Maarten van Egmond

ABSTRACT Background: Improvement of functional status with physiotherapy is an important goal for patients suffering from postoperative complications and with an increased length of hospital stay (LoS) after esophagectomy. Supervised physiotherapy with telerehabilitation instead of conventional face-to-face care could be an alternative to treat these patients in their home environment after hospital discharge (T0), but its feasibility has not yet been investigated in detail. Objective: The aim of this study was to investigate the feasibility of a 12-week postoperative supervised physiotherapy intervention with telerehabilitation for patients with esophageal cancer treated with esophagectomy and suffering from postoperative complications or with an increased LoS. The secondary objective was to investigate the preliminary effectiveness of telerehabilitation on functional recovery compared with usual care. Methods: A prospective feasibility study with a matched historical comparison group was performed. Feasibility outcomes included willingness and adherence to participate, refusal rate, treatment duration, occurrence of adverse events, and patient satisfaction. Secondary outcome measures were measurements of musculoskeletal and cardiovascular functions and activities according to the domains of the International Classification of Functioning, disability and health. Results: A total of 22 patients with esophageal cancer treated with esophagectomy and suffering from postoperative complications or with an increased LoS were included. Mean age at surgery was 64.55 (SD 6.72) years, and 17/22 (77%) patients were male. Moreover, 15 patients completed the intervention. Patient adherence was 99.8% in the first 6 weeks and dropped to 75.6% in the second period of 6 weeks, with a mean difference of −24.3% (95% CI 1.3 to 47.2; P = .04). Three months postoperatively, no differences in functional status were found between the intervention group and the matched historical comparison group. Conclusions: This study showed that a postoperative physiotherapeutic intervention with telerehabilitation is feasible for patients with postoperative complications or an increased LoS after esophageal cancer surgery up to 6 weeks after T0.