target intensity: 1-4 RIR; utilising upper and lower body strength exercises e.g., push-up and squat. Aerobic Exercise: HIIT, MICT, or PA HIIT: 5 min warm up 4 min HII 3 min recovery 4 min HII 3 min cooldown MICT: 20-30 min moderate intensity (50-80% HR peak) PA: Accumulate 150 minutes of MVPA HII, High intensity interval; HIIT, High intensity interval training; HR, Hear rate; MICT, Moderate intensity continuous training; MVPA, Moderate to vigorous physical acidity; PA, Physical activity; RIR, Repetitions in reserve; 1RM, One repetition maximum Exercise attendance and adherence will be recorded during exercise consults by the delivering ExP. This will include recording of the current exercise session, with notation of exercise dose and exercise selection (intensity, sets, reps, time of aerobic exercise), as well as prescription of an unsupervised session to be conducted in the same week. At the subsequent exercise consult, the ExP will retrospectively record participant adherence and attendance to this unsupervised session via participant self-report. Reasons for non-adherence will be recorded, and stoma specific barriers and concerns that may contribute to either modification of exercise prescription or non-adherence will also be recorded. Any AEs will also be recorded during ExP consults and facilitate identification of study relatedness and severity. One-week additional time may be allocated to participants that need to postpone exercise for any reason during the intervention; i.e., 13-weeks will be allowed to complete the 12-week intervention. Any exercise consults or “missed” exercise sessions that cannot be included in this time will inform the feasibility and acceptability assessment of the program